Latest news with #Epidemiology
Medscape
6 days ago
- Health
- Medscape
CRC Outcomes Better When First of Multiple Cancers
Colorectal cancer (CRC) survival is longer when it's the first of multiple primary malignancies than when it's the second or solo, new data suggest. The findings came from a retrospective analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database of more than half a million people in the US with primary CRC. They were divided into three groups: Group A, with CRC as their only malignancy; group B, with CRC as the first with one or more subsequent primary malignancies; and group C, with CRC as the second of multiple primary malignancies. The finding that Group B had the highest 5-year survival of the three groups is novel and surprised the authors, but they have some theories to explain it. 'We potentially thought group A would do the best, seeing as they only had one type of cancer. But what we found…is that [group B] actually had the best survival outcome. It could have something to do with the tumor characteristics at a molecular biological level, or potentially because of increased surveillance from having colorectal cancer first,' first author Anjelli Wignakumar, MD, told Medscape Medical News . On the other hand, those in group A tended to be younger and to present with more aggressive disease, although they still fared better than did those in group C. 'There are lots of potential explanations,' said Wignakumar, a clinical research fellow in Colorectal Department, Cleveland Clinic, Weston, Florida. Clinically, the takeaway is for comprehensive screening for other types of cancer in people with primary cancers, and in particular screening for CRC in people with other primary cancers. 'Depending on the patient's family history and other things, increasing that screening hopefully increases our risk of picking up something earlier,' she said. Of the total 592,063 patients with CRC in SEER from 2000-2020, 71.8% were in group A, 11.9% in group B, and 16.3% in group C. Group B included a higher proportion of men (57.1% vs 51.8% and 53.1% for A and C, respectively; P < .001). Group A was significantly younger at CRC presentation (65.7 years vs 67.3 years and 72.6 years, for B and C, respectively; P < .001). Those in group A were more likely to have elevated pretreatment tumor marker carcinoembryonic antigen (49.7% vs 43.2% and 46.9%, in B and C, respectively; P < .001) and presented more often with liver metastases (17.5% vs 7.4% and 12.1%, respectively; P < .001) or lung metastases (6.3% vs 2.5% and 4.2%, respectively, P < .001). Right-sided CRC, which has been associated with worse survival compared to left-sided, was more common in group C (38.6%), while left-sided colonic cancer, associated with better survival, was more common in group B (37.9%). Both were significant compared to the other groups ( P < .001). Surgical treatment was recommended significantly ( P < .001) more often for group B (20.5%) than for groups A (13.0%) or C (14.3%), while systemic adjuvant therapy was given significantly ( P < .001) more often to those in group A (29.0%) than groups B (27.8%) or C (21.3%). Compared to group B, overall 5-year mortality hazard ratios were 1.26 for group A, which could be attributed to their more advanced disease, the authors said. Those in group C also had higher 5-year mortality (1.66). Those were both statistically significant, with similar trends for cancer-specific mortality. Mean 5-year survival was 50.4 months for group B, significantly ( P < .001) longer than the 41.8 months for group A and 39.2 months for group C. In their discussion in the paper, Wignakumar and colleagues presented a variety of hypotheses about the findings, including that group B might have a distinct immune profile that 'enhances their ability to survive multiple cancers and potentially improve their responsiveness to treatment.' Alternatively, 'Patients who develop a second primary cancer have already demonstrated resilience, having endured the physical and emotional challenges of their initial cancer treatment. This experience may reflect a stronger baseline health status and the benefits of previous successful interventions, contributing to potentially better survival outcomes compared with those facing cancer for the first time.' Wignakumar had no disclosures.
