7 research outputs found
Recommended from our members
Molecular biomarker-defined brain tumors: Epidemiology, validity, and completeness in the United States.
BACKGROUND: Selected molecular biomarkers were incorporated into the US cancer registry reporting for patients with brain tumors beginning in 2018. We investigated the completeness and validity of these variables and described the epidemiology of molecularly defined brain tumor types. METHODS: Brain tumor patients with histopathologically confirmed diagnosis in 2018 were identified within the Central Brain Tumor Registry of the United States and NCIs Surveillance, Epidemiology, and End Results Incidence databases. The brain molecular markers (BMM) site-specific data item was assessed for coding completeness and validity. 1p/19q status, MGMT promoter methylation, WHO grade data items, and new ICD-O-3 codes were additionally evaluated. These data were used to profile the characteristics and age-adjusted incidence rates per 100 000 population of molecularly defined brain tumors with 95% confidence intervals (95% CI). RESULTS: BMM completeness across the applicable tumor types was 75%-92% and demonstrated favorable coding validity. IDH-wildtype glioblastomas incidence rate was 1.74 (95% CI: 1.69-1.78), as compared to 0.14 for WHO grade 2 (95% CI: 0.12-0.15), 0.15 for grade 3 (95% CI: 0.14-0.16), and 0.07 for grade 4 (95% CI: 0.06-0.08) IDH-mutant astrocytomas. Irrespective of WHO grade, IDH mutation prevalence was highest in adolescent and young adult patients, and IDH-mutant astrocytomas were more frequently MGMT promoter methylated. Among pediatric-type tumors, the incidence rate was 0.06 for H3K27M-mutant diffuse midline gliomas (95% CI: 0.05-0.07), 0.03 for SHH-activated/TP53-wildtype medulloblastomas (95% CI: 0.02-0.03), and <0.01 for both C19MC-altered embryonal tumor with multilayered rosettes and RELA-fusion ependymomas. CONCLUSIONS: Our findings illustrate the success of developing a dedicated, integrated diagnosis variable, which provides critical molecular information about brain tumors related to accurate diagnosis
Disparities in lung cancer survival and receipt of surgical treatment
•While lung cancer survival in Nevada is uniformly low, 15.6%, disparities exist.•The populous Las Vegas metropolitan area has worse survival than Northern Nevada.•Southern Nevadans have lower odds of receiving surgery even for curative stages.•No discernible racial/ethnic survival disparities in the Mountain West state.
Lung cancer accounts for the greatest proportion of cancer deaths in the United States. This study aims to characterize lung cancer survival by racial/ethnic group and ascertain any modifiable determinants of identified disparities in the newly diverse Mountain West by using the state of Nevada.
12,964 first primary lung cancer cases diagnosed between 2003 and 2010 were identified for analysis from the Nevada Central Cancer Registry and followed for vital status until December 31, 2011. Standardized age-adjusted five-year survival stratified by race/ethnicity was computed using life table methods. Hazard ratios adjusted for covariates were estimated using Cox proportional hazards regression modeling. Adjusted odds of receiving surgical treatment for localized non-small cell lung cancer by region of Nevada were compared using logistic regression.
By the end of the follow-up period, 86% of lung cancer cases in Nevada were deceased. Five-year overall survival was 12.3% (95%CI: 11.5–13.1) for males and 18.9% (95%CI: 17.9–19.9) for females. Compared to cases in Northwestern Nevada, patients in Southern and Rural Nevada had 9% (HR:1.09; 95% CI:1.04–1.14) and 10% (HR:1.10; 95% CI:1.02–1.19) higher risk of dying from lung cancer, respectively. For localized non-small cell lung cancer (NSCLC), which is potentially curable, Southern Nevadans had 67% higher odds of not receiving surgical treatment than Northwestern Nevadans (OR 1.67; 95%CI: 1.30–2.13).
While the prognosis for lung cancer survival in Nevada is poor for all populations, there is no racial/ethnic disparity. However, there is a considerable survival disparity by geographic region, with Southern Nevadans disproportionately impacted. Potential modifiable factors include treatment differences, particularly in receipt of surgery for potentially curative tumor types such as localized NSCLC. Further studies are required to identify barriers to receipt of surgery in Southern Nevada