Descriptive Studies and Record Linkage

描述性研究和记录链接

• 批准号: 8938252
• 负责人: William Anderson
• 金额: $ 17.38万
• 依托单位: DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8938252
• 关键词: Age; Age Distribution; American Indian and Alaska Native; Anatomic Sites; Anemia; Area; Asia; Asians; Attention; Bilateral; Birth; Blood Transfusion; Brain Neoplasms; Breast; Breast Cancer Treatment; Calendar; California; Cancer Biology; Cancer Etiology; Cancer Patient; Cancer Surveillance Research; Carcinogens; Case-Control Studies; Categories; Characteristics; Chest; Cigarette; Classification; Clinical; Cohort Effect; Colon Carcinoma; Complication; Country; Cross-Sectional Studies; Data; Data Linkages; Diagnosis; Disease; Documentation; ERBB2 gene; Elderly; Environmental Exposure; Epstein-Barr Virus Infections; Ethnic group; Etiology; Exposure to; Extranodal; Eye; Female Breast Carcinoma; Frequencies; Gender; General Population; Generations; Heart; Heterogeneity; Hispanics; Histologic; Hormone Receptor; Incidence; Kidney; Life; Link; Living Donors; Lung Neoplasms; Lymphoma; Malignant Neoplasms; Malignant neoplasm of liver; Malignant neoplasm of lung; Mammography; Medicare claim; Modeling; Molecular; Monitor; Multiple Myeloma; Natural History; Nodal; Non-Hodgkin' s Lymphoma; Not Hispanic or Latino; Odds Ratio; Organ; Organ Procurements; Organ Transplantation; Pacific Island Americans; Pattern; Plasma Cell Neoplasm; Pleura; Population; Predisposition; Prevention; Primary biliary cirrhosis; Prostate; Registries; Renal carcinoma; Renal pelvis; Reporting; Retinoblastoma; Risk; Risk Factors; Role; Shapes; Site; Solid; Spleen; Stomach; Subgroup; Testicular Germ Cell Tumor; Thymus Gland; Transfusion; Transplant Recipients; Transplantation; United States; Update; Ureter; Variant; Woman; aged; boys; cancer diagnosis; cancer risk; cancer type; cell type; cigarette smoking; cohort; falls; high risk; improved; leukemia; malignant breast neoplasm; malignant stomach neoplasm; men; middle age; mortality; neoplasm registry; older women; outcome forecast; population based; programs; racial and ethnic; racial and ethnic disparities; receptor; screening; sex; transmission process; trend; tumor

General descriptive studies (00350): Following decades of rising breast cancer incidence in the U.S. there were abrupt declines circa 2000 that stabilized during 2003-2004. The fall in breast cancer rates occurred mostly among older women with ER positive cancers. Much less attention was given to falling ER negative cancer rates. Circa 1990 breast cancer mortality rates began to fall with an estimated annual percentage change of approximately 2% per year. The fall in breast cancer mortality rates have generally been attributed to the combined effect of improvements in screening mammography and/or breast cancer treatment. However, declining breast cancer mortality may not simply reflect better screening and treatment, but also might be related to changing breast cancer biology due to falling ER negative incidence rates. Breast cancer is a heterogeneous disease, divisible into a variable number of clinical subtypes. A fundamental question is how many etiological classes underlie the clinical spectrum of breast cancer? We reviewed the evidence for breast cancer etiological heterogeneity. Results showed a bimodal age distribution at diagnosis with peak frequencies near ages 50 and 70 years for important tumor features, consistent with a two-component mixture model and compatible with a hierarchal view of breast cancers arising from two main cell types of origin. There are limited data regarding the burden of breast cancer subtypes among Hispanic women. We, therefore, assessed the distribution and prognosis of the molecular subtypes among Hispanics using California Cancer Registry data from 2005-2010. Breast cancer subtypes were defined as hormone receptor (HR) and HER2 receptor: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2- (triple negative). Among 16,380 Hispanic breast cancer patients, HR+/HER- subtype was most common, followed by triple negative, HR+/HER2+ and HR-/HER2+. Previous reports suggested that female breast cancer is associated with earlier ages at onset among Asian than Western populations. However, most studies utilized cross-sectional analysis that may be confounded by calendar-period and birth-cohort effects. We, therefore, considered a more longitudinal approach adjusted for calendar period changes and conditioned upon birth-cohorts. Invasive female breast cancer case and population data (1988-2009) were obtained from cancer registries in Asia and the United States. Similar shapes in longitudinal curves along with converging IRRs from one generation to the next suggested that the natural history of invasive breast cancer was more similar among Asian and Western populations than might be expected from a solely cross-sectional analysis. Indeed, estimates for the most recent cohorts in some Asian countries show even later