Identification of area-level influences on regions of high cancer incidence in Queensland, Australia: a classification tree approach

Background: Strategies for cancer reduction and management are targeted at both individual and area levels. Area-level strategies require careful understanding of geographic differences in cancer incidence, in particular the association with factors such as socioeconomic status, ethnicity and accessibility. This study aimed to identify the complex interplay of area-level factors associated with high area-specific incidence of Australian priority cancers using a classification and regression tree (CART) approach. Methods: Area-specific smoothed standardised incidence ratios were estimated for priority-area cancers across 478 statistical local areas in Queensland, Australia (1998-2007, n=186,075). For those cancers with significant spatial variation, CART models were used to identify whether area-level accessibility, socioeconomic status and ethnicity were associated with high area-specific incidence. Results: The accessibility of a person’s residence had the most consistent association with the risk of cancer diagnosis across the specific cancers. Many cancers were likely to have high incidence in more urban areas, although male lung cancer and cervical cancer tended to have high incidence in more remote areas. The impact of socioeconomic status and ethnicity on these associations differed by type of cancer. Conclusions: These results highlight the complex interactions between accessibility, socioeconomic status and ethnicity in determining cancer incidence risk

Epigenetics and Field Cancerization the Caveats of Carcinogenesis and Recurrence of Gastrointestinal Malignancies – A Systematic Review and Meta-analysis Protocol

Abstract Background Gastrointestinal malignancies constitute the most common neoplasms with increasing prevalence worldwide, which portend a dismal morbidity and higher mortality rate. Epigenetic phenotypes and field cancerization impute a cutting edge for precursor of several gastrointestinal malignancies, this genetic aberration have been critically implicated in tumorigenesis and recurrence of gastrointestinal malignancies. There has been a paucity of knowledge about the interface effect between epigenetic signatures, epigenetic phenotype and field cancerization for carcinogenesis and recurrence of disease, a comprehensive analysis on the interplay of these biomarkers would streamline the strategy for epigenetic screening and chemoprevention therapy of gastrointestinal malignancy. This systematic review aims at assessing the effect of epigenetics and field cancerization on carcinogenesis and recurrence of gastrointestinal malignancies. Methods and Analysis This Systematic review and Meta-analysis will administer the provisions of Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) 2020 guideline and the review protocol will be submitted to PROSPERO review registry for registration. The literature search will be executed through several electronic databases including EMBASE, PubMed, Scopus, Web of Science, Cochraine , Global index medicus , semantic scholar and google scholar . All original research articles reporting on the effect of epigenetic signatures, epigenetics and field cancerization on the carcinogenesis and recurrence of gastrointestinal cancers in adults will be included. Only articles with NOS score above 4 and Low ROB based on D1-D5 for RCTs will be included for a Meta-analysis. Ethical Consideration and Dissemination There is no involvement of human subject participation in this review thus giving no effect to ethical implication .The evidence report of this review will be disseminated on scientific conferences and will be published to a reputable journal of gastroenterology oncology. This review has been registered at PROSPERO registry ID CRD 42023391339</jats:p