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Changing Patterns in Place of Cancer Death in England: A Population-Based Study
Changing Patterns in Place of Cancer Death in England: A Population-Based Study
Source: PLoS Medicine
Background
Most patients with cancer prefer to die at home or in a hospice, but hospitals remain the most common place of death (PoD).This study aims to explore the changing time trends of PoD and the associated factors, which are essential for end-of-life care improvement.
Methods and Findings
The study analysed all cancer deaths in England collected by the Office for National Statistics during 1993–2010 (n = 2,281,223). Time trends of age- and gender-standardised proportion of deaths in individual PoDs were evaluated using weighted piecewise linear regression. Variables associated with PoD (home or hospice versus hospital) were determined using proportion ratio (PR) derived from the log-binomial regression, adjusting for clustering effects. Hospital remained the most common PoD throughout the study period (48.0%; 95% CI 47.9%–48.0%), followed by home (24.5%; 95% CI 24.4%–24.5%), and hospice (16.4%; 95% CI 16.3%–16.4%). Home and hospice deaths increased since 2005 (0.87%; 95% CI 0.74%–0.99%/year, 0.24%; 95% CI 0.17%–0.32%/year, respectively, p<0.001), while hospital deaths declined (−1.20%; 95% CI −1.41 to −0.99/year, p<0.001). Patients who died from haematological cancer (PRs 0.46–0.52), who were single, widowed, or divorced (PRs 0.75–0.88), and aged over 75 (PRs 0.81–0.84 for 75–84; 0.66–0.72 for 85+) were less likely to die in home or hospice (p<0.001; reference groups: colorectal cancer, married, age 25–54). There was little improvement in patients with lung cancer of dying in home or hospice (PRs 0.87–0.88). Marital status became the second most important factor associated with PoD, after cancer type. Patients from less deprived areas (higher quintile of the deprivation index) were more likely to die at home or in a hospice than those from more deprived areas (lower quintile of the deprivation index; PRs 1.02–1.12). The analysis is limited by a lack of data on individual patients’ preferences for PoD or a clinical indication of the most appropriate PoD.
Conclusions
More efforts are needed to reduce hospital deaths. Health care facilities should be improved and enhanced to support the increased home and hospice deaths. People who are single, widowed, or divorced should be a focus for end-of-life care improvement, along with known at risk groups such as haematological cancer, lung cancer, older age, and deprivation.
Meat consumption and mortality – results from the European Prospective Investigation into Cancer and Nutrition
Source: BMC Medicine
Background
Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Methods
Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality.
Results
Until June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (HR=1.14, 95% CI 1.01-1.28, 160+ vs. 10-19.9 g/day), and the association was stronger for processed meat (HR=1.44, 95% CI 1.24-1.66, 160+ vs. 10-19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR=1.18, 95% CI 1.11-1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5-5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g per day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and ‘other causes of death’. The consumption of poultry was not related to all-cause mortality.
Conclusions
The results of our analysis support a moderate positive association between processed meat consumption and mortality in particular due to cardiovascular diseases, but also cancer.
Implications of Lessons Learned From Tobacco Control for Tanning Bed Reform
Implications of Lessons Learned From Tobacco Control for Tanning Bed Reform
Source: Preventing Chronic Disease (CDC)
Tanning beds used according to the manufacturer’s instructions expose the user to health risks, including melanoma and other skin cancers. Applying the MPOWER model (monitor, protect, offer alternatives, warn, enforce, and raise taxes), which has been used in tobacco control, to tanning bed reform could reduce the number of people at risk of diseases associated with tanning bed use. Among the tactics available to government are restricting the use of tanning beds by people under age 18 and those with fair skin, increasing the price of tanning bed services through taxation, licensing tanning bed operators, and banning unsupervised tanning bed operations.
Global report on Fukushima nuclear accident details health risks
Global report on Fukushima nuclear accident details health risks
Source: World Health Organization
A comprehensive assessment by international experts on the health risks associated with the Fukushima Daiichi nuclear power plant (NPP) disaster in Japan has concluded that, for the general population inside and outside of Japan, the predicted risks are low and no observable increases in cancer rates above baseline rates are anticipated.
