Linda Malulu-Chiwele

Background: Esophageal and gastric cancers have a high incidence and mortality in the US. Understanding the risk factors and trends associated with these cancers is crucial for developing effective prevention strategies.Objective: This descriptive study analyzed time trends for esophageal and gastric cancer incidence and related modifiable risk factors.Methods: Data from the Surveillance, Epidemiology, and End Results Survey Program (1975-2020), and the National Health and Nutrition Examination Survey (1988-2018) were used. Temporal trends in incidence rates and risk factor prevalence were determined, including for groups defined by sex, race, and subtype.Results: Esophageal squamous cell carcinoma rates declined, particularly among Black males (from 16.1 to 1.5 per 100,000), while esophageal adenocarcinoma rates increased among White males (from 0.7 to 4.3 per 100,000). Cardia gastric cancer rates remained stable, with higher incidence among males (average 3.1 per 100,000 compared to 0.7 per 100,000), whereas non-cardia gastric cancer incidence decreased for all. The percentage of the population that was overweight/obese increased from 52.4% to 73.8%. In contrast, prevalence of heavy alcohol drinking and current smoking decreased while the prevalence of inadequate intakes of nutrients such as calcium, particularly folate, significantly improved. Recently, inactivity prevalence has decreased, but >50% of the population remains physically inactive.Conclusion: Trends in modifiable lifestyle factors, such as increased obesity, reduced heavy alcohol consumption, and changing dietary habits, could explain some of the observed trends in esophageal and gastric cancer rates. Therefore, continued public health efforts are needed to address modifiable risk factors and reduce cancer incidence..

PURPOSE: Zambia is among the countries with the highest cervical cancer incidence and mortality rates globally. Stigma can hinder treatment adherence and overall quality of life for patients with cervical cancer. Research on this topic, however, is lacking in Zambia. This study aimed to assess the levels of stigma among patients with cervical cancer in Zambia and examine the association between social support and quality of life. METHODS: We enrolled patients newly diagnosed with cervical cancer at the Cancer Diseases Hospital in Lusaka, Zambia, from July to October 2024. In-person or telephone interviewers collected information on demographic, clinical, and socioeconomic status before treatment. Stigma was assessed using a modified Perceived Stigma Scale, quality of life using the PROMIS-57, and social support with the Multidimensional Scale of Perceived Social Support. Associations between stigma, social support, and quality of life were analyzed using multivariable logistic regression, adjusting for age, education, income, and cancer stage, with significance set at P < .05. RESULTS: A total of 213 participants were included in the study with a response rate of 96%. Of the total participants, 30.5% were classified as having high stigma. High levels of support from family (odds ratio [OR], 0.44 [95% CI, 0.22 to 0.87]) and friends (OR, 0.43 [95% CI, 0.21 to 0.91]) reduced the odds of stigma. Severe anxiety, depression, fatigue, sleep disturbances, pain, poor physical function, and low social well-being were all strongly associated with higher stigma (all P ≤ .004). CONCLUSION: Perceived cervical cancer–related stigma in Zambia is associated with limited social support and poorer quality of life. Programs to strengthen social network support, as well as targeted mental health treatment, are needed to improve the well-being of patients with cervical cancer in Zambia.