ages at onset than in the US. Cancer risk after blood transfusion was evaluated in a US population-based case-control study using 552,951 elderly cases identified from cancer registries and 100,000 frequency-matched controls. Transfusions received 0 to 12, 13 to 30, and 31 to 48 months before cancer diagnosis or selection dates were identified using Medicare claims. Transfusions received 0 to 12 months before cancer diagnosis and/or selection were associated with significantly elevated risk of cancer overall (odds ratio [OR], 2.05; 95% CI, 1.95-2.16) and cancer of the stomach; cancer of the colon; cancer of the liver, kidney, renal pelvis, and/or ureter; lymphoma; myeloma; and leukemia. No significant associations for cancer overall were observed for the two earlier intervals. No site was associated with transfusions received 13 to 30 or 31 to 48 months before diagnosis and/or selection. Nonetheless, overall cancer risk increased with the number of transfused periods (p-trend 0.0001). The increased risk of overall cancer and specific sites 0 to 12 months after blood transfusion is likely due to reverse causation, that is, incipient cancers or cancer precursors causing anemia. Transmission of cancer is a life-threatening complication of transplantation. Monitoring transplantation practice requires complete recording of donor cancers. The US Scientific Registry of Transplant Recipients (SRTR) captures cancers in deceased donors (beginning in 1994) and living donors (2004). We linked the SRTR (52 599 donors, 110 762 transplants) with state cancer registries. Cancer registries identified cancers in 519 donors: 373 deceased donors (0.9%) and 146 living donors (1.2%). Among deceased donors, 50.7% of cancers were brain tumors. Among living donors, 54.0% were diagnosed after donation; most were cancers common in the general population (e.g. breast, prostate). There were 1063 deceased donors with cancer diagnosed in the SRTR or cancer registry, and the SRTR lacked a cancer diagnosis for 107 (10.1%) of these. There were 103 living donors with cancer before or at donation, diagnosed in the SRTR or cancer registry, and the SRTR did not have a cancer diagnosis for 43 (41.7%) of these. The SRTR does not record cancers after donation in living donors and so missed 81 cancers documented in cancer registries. In conclusion, donor cancers are uncommon, but lack of documentation of some cases highlights a need for improved ascertainment and reporting by organ procurement organizations and transplant programs. Solid organ transplantation recipients have elevated cancer incidence. The cumulative incidence of 6 preventable or screen-detectable cancers after transplantation was estimated using population-based data on 164,156 US transplantation recipients. High-risk subgroups are identified that may benefit from targeted screening or prevention, including thoracic organ recipients at the extremes of age for non-Hodgkin lymphoma, older thoracic organ recipients for lung cancer, and kidney recipients aged 35 years for kidney cancer In a large US population-based study, the authors demonstrate that transplant recipients have an elevated risk for plasma cell neoplasms and document several risk factors for this type of malignancy, including Epstein Barr virus infection, recipient age, and the presence of primary biliary cirrhosis. The classification of lung cancers by histologic type was updated and the new refined categories were used to assess the US incidence patterns. Temporal trends were found to vary by gender, type, racial/ethnic group, and age, reflecting historical cigarette smoking rates, duration, cessation, cigarette composition, and exposure to other carcinogens. The new categories and SEER data are being used in the upcoming 4th edition of the WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart. Testicular germ cell tumors are the most commonly occurring cancers among US men ages 15-44 years, and rates were found to be highest among non-Hispanics, followed by American Indian/Alaska Natives, Hispanic whites, Asian/Pacific Islanders, and blacks. Retinoblastoma incidence rates were found to be decreasing significantly since 1992 among those younger than 1 year and since 1998 among those with bilateral disease. In addition, consistent with other cancers, an excess of retinoblastoma diagnosed in boys suggests a potential effect of sex on cancer origin. The incidence of extranodal marginal zone lymphoma exceeds that of nodal disease, and the most common extranodal sites are the stomach, spleen, and eye/adnexa. The age-specific patterns increased steeply at young ages and less prominently after mid-life for several sites. The temporal trends, gender and racial/ethnic disparities varied by site, supporting the contention that marginal zone lymphoma is characterized by etiological heterogeneity across sites and that susceptibility is probably influenced by intrinsic characteristics and environmental exposures.

