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  1. Article ; Online: Prevalence of comorbidities and their impact on survival among older adults with the five most common cancers in Taiwan: a population study.

    Chien, Li-Hsin / Tseng, Tzu-Jui / Chen, Tzu-Yu / Chen, Chung-Hsing / Chen, Chia-Yu / Jiang, Hsin-Fang / Tsai, Fang-Yu / Ku, Hsiu-Ying / Jiang, Shih Sheng / Hsiung, Chao A / Liu, Tsang-Wu / Chang, I-Shou

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 6727

    Abstract: Because of the cancer incidence increase and population aging in Taiwan, we aimed to assess the cancer prevalence, to summarize the comorbidities of older patients with the five most common cancers (i.e., breast, colorectal, liver, lung, and oral), and ... ...

    Abstract Because of the cancer incidence increase and population aging in Taiwan, we aimed to assess the cancer prevalence, to summarize the comorbidities of older patients with the five most common cancers (i.e., breast, colorectal, liver, lung, and oral), and to develop a Taiwan cancer comorbidity index (TCCI) for studying their actual prognosis. The linkage of the Taiwan Cancer Registry, Cause of Death Database, and National Health Insurance Research Database was used. We followed the standard statistical learning steps to obtain a survival model with good discriminatory accuracy in predicting death due to noncancer causes, from which we obtained the TCCI and defined comorbidity levels. We reported the actual prognosis by age, stage, and comorbidity level. In Taiwan, cancer prevalence nearly doubled in 2004-2014, and comorbidities were common among older patients. Stage was the major predictor of patients' actual prognoses. For localized and regional breast, colorectal, and oral cancers, comorbidities correlated with noncancer-related deaths. Compared with the US, the chances of dying from comorbidities in Taiwan were lower and the chances of dying from cancer were higher for breast, colorectal, and male lung cancers. These actual prognoses could help clinicians and patients in treatment decision-making and help policymakers in resource planning.
    MeSH term(s) Humans ; Male ; Aged ; Prevalence ; Taiwan/epidemiology ; Comorbidity ; Lung Neoplasms/epidemiology ; Colorectal Neoplasms/epidemiology
    Language English
    Publishing date 2023-04-25
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-29582-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Incidence of Lung Adenocarcinoma by Age, Sex, and Smoking Status in Taiwan.

    Chien, Li-Hsin / Jiang, Hsin-Fang / Tsai, Fang-Yu / Chang, Hsing-Yi / Freedman, Neal D / Rothman, Nathaniel / Lan, Qing / Hsiung, Chao A / Chang, I-Shou

    JAMA network open

    2023  Volume 6, Issue 11, Page(s) e2340704

    Abstract: Importance: Knowing whether the effects of smoking and other risk factors with lung adenocarcinoma (ADC) incidence varies by sex would provide information on lung cancer prevention strategies.: Objective: To evaluate whether women in Taiwan have ... ...

    Abstract Importance: Knowing whether the effects of smoking and other risk factors with lung adenocarcinoma (ADC) incidence varies by sex would provide information on lung cancer prevention strategies.
    Objective: To evaluate whether women in Taiwan have higher age- and tumor stage-specific lung ADC incidence rates than men irrespective of smoking status (ie, ever smoker or never smoker).
    Design, setting, and participants: This population-based cohort study used data sets synthesized from the Taiwan Cancer Registry (TCR) from 1979 to 2019; the TCR Long Form (TCRLF) from 2011 to 2019, which provides individual-level smoking and tumor stage information; the Taiwan Cause of Death Database (TCOD) from 1985 to 2019; the National Health Insurance Research Database (NHIRD) from 2000 to 2020; the Monthly Bulletin of Interior Statistics (MBIS) from 2011 to 2019; the National Health Interview Survey from 2001, 2005, 2009, 2013, and 2017; and Taiwan Biobank data from 2008 to 2021. Included patients were aged 40 to 84 years and had any invasive lung cancer from January 1, 2011, to December 31, 2019.
    Exposure: Smoking status.
    Main outcomes and measures: The main outcomes were age-specific female-to-male incidence rate ratios (IRRs) of lung ADC by smoking status and tumor stage. Linked data from the TCR, TCOD, NHIRD, Taiwan National Health Interview Survey, and MBIS were used to estimate the age- and sex-specific numbers of cancer-free individuals at midyears from 2011 to 2019 by smoking status. Using the TCR and TCRLF, age-, sex-, tumor stage-, and diagnosis year-specific numbers of patients with lung ADC from 2011 to 2019 by smoking status were estimated.
    Results: A total of 61 285 patients (32 599 women [53.2%]) aged 40 to 84 years (mean [SD] age, 64.66 [10.79] years) in the Taiwanese population of approximately 23 million were diagnosed with invasive lung ADC as their first lifetime cancer between 2011 and 2019. Among smokers, men had higher tobacco use by almost all examined metrics, including nearly twice the mean (SD) number of pack-years smoked (eg, 7.87 [8.30] for men aged 30-34 years vs 4.38 [5.27] for women aged 30-34 years). For 5-year age bands between 40 and 84 years, incidence of lung ADC was significantly higher among females than males for nearly all age groups irrespective of tumor stage and smoking status (eg, for the age group 70-74 years, the female-to-male IRR for late-stage lung ADC among never smokers was 1.38 [95% CI, 1.30-1.50]).
    Conclusions and relevance: In this cohort study, women had higher age- and stage-specific lung ADC incidence rates than men in Taiwan for both never and ever smokers, suggesting the possibility of differential exposures between sexes to risk factors other than smoking and the potential modification of ADC risk factors by sex. Further work is needed to determine whether this pattern replicates in other populations, discover the causes of lung ADC, and put preventive measures in place.
    MeSH term(s) Female ; Humans ; Male ; Child ; Incidence ; Smoking/epidemiology ; Cohort Studies ; Taiwan/epidemiology ; Adenocarcinoma of Lung/epidemiology ; Lung Neoplasms/epidemiology ; Lung Neoplasms/etiology ; Receptors, Antigen, T-Cell
    Chemical Substances Receptors, Antigen, T-Cell
    Language English
    Publishing date 2023-11-01
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.40704
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Age at lung cancer diagnosis in females versus males who never smoke by race and ethnicity.