The WHO report ‘Health Risk Assessment from the nuclear accident after the 2011 Great East Japan Earthquake and Tsunami based on preliminary dose estimation’ noted, however, that the estimated risk for specific cancers in certain subsets of the population in Fukushima Prefecture has increased and, as such, it calls for long term continued monitoring and health screening for those people.
Experts estimated risks in the general population in Fukushima Prefecture, the rest of Japan and the rest of the world, plus the power plant and emergency workers that may have been exposed during the emergency phase response.
…
In terms of specific cancers, for people in the most contaminated location, the estimated increased risks over what would normally be expected are:
- all solid cancers – around 4% in females exposed as infants;
- breast cancer – around 6% in females exposed as infants;
- leukaemia – around 7% in males exposed as infants;
- thyroid cancer – up to 70% in females exposed as infants (the normally expected risk of thyroid cancer in females over lifetime is 0.75% and the additional lifetime risk assessed for females exposed as infants in the most affected location is 0.50%).
For people in the second most contaminated location of Fukushima Prefecture, the estimated risks are approximately one-half of those in the location with the highest doses.
Invasive Cancer Incidence — United States, 2009
Invasive Cancer Incidence — United States, 2009
Source: Morbidity and Mortality Weekly Report (CDC)
Cancer is a leading cause of illness and death in the United States, and many cancers are preventable (1). Surveillance of cancer incidence can help public health officials target areas for cancer control efforts (2) and track progress toward the national cancer objectives set forth in Healthy People 2020 (3). This report summarizes the most recent invasive cancer incidence rates by sex, age, race, ethnicity, primary site, and state of residence using data from U.S. Cancer Statistics (USCS) for 2009. USCS includes incidence data from CDC’s National Program of Cancer Registries (NPCR) and the National Cancer Institute’s (NCI’s) Surveillance, Epidemiology, and End Results (SEER) program and mortality data from the National Vital Statistics System (4). In 2009, a total of 1,476,504 invasive cancers were diagnosed in the United States, an annual incidence rate of 459 cases per 100,000 persons. Cancer incidence rates were higher among men (524) than women (414), highest among blacks (473) and lowest among American Indian/Alaska Natives (273), and ranged by state from 387 to 509. Populations defined by state of residence, race, or ethnicity with high rates of cancer might benefit most from targeted cancer prevention and control efforts.
Trends in adherence to recommended cancer screening: the US population and working cancer survivors
Trends in adherence to recommended cancer screening: the US population and working cancer survivors
Source: Frontiers in Cancer Epidemiology and Prevention
Introduction: Over the past decade the United States (US) has seen a decrease in advanced cancer diagnoses. There has also been an increase in the number of cancer survivors returning to work. Cancer screening behaviors among survivors may play an important role in their return-to-work process. Adherence to a post-treatment cancer screening protocol increases early detection of secondary tumors and reduces potentially limiting side-effects. We compared screening trends among all cancer survivors, working survivors, and the general population over the last decade.
Materials and Methods: Trends in adherence to recommended screening were analyzed by site-specific cancer. We used the Healthy People goals as a measure of desired adherence. We selected participants 18+ years from 1997 to 2010 National Health Interview Survey for years where detailed cancer screening information was available. Using the recommendations of the American Cancer Society as a guide, we assessed adherence to cancer screening across the decade. There were 174,393 participants. Analyses included 7,528 working cancer survivors representing 3.8 million US workers, and 119,374 adults representing more than 100 million working Americans with no cancer history.
Results: The US population met the Healthy People 2010 goal for colorectal screening, but declined in all other recommended cancer screening. Cancer survivors met and maintained the HP2010 goal for all, except cervical cancer screening. Survivors had higher screening rates than the general population. Among survivors, white-collar and service occupations had higher screening rates than blue-collar survivors.
Conclusion: Cancer survivors report higher screening rates than the general population. Nevertheless, national screening rates are lower than desired, and disparities exist by cancer history and occupation. Understanding existing disparities, and the impact of cancer screening on survivors is crucial as the number of working survivors increases.
