trends in incidence, mortality and survival of penile squamous cell carcinoma in norway 1956-2015 bo t. hansen资料.pdf

该【trends in incidence, mortality and survival of penile squamous cell carcinoma in norway 1956-2015 bo t. hansen资料 】是由【小舍儿】上传分享，文档一共【19】页，该文档可以免费在线阅读，需要了解更多关于【trends in incidence, mortality and survival of penile squamous cell carcinoma in norway 1956-2015 bo t. hansen资料 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。:..Trendsinincidence,mortalityandsurvivalofpenilesquamouscellcarcinomainNorway1956-2015Authors:*,MadleenOrumaa1,,Bj?rnBrennhovd3,MariNyg?rd1Affiliations:1DepartmentofResearch,CancerRegistryofNorway,Oslo,Norway,E-mail:.******@,mari.******@,madleen.******@,CenterforLaboratoryMedicine,?stfoldHospitalTrust,Norway,E-mail:.******@so-,TransplantationandSurgery,OsloUniversityHospital,Oslo,Norway,E-mail:******@ous-*Correspondingauthor:BoTerningHansen,DepartmentofResearch,CancerRegistryofNorway,,N-0304,Oslo,Norway;Phone:+4723333959;E-mail:.******@,maintext:3400Keywords:epidemiology,relativesurvival,incidence,mortality,penilecancerNoveltyandimpact:hasincreasedinNorwayoveraperiodof60years,,whilesurvivaldidnotchangesignificantly,,,typesetting,‘AcceptedArticle’,doi:.Allrightsreserved.:..InternationalJournalofCancerPage2of19Abstractrendsinincidence,mortalityandsurvivalofpenilesquamouscellcarcinoma(SCC)--incidence,mortalityand5--2015,amongwhich1474(%).During2011-2015,theage-(95%confidenceinterval(CI):;)(;)per100,000,respectively,andthe5-%(;).Theincreasedduring1956-2015,withanaverageannualpercentagechange(AAPC)%(;).Theincreasewasstrongestamongmendiagnosedatarelativelyearlyage(age<=64years;AAPC:%(;)).Mortalityalsoincreasedoverthestudyperiod(AAPC:%(;)),whereas5-yearrelativesurvivaldidnotchange(AAPC:%(-;)).hasincreasedatamoderateandconstantrateduring1956-2015,,survivaldidnotchange,(HPV),&Sons,.:..Page3of19InternationalJournalofCancerIntroductionPenilecancerisararedisease,uratratesaround1per100,000meninseveralWesterncountries[1-3],whilesomewhathigherrateshavebeenreportedfromcountriesinAfrica,AsiaandSouth-,300peryear[4].Squamouscellcarcinomas(SCC)accountforthevastmajorityofpenilecancercases[5].Penileasionallyalsomaypresentinyoungermen[67].Prognosticfactorsforpenilecancerincludeadvancedage,tumorstage,histologicgradeandsubtype,presenceofperineuralandlymphaticinfiltration,depthofinfiltrationandlymphnodeinvolvementatdiagnosis[589].Thetreatmentofpenilecancerisoftenmutilating[10],andmaynegativelyimpactonthequalityoflifeandsexualfunctioningofpatients[1112].Thetreatmentcostpercaseofpenilecancerissubstantial,parabletothatofotherurologicalcancers[13].Strongriskfactorsforpenilecancerincludephimosisandchronicinflammatoryconditions[14].Theincreasedriskofpenilecanceramongmenwithphimosisisassociatedwithlichensclerosisorinadequatepenilehygiene,-analysisshowedthatchildhoodcircumcisionmayhaveaprotectiveeffectagainstpenilecancer[15],possiblyduetoareductioninthesusceptibilitytoinfectionbyhyperkeratosisontheglanspenisand/(HPV)-48%,HPV16,18and6/11arethe,andHPVismoststrongly[1617].Ahighernumberofsexualpartnersandahistoryofgenitalwartsalsoincreasepenilecancerrisk[18],[1819],whichmaybeassociatedwithincreasedsusceptibilitytoinfection[20].AnincreaseintheincidenceofsomeHPV-relatedcarcinomashasbeenreported,mostconsistentlyforcarcinomasoftheanus,oropharynxandcervicaladenocarcinoma[4].Trendanalysesforpenilecancerseemlessclear-cut,somestudiesreportingadecrease[6],somenochange[21]andsomeanincrease[3].Fewstudieshaveexaminedtrendsinpenilecancermortalityand/orsurvival,esaresmallandmayalsodifferbetweengeographicalregions[222].rendsinincidence,inNorwayduringtheperiod1956-,andbecauseitination[23].WealsodescribecharacteristicsofallprimarycasesofpeniletumorsdiagnosedinNorwayduringthis60-&Sons,.:..InternationalJournalofCancerPage4of19DataPenilecancerdatawasextractedfromtheCancerRegistryofNorway(CRN).Since1953,,andtheCRNreceivesdatafromclinicians