What are the Epidemiologic Signatures in Cancer? A new special report out in NEJM by Gil Welch, Barnett Kramer, and William Black is so good I had to do a #tweetorial. πŸ‘‡πŸΎπŸ‘‡πŸΎπŸ‘‡πŸΎ
Special Report: Epidemiologic Signatures in Cancer
The US epidemiological story of #cancer 1975-2015, a mixed story of the good after reduction of cigarette smoking and the bad on rising incidence/ "side-effect" of early detection
#CML and #Hodgkin disease epidemiology When there is a real improvement in #cancer care, mortality decreases while incidence remains stable (CML and HD). If both have reduced, a risk factor was addressed (smoke & lung cancer) Look at this πŸ‘‡πŸ‘‡πŸ‘‡
Early detection is a gigantic shruggee. Great to see Welch back!
This recent article in is really relevant to this β€” detecting more cancers is not the same as curing more cancers.
Epidemiologic Signatures in #Cancer #Epidemiology
These epi "signatures" of cancer incidence and mortality really help illustrate the population-level effects of screening, treatment advances, and overdiagnosis of indolent disease. Simple, yet useful visualizations.
Always interpret cancer incidence in concert with mortality. A stable incidence and falling mortality is a strong signal of improved Tt. Likely the case with MM Epidemiologic Signatures in Cancer | NEJM
"Coincident with the introduction of widespread prostate-specific antigen (PSA) screening, prostate-cancer incidence increased dramatically β€” yet has subsequently declined nearly to its 1975 baseline."
neither these authors nor the prior paper's authors present the mortality rate per 100k over time. If they did that, they would know the answer. They could look up the pattern here: Gil welch would have a stroke reading this.
Nice overview of cancer incidence vs. mortality decline. Overdiagnosis vs. true improvement #radonc
Just went back and read this gem: -- stable incidence and stable mort, as for bladder cancer, signals little change in cancer occurrence and little change in the effectiveness of tx. stable incidence and falling mort, provides signal of improved tx
β€œA sustained increase in incidence coupled with stable mortality, however, suggests something fundamentally different: overdiagnosis superimposed on stable true cancer occurrence.”
Epidemiologic Signatures in Cancer | NEJM