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  • Population based studies have reported that only

    2019-08-20

    Population-based studies have reported that only one fifth of all CMML patients receive disease modifying treatment and reasons for this observation remain unclear [5,7]. A potential explanation is that physicians may be reluctant in using treatment without sufficient evidence from clinical trials. Under these circumstances, more information on treatment allocation is indispensable to investigate the influence of HMA on population-based survival. Data on treatment is currently not available from the Swiss CCRs. Due to the restrictive data protection law in Switzerland, a correlation with patients’ treatment information derived from health insurances, as performed by Zeidan et. al in the US, is currently not possible. The Swiss CCR data will be soon complemented with information on first line treatment, which will increase the utility. However, responses and side-effects will remain inaccessible. Therefore, a prospective registry was implemented in Switzerland that allows inclusion of patients with MDS and related disorders such as CMML.
    Funding
    Conflict of interest
    Author’s contributions
    Acknowledgements
    Introduction Cancer is the leading cause of death in Canada, responsible for 30% of all deaths in 2012 [1]. According to the Canadian Cancer Society, approximately 49% of males and 45% of females will develop cancer in their lifetime and 25% of Canadians will die from cancer. Based on the projected cancer incidence estimates for 2017, the four most common cancer types (prostate, breast, lung and colorectal) account for over half of all cancers diagnosed in Canada [1]. In men, the most common cancer type is prostate, followed by colorectal cancer and lung cancer. In women, the most common cancer type is breast, followed by lung and colorectal cancer. In addition to its health burden, cancer also leads to substantial economic cost. Between 2005 and 2012, the economic burden of cancer care in Canada rose from $2.9 billion to $7.5 billion annually, mostly due to hospital expenditures and physician care costs [2]. Given the considerable health and economic burden of cancer in Canada, projecting cancer incidence is essential for resource planning and informing cancer control programs. Furthermore, it Kainic acid is imperative to understand epidemiologic trends and cancer incidence to decrease the burden, by targeting and prioritizing prevention initiatives. Previous Canadian estimates projected an 84% increase in the number of incident cancer cases between 2003–2007 and 2028–2032 in men and a 74% increase in women [3,4]. The four most common types of cancer in Canada were projected to rank in the same way by 2028–2032 [3]. Cancer incidence and mortality rates can be projected by extrapolating past trends to estimate plausible future trends, using statistical models. In previous models used to project cancer incidence frequencies and rates in specific countries and the world, trends over age at diagnosis, year of diagnosis (period) and/or year of birth (cohort) as well as hybrids of these models have been adopted [[5], [6], [7]]. In recent years, the age-period-cohort [8] and the age-drift-period-cohort (Nordpred) [9] models have been widely used. The Nordpred model has been used for previously completed cancer projections in Canada [3,4], however, our approach builds on this previous model by including a series of models, rather than only the Nordpred model in a ‘one size fits all’ approach, which can lead to inaccurate results. In so doing, the most appropriate model could be used for our analyses As part of the large Canadian population attributable risk of cancer (ComPARe) study [10], we produced comprehensive estimates of future cancer incidence and age-standardized incidence rates (ASIR) for prostate, breast, lung and colorectal cancer until 2042, using a modeling algorithm and expert opinion.
    Material and methods
    Discussion In men, the number of incident cases of colorectal, lung, bladder and prostate cancers is projected to increase from 50,190 in 2012 to 92,362 in 2042. In women, the number of incident colorectal, lung, bladder and breast cancer cases is projected to increase from 46,270 to 84,342. These increases in incidence are largely driven by the aging population in Canada and, to a smaller extent, by an increase in population size, as previously noted [3]. In Canadian men, we estimate that by 2042 the ASIRs for colorectal and prostate cancer will increase and the ASIRs for lung and bladder cancer in men will decrease. In Canadian women, we estimate that ASIRs for colorectal and bladder cancer will decrease between 1983 and 2042 and the ASIR for female lung cancer and breast cancer will increase