Comprehensive analysis of cutaneous T-cell lymphoma (CTCL) incidence and mortality in Canada reveals changing trends and geographic clustering for this malignancy
Comprehensive analysis of cutaneous T-cell lymphoma (CTCL) incidence and mortality in Canada reveals changing trends and geographic clustering for this malignancy
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DOI：
10.1002/cncr.30758
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发表时间：
2017-09-15
期刊：
影响因子：
6.2
通讯作者：
Litvinov, Ivan V.
中科院分区：
文献类型：
--
作者：
Ghazawi, Feras M.;Netchiporouk, Elena;Litvinov, Ivan V.
背景以前的报告的地理聚集性皮肤T细胞淋巴瘤（CTCL）在得克萨斯州，匹兹堡，瑞典以及CTCL的发生在已婚夫妇和家庭成员提出了一种可能性存在的外部和潜在的可预防的触发（S）为这种罕见的皮肤cancer. METHODS作者研究了CTCL的发病率和死亡率在加拿大使用3个不同的人口为基础的癌症数据库。分析患者的性别、确诊时年龄、CTCL恶性肿瘤亚型、报告省份、城市和邮政编码等资料。使用地理信息系统软件绘制了整个加拿大的CTCL病例图。在1992年至2010年期间，加拿大共确定了6685例CTCL患者（CTCL发病率，每年每百万人11.32例），其中58%为男性。诊断时的平均年龄为59.4 - 21.5岁。对患者的地理分析显示，在东部几个省和马尼托巴省，省和市的CTCL发病率增加。根据邮政编码（前向分拣区[FSA]）进行的分析确定了几个高发FSA连续或相邻的选定社区。其中一些FSA位于加拿大城市的工业区。相反，8个低发病率的FSA中有3个聚集在安大略的渥太华，那里几乎没有工业存在。CTCL死亡率在加拿大的分析证实了目前的发病率findings. CONCLUSIONSSThe目前的结果提供了一个全面的分析CTCL负担在加拿大，并突出了几个重要领域的地理病例聚集。这些研究结果表明，工业暴露可能在促进CTCL发病中发挥重要作用。Cancer 2017;123：3550-67. (c)2017年美国癌症学会。
BACKGROUNDPrevious reports of geographic clustering of cutaneous T-cell lymphoma (CTCL) in Texas, Pittsburgh, and Sweden as well as the occurrence of CTCL in married couples and family members raise a possibility of the existence of an external and potentially preventable trigger(s) for this rare skin cancer.METHODSThe authors studied CTCL incidence and mortality in Canada using 3 distinct population-based cancer databases. Data on patients' sex, age at the time of diagnosis, subtype of CTCL malignancy, reporting province, city, and postal code were analyzed. CTCL cases were mapped across Canada using geographic information systems software.RESULTSIn total, 6685 patients with CTCL were identified in Canada during 1992 through 2010 (CTCL incidence rate, 11.32 cases per million individuals per year), of which 58% were males. The mean age at diagnosis was 59.4 21.5 years. Geographic analysis of patients revealed increased CTCL incidence on the provincial and city levels in several eastern provinces and in Manitoba. An analysis according to postal codes (Forward Sortation Area [FSA]) identified select communities in which several high-incidence FSAs were contiguous or adjacent. Several of these FSAs were located in industrial regions of Canadian cities. Conversely, 3 of 8 low-incidence FSAs were clustered in Ottawa, Ontario, which has very little industrial presence. An analysis of CTCL mortality in Canada corroborated the current incidence findings.CONCLUSIONSThe current results provide a comprehensive analysis of CTCL burden in Canada and highlight several important areas of geographic case clustering. These findings argue that industrial exposures may play an important role in promoting CTCL pathogenesis. Cancer 2017;123:3550-67. (c) 2017 American Cancer Society.