Epidemiology of human papillomavirus-related oropharyngeal cancer in a classically low-burden region of southern Europe

The incidence of human papillomavirus (HPV)-related oropharyngeal cancer is increasing in some regions. Nevertheless, the epidemiology of this disease has not been extensively investigated in southern Europe. We conducted a retrospective cohort study of patients diagnosed with primary oropharyngeal cancer from 1991 to 2016. Cancer tissues underwent histopathological evaluation, DNA quality control, HPV-DNA detection and p16 immunohistochemistry. Data were collected from medical records. Factors associated with HPV positivity and time trends were evaluated with multivariable Bayesian models. The adjusted prevalence of HPV-related cases in 864 patients with a valid HPV-DNA result was 9.7%, with HPV-DNA/p16 double positivity being considered. HPV-related oropharyngeal cancer was likely to occur in non-smokers and non-drinkers, to be located in the tonsil or diagnosed at advanced stages. Time-trend analysis showed an increasing risk of HPV-related oropharyngeal cancer in the most recent periods (5-year period increase of 30%). This increase was highest and with a clear increasing trend only in the most recent years (2012-2016). The prevalence of HPV-related oropharyngeal cancer started to sharply increase in the most recent years in our setting, as occurred two decades ago in areas where most oropharyngeal cancer cases are currently HPV-related. Our results provide a comprehensive assessment of the epidemiological landscape of HPV-related oropharyngeal cancer in a region of southern Europe

Genotypic classification of patients with Wolfram syndrome: insights into the natural history of the disease and correlation with phenotype

Purpose: Wolfram syndrome is a degenerative, recessive rare disease with an onset in childhood. It is caused by mutations in WFS1 or CISD2 genes. More than 200 different variations in WFS1 have been described in patients with Wolfram syndrome, which complicates the establishment of clear genotype-phenotype correlation. The purpose of this study was to elucidate the role of WFS1 mutations and update the natural history of the disease. Methods: This study analyzed clinical and genetic data of 412 patients with Wolfram syndrome published in the last 15 years. Results: (i) 15% of published patients do not fulfill the current ­inclusion criterion; (ii) genotypic prevalence differences may exist among countries; (iii) diabetes mellitus and optic atrophy might not be the first two clinical features in some patients; (iv) mutations are nonuniformly distributed in WFS1; (v) age at onset of diabetes mellitus, hearing defects, and diabetes insipidus may depend on the patient"s genotypic class; and (vi) disease progression rate might depend on genotypic class. Conclusion: New genotype-phenotype correlations were established, disease progression rate for the general population and for the genotypic classes has been calculated, and new diagnostic criteria have been proposed. The conclusions raised could be important for patient management and counseling as well as for the development of treatments for Wolfram syndrome

Supervivencia a los cinco años de las mujeres diagnosticadas de cáncer de mama durante el periodo 1997-1999 en el área de Toledo centro y Mancha

Fundamentos: El cáncer de mama representa la primera causa de mortalidad prematura en las mujeres de la provincia de Toledo. El objetivo es conocer el estadío al diagnóstico para cada grupo de edad y la supervivencia relativa (SR) del cáncer de mama a los 5 años, en el Área de Toledo-Centro y Mancha de los tumores diagnosticados durante 1997-1999. Métodos: Se utilizó la información del Registro Poblacional de Cáncer de Toledo. Se incluyó a 366 mujeres con tumores clasificados por estadio y grupo de edad (en función de su inclusión en el programa de detección precoz de cáncer de mama, 64). La SR e intervalo de confianza al 95% (IC) fueron calculados mediante el método de Hakulinen utilizando la aplicación WAERS. Resultados: La SR global fue 78,4% (IC: 73,6-83,6), siendo 93,3% (IC: 87,0-99,4) en < 45 años; 87,6% (IC: 81,5-94,1) para el grupo de 45-64 años; y 75,4% (IC: 65,3-86,9) en > 64 años. La SR fue 99,3% (IC: 94,4-104,5) para tumores localizados; 81,9% (IC: 74,0-90,8) para tumores con afectación ganglionar; y 20,1% (IC: 9,7-41,6) para tumores con metástasis. Al diagnóstico, el 52,3% de los tumores en < 45 años presentaba afectación ganglionar; el 14,8% en > 64 años presentaba metástasis. Conclusiones: La SR es similar a la media del estudio EUROCARE- 4. Estos resultados son un punto de partida para valorar, mediante el seguimiento de estos indicadores, el impacto de las actividades de detección precoz y terapéuticas en la SR del cáncer de mama en nuestra área