Arab Times
15-06-2025
- Health
- Arab Times
Rare appendix cancer increasing in younger adults, research shows
NEW YORK, June 15: Though still extremely rare, appendix cancer is becoming more common, particularly among younger generations, according to a new study published in the Annals of Internal Medicine. An analysis of data from the National Cancer Institute has revealed that rates of appendix cancer have tripled among Generation X and quadrupled among millennials when compared to older generations. 'There is a disproportionate burden of appendix cancer among young individuals,' said Dr. Andreana Holowatyj, the study's lead author and assistant professor of hematology and oncology at Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center. Holowatyj noted that earlier research had already shown that one in three appendix cancer cases occurs in adults under 50, a significant contrast to colorectal cancer, where only one in eight cases affects those under 50. Appendix cancer remains extremely rare, with the National Cancer Institute estimating an annual incidence of only 1 to 2 cases per million people in the U.S. To examine trends over time, Holowatyj and her team analyzed data from the Surveillance, Epidemiology, and End Results (SEER) program, which covers nearly half of the U.S. population. Between 1975 and 2019, a total of 4,858 appendix cancer cases were recorded. The generational increase in younger patients diagnosed with appendix cancer highlights the urgent need to investigate underlying causes, Holowatyj said. 'It's important that we find the causes underpinning these statistics in order to reverse this trend and reduce the disease burden.' Experts say this pattern reflects a broader rise in gastrointestinal cancers among younger adults. Dr. Andrea Cercek, co-director of the Center for Early Onset Colorectal and GI Cancers at Memorial Sloan Kettering Cancer Center, emphasized that while the exact cause remains unclear, environmental and lifestyle factors may be playing a role. 'It's likely that there are environmental causes, including exposures through food, water, and microplastics, as well as lifestyle and dietary changes,' Cercek said. 'It's probably not one single factor but multiple contributing elements since 1945.' The appendix, a small pouch attached to the large intestine, is best known for causing appendicitis. Unlike other gastrointestinal cancers, appendix cancers are harder to detect on scans or through colonoscopy. Dr. Deborah Doroshow of the Icahn School of Medicine at Mount Sinai noted that most appendix cancers are not identified until after a patient undergoes surgery for appendicitis. 'About 95% of appendix cancers are discovered only after removal and pathological examination of the appendix,' Holowatyj added. This typically results in later-stage diagnoses and poorer outcomes. Doroshow, who was not involved in the study, stressed the importance of paying attention to subtle symptoms, especially among younger people. Persistent fatigue, unexplained pain, or weight loss should not be overlooked. 'If a person feels something is wrong, it's always best to seek a medical opinion,' Doroshow said. 'We've seen young patients with cancer who were initially dismissed because of their age.' She also urged women and people of color to advocate for themselves, as their concerns are more likely to be underestimated. Still, Doroshow cautioned against overreacting to occasional discomfort. 'Not every abdominal pain is a cause for concern,' she said. 'It's the persistent or unusual symptoms that should prompt evaluation.'
Newsweek
10-06-2025
- Health
- Newsweek
Quadruple Rise in Uncommon Cancer Seen in Older Millennials
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. A new study has found a striking increase in appendix cancer in Americans born after 1945, with older millennials experiencing the most dramatic rise. Appendix cancer, according to the National Cancer Institute, is fortunately very rare, affecting only about 1–2 people in every million annually. However, the study led by researchers at Vanderbilt University Medical Center in Nashville, Tennessee, found that appendiceal adenocarcinoma (AA) diagnoses have more than tripled in those born around 1980 and quadrupled in those born around 1985. While older millennials were those with the highest number of diagnoses, researchers believe that as higher-risk birth cohorts continue to age, it is likely that AA incidence rates will increase in the future. The study was based on data from the National Cancer Institute SEER (Surveillance, Epidemiology, and End Results) Program, with the researchers analyzing the incidence of AA in people aged 20 or older from 1975 to 2019. In total, they examined 4,858 confirmed cases. A stock image shows a doctor pressing on a young woman's appendix. A stock image shows a doctor pressing on a young woman's appendix. getty images According to the Cleveland Clinic, sex and age are risk factors for appendix cancer; women are more likely to develop AA, are are those aged 50 and over. Other factors include smoking, a family history of cancer and health conditions such as atrophic gastritis (where the stomach lining becomes chronically inflamed), pernicious anemia (an autoimmune condition which affects the red blood cells) and Zollinger–Ellison syndrome (in which tumors cause ulcers in the stomach and upper small intestine), which have all been linked to a higher risk. Symptoms of appendix cancer vary from person to person—and sometimes can be asymptomatic. When present, symptoms usually include appendicitis, bloating, fluid buildup in the abdomen, increase in waist size, pain in the abdomen or pelvis, changes in bowel habits, nausea, vomiting and a tendency to feel full. According to the Centers for Disease Control and Prevention (CDC), risk factors for cancer in general include alcohol usage, HPV and obesity, which is associated with a higher risk of 13 types of cancer. These include adenocarcinoma of the esophagus, breast, colon/rectum, uterus, gallbladder, upper stomach, kidneys, liver, ovaries, pancreas, thyroid, meningioma, and multiple myeloma. Do you have a tip on a science story that Newsweek should be covering? Do you have a question about appendiceal adenocarcinoma? Let us know via science@ Reference Holowatyj, A. N., Washington, M. K., Goldberg, R. M., & Murphy, C. C. (2025). Birth cohort effects in appendiceal adenocarcinoma incidence across the United States. Annals of Internal Medicine, 178(7).