Cervical Cancer Screening Among Women by Hysterectomy Status and Among Women Aged ≥65 Years — United States, 2000–2010
Cervical Cancer Screening Among Women by Hysterectomy Status and Among Women Aged ≥65 Years — United States, 2000–2010
Source: Morbidity and Mortality Weekly Report
Since 2003, major U.S. organizations consistently have recommended against screening most women for cervical cancer after a total hysterectomy for benign disease. Starting in 2003 and becoming consistent across organizations in 2012, guidelines also state that women with a history of adequate screening no longer should be screened after age 65 years. Reports have shown that many of those women continue to receive Papanicolaou (Pap) testing, contrary to recommendations. To measure recent screening behaviors and trends in accordance with evidence-based recommendations, biennial cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) on women aged ≥30 years were analyzed and stratified by hysterectomy status and by age (30–64 years and ≥65 years). The proportion of women reporting having had a hysterectomy who reported a recent (within 3 years) Pap test declined from 73.3% in 2000 to 58.7% in 2010. Declines among women having had a hysterectomy were significant among those aged 30–64 years, from 81.0% in 2000 to 68.5% in 2010, and among those aged ≥65 years, from 62.0% to 45.0%. Among women aged ≥65 years with no history of hysterectomy, recent Pap testing also declined significantly, from 73.5% to 64.5%. Although recommendations have resulted in reductions in screening posthysterectomy and of those aged ≥65 years, many women still are being screened who will not benefit from it.
Cervical Cancer Screening Among Women Aged 18–30 Years — United States, 2000–2010
Cervical Cancer Screening Among Women Aged 18–30 Years — United States, 2000–2010
Source: Morbidity and Mortality Weekly Report (CDC)
Screening women for cervical cancer can save lives. However, among young women, cervical cancer is relatively rare (1,2), and too-frequent screening can lead to high costs and adverse events associated with overtreatment (3). Before 2012, cervical cancer screening guidelines of the American College of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), and U.S. Preventive Services Task Force (USPSTF) differed on age to start and how often to get screened for cervical cancer. (4). In 2012, however, all three organizations recommended that 1) screening by Papanicolau (Pap) test should not be used for women aged <21 years, regardless of initiation of sexual activity, and 2) a screening interval of 3 years should be maintained for women aged 21–30 years. ACS and ACOG explicitly recommend against yearly screening (5–7). To assess trends in Pap testing before the new guidelines were introduced, CDC analyzed 2000–2010 data from the Behavioral Risk Factor Surveillance System (BRFSS) for women aged 18–30 years. CDC found that, among women aged 18–21 years, the percentage reporting never having been screened increased from 26.3% in 2000 to 47.5% in 2010, and the proportion reporting having had a Pap test in the past 12 months decreased from 65.0% to 41.5%. Among those aged 22–30 years, the proportion reporting having had a Pap test within the preceding 12 months decreased from 78.1% to 67.0%. These findings showed that Pap testing practices for young women have been moving toward the latest guidelines. However, the data also showed a concerning trend: among women aged 22–30 years, who should be screened every 3 years, the proportion who reported never having had a Pap test increased from 6.6% to 9.0%. More effort is needed to promote acceptance of the latest evidence-based recommendations so that all women receive the maximal benefits of cervical cancer screening.
Report to the Nation shows U.S. cancer death rates continue to drop; Special feature highlights trends in HPV-associated cancers and HPV vaccination coverage levels
Report to the Nation shows U.S. cancer death rates continue to drop; Special feature highlights trends in HPV-associated cancers and HPV vaccination coverage levels
Source: National Cancer Institute
The Annual Report to the Nation on the Status of Cancer, 1975–2009, shows that overall cancer death rates continued to decline in the United States among both men and women, among all major racial and ethnic groups, and for all of the most common cancer sites, including lung, colon and rectum, female breast, and prostate. However, the report also shows that death rates continued to increase during the latest time period (2000 through 2009) for melanoma of the skin (among men only) and for cancers of the liver, pancreas, and uterus. The special feature section on human papillomavirus (HPV)-associated cancers shows that incidence rates are increasing for HPV-associated oropharyngeal and anal cancers and that vaccination coverage levels in the U.S. during 2008 and 2010 remained low among adolescent girls.
Vital Signs: Racial Disparities in Breast Cancer Severity — United States, 2005–2009
Vital Signs: Racial Disparities in Breast Cancer Severity — United States, 2005–2009
Source: Morbidity and Mortality Weekly Report (CDC)
Background: Breast cancer death rates have been declining among U.S. women since 1990 because of early detection and advances in treatment; however, all racial groups have not benefited equally.
