Deep Q-networks with web-based survey data for simulating lung cancer intervention prediction and assessment in the elderly: a quantitative study

Background Lung cancer screening and intervention might be important to help detect lung cancer early and reduce the mortality, but little was known about lung cancer intervention strategy associated with intervention effect for preventing lung cancer. We employed Deep Q-Networks (DQN) to respond to this gap. The aim was to quantitatively predict lung cancer optimal intervention strategy and assess intervention effect in aged 65 years and older (the elderly). Methods We screened lung cancer high risk with web-based survey data and conducted simulative intervention. DQN models were developed to predict optimal intervention strategies to prevent lung cancer in elderly men and elderly women separately. We assessed the intervention effects to evaluate the optimal intervention strategy. Results Proposed DQN models quantitatively predicted and assessed lung cancer intervention. DQN models performed well in five stratified groups (elderly men, elderly women, men, women and the whole population). Stopping smoking and extending quitting smoking time were optimal intervention strategies in elderly men. Extending quitting time and reducing smoked cigarettes number were optimal intervention strategies in elderly women. In elderly men and women, the maximal reductions of lung cancer incidence were 31.81% and 24.62% separately. Lung cancer incidence trend was deduced from the year of 1984 to 2050, which predicted that the difference of lung cancer incidence between elderly men and women might be significantly decreased after thirty years quitting time. Conclusions We quantitatively predicted optimal intervention strategy and assessed lung cancer intervention effect in the elderly through DQN models. Those might improve intervention effects and reasonably prevent lung cancer.

Oxidative Stress Induction By Pesticides May Cause Lung Cancer Incidence

Background and aims: Pesticides are nowadays known as one of the most important causes of human disorders worldwide. The aim of the present study was to investigate the role of organochlorine pesticides (OCPs) and organophosphorus pesticides (OPPs) in the development of lung cancer. Methods We determined the levels of seven derived OCP residues (α-HCH, β-HCH, γ-HCH, 2,4 DDT, 4,4 DDT, 2,4 DDE, and 4,4 DDE) and enzymatic antioxidant biomarkers including paraoxonase-1 (PON-1), erythrocyte's acetylcholinesterase (AChE), glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT), and non-enzymatic antioxidant biomarkers including total antioxidant capacity (TAC), protein carbonyl (PC), malondialdehyde (MDA), and nitric oxide (NO) in the blood samples of 51 lung cancer patients and 51 healthy subjects as controls. Furthermore, the effects of OPP exposure on the development of lung cancer and oxidative stress (OS) are indirectly assessed by measuring AChE and PON-1 enzyme activities. Results The average values of all the measured OCPs were significantly higher in lung cancer patients when compared with healthy control subjects. AChE, PON-1, GPx, and CAT activity levels as well as the amounts of PC, MDA, and NO were higher in patients with lung cancer than in the control subjects, while TAC values were lower in the patients. Moreover, our data showed a significant association between OCP concentrations and OS parameters. Conclusion The results suggest that OCPs and OPPs may have a role in lung cancer incidence in southeastern Iran, and at least one of the mechanisms by which OCPs and OPPs may contribute to increasing the development of lung cancer in the studied area is through OS generation.

Lung cancer incidence and mortality trends in the Republic of Belarus (1990-2019)

favorable malignant diseases globally. In the Republic of Belarus, it ranks third (8.2%) in the cancer incidence structure and first (21.5%) in the cancer mortality structure. The object of the study were the lung cancer incidence and mortality trends in the Republic of Kazakhstan in 1990-2019. Methods: The present study included all patients - residents of Belarus, registered in the national cancer registry from 1990 to 2019 with a diagnosis of lung cancer (ICD-10 code: C33-C34). Demographic variables included gender, age, and area of residence (urban or rural). The number of PD cases is presented as absolute values and rough intensity indicators per 100,000 population. Standardized morbidity and mortality rates are calculated using the world standard (World) and are indicated per 100,000 population. Results: In the study period, the standardized incidence rate decreased from 27.5 to 25.6 per 100 000 population (– 7.1%, p<0.01). In males, it decreased from 62.1 to 54.6 per 100 000 males (– 12.1%, p<0.001); in females, it increased from 5.3 to 6.4 per 100 000 females (+20.7%, p<0.05). The standardized lung cancer mortality rate has decreased over the study period from 23.0 to 18.3 per 100 000 population (– 20.4%, p<0.001). In males, it went down from 53.6 to 40.7 (– 24.1%, p<0.001), and in women it changed slightly from 3.6 to 3.7 (+2.8%, p>0.05) per 100 000 of the relevant sex. The average annual increase in standardized mortality decreased eight times faster than the growth in standardized incidence. Conclusion: In the Republic of Belarus, lung cancer incidence is increasing in males and decreasing in females. At that, lung cancer mortality is decreasing. Quality specialized cancer care creates conditions for quicker negative growth of lung cancer standardized mortality vs. incidence

