Cancer has become the second most serious disease threatening human health, followed by cardiovascular diseases. This study aimed to quantitatively estimate the mortality, morbidity, and analyze the trends of 29 cancer groups in 195 countries/regions between 1990 and 2017. Detailed information of 29 cancer groups were collected from the Global Burden of Disease (GBD) study in 2017 and age-standardized incidence rates (ASIR) and age-standardized death rates (ASDR) of 29 cancer groups were calculated based on gender, age, region, and country. Trend analyses were conducted for major cancer types. In 2017, the global death population caused by cancer reached 9 million, which was nearly twice the number in 1990. The ASDR and ASIR of cancer in males were about 1.5 times those of females. Breast cancer showed the highest mortality rate in females in 2017. Individuals aged over 50 are at high risk of developing cancer and the number of cases and deaths in this age group accounted for more than 80% of all cancers in all age groups. Asia has the heaviest cancer burden due to its large population density. Different cancers in varied countries globally have their own characteristics. The ASDR and ASIR of some major cancers demonstrated changes from 1990 to 2017. Analyses of these data provided basis for future investigations to the common etiological factors, leading to the occurrence of different cancers, the development of prevention strategies based on local characteristics, socioeconomic and other conditions, and the formulation of more targeted interventions.

/pdf/incidence-and-death-in-29-cancer-groups-in-2017-and-trend-2vmdf0w183.pdf

Incidence and death in 29 cancer groups in 2017 and trend analysis from 1990 to 2017 from the Global Burden of Disease Study

The role of LncRNA ADAMTS9-AS2 in the regulation of chemoresistance of gastric cancer (GC) is largely unknown. Here we found that LncRNA ADAMTS9-AS2 was low-expressed in GC tissues and cells compared to their normal counterparts. In addition, LncRNA ADAMTS9-AS2 inhibited miR-223-3p expressions in GC cells by acting as competing endogenous RNA, and the levels of LncRNA ADAMTS9-AS2 and miR-223-3p showed negative correlations in GC tissues. Of note, overexpression of LncRNA ADAMTS9-AS2 inhibited GC cell viability and motility by sponging miR-223-3p. In addition, the levels of LncRNA ADAMTS9-AS2 were lower, and miR-223-3p was higher in cisplatin-resistant GC (CR-GC) cells than their parental cisplatin-sensitive GC (CS-GC) cells. LncRNA ADAMTS9-AS2 overexpression enhanced the cytotoxic effects of cisplatin on CR-GC cells, which were reversed by overexpressing miR-223-3p. Furthermore, LncRNA ADAMTS9-AS2 increased NLRP3 expressions by targeting miR-223-3p, and upregulation of LncRNA ADAMTS9-AS2 triggered pyroptotic cell death in cisplatin treated CR-GC cells by activating NLRP3 inflammasome through downregulating miR-223-3p. Finally, the promoting effects of LncRNA ADAMTS9-AS2 overexpression on CR-GC cell death were abrogated by pyroptosis inhibitor Necrosulfonamide (NSA). Collectively, LncRNA ADAMTS9-AS2 acted as a tumor suppressor and enhanced cisplatin sensitivity in GC cells by activating NLRP3 mediated pyroptotic cell death through sponging miR-223-3p.

/pdf/lncrna-adamts9-as2-inhibits-gastric-cancer-gc-development-3asw7a0zyc.pdf

LncRNA ADAMTS9-AS2 inhibits gastric cancer (GC) development and sensitizes chemoresistant GC cells to cisplatin by regulating miR-223-3p/NLRP3 axis.

Background: Gastric cancer is associated with significant morbidity and mortality. Over one-half of patients have advanced disease at the time of presentation, leading to a significant burden on the healthcare system. Limited epidemiological data exists on national inpatient hospitalization trends. The aim of this study is to determine the inpatient burden of gastric cancer in the United States.
 Methods: We analyzed the Nationwide Inpatient Sample (NIS) database for all subjects with the diagnosis of malignant neoplasm of the stomach (ICD-9 code 151.x) as primary diagnosis during the period from 2001–2011. NIS is the largest all-payer inpatient care database in the U.S. Statistical significance of variation in the number of hospitalizations, patient demographics, and comorbidity measures was determined using Cochran-Armitage trend test.
 Results: From 2001 to 2011, the number of hospitalizations with the diagnosis of malignant neoplasm of the stomach ranged between 22,430 and 25,371, however, the trend was not significant. Men were always more affected than women with no significant change in overall proportion (P Conclusions: The total number of hospitalizations remained relatively stable throughout the study period with higher proportion of men affected every year. Although in-hospital mortality in patients with the diagnosis of gastric cancer decreased over the study period, there was a significant rise in the cost of care.