Methods: Breast cancer incidence, stage at diagnosis, and mortality rates for 2005–2009 for women in the United States and for each state were calculated using United States Cancer Statistics (USCS) data. Black to white mortality ratios and mortality to incidence ratios by race were calculated.
Results: Despite having lower incidence rates, black women had a 41% higher breast cancer death rate. More black women were diagnosed at regional or distant cancer stage compared with white women (45% versus 35%). For every 100 breast cancers diagnosed, black women had nine more deaths than white women (27 deaths per 100 breast cancers diagnosed among black women compared with 18 per 100 among white women).
Conclusions: Despite significant progress in breast cancer detection and treatment, black women experience higher death rates even though they have a lower incidence of breast cancer compared to white women.
Implications for Public Health Practice: Advances in screening and treatment have improved survival for U.S. women with breast cancer. However, black women experience inequities in breast cancer screening, follow-up, and treatment after diagnosis, leading to greater mortality. At the individual level, the maximal effectiveness of screening for breast cancer can only be achieved when all women have timely follow-up to breast cancer exams and state-of-the-art treatment. At the health system level, optimal health-care delivery may be strengthened through performance-based reimbursement, expanded use of information technology, and quality assurance reporting-protocols. Proven effective interventions such as patient navigation could be expanded for use in other settings.
Radiation and the Risk of Chronic Lymphocytic and Other Leukemias among Chornobyl Cleanup Workers
Radiation and the Risk of Chronic Lymphocytic and Other Leukemias among Chornobyl Cleanup Workers
Source: Environmental Health Perspectives
Background: Risks of most types of leukemia from exposure to acute high doses of ionizing radiation are well known, but risks associated with protracted exposures, and associations between radiation and chronic lymphocytic leukemia (CLL) are not clear.
Objectives: To estimate relative risks of CLL and non-CLL from protracted exposures to low-dose ionizing radiation.
Methods: A nested case-control study was conducted in a cohort of 110,645 Ukrainian cleanup workers of the 1986 Chornobyl nuclear power plant accident. Cases of incident leukemia diagnosed in 1986-2006 were confirmed by a panel of expert hematologists/hematopathologists. Controls were matched to cases on place of residence and year of birth. Individual bone marrow radiation doses were estimated by the Realistic Analytical Dose Reconstruction with Uncertainty Estimation (RADRUE) method. A conditional logistic regression model was used to estimate excess relative risk of leukemia per gray (ERR/Gy) of radiation dose.
Results:A significant linear dose-response was found for all leukemia (137 cases, ERR/Gy=1.26 (95% confidence interval 0.03, 3.58)). There were non-significant positive dose-responses for both CLL and non-CLL (ERR/Gy=0.76 and 1.87, respectively). In our primary analysis excluding 20 cases with direct in-person interviews
Conclusions: Exposure to low doses and low dose-rates of radiation from post-Chornobyl cleanup work was associated with a significant increase in risk of leukemia, which was statistically consistent with estimates for the Japanese atomic bomb survivors. Based on the primary analysis, we conclude that CLL and non-CLL are both radiosensitive.
See: Chernobyl Cleanup Workers Had Significantly Increased Risk of Leukemiahttp://www.sciencedaily.com/releases/2012/11/121108073635.htm (Science Daily)
Continuation With Statin Therapy and the Risk of Primary Cancer: A Population-Based Study
Continuation With Statin Therapy and the Risk of Primary Cancer: A Population-Based Study
Source: Preventing Chronic Disease (CDC)
Introduction
Studies have suggested that statins may inhibit tumor cell growth and possibly prevent carcinogenesis. The objective of this study was to investigate the association between persistent statin use and the risk of primary cancer in adults.
Methods
This retrospective study was conducted by using the computerized data sets of a large health maintenance organization (HMO) in Israel. The study population was 202,648 enrollees aged 21 or older who purchased at least 1 pack of statin medication from 1998 to 2006. The follow-up period was from the date of first statin dispensation (index date) to the date of first cancer diagnosis, death, leaving the HMO, or September 1, 2007, whichever occurred first. Persistence was measured by calculating the mean proportion of follow-up days covered (PDC) with statins by dividing the quantity of statin dispensed by the total follow-up time.