    Blechter, Batel / Wong, Jason Y Y / Chien, Li-Hsin / Shiraishi, Kouya / Shu, Xiao-Ou / Cai, Qiuyin / Zheng, Wei / Ji, Bu-Tian / Hu, Wei / Rahman, Mohammad L / Jiang, Hsin-Fang / Tsai, Fang-Yu / Huang, Wen-Yi / Gao, Yu-Tang / Han, Xijing / Steinwandel, Mark D / Yang, Gong / Daida, Yihe G / Liang, Su-Ying /
    Gomez, Scarlett L / DeRouen, Mindy C / Diver, W Ryan / Reddy, Ananya G / Patel, Alpa V / Le Marchand, Loïc / Haiman, Christopher / Kohno, Takashi / Cheng, Iona / Chang, I-Shou / Hsiung, Chao Agnes / Rothman, Nathaniel / Lan, Qing

    British journal of cancer

    2024  Volume 130, Issue 8, Page(s) 1286–1294

    Abstract: Background: We characterized age at diagnosis and estimated sex differences for lung cancer and its histological subtypes among individuals who never smoke.: Methods: We analyzed the distribution of age at lung cancer diagnosis in 33,793 individuals ... ...

    Abstract Background: We characterized age at diagnosis and estimated sex differences for lung cancer and its histological subtypes among individuals who never smoke.
    Methods: We analyzed the distribution of age at lung cancer diagnosis in 33,793 individuals across 8 cohort studies and two national registries from East Asia, the United States (US) and the United Kingdom (UK). Student's t-tests were used to assess the study population differences (Δ years) in age at diagnosis comparing females and males who never smoke across subgroups defined by race/ethnicity, geographic location, and histological subtypes.
    Results: We found that among Chinese individuals diagnosed with lung cancer who never smoke, females were diagnosed with lung cancer younger than males in the Taiwan Cancer Registry (n = 29,832) (Δ years = -2.2 (95% confidence interval (CI):-2.5, -1.9), in Shanghai (n = 1049) (Δ years = -1.6 (95% CI:-2.9, -0.3), and in Sutter Health and Kaiser Permanente Hawai'i in the US (n = 82) (Δ years = -11.3 (95% CI: -17.7, -4.9). While there was a suggestion of similar patterns in African American and non-Hispanic White individuals. the estimated differences were not consistent across studies and were not statistically significant.
    Conclusions: We found evidence of sex differences for age at lung cancer diagnosis among individuals who never smoke.
    MeSH term(s) Humans ; Male ; Female ; United States/epidemiology ; Ethnicity ; Smoke ; Lung Neoplasms/diagnosis ; Lung Neoplasms/epidemiology ; Lung Neoplasms/pathology ; China ; White
    Chemical Substances Smoke
    Language English
    Publishing date 2024-02-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 80075-2
    ISSN 1532-1827 ; 0007-0920
    ISSN (online) 1532-1827
    ISSN 0007-0920
    DOI 10.1038/s41416-024-02592-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Comparison of annual percentage change in breast cancer incidence rate between Taiwan and the United States-A smoothed Lexis diagram approach.

    Chien, Li-Hsin / Tseng, Tzu-Jui / Chen, Chung-Hsing / Jiang, Hsin-Fang / Tsai, Fang-Yu / Liu, Tsang-Wu / Hsiung, Chao A / Chang, I-Shou

    Cancer medicine

    2017  Volume 6, Issue 7, Page(s) 1762–1775

    Abstract: Recent studies compared the age effects and birth cohort effects on female invasive breast cancer (FIBC) incidence in Asian populations with those in the US white population. They were based on age-period-cohort model extrapolation and estimated annual ... ...