/pdf/inpatient-burden-of-gastric-cancer-in-the-united-states-2w8gelcg76.pdf

Inpatient burden of gastric cancer in the United States.

ABSTRACT Introduction Helicobacter pylori (Hp) is causal in benign and malignant gastrointestinal diseases. Accordingly, current guidelines recommend Hp eradication in patients with active infection. Unfortunately, treatment failure is common, exposing patients to complications associated with persistent Hp infection and consequences of repeated treatment, including promotion of antibiotic resistance. In the United States (US), data regarding eradication rates with available therapies are limited. Moreover, the clinical and economic burden of eradication treatment failure have not been thoroughly described. Areas covered We aimed to characterize Hp eradication rates and the clinical consequences and associated costs of persistent Hp infection among US adults. We conducted focused literature reviews using initial searches in Embase, MEDLINE, and Cochrane Database of Systematic Reviews via Ovid followed by manual searches to identify relevant publications. Expert opinion Hp eradication rates were suboptimal, with most studies reporting rates ≤80% with clarithromycin-based triple therapy and bismuth quadruple therapy. There was direct evidence supporting numerous benefits of successful Hp eradication, including decreased risk of recurrent or complicated peptic disease and non-cardia gastric cancer. Cost benefits of eradication were related to mitigation of conditions associated with persistent Hp infection, (e.g. complicated peptic ulcer disease, and gastric cancer) which altogether exceed US$5.3 billion.

https://www.tandfonline.com/doi/pdf/10.1080/17474124.2022.2056015?needAccess=true

Helicobacter pylori infection treatment in the United States: clinical consequences and costs of eradication treatment failure

Socioeconomic Status and Gastric Cancer Surgical Outcomes: A National Cancer Database Study.

There is no convincing data on the trends of hospitalizations, mortality, cost, and demographic variations associated with inpatient admissions for gastric cancer in the USA. The aim of this study was to use a national database of US hospitals to evaluate the trends associated with gastric cancer. We analyzed the National Inpatient Sample (NIS) database for all patients in whom gastric cancer (ICD-9 code: 151.0, 151.1, 151.2, 151.3, 151.4, 151.5, 151.6, 151.8, 151.9) was the principal discharge diagnosis during the period, 2003–2014. The NIS is the largest publicly available all-payer inpatient care database in the US. It contains data from approximately eight million hospital stays each year. The statistical significance of the difference in the number of hospital discharges, length of stay, and hospital costs over the study period was determined by regression analysis. In 2003, there were 23,921 admissions with a principal discharge diagnosis of gastric cancer as compared to 21,540 in 2014 (P < 0.01). The mean length of stay for gastric cancer decreased by 17% between 2003 and 2014 from 10.9 days to 8.95 days (P < 0.01). However, during this period, the mean hospital charges increased significantly by 21% from $ 75,341 per patient in 2003 to $ 91,385 per patient in 2014 (P < 0.001). There was a more significant reduction in mortality over a period of 11 years from 2428 (10.15%) in 2003 to 1345 (6.24%) in 2014 (P < 0.01). The aggregate charges (i.e., “national bill”) for gastric cancer increased significantly from 1.79 bn $ to 1. 96 bn $ (P < 0.001), despite decrease in hospitalization (inflation adjusted). Although the number of inpatient admissions for gastric cancer have decreased over the past decade, the healthcare burden and cost related to it has increased significantly. Inpatient mortality is decreasing which is consistent with overall decrease in gastric cancer-related deaths. Cost increase associated with gastric cancer contributed significantly to the national healthcare bill.

/pdf/decreasing-mortality-and-hospitalizations-with-rising-costs-4jetvbeae3.pdf

Decreasing mortality and hospitalizations with rising costs related to gastric cancer in the USA: an epidemiological perspective.