Results
During the study period, 8,662 incident cancers were reported. In a multivariable model, the highest cancer risk was calculated among nonpersistent statin users. A strong negative association between persistence with statin therapy and cancer risk was calculated for hematopoietic malignancies, where patients covered with statins in 86% or more of the follow-up time had a 31% (95% confidence interval, 0.55-0.88) lower risk than patients in the lowest persistence level (≤12%).
Conclusion
Our study demonstrated that persistent use of statins is associated with a lower overall cancer risk and particularly the risk of incident hematopoietic malignancies. In light of widespread statin consumption and increases in cancer incidence, the association between statins and cancer incidence may be relevant for cancer prevention.
Cancer Statistics About Hispanics Released
Cancer Statistics About Hispanics Released
Source: American Cancer Society
A new Cancer Facts & Figures for Hispanics/Latinos has been released in conjunction with National Hispanic Heritage Month. This publication is updated every 3 years and is a resource for current information about cancer among Hispanics. But you may be wondering why we produce a 35-page report devoted solely to cancer statistics for Hispanics.
For 60 years the American Cancer Society’s Research department has promoted cancer prevention and control by providing cancer data in a user-friendly format called Cancer Facts & Figures. Over the years, new Facts & Figures publications have been developed to highlight a particular cancer type or a specific population. In 2000, to answer the increasing demand for more in-depth information on cancer in the growing Hispanic community, the inaugural Cancer Facts & Figures for Hispanics/Latinos was introduced.
See: Cancer Now Leading Cause of Death in US Hispanics (Science Daily)
Parents’ Perceptions of Skin Cancer Threat and Children’s Physical Activity
Parents’ Perceptions of Skin Cancer Threat and Children’s Physical Activity
Source: Preventing Chronic Disease (CDC)
Introduction
Sun exposure is a major risk factor for skin cancer, but without physical activity, children are at risk of childhood obesity. The objective of this study was to explore relationships between parental perceptions of skin cancer threat, sun protection behaviors, physical activity, and body mass index (BMI) in children.Methods
This is a cross-sectional analysis nested within the Colorado Kids Sun Care Program sun safety intervention trial. In summer 2007, parent telephone interviews provided data on demographics, perceptions of skin cancer threat, sun protection behaviors, and physical activity. Physical examinations provided data on phenotype, freckling, and BMI. Data from 999 Colorado children born in 1998 were included in analysis. We used analysis of variance, Spearman’s rho (ρ) correlation, and multivariable linear regression analysis to evaluate relationships with total amount of outdoor physical activity.Results
After controlling for sex, race/ethnicity, skin color, and sun protection, regression analysis showed that each unit increase in perceived severity of nonmelanoma skin cancer was associated with a 30% increase in hours of outdoor physical activity (P = .005). Hours of outdoor physical activity were not related to perceived severity of melanoma or perceived susceptibility to skin cancer. BMI-for-age was not significantly correlated with perceptions of skin cancer threat, use of sun protection, or level of physical activity.Conclusion
The promotion of sun safety is not likely to inhibit physical activity. Skin cancer prevention programs should continue to promote midday sun avoidance and sun protection during outdoor activities.
Environmental Causes of Breast Cancer and Radiation From Medical Imaging Findings — From the Institute of Medicine Report
Source: Archives of Internal Medicine
Susan G. Komen for the Cure asked the Institute of Medicine (IOM) to perform a comprehensive review of environmental causes and risk factors for breast cancer. Interestingly, none of the consumer products (ie, bisphenol A, phthalates), industrial chemicals (ie, benzene, ethylene oxide), or pesticides (ie, DDT/DDE) considered could be conclusively linked to an increased risk of breast cancer, although the IOM acknowledged that the available evidence was insufficient to draw firm conclusions for many of these exposures, calling for more research in these areas. The IOM found sufficient evidence to conclude that the 2 environmental factors most strongly associated with breast cancer were exposure to ionizing radiation and to combined postmenopausal hormone therapy. The IOM’s conclusion of a causal relation between radiation exposure and cancer is consistent with a large and varied literature showing that exposure to radiation in the same range as used for computed tomography will increase the risk of cancer. It is the responsibility of individual health care providers who order medical imaging to understand and weigh the risk of any medical procedures against the expected benefit.