一般描述性研究 (00350)：美国乳腺癌发病率几十年来不断上升，在 2000 年左右突然下降，并在 2003 年至 2004 年期间趋于稳定。乳腺癌发病率的下降主要发生在患有 ER 阳性癌症的老年女性中。人们对 ER 阴性癌症发病率下降的关注要少得多。大约 1990 年，乳腺癌死亡率开始下降，估计每年百分比变化约为 2%。 乳腺癌死亡率的下降通常归因于乳房X光检查筛查和/或乳腺癌治疗改进的综合作用。 然而，乳腺癌死亡率的下降可能不仅仅反映了更好的筛查和治疗，还可能与由于 ER 阴性发病率下降而导致的乳腺癌生物学变化有关。乳腺癌是一种异质性疾病，可分为多种临床亚型。一个基本问题是乳腺癌的临床谱有多少病因学分类？我们回顾了乳腺癌病因异质性的证据。结果显示，诊断时呈双峰年龄分布，重要肿瘤特征的峰值频率接近 50 岁和 70 岁，这与双成分混合模型一致，并且与源自两种主要细胞类型的乳腺癌的分层观点相一致。关于西班牙裔女性乳腺癌亚型负担的数据有限。因此，我们使用 2005-2010 年加州癌症登记数据评估了西班牙裔分子亚型的分布和预后。乳腺癌亚型定义为激素受体 (HR) 和 HER2 受体：HR+/HER2-、HR+/HER2+、HR-/HER2+ 和 HR-/HER2-（三阴性）。在 16,380 名西班牙裔乳腺癌患者中，HR+/HER- 亚型最常见，其次是三阴性、HR+/HER2+ 和 HR-/HER2+。此前的报告表明，亚洲女性乳腺癌的发病年龄早于西方女性。然而，大多数研究采用横断面分析，这可能会受到日历周期和出生队列效应的混淆。因此，我们考虑了一种更纵向的方法，根据日历周期的变化进行调整，并以出生队列为条件。侵袭性女性乳腺癌病例和人口数据（1988-2009）来自亚洲和美国的癌症登记处。纵向曲线的相似形状以及从一代到下一代的IRR趋同表明，亚洲和西方人群中浸润性乳腺癌的自然史比单纯的横截面分析所预期的更为相似。事实上，对一些亚洲国家最近队列的估计显示，发病年龄甚至比美国晚。美国一项基于人群的病例对照研究评估了输血后的癌症风险，该研究使用了从癌症登记处确定的 552,951 名老年病例和 100,000 名频率匹配的对照。使用医疗保险索赔确定癌症诊断或选择日期之前的 0 至 12、13 至 30 和 31 至 48 个月接受输血。癌症诊断和/或选择前 0 至 12 个月接受的输血与总体癌症风险显着升高（优势比 [OR]，2.05；95% CI，1.95-2.16）和胃癌风险相关；结肠癌；肝癌、肾癌、肾盂癌和/或输尿管癌；淋巴瘤；骨髓瘤；和白血病。在之前的两个时间间隔中，没有观察到总体上与癌症存在显着关联。没有任何部位与诊断和/或选择前 13 至 30 或 31 至 48 个月接受的输血相关。尽管如此，总体癌症风险随着输血次数的增加而增加（p 趋势 0.0001）。 输血后 0 至 12 个月整体癌症和特定部位的风险增加可能是由于反向因果关系，即初期癌症或癌症前兆导致贫血。