Ovarian Cancer Incidence in the U.S. and Toxic Emissions from Pulp and Paper Plants: A Geospatial Analysis

Abstract

Ovarian cancer is the fifth leading cause of female cancer mortality in the U.S. and accounts for five percent of all cancer deaths among women. No environmental risk factors for ovarian cancer have been confirmed. We previously reported that ovarian cancer incidence rates at the state level were significantly correlated with the extent of pulp and paper manufacturing. We evaluated that association using county-level data and advanced geospatial methods. Specifically, we investigated the relationship of spatial patterns of ovarian cancer incidence rates with toxic emissions from pulp and paper facilities using data from the Environmental Protection Agency’s Toxic Release Inventory (TRI). Geospatial analysis identified clusters of counties with high ovarian cancer incidence rates in south-central Iowa, Wisconsin, New York, Pennsylvania, Alabama, and Georgia. A bivariate local indicator of spatial autocorrelation (LISA) analysis confirmed that counties with high ovarian cancer rates were associated with counties with large numbers of pulp and paper mills. Regression analysis of state level data indicated a positive correlation between ovarian cancer and water pollutant emissions. A similar relationship was identified from the analysis of county-level data. These data support a possible role of water-borne pollutants from pulp and paper mills in the etiology of ovarian cancer.

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

“…However, the prognosis of patients with ETOC and PPSC is still disappointing, because of vague or free symptoms of patients, often misdiagnosed as less deadly gastro-enteral tract problems, and the absence of effective screening programs, and, in addition, its heterogeneous nature and different clinical development, accounting for late diagnosis in its advanced stages [52][53][54][55]. All result in a therapeutic challenge, contributing to low cure rate and high mortality rate, [1][2][3][4][5][19][20][21][22][23][24][25]. A median progression-free survival (PFS) is 16-21 months and an overall survival (OS) is 32-57 months [1][2][3][4][5][19][20][21][22][23][24][25].…”

“…All result in a therapeutic challenge, contributing to low cure rate and high mortality rate, [1][2][3][4][5][19][20][21][22][23][24][25]. A median progression-free survival (PFS) is 16-21 months and an overall survival (OS) is 32-57 months [1][2][3][4][5][19][20][21][22][23][24][25]. Therefore, an improvement of therapeutic effect as well as a prolongation of PFS and/or OS is urgently needed.…”

“…Epithelial tubo-ovarian cancer (ETOC) is the deadliest cancer among women, placing with fourth place of all the fetal diseases among women and ranking seventh of most common cancers in women's cancer and women's cancer-related deaths in Taiwan and globally in 2018 [1][2][3][4][5][6]. Serous-type is the most common subtype among EOCs in general; however, endometriosis-associated EOCs, such as clear cell type or endometrioid type are relatively common in certain populations, including Taiwan and Japan [7][8][9][10][11].…”

Deregulation of Lipid Metabolism: The Critical Factors in Ovarian Cancer

“…Because of hidden symptoms and lack of effective diagnostic methods, about 70% of patients are diagnosed in advanced stage when they receive treatment for the first time (3), which underlines the status of ovarian cancer as a serious public health concern for women. Based on the various research and epidemiological investigations, the pathogenesis of ovarian cancer mainly include viral infection, endocrine disorders, genetics, and environmental pollution (4)(5)(6)(7). Ovarian cancer is characterized by widespread and rapid metastasis in the peritoneal cavity, which facilitates metastatic dissemination and poor disease progression.…”

Women’s cancers in China: a spatio-temporal epidemiology analysis

“…Females in different areas do not suffer equally from women’s cancers. The incidence of women’s cancers is always heterogeneous across geographic settings, either between countries or within a country [ 23 ], which may be attributed to the inequality in health services accessibility, socioeconomic and environmental differences [ 9 ]. Understanding the spatial disparities between different geographical units serves as a basis for identifying the populations at high risk and making region-specific prevention and control strategies targeting the high-risk areas.…”