,pathologylaboratoriesandtheCauseofDeathRegistry,pletenessandquality[24].,weextractedthepatient’sdateofbirthandvitalstatus(,emigrationdateordeathdate),andthetumorlocalization,morphology,,migrationorendofstudy(),(preputium),(glanspenis),(penilecorpus),(overlappingsitesofpenis)(penisNOS),andmorphologycodesfromICD-O--(withoutmetastases),regionalspread(anyinfiltrationintosurroundingareasorregionalmetastases),(Table1).StatisticsWecalculatedincidenceandmortalityratesper100,000person-yearswithcorresponding95%confidenceintervals(CI),usingtheWorldStandardPopulation[25]forage---[26],applyingnationalpopulationlife-tablesformalesbyage--standardisedusingtheInternationalCancerSurvivalStandardweights[27].Whenthestandardweightingcouldnotbeusedduetosparsedata,age-standardisedestimateswereobtainedbythealternativeweightingmethodproposedbyBrenner[28].Thecohort-approachwasusedforpatientswhohadcompleted5-yearfollow--approachwasusedtoestimate5-yearrelativesurvivalforthemostrecentcohorts(2011-2015)[29].Onlypatientswithlocalizedtumorsandregionalspreadwereincludedinthe5-(n=97)orwithdistantmetastases(n=73),,anddetermineshowmany(ifany)joinpointsshouldbeusedtobestdescribetrendsinthedata[30].TheJohnWiley&Sons,.:..Page5of19InternationalJournalofCancerannualpercentagechange(APC)with95%,respectively,andtherehadtobeatleastfourdatapointsbetweenanyjoinpoints,(AAPC)overthewhole60-yearperiod1956-,theAAPCistheaverageoftheindividualAPCsweightedbythelengthofeachsegment[31].Foroverallanalyseswithnoidentifiedjoinpoints,,weusedfive-yearlyratesduetoalownumberofstage-,weusedtheagestrata<=64,65-74and>=75,-sidedP-valueswereconsideredsignificantwhentheywere<,1596casesofpenilecancerwerediagnosedinNorwayduringtheperiod1956-,%ofallcases,%ofallpenilecancersoccurredamongmenage75orolder(Table1).Thenumberofcasesmorethandoubledfromthefirsttothelastdecadeofthestudyperiod,fromatotalof189casesin1956-1965to419casesin2006-2015(Table1).Themajorityoftumorsoriginatedfromtheglanspenis(%)orthepreputium(%),%originatedfromthepenilecorpus(Table1).Thetumororiginfortheremainingcaseswasoverlappingbetweenpenilesubsites(%),orunknown(%).%ofthetotalpenilecancercases(Table1).Theremainingtypesincludedmalignantmelanoma(%),Paget’sdisease(%),adenocarcinoma(%),a(%)andadiversegroupofotherhistologicaltypes(%)(Table1).Atdiagnosis,%oftumorswerelocalized,%hadspreadregionally,%%hadanunknowntumorstageatdiagnosis(Table1).was69years(1st,3rdquartile:59,78years).asesdiagnosedpeakedaroundage70,afterwhichitdeclined(Figure1),whiletheage-specificincidencerateincreasedwithageandwashighestamongmenage85orolder,,,formostage-groups,aseswashigherduring1996-2015thanduringthepreviousdecades(Figure1).JohnWiley&Sons,.:..InternationalJournalofCancerPage6of19Theage-forthemostrecentfive-yearperiod(2011-2015),000person-years(95%CI:,).Thenumberofcasesandtheage-standardisedincidenceratesfluctuatedduring1956-2000,whilethethreemostrecent5-yearperiods(2001-2015)hadparedtothepreviousperiods(Table2).However,didnotincludeanyjoinpoints,andhencedescribesaconstantlyincreasingage-standardisedincidenceduringtheperiod1956-2015(Figure2a).Theincreasingincidencetrendwasstatisticallysignificant,withanaverageannualpercentagechange(AAPC)%(95%CI:;)(Table3).Age-stratifiedanalysesshowedthattheaverageincreaseoverthewhole60-yearperiodwassignificantonlyformendiagnosedatage64yearsoryounger(AAPC:%(95%CI:;)).Theincreasewaslesspronouncedandnon-significantformendiagnosedatage65-74years(AAPC:%(95%CI:-;))andage75yearsorolder(AAPC:%(95%CI:-;)).Theincidencetrendformendiagnosedatage65-74yearsincludedjoinpointsin1971,1991and1996(Table3).age-standardisedmortalityrateforthemostrecentfive-yearperiod(2011-2015),000person-years(95%CI:,).Themortalityrateswerequitestableoverthe60-yearperiodinvestigated(Table2).Withtheexceptionofthefirstfive-yearperiod(1956-1960),whichhadarelativelylowmortalityrate,thedifferenceinmortalitybetweenanyfive--fittingtrendmodeldidnotincludea