Análisis de la supervivencia relativa en cáncer. Años 2003-2009

Background: To determine the survival of cancer allows a posteriori know the effectiveness and efficiency of the different treatments. The current justification is essential because the cancer is the second leading cause of death and many factors: etiology, early diagnosis and different treatments. The observed and relative survival are the focus of this article. Methods: Through Registry Cancer Hospital Lozano Blesa Hospital of Zaragoza, as a source of information, we selected patients who entered with a diagnosis of cancer, such as. first episode between 2003-2009 whereby a 10-year period allowed (until 2014) of study after the last patient entered the cohort The diagnostic certainty was Anatomopathological. Survival time in years was calculated and these walls were considered: age, year of entry into the Register of cancer, years of survival, sex, living or dead state. From these data the absolute and relative survival and the limits of 95% confidence WAERS providing application was calculated. Results: The largest relative survival at five years were 94% of testicular cancer (LC: 95%, 81%, 194%); breast cancer 92% (LC: 91.6%, 101%); cervix 88% (LC: 71-105); prostate cancer 85% (LC: 77%, 93%) and worst in lung cancer 1% (LC: 0,5%); brain 17% (LC: 12%, 25%), stomach 22% (LC: 17%, 29%) and 21% pancreas (LC: 14%, 32%). Conclusions: A five-year survival is better for testicular cancer and worse for lung.Fundamentos: Conocer la supervivencia del cáncer permite a posteriori saber la efectividad y eficacia de los diferentes tratamientos. La justificación actual es imprescindible debido a que el cáncer constituye la segunda causa de mortalidad e intervienen muchos factores: etiológicos, diagnóstico precoz y diferentes tratamientos. La supervivencia observada y relativa, constituye el objetivo de este artículo. Métodos: A través del Registro de cáncer hospitalario del Hospital Lozano Blesa de Zaragoza, como fuente de información, se seleccionó a los pacientes que entraron con un diagnóstico de cáncer, como primer episodio entre los años 2003 a 2009, con lo cual se permite un periodo de estudio de 10 años (hasta el año 2014), después que el último paciente entró en la cohorte. El diagnóstico de certeza fue Anatomopatológico. Se calculó el tiempo de supervivencia en años y se tuvieron en cuenta los siguientes paramentos: Edad, año de entrada en el Registro de cáncer, años de supervivencia, sexo y estado vivo o muerto. A partir de estos datos se calculó la supervivencia absoluta y relativa así como los límites de confianza al 95 % que proporciona la aplicación Waers. Resultados: las mayores supervivencias relativas a los cinco años fueron en cáncer de testículo 94% (LC: 95%: 81%; 194%); cáncer de mama 92% (LC: 91.6 %; 101%); cuello de útero 88% (LC: 71-105); cáncer de próstata 85% (LC: 77 %, 93%). Las peores en cáncer de pulmón 1% (LC: 0; 5 %); encéfalo 17 % (LC: 12%, 25%); estómago 22% (LC: 17%, 29%); páncreas 21% (LC: 14%, 32%). Conclusiones: A cinco años la mejor supervivencia es para el cáncer de testículo y la peor para el de pulmón

Occupational health impact of the 2009 H1N1 flu pandemic: Surveillance of sickness absence

Objectives: Workplace absences due to illness can disrupt usual operations and increase costs for businesses. This study of sickness absence due to influenza and influenza-related illness presents a unique opportunity to characterise and measure the impact of the 2009 (H1N1) pandemic, by comparing trends during the pandemic to those of previous years, and adding this information to that obtained by traditional epidemiological surveillance systems. Methods: We compared the numbers of cases of sickness absence due to illness caused by influenza and influenza-related illness in 2007-2009, and in the first 3 months of 2010 in Catalonia (n=811 940) using a time series approach. Trends were examined by economic activity, age and gender. The weekly endemic-epidemic index (EEI) was calculated and its 95% CI obtained with the delta method, with observed and expected cases considered as independent random variables. Results: Influenza activity peaked earlier in 2009 and yielded more cases than in previous years. Week 46 (in November 2009) had the highest number of new cases resulting in sickness absence (EEI 20.99; 95% CI 9.44 to 46.69). Women and the 'education, health and other social activities' sector were the most affected. Conclusions: Results indicate that the new H1N1 pandemic had a significant impact on business, with shifts in the timing of peak incidence, a doubling in the number of cases, and changes in the distribution of cases by economic activity sector and gender. Traditional epidemiological surveillance systems could benefit from the addition of information based on sickness absence data.Peer Reviewe