癌症传播是危及生命的移植并发症。监测移植实践需要完整记录供体癌症。美国移植受者科学登记处 (SRTR) 记录了已故捐献者（从 1994 年开始）和活体捐献者（2004 年）的癌症情况。我们将 SRTR（52 599 名捐赠者，110 762 名移植者）与州癌症登记处联系起来。癌症登记处发现 519 名捐献者患有癌症：373 名已故捐献者 (0.9%) 和 146 名活体捐献者 (1.2%)。在已故捐献者中，50.7%的癌症是脑肿瘤。活体捐献者中，54.0%是捐献后确诊的；大多数是普通人群中常见的癌症（例如乳腺癌、前列腺癌）。 SRTR 或癌症登记处有 1063 名已故捐献者被诊断患有癌症，其中 107 名捐献者 (10.1%) 没有被 SRTR 诊断出癌症。有 103 名活体捐献者在捐献前或捐献时患有癌症，并在 SRTR 或癌症登记处得到诊断，其中 43 名 (41.7%) 没有被 SRTR 诊断为癌症。 SRTR 不记录活体捐赠者捐献后的癌症，因此遗漏了癌症登记处记录的 81 种癌症。总之，供体癌症并不常见，但某些病例缺乏记录，凸显了器官采购组织和移植计划需要改进确定和报告。实体器官移植受者的癌症发病率较高。 使用 164,156 名美国移植受者的人口数据估算了移植后 6 种可预防或可筛查检测的癌症的累积发病率。确定了可能受益于有针对性的筛查或预防的高风险亚组，包括极端年龄的胸器官受者的非霍奇金淋巴瘤、老年胸器官受者的肺癌以及年龄在 35 岁的肾受者的肾癌。基于美国人口的研究，作者证明移植受者患浆细胞肿瘤的风险较高，并记录了此类恶性肿瘤的几个危险因素，包括 Epstein Barr 病毒感染、受者年龄和原发性胆汁性肝硬化的存在。 更新了按组织学类型对肺癌的分类，并使用新的细化类别来评估美国的发病模式。 研究发现，时间趋势因性别、类型、种族/民族和年龄而异，反映了历史吸烟率、持续时间、戒烟情况、香烟成分和接触其他致癌物的情况。 新的类别和 SEER 数据将用于即将发布的第 4 版 WHO 肺、胸膜、胸腺和心脏肿瘤分类。 睾丸生殖细胞肿瘤是 15-44 岁美国男性中最常见的癌症，非西班牙裔的发病率最高，其次是美洲印第安人/阿拉斯加原住民、西班牙裔白人、亚洲/太平洋岛民和黑人。 自 1992 年以来，1 岁以下儿童的视网膜母细胞瘤发病率显着下降，自 1998 年以来，双侧患病儿童的视网膜母细胞瘤发病率显着下降。 此外，与其他癌症一致，男孩中诊断出的视网膜母细胞瘤过多表明性别对癌症起源有潜在影响。 结外边缘区淋巴瘤的发病率超过淋巴结疾病，最常见的结外部位是胃、脾和眼/附件。 在一些地点，特定年龄的模式在年轻时急剧增加，而在中年之后则不那么明显。 时间趋势、性别和种族/民族差异因地点而异，支持边缘区淋巴瘤的特点是跨地点的病因异质性以及易感性可能受到内在特征和环境暴露的影响的论点。