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      National and Subnational Population-Based Incidence of Cancer in Thailand: Assessing Cancers with the Highest Burdens

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          Abstract

          In Thailand, five cancer types—breast, cervical, colorectal, liver and lung cancer—contribute to over half of the cancer burden. The magnitude of these cancers must be quantified over time to assess previous health policies and highlight future trajectories for targeted prevention efforts. We provide a comprehensive assessment of these five cancers nationally and subnationally, with trend analysis, projections, and number of cases expected for the year 2025 using cancer registry data. We found that breast (average annual percent change (AAPC): 3.1%) and colorectal cancer (female AAPC: 3.3%, male AAPC: 4.1%) are increasing while cervical cancer (AAPC: −4.4%) is decreasing nationwide. However, liver and lung cancers exhibit disproportionately higher burdens in the northeast and north regions, respectively. Lung cancer increased significantly in northeastern and southern women, despite low smoking rates. Liver cancers are expected to increase in the northern males and females. Liver cancer increased in the south, despite the absence of the liver fluke, a known factor, in this region. Our findings are presented in the context of health policy, population dynamics and serve to provide evidence for future prevention strategies. Our subnational estimates provide a basis for understanding variations in region-specific risk factor profiles that contribute to incidence trends over time.

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          Lung cancer in never smokers--a different disease.

          Although most lung cancers are a result of smoking, approximately 25% of lung cancer cases worldwide are not attributable to tobacco use, accounting for over 300,000 deaths each year. Striking differences in the epidemiological, clinical and molecular characteristics of lung cancers arising in never smokers versus smokers have been identified, suggesting that they are separate entities. This Review summarizes our current knowledge of this unique and poorly understood disease.
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            Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis.

            The proportion of women infected with human papillomavirus (HPV) varies greatly across populations, as might the distribution of HPV types. We aimed to compare HPV-type distribution in representative samples of women from different world regions. Women were randomly selected from the general population of 13 areas from 11 countries (Nigeria, India, Vietnam, Thailand, Korea, Colombia, Argentina, Chile, the Netherlands, Italy, and Spain). A standardised protocol was used for cervical specimen collection. All HPV testing was by GP5+/6+ PCR-based EIA. The proportion of HPV-positive women infected with different HPV types was compared by study area and between pooled regions with age-adjusted odds ratios (ORs) with corresponding 95% floating CIs. 15 613 women aged 15-74 years without cytological abnormalities were included in a pooled analysis. Age-standardised HPV prevalence varied nearly 20 times between populations, from 1.4% (95% CI 0.5-2.2) in Spain to 25.6% (22.4-28.8) in Nigeria. Although both overall HPV prevalence and HPV16 prevalence were highest in sub-Saharan Africa, HPV-positive women in Europe were significantly more likely to be infected with HPV16 than were those in sub-Saharan Africa (OR 2.64, p=0.0002), and were significantly less likely to be infected with high-risk HPV types other than HPV16 (OR 0.57, p=0.004) and/or low-risk HPV types (OR 0.44. p=0.0002). Women from South America had HPV-type distribution in between those from sub-Saharan Africa and Europe. Heterogeneity between areas of Asia was significant. Heterogeneity in HPV type distribution among women from different populations should be taken into account when developing screening tests for the virus and predicting the effect of vaccines on the incidence of infection.
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              Cigarette smoking and lung cancer--relative risk estimates for the major histological types from a pooled analysis of case-control studies.

              Lung cancer is mainly caused by smoking, but the quantitative relations between smoking and histologic subtypes of lung cancer remain inconclusive. By using one of the largest lung cancer datasets ever assembled, we explored the impact of smoking on risks of the major cell types of lung cancer. This pooled analysis included 13,169 cases and 16,010 controls from Europe and Canada. Studies with population controls comprised 66.5% of the subjects. Adenocarcinoma (AdCa) was the most prevalent subtype in never smokers and in women. Squamous cell carcinoma (SqCC) predominated in male smokers. Age-adjusted odds ratios (ORs) were estimated with logistic regression. ORs were elevated for all metrics of exposure to cigarette smoke and were higher for SqCC and small cell lung cancer (SCLC) than for AdCa. Current male smokers with an average daily dose of >30 cigarettes had ORs of 103.5 (95% confidence interval (CI): 74.8-143.2) for SqCC, 111.3 (95% CI: 69.8-177.5) for SCLC and 21.9 (95% CI: 16.6-29.0) for AdCa. In women, the corresponding ORs were 62.7 (95% CI: 31.5-124.6), 108.6 (95% CI: 50.7-232.8) and 16.8 (95% CI: 9.2-30.6), respectively. Although ORs started to decline soon after quitting, they did not fully return to the baseline risk of never smokers even 35 years after cessation. The major result that smoking exerted a steeper risk gradient on SqCC and SCLC than on AdCa is in line with previous population data and biological understanding of lung cancer development. Copyright © 2011 UICC.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Cancers (Basel)
                Cancers (Basel)
                cancers
                Cancers
                MDPI
                2072-6694
                17 August 2017
                August 2017
                : 9
                : 8
                : 108
                Affiliations
                [1 ]Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Thailand; shamav@ 123456umich.edu (S.V.); surichai.bil@ 123456gmail.com (S.B.)
                [2 ]Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; rozekl@ 123456umich.edu
                [3 ]Cancer Registry Unit, Surat Thani Cancer Hospital, Surath Thani 84100, Thailand; wasan1013@ 123456gmail.com (W.C); sukitsi91@ 123456gmail.com (S.T.)
                [4 ]Chiang Mai Cancer Registry, Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; imjai@ 123456hotmail.com
                [5 ]Cancer Registry Unit, Lampang Cancer Hospital, Lampang 52000, Thailand; kdaoprasert@ 123456gmail.com (K.D.); donsukp@ 123456hotmail.com (D.P.)
                [6 ]Cancer Unit, Lopburi Cancer Center, Lopburi 15000, Thailand; s098030971@ 123456yahoo.co.th (S.K.); s098030971@ 123456yahoo.co.th (A.L.); catsurattaya@ 123456hotmail.com (S.S.)
                [7 ]Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; ksuwanrungruang@ 123456gmail.com (K.S.); patvat@ 123456kku.ac.th (P.V.)
                Author notes
                [* ]Correspondence: hutcha.s@ 123456gmail.com ; Tel.: +66-744-51-165
                Author information
                https://orcid.org/0000-0002-1163-432X
                https://orcid.org/0000-0002-8552-0149
                https://orcid.org/0000-0002-8149-561X
                https://orcid.org/0000-0002-7993-9912
                https://orcid.org/0000-0002-3637-5109
                https://orcid.org/0000-0001-6037-8994
                https://orcid.org/0000-0002-8483-0460
                Article
                cancers-09-00108
                10.3390/cancers9080108
                5575611
                28817104
                4b472313-1596-4376-bde3-0e8ec9ffe56d
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 05 July 2017
                : 12 August 2017
                Categories
                Article

                thailand,incidence,trends,projections,health policy
                thailand, incidence, trends, projections, health policy

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