Susan G. Komen for the Cure, the largest grassroots network of breast cancer survivors and activists in the United States, asked the Institute of Medicine (IOM) to perform a comprehensive and evidence-based review of environmental causes and risk factors for breast cancer, with a focus on identifying evidence-based actions that women can take to reduce their risk.1 Environmental exposures were defined broadly to include all factors not genetically inherited, and the IOM committee appointed to write this report included academicians and chairs from departments of environmental health, toxicology, cancer epidemiology, preventive medicine, and biostatistics in addition to advocates for patients with breast cancer. Committee members conducted their own reviews of the peer-reviewed epidemiological and basic science literature, commissioned several papers specifically for their report, and drew on evidence-based reviews already completed by organizations such as the Agency for Research on Cancer and the World Cancer Research Fund International. The publication Breast Cancer and the Environment: A Life Course Approach was released online in December 2011.
Measuring Resilience in Adult Women Using the 10-Items Connor-Davidson Resilience Scale (CD-RISC). Role of Trauma Exposure and Anxiety Disorders
Source: PLoS ONE
Purpose
Resilience is the ability of individuals to adapt positively in the face of trauma. Little is known, however, about lifetime factors affecting resilience.
Methods
We assessed the effects of psychiatric disorder and lifetime trauma history on the resilience self-evaluation using the Connor-Davidson Resilience Scale (CD-RISC-10) in a high-risk-women sample. Two hundred and thirty eight community-dwelling women, including 122 participants in a study of breast cancer survivors and 116 participants without previous history of cancer completed the CD-RISC-10. Lifetime psychiatric symptoms were assessed retrospectively using two standardized psychiatric examinations (Mini International Neuropsychiatric Interview and Watson’s Post-Traumatic Stress Disorder Inventory).
Results
Multivariate logistic regression adjusted for age, education, trauma history, cancer, current psychiatric diagnoses, and psychoactive treatment indicated a negative association between current psychiatric disorder and high resilience compared to low resilience level (OR = 0.44, 95% CI [0.21–0.93]). This was related to anxiety and not mood disorder. A positive and independent association with a trauma history was also observed (OR = 3.18, 95% CI [1.44–7.01]).
Conclusion
Self-evaluation of resilience is influenced by both current anxiety disorder and trauma history. The independent positive association between resilience and trauma exposure may indicate a “vaccination” effect. This finding need to be taken into account in future studies evaluating resilience in general or clinical populations.
Cancer treatment and survivorship statistics, 2012
Cancer treatment and survivorship statistics, 2012
Source: CA: A Cancer Journal for Clinicians
Although there has been considerable progress in reducing cancer incidence in the United States, the number of cancer survivors continues to increase due to the aging and growth of the population and improvements in survival rates. As a result, it is increasingly important to understand the unique medical and psychosocial needs of survivors and be aware of resources that can assist patients, caregivers, and health care providers in navigating the various phases of cancer survivorship. To highlight the challenges and opportunities to serve these survivors, the American Cancer Society and the National Cancer Institute estimated the prevalence of cancer survivors on January 1, 2012 and January 1, 2022, by cancer site. Data from Surveillance, Epidemiology, and End Results (SEER) registries were used to describe median age and stage at diagnosis and survival; data from the National Cancer Data Base and the SEER-Medicare Database were used to describe patterns of cancer treatment. An estimated 13.7 million Americans with a history of cancer were alive on January 1, 2012, and by January 1, 2022, that number will increase to nearly 18 million. The 3 most prevalent cancers among males are prostate (43%), colorectal (9%), and melanoma of the skin (7%), and those among females are breast (41%), uterine corpus (8%), and colorectal (8%). This article summarizes common cancer treatments, survival rates, and posttreatment concerns and introduces the new National Cancer Survivorship Resource Center, which has engaged more than 100 volunteer survivorship experts nationwide to develop tools for cancer survivors, caregivers, health care professionals, advocates, and policy makers. CA Cancer J Clin 2012. Published 2012 American Cancer Society.
