Examining the relationship between incidence and mortality for commonly diagnosed cancers in the USA: an observational study using population-based SEER database

Objective
Incidence and mortality are fundamental epidemiologic measures of cancer burden, yet few studies have examined individual cancers to determine how these measures correlate across place. We assessed the relationship between incidence and mortality for commonly diagnosed cancers in the USA.

Design
Population-based observational study of US counties.

Setting and participants
The Surveillance, Epidemiology and End Results (SEER) database was used to obtain incidence (2000–2016) and mortality (2002–2018) data for the 12 most commonly diagnosed non-haematologic cancers.

Outcome measures
County-level correlation between cancer incidence and mortality. Cancers were grouped into terciles based on the population-weighted correlation coefficient (r). We also examined the 10 year risk of death, both from the diagnosed cancer and other causes.

Results
County-level incidence and mortality were strongly correlated in some cancers, yet uncorrelated in others. Cancers in the high-correlation tercile (r range: 0.96 to 0.78) included lung, stomach, liver and pancreas. For patients with these cancers, the risk of death from the diagnosed cancer was >4-times the risk of death from other causes. The moderate-correlation tercile (r: 0.75 to 0.58) included cancers of the colon, bladder, kidney and uterus. There was little or no relationship between incidence and mortality for cancers in the low-correlation tercile (r: 0.33 to –0.10): melanoma, prostate, breast and thyroid. The risk of death from the diagnosed cancer for these patients was either lower or no different than their risk of death from other causes.

Conclusions
For some cancers in the USA, the fundamental epidemiologic measure of disease frequency—incidence—now has little relationship with cancer death (mortality). Low correlations are most likely explained by differences in diagnostic practice leading to variable amounts of cancer overdiagnosis between different US counties.

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Abstract 161: Cooling the Intestines Offers Superior Protection in the Mouse Stroke Model

Stroke, Volume 56, Issue Suppl_1, Page A161-A161, February 1, 2025. Background:Intestinal immune response plays a detrimental role following a stroke. The objective of this study aims to investigate if cooling the gut can protect the brain against ischemic injury.Methods:Mice were subjected to 60 min middle cerebral artery occlusion (MCAO) followed by 7 days of reperfusion. The experimental groups were: (i) normothermic group (NT) (n=11); (ii) colon cooling (CC) group (n=13); and (iii) surface cooling (SC) group (n=15). A temperature management catheter was inserted via the rectum into the descending colon to maintain the colon temperature at 37°C (NT group) and at 15°C (CC group), while the esophageal temperature was kept as close to 37°C as possible for both groups. In the SC group, both esophageal and colon temperatures were maintained at the same level as the esophageal temperature in the CC group. Temperature management was initiated at 30 min reperfusion and continued for 3 hours. The regional cerebral blood flow (rCBF) was measured during the peri-MCAO period. Bodyweight, behavioral deficits (nesting, pole test, and Y-maze), and neurological scores were examined daily until the 7-day endpoint. At the endpoint, mice were perfusion-fixed for histopathological analysis.Results:The rCBF was reduced below 10% of the preischemic level during the entire 60 min MCAO period. It returned to the preischemic level at 10 min post-MCAO but gradually declined to 50% of the preischemic level in CC and SC groups and to 70% in NT group by the end of temperature management. Stroke volume was the smallest in CC, smaller in SC, but the largest in NT group. Bodyweight continuously declined in SC and NT but recovered in CC group post-MCAO. Nest building activity and pole test deficits improved in CC but remained in NT or SC group. Neurological score deficits were recovered in CC, partially recovered in SC, but not recovered in NT group. The mortality rate was the lowest in CC, lower in SC, and the highest in NT group. Stroke volumes and behavioral deficits were significantly reduced in the CC compared to the NT group (p

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