    Abstract Recent studies compared the age effects and birth cohort effects on female invasive breast cancer (FIBC) incidence in Asian populations with those in the US white population. They were based on age-period-cohort model extrapolation and estimated annual percentage change (EAPC) in the age-standardized incidence rates (ASR). It is of interest to examine these results based on cohort-specific annual percentage change in rate (APCR) by age and without age-period-cohort model extrapolation. FIBC data (1991-2010) were obtained from the Taiwan Cancer Registry and the U.S. SEER 9 registries. APCR based on smoothed Lexis diagrams were constructed to study the age, period, and cohort effects on FIBC incidence. The patterns of age-specific rates by birth cohort are similar between Taiwan and the US. Given any age-at-diagnosis group, cohort-specific rates increased overtime in Taiwan but not in the US; cohort-specific APCR by age decreased with birth year in both Taiwan and the US but was always positive and large in Taiwan. Given a diagnosis year, APCR decreased as birth year increased in Taiwan but not in the US. In Taiwan, the proportion of APCR attributable to cohort effect was substantial and that due to case ascertainment was becoming smaller. Although our study shows that incidence rates of FIBC have increased rapidly in Taiwan, thereby confirming previous results, the rate of increase over time is slowing. Continued monitoring of APCR and further investigation of the cause of the APCR decrease in Taiwan are warranted.
    MeSH term(s) Adult ; Age Factors ; Aged ; Aged, 80 and over ; Breast Neoplasms/epidemiology ; Cohort Studies ; Female ; Humans ; Incidence ; Middle Aged ; Registries ; SEER Program ; Taiwan/epidemiology ; United States/epidemiology
    Language English
    Publishing date 2017-05-31
    Publishing country United States
    Document type Journal Article
    ISSN 2045-7634
    ISSN (online) 2045-7634
    DOI 10.1002/cam4.1102
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Recalibrating Risk Prediction Models by Synthesizing Data Sources: Adapting the Lung Cancer PLCO Model for Taiwan.

    Chien, Li-Hsin / Chen, Tzu-Yu / Chen, Chung-Hsing / Chen, Kuan-Yu / Hsiao, Chin-Fu / Chang, Gee-Chen / Tsai, Ying-Huang / Su, Wu-Chou / Huang, Ming-Shyan / Chen, Yuh-Min / Chen, Chih-Yi / Liang, Sheng-Kai / Chen, Chung-Yu / Wang, Chih-Liang / Hung, Hsiao-Han / Jiang, Hsin-Fang / Hu, Jia-Wei / Rothman, Nathaniel / Lan, Qing /
    Liu, Tsang-Wu / Chen, Chien-Jen / Yang, Pan-Chyr / Chang, I-Shou / Hsiung, Chao A

    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

    2022  Volume 31, Issue 12, Page(s) 2208–2218

    Abstract: Background: Methods synthesizing multiple data sources without prospective datasets have been proposed for absolute risk model development. This study proposed methods for adapting risk models for another population without prospective cohorts, which ... ...

    Abstract Background: Methods synthesizing multiple data sources without prospective datasets have been proposed for absolute risk model development. This study proposed methods for adapting risk models for another population without prospective cohorts, which would help alleviate the health disparities caused by advances in absolute risk models. To exemplify, we adapted the lung cancer risk model PLCOM2012, well studied in the west, for Taiwan.
    Methods: Using Taiwanese multiple data sources, we formed an age-matched case-control study of ever-smokers (AMCCSE), estimated the number of ever-smoking lung cancer patients in 2011-2016 (NESLP2011), and synthesized a dataset resembling the population of cancer-free ever-smokers in 2010 regarding the PLCOM2012 risk factors (SPES2010). The AMCCSE was used to estimate the overall calibration slope, and the requirement that NESLP2011 equals the estimated total risk of individuals in SPES2010 was used to handle the calibration-in-the-large problem.
    Results: The adapted model PLCOT-1 (PLCOT-2) had an AUC of 0.78 (0.75). They had high performance in calibration and clinical usefulness on subgroups of SPES2010 defined by age and smoking experience. Selecting the same number of individuals for low-dose computed tomography screening using PLCOT-1 (PLCOT-2) would have identified approximately 6% (8%) more lung cancers than the US Preventive Services Task Forces 2021 criteria. Smokers having 40+ pack-years had an average PLCOT-1 (PLCOT-2) risk of 3.8% (2.6%).
    Conclusions: The adapted PLCOT models had high predictive performance.
    Impact: The PLCOT models could be used to design lung cancer screening programs in Taiwan. The methods could be applicable to other cancer models.
    MeSH term(s) Humans ; Lung Neoplasms/epidemiology ; Early Detection of Cancer ; Taiwan/epidemiology ; Case-Control Studies ; Smokers
    Language English
    Publishing date 2022-09-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1153420-5
    ISSN 1538-7755 ; 1055-9965
    ISSN (online) 1538-7755
    ISSN 1055-9965
    DOI 10.1158/1055-9965.EPI-22-0281
    Database MEDical Literature Analysis and Retrieval System OnLINE

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