See: New Report Estimates Nearly 18 Million Cancer Survivors in the US by 2022 (Science Daily)
Lung Cancer and Elemental Carbon Exposure in Trucking Industry Workers
Lung Cancer and Elemental Carbon Exposure in Trucking Industry Workers
Source: Environmental Health Perspectives
Background: Diesel exhaust has been considered to be a probable lung carcinogen based on studies of occupationally exposed workers. Efforts to define lung cancer risk in these studies have been limited in part by lack of quantitative exposure estimates.
Objectives: We conducted a retrospective cohort study to assess lung cancer mortality risk in US trucking industry workers. Elemental carbon (EC) was used as a surrogate of exposure to engine exhaust from diesel vehicles, traffic, and loading dock operations.
Methods: Work records were available for 31,135 male workers employed in the unionized US trucking industry in 1985. A statistical model based on a national exposure assessment was used to estimate historical work-related exposures to EC. Lung cancer mortality was ascertained through 2000 and associations with cumulative and average EC were estimated using proportional hazards models.
Results: Duration of employment was inversely associated with lung cancer risk consistent with a healthy worker survivor effect and a cohort comprised of prevalent hires. Adjusting for employment duration, there was suggestion of a linear exposure-response relationship. For each 1000 µg/m3-months of cumulative EC, based on a 5-year exposure lag, the Hazard Ratio (HR) = 1.07 (95%CI: 0.99, 1.15) with a similar association for a 10-year exposure lag, HR=1.09 (95%CI: 0.99, 1.20). Average exposure was not associated with relative risk.
Conclusions: Lung cancer mortality in trucking industry workers increased in association with cumulative exposure to EC after adjustment for negative confounding by employment duration.
Global cancer transitions according to the Human Development Index (2008—2030): a population-based study
Source: The Lancet
Background
Cancer is set to become a major cause of morbidity and mortality in the coming decades in every region of the world. We aimed to assess the changing patterns of cancer according to varying levels of human development.
Methods
We used four levels (low, medium, high, and very high) of the Human Development Index (HDI), a composite indicator of life expectancy, education, and gross domestic product per head, to highlight cancer-specific patterns in 2008 (on the basis of GLOBOCAN estimates) and trends 1988—2002 (on the basis of the series in Cancer Incidence in Five Continents), and to produce future burden scenario for 2030 according to projected demographic changes alone and trends-based changes for selected cancer sites.
Findings
In the highest HDI regions in 2008, cancers of the female breast, lung, colorectum, and prostate accounted for half the overall cancer burden, whereas in medium HDI regions, cancers of the oesophagus, stomach, and liver were also common, and together these seven cancers comprised 62% of the total cancer burden in medium to very high HDI areas. In low HDI regions, cervical cancer was more common than both breast cancer and liver cancer. Nine different cancers were the most commonly diagnosed in men across 184 countries, with cancers of the prostate, lung, and liver being the most common. Breast and cervical cancers were the most common in women. In medium HDI and high HDI settings, decreases in cervical and stomach cancer incidence seem to be offset by increases in the incidence of cancers of the female breast, prostate, and colorectum. If the cancer-specific and sex-specific trends estimated in this study continue, we predict an increase in the incidence of all-cancer cases from 12·7 million new cases in 2008 to 22·2 million by 2030.
Interpretation
Our findings suggest that rapid societal and economic transition in many countries means that any reductions in infection-related cancers are offset by an increasing number of new cases that are more associated with reproductive, dietary, and hormonal factors. Targeted interventions can lead to a decrease in the projected increases in cancer burden through effective primary prevention strategies, alongside the implementation of vaccination, early detection, and effective treatment programmes.
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Nature and Impact of Grief Over Patient Loss on Oncologists’ Personal and Professional Lives
Nature and Impact of Grief Over Patient Loss on Oncologists’ Personal and Professional Lives (PDF)
Source: Archives of Internal Medicine
Caring for critically ill and terminal patients can generate grief reactions in health care professionals (HCPs). While all HCPs can potentially experience grief over patient loss, oncologists face unique pressures because they are legally responsible for the patients’ care and may be blamed when patients die.5 Despite the evidence that grief over patient loss is an intrinsic part of clinical oncology, there are no qualitative studies examining the nature and extent of oncologists’ grief over patient loss nor the impact of this grief on oncologists’ lives. The objectives of our study were to explore and identify oncologists’ grief over patient loss and the ways in which this grief may affect their personal and professional lives.