Gizmodo
09-06-2025
- Health
- Gizmodo
The Upsetting Truth About What Wildfire Smoke Does to Your Body
Much of Canada is ablaze again, with more than 200 active wildfires having consumed roughly 10,000 square miles (26,000 square kilometers) since January, the Canadian Interagency Forest Fire Centre reported Thursday, June 5. This escalating situation pumped massive amounts of smoke across the Canada-U.S. border, affecting air quality as far south as Florida, according to the National Oceanic and Atmospheric Administration (NOAA). As climate change lengthens and intensifies wildfire season in many regions across the world, understanding the dangers of smoke exposure is increasingly important. A wave of new research paints a complex picture of how wildfire smoke impacts the body, linking it to startling health outcomes that go far beyond the respiratory system. 'There is an urgent need for research to fully understand the health impacts of wildfire smoke to raise awareness among public and health professionals, as well as to support the development of effective regulations to mitigate the impacts,' Yaguang Wei, assistant professor of environmental medicine at Mount Sinai's Icahn School of Medicine, recently told the Harvard Gazette. Wei is the lead author of a new study, published in May in the journal Epidemiology, which found that wildfire smoke can damage the lungs and heart for up to three months after the fire is out. He and his colleagues linked this 'medium-term' exposure to increased risks of various cardiorespiratory conditions, including heart disease, stroke, high blood pressure, pneumonia, chronic lung disease, and asthma. 'Even brief exposures from smaller fires that last only a few days can lead to long-lasting health effects,' Wei told the Harvard Gazette. Infectious fumes Wildfire smoke is a mixture of gases, air pollutants, water vapor, and fine particulate matter (PM2.5), according to the Environmental Protection Agency (EPA). It contains significant levels of toxic compounds such as polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), some of which are known carcinogens. Recent studies even suggest that wildfire smoke carries microbial and fungal pathogens. One such study, published in the ISME Journal in 2021, noted that 80% of microbes found in wildfire smoke samples were still viable. While it's still unclear how these organisms survive the extremely high temperatures in wildfires, researchers do have an idea of how they get into the smoke in the first place. George Thompson, a professor of medicine at the University of California, Davis, who was not involved in the study, told Gizmodo that wildfires pull pathogens from the surrounding soil and vegetation as they draw in air. 'The good news is, most of those bacteria and fungi really don't cause infections [in healthy individuals],' Thompson said. 'We're most concerned for our patients whose immune systems have been impacted already,' such as those receiving chemotherapy or recovering from trauma, he added. A 2023 study, however, found evidence to suggest that wildfire smoke could raise infection risk among the general population. The findings, published in The Lancet, Planetary Health, associated California wildfires with an 18% to 22% increase in invasive fungal infections such as valley fever. Thompson pointed out that the study was based on large hospital data, which is 'a great start,' but further research will need to corroborate this link. The brain on fire The most hazardous component of wildfire smoke is not pathogens, but PM2.5. These minuscule particles penetrate deep inside the lungs and wreak havoc on the respiratory system. Previous research has shown that the tiniest, ultrafine particles can pass from the lungs directly into the bloodstream. This can damage blood vessels and trigger harmful inflammation and oxidative stress in various organs, including the brain. Multiple studies have associated wildfire smoke exposure with incidence of dementia. Last year, research published in JAMA Neurology analyzed health data from more than 1.2 million Southern Californians aged 60 and older, and found a significant link between long-term exposure to wildfire-related PM2.5 and a heightened risk of dementia. Specifically, every 1 microgram per cubic meter increase in the three-year average of wildfire PM2.5 raised the odds of a dementia diagnosis by 18%. In comparison, the same increase in PM2.5 from non-wildfire sources was linked to only a 1% greater risk of developing dementia. 'I was expecting for us to see an association between wildfire smoke exposure and dementia,' lead author Holly Elser, an epidemiologist and resident physician in neurology at the University of Pennsylvania, told the Los Angeles Times in 2024. 'But the fact we see so much stronger of an association for wildfire as compared to non-wildfire smoke exposure was kind of surprising.' Psychological fallout Other studies have linked wildfire smoke to adverse psychological outcomes. Research published in JAMA Network Open in April analyzed data on wildfire PM2.5 levels and mental health-related emergency department visits throughout California between July and December 2022—the state's worst wildfire season on record. The study found that wildfire smoke correlated with a significant spike in mental health emergency department visits for up to seven days post-exposure. 'Our study suggests that—in addition to the trauma a wildfire can induce—smoke itself may play a direct role in worsening mental health conditions like depression, anxiety, and mood disorders,' co-author Kari Nadeau, a physician-scientist at the Harvard T.H. Chan School of Public Health, said in a university statement. Questions remain All of this research demonstrates that wildfire smoke is more than just a respiratory hazard. But experts are still in the early stages of unraveling its complex health impacts—particularly in terms of mental health, Angela Yao, a senior scientist with the Environmental Health Services at the B.C. Centre for Disease Control in Canada, told Gizmodo. Many questions remain unanswered, she said. For example, 'How do you disentangle the impact of smoke from the impact of the fire itself?' Future studies will need to investigate these confounding factors. But, 'even with the current evidence that we have—it already gives us confidence that we should take a lot of action,' she added. To protect yourself from the hazards of wildfire smoke, Yao recommended limiting the length and intensity of time spent outdoors. 'The harder you breathe, the more smoke you inhale,' she said. If you must go outside, wearing an N95 mask or a P100 can reduce your smoke exposure, according to the EPA. Keep windows and doors shut to ensure that your indoor air is safe. It's also important to make sure your home's HVAC system is running properly, Yao added. If you don't have one, you can purchase a portable air filter or build your own using a furnace filter and a box fan. As wildfire season becomes increasingly impactful, taking steps to protect yourself and your family from smoke has never been more critical. Experts still have a long way to go towards fully understanding the risks of wildfire exposure, but one thing is clear—these hazards aren't going away any time soon.