To the Editor: Drug reaction with eosinophilia and systemic symptoms (DRESSs), also called drug-induced hypersensitivity syndrome, is a life-threatening adverse drug reaction with mortality rates of up to 10%–20%.1 The clinical presentation includes mucocutaneous rash, fever, lymphadenopathy, hematologic abnormalities such as eosinophilia and atypical lymphocytes, and multiple organ dysfunction, including liver, kidneys, heart, and lungs.1 Although fever and rash are the most common presentations, the defining characteristic of the syndrome is organ dysfunction. It usually presents 2–8 weeks after the introduction of the causative agent and symptoms may persist for a longer period of time, despite discontinuing the offending drug. Most commonly associated medications are aromatic antiepileptics.2,3 Others include sulfonamides/sulfones, nonsteroidal anti-inflammatory agents, angiotensinogen-converting enzyme inhibitors, and antidepressants. The precise incidence of DRESS is yet to be determined; an estimate is 1/1000 to 1/10,000 new users of antiepileptic therapy may present with this hypersensitivity reaction.4,5 The patient is a 29-year-old woman with a history of chronic pancreatitis and gastric bypass surgery, who initially presented with lower extremity swelling in the setting of hypoalbuminemia and protein-calorie malnutrition. She was started on a high calorie/protein diet and was discharged on furosemide andmultivitamin tablets. Three weeks after discharge, she noticed peri-oral rash, which extended to lower extremities, groin, and trunk. On presentation she had multiple areas of erythema and crusting over body, with small tense vesicles of legs and bilateral lower extremity edema. Blood work showed elevated liver enzymes, elevated International normalized ratio, low vitamin D, macrocytic anemia, and elevated eosinophils. She underwent skin biopsy of the left forearm, which showed spongiotic epidermis with paucicellular intraepidermal vesicle/bullae with scattered eosinophils and neutrophils. Rare necrotic keratinocytes sites were identified within the epidermis. The Naranjo algorithm score was 5 that indicated probable adverse dug reaction to furosemide, and no other offending agents were identified. She was diagnosed with DRESS syndrome secondary to furosemide and was started on oral prednisone therapy in view of liver dysfunction. The rash and liver function improved with oral steroid therapy. Hospital course was complicated by sudden drop in hemoglobin. No source of bleeding was identified. Hemolysis workup came back positive with elevated Lactate Dehydrogenase, low haptoglobin, elevated reticulocyte count, and positive C3 and poly antibody Coombs tests (negative Immunoglobulin G Coombs test). She was diagnosed with autoimmune hemolytic anemia refractory to oral prednisone therapy and received 1 dose of intravenous immunoglobulin therapy. She also received 1 unit of packed red blood cells. Her hemoglobin remained stable, without any further drop. She was discharged on oral prednisone therapy and completed prednisone taper over the next 12 weeks as an outpatient. No recurrence of hemolytic episodes is seen in 6 months outpatient follow-up. DRESS syndrome is a severe delayed type hypersensitivity (type IV hypersensitivity) reaction with a prolonged latency period of 3–8 weeks. The clinical course of the syndrome varies widely. Early in the course it may present with prodromal symptoms (fever, pruritus, dysphagia, or lymphadenopathy) and a mucocutaneous rash.1 Internal organ involvement is the characteristic feature of DRESS syndrome, and the most commonly involved organs are the liver, kidneys, heart, and lungs. Although fever and rash are the most common presenting features, liver damage may develop before the onset of a rash in up to 10% of patients.6 Hematologic abnormalities, including eosinophilia and atypical lymphocytosis may be seen on initial presentation. The most commonly associated drugs are aromatic anticonvulsants (carbamazepine, phenytoin, and phenobarbital). Although cross-sensitivity as high as 75% has been reported among the aromatic anticonvulsants, carbamazepine remains the most widely reported agent.7 There are only a few case reports of DRESS syndrome in association with loop diuretics (furosemide and torsemide). American Journal of Therapeutics 0, 1–3 (2020)

Furosemide-Associated Drug Reaction With Eosinophilia and Systemic Symptoms.

PO-1091 GTV as prognostic marker in head and neck cancer - Time to redefine GTV beyond contouring

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Decreasing mortality and hospitalizations with rising costs related to gastric cancer in the USA: an epidemiological perspective.

Furosemide-Associated Drug Reaction With Eosinophilia and Systemic Symptoms.

PO-1091 GTV as prognostic marker in head and neck cancer - Time to redefine GTV beyond contouring