Trends in lung cancer incidence by age, sex and histology from 2012 to 2025 in Catalonia (Spain)

Lung cancer remains one the most common cancers in Europe and ranks first in terms of cancer mortality in both sexes. Incidence rates vary by region and depend above all on the prevalence of tobacco consumption. In this study we describe recent trends in lung cancer incidence by sex, age and histological type in Catalonia and project changes according to histology by 2025. Bayesian age-period-cohort models were used to predict trends in lung cancer incidence according to histological type from 2012 to 2025, using data from the population-based Catalan cancer registries. Data suggest a decrease in the absolute number of new cases in men under the age of 70 years and an increase in women aged 60 years or older. Adenocarcinoma was the most common type in both sexes, while squamous cell carcinoma and small cell carcinoma were decreasing significantly among men. In both sexes, the incident cases increased by 16% for patients over 70 years. Increases in adenocarcinoma and rising incidence in elderly patients suggest the need to prioritize strategies based on multidisciplinary teams, which should include geriatric specialists.

Association of lung cancer incidence and COVID-19 case fatality with income level in Ohio.

110 Background: Social determinants of health (SDOH) have an impact of health and quality-of-life. However, most models of clinical disease and risk calculators do not incorporate SDOH. Many diseases have residual, unexplained risk after known risk factors have been incorporated. SDOH is important component of this residual risk and resources should be allocated to study their relation to disease. Here, we investigate the role of SDOH on the incidence and severity of respiratory diseases by evaluating the association of income level with lung cancer incidence and COVID-19 case fatality ratio in the state of Ohio. Methods: Socioeconomic data for the state of Ohio was manually collected. Lung cancer incidence was acquired from the National Cancer Institute’s online portal. COVID-19 case fatality ratios were downloaded from Johns Hopkins University’s GitHub repository. All three datasets contained complete information for each of Ohio’s 88 counties and were merged by county name. The first two datasets are up-to-date as of 2019, while the COVID-19 data was up-to-date as of 22 May 2021. Data manipulation, visualization, and statistical inference was conducted in the R programming language. Results: Median county-level income across Ohio was $52,722 (IQR: 47,273-59,166). Median county-level lung cancer incidence was 68.4 per 100,000 population (IQR: 62.0-80.6) and median COVID-19 case fatality ratio was 1.98% (IQR: 1.65-2.36). Data for counties with highest and lowest median income are shown in table. Lung cancer incidence and COVID-19 case fatality ratio were not significantly correlated ( n = 88, p > 0.05). Median income was significantly correlated with both, lung cancer incidence ( r = -0.49, p < 0.001) and COVID-19 case fatality ratio ( r = -0.41, p < 0.001). This implies that 24% of the variation in lung cancer incidence and 17% of the variation in COVID-19 case fatality ratio in counties across Ohio can be explained by median county income. Conclusions: SDOH is significantly associated with the incidence and severity of infectious and oncologic respiratory diseases. This association is strengthened since the disease variables themselves are uncorrelated, decreasing the likelihood of confounding. COVID-19 incidence was not used because of uncertainty in the mechanism of SDOH affecting transmission. However, theories suggest that oncologic incidence and infectious disease treatment are affected by SDOH. We validate these theories and encourage the incorporation of SDOH into clinical care and public health. Future directions include testing the association between income level and lung cancer severity in clinical datasets from medical institutions in Ohio.[Table: see text]

Lifetime Risk Assessment of Lung Cancer Incidence for Nonsmokers in Japan Considering the Joint Effect of Radiation and Smoking Based on the Life Span Study of Atomic Bomb Survivors

Background: The lifetime risk of lung cancer incidence due to radiation for nonsmokers is overestimated because of the use of the average cancer baseline risk among a mixed population, including smokers. In recent years, the generalized multiplicative (GM)-excess relative risk (ERR) model has been developed in the life span study of atomic bomb survivors to consider the joint effect of radiation and smoking. Based on this background, this paper discusses the issues of radiation risk assessment considering smoking in two parts.Materials and Methods: In Part 1, we proposed a simple method of estimating the baseline risk for nonsmokers using current smoking data. We performed sensitivity analysis on baseline risk estimation to discuss the birth cohort effects. In Part 2, we applied the GM-ERR model for Japanese smokers to calculate lifetime attributable risk (LAR). We also performed a sensitivity analysis using other ERR models (e.g., simple additive (SA)-ERR model).Results and Discussion: In Part 1, the lifetime baseline risk from mixed population including smokers to nonsmokers decreased by 54% (44%–60%) for males and 24% (18%–29%) for females. In Part 2, comparison of LAR between SA- and GM-ERR models showed that if the radiation dose was ≤200 mGy or less, the difference between these ERR models was within the standard deviation of LAR due to the uncertainty of smoking information.Conclusion: The use of mixed population for baseline risk assessment overestimates the risk for lung cancer due to low-dose radiation exposure in Japanese males.