Medscape
19-05-2025
- Health
- Medscape
No Increased Mortality Seen in axSpA Patients With Cancer
TORONTO — Older patients with axial spondyloarthritis (axSpA) are known to have a higher overall risk for cancer than the general population, but new evidence from a large population-based study indicated that when these patients have concurrent breast, lung, prostate, or colorectal cancer — the four most common cancer types — their rates of overall survival (OS) and cancer-specific survival (CSS) are similar to or better than those of patients with cancer alone. Results from this new analysis of data from Medicare claims linked to the Surveillance, Epidemiology, and End Results database also showed that the rates of OS and CSS were significantly higher for patients with axSpA and concomitant colorectal cancer than for patients with colorectal cancer but not axSpA, even though past evidence suggested that for older patients with some other rheumatic diseases, there are worse cancer survival outcomes — for instance, patients with rheumatoid arthritis and concomitant breast or prostate cancer and those with systemic lupus erythematosus and breast cancer. 'We're not entirely sure why survival rates were higher in colorectal cancer patients with axSpA, but it's likely the use of [nonsteroidal anti-inflammatory drugs] NSAIDs in the treatment of axSpA played a role,' study presenter Savannah M. Bowman, MD, of Baylor College of Medicine in Houston told Medscape Medical News at the Spondyloarthritis Research and Treatment Network (SPARTAN) 2025 Annual Meeting. The hazard ratio (HR) for 5-year OS from colorectal cancer in patients with axSpA was 0.72 (95% CI, 0.62-0.83; P < .0001), and the HR for 5-year CSS was 0.73 (95% CI, 0.55-0.97; P = .03). There were also no significant differences in OS and CSS in patients with axSpA and concomitant breast, prostate, or lung cancer compared with patients with cancer alone, with HRs of 0.87, 0.97, and 0.94, respectively. When asked to comment on the study findings, John D. Reveille, MD, professor of rheumatology at the University of Texas McGovern Medical School, Houston, said that the better survival rates seen in patients with axSpA may result from the close monitoring they receive because of their increased risk for inflammatory bowel disease. 'It's likely these patients had colonoscopy [or other colorectal cancer screenings], and that this detected cancer earlier [than in patients without axSpA]. This would have resulted in better survival,' said Reveille, who was not involved in the study. For the analysis, Bowman and study co-authors examined data from 6103 patients, with and without axSpA, and a primary diagnosis of breast, prostate, colorectal, or lung cancer between 2006 and 2019. Of these patients, 2061 had breast cancer, 1988 had prostate cancer, 1234 had lung cancer, and 820 had colorectal cancer. The mean age ranged from 74 to 77 years. Patients in the axSpA cohorts were required to have two or more claims with a diagnosis of axSpA either 12 months before or after cancer diagnosis. They were matched to controls by gender, cancer type and stage, age at cancer diagnosis, and year of cancer diagnosis. Patients with diagnostic claims for connective tissue diseases were excluded from the control cohorts. Survival time was assessed using Kaplan-Meier analysis and log-rank tests. Cox proportional hazard regression models were performed for each type of cancer and adjusted for competing risks for CSS. 'Further research is needed to explore the potential reasons for longer survival in elderly patients with colorectal cancer and axSpA compared to those without axSpA,' the investigators concluded. Reveille agreed. 'The lack of previous research on colorectal cancer in axSpA patients suggests a need for further studies,' he told Medscape Medical News. Bowman said she plans to use the IQVIA claims database to conduct the same analysis in younger patients. She would also like to analyze the impact of treatment with tumor necrosis factor inhibitors, interleukin 17 inhibitors, and Janus kinase inhibitors on cancer outcomes in patients with axSpA.
