Balderrama-Brondani Vania, Griffin Allison M, Owen Taylor J, Merriman Kelly W, Chahla Brenda B, Varghese Jeena, Jimenez Camilo, Waguespack Steven G, Graham Paul H, Perrier Nancy D, Fisher Sarah B, Karam Jose A, Shah Amishi Y, Campbell Matthew, Hassan Manal M, Habra Mouhammed Amir
Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Financial Planning & Analysis, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Endocr Pract. 2024 Jan;30(1):25-30. doi: 10.1016/j.eprac.2023.10.004. Epub 2023 Oct 18.
Adrenocortical carcinoma (ACC) is a rare malignancy without established association with environmental risk factors. ACC incidence is stable based on large surgical databases while referral centers data reported increasing number of cases seen. We studied ACC incidence and distribution at a county level to find potential ACC "hot spots" that could be linked to environmental exposures.
A retrospective analysis of Texas Cancer Registry that included ACC patients diagnosed between 2000 and 2018. County-level heatmaps were created and compared with breast, prostate, and lung cancer.
We identified 448 ACC cases during the study period. Cases were registered in 110 of the 254 counties (43.3%) in Texas, representing 92.74% of the total population. The median incidence was 23 new cases/y (range 14-33). The mean population-adjusted ACC incidence rate was 0.104 per 100 000 per year (standard deviation 0.005; 95% CI, 0.092-0.116). Seven counties (6.3%) accounted for 215 (48.0%) cases, with more than 10 cases each and median standardized incidence ratio (SIR) of 0.1 (range, 0.0-0.9). One hundred three counties (93.7%) accounted for the remaining 233 cases (52%), with fewer than 10 cases per county. The highest standardized incidence ratios were found in counties with a median population of fewer than 14 000 residents and with only one reported case.
Our analysis is the first report to create ACC heatmap and could not detect any geographic clustering of ACC in Texas. The incidence of ACC remained stable and consistent with data from other large databases.
肾上腺皮质癌（ACC）是一种罕见的恶性肿瘤，与环境危险因素之间尚无既定关联。基于大型手术数据库，ACC的发病率保持稳定，而转诊中心的数据显示所见病例数量在增加。我们研究了县级层面的ACC发病率及分布情况，以寻找可能与环境暴露相关的潜在ACC“热点地区”。
对德克萨斯癌症登记处进行回顾性分析，纳入2000年至2018年间确诊的ACC患者。绘制县级热图，并与乳腺癌、前列腺癌和肺癌的热图进行比较。
在研究期间，我们共识别出448例ACC病例。病例分布在德克萨斯州254个县中的110个（43.3%），占总人口的92.74%。发病率中位数为每年23例新发病例（范围为14 - 33例）。经人口调整后的ACC平均发病率为每年每10万人0.104例（标准差0.005；95%置信区间，0.092 - 0.116）。7个县（6.3%）占215例（48.0%），每个县病例数超过10例，标准化发病率（SIR）中位数为0.1（范围为0.0 - 0.9）。其余103个县（93.7%）占233例（52%），每个县病例数少于10例。标准化发病率最高的县，其居民中位数人口少于14000人，且仅报告了1例病例。
我们的分析是首份创建ACC热图的报告，未在德克萨斯州发现ACC的任何地理聚集现象。ACC的发病率保持稳定，与其他大型数据库的数据一致。
