There will be 280,000 cancer cases in 2022, not counting the covid effect

The report «Cancer figures in Spain»presented this Tuesday by the SEOM and the Spanish Network of Cancer Registries (Redecan) in the run-up to World Cancer Day, which is celebrated on Friday, forecasts that in 2040 the incidence will reach 340,000 cases, which represents an increase 21.74% of those planned for this year.

The most frequently diagnosed cancers in 2022 will be those of the colon and rectum (43,370), breast (34,750), lung (30,948), prostate (30,884) and urinary bladder (22,295) and, far behind, non-Hodgkin’s lymphomas (9,514), pancreas (9,252), kidney (8,078), oral cavity and pharynx (7,779), stomach (6,913), uterine body (6,773) and liver (6,604).

And they will appear more in men: 160,066 tumors will occur in them: above all, prostate, with 30,884, colon and rectum (26,862), lung (22,316) and urinary bladder (17,992) – compared to 120,035 in women, who will suffer plus those of the breast (34,750) and those of the colon and rectum (16,508).

However, the report once again puts the emphasis on lung cancer in women: with an estimated 8,632 cases, it remains the third most incident tumor due to the increase in tobacco consumption since the 1970s.

Diagnostic deficit in 2020

In total, 280,101 are expected to be new cancer cases, compared to the 276,239 calculated in 2021, although these estimates are made without taking into account the impact of the pandemic, because they are made from projections made with data from years previous ones, and already those of 2020, when the covid crisis broke out, “very probably did not correspond to what was finally reality.”

For example, and although they have now recovered “at full capacity”, as pointed out at a press conference by the President of Redecan, Jaume Galceráncancer screening programs were affected, so the number of colorectal and breast cancers finally diagnosed in 2020 were lower than expected.

It is also unclear how the coronavirus has affected the number of diagnoses in 2021 and how it will affect 2022. In any case, he has guaranteed that all this “may alter the results a little, but not too much.”

What they do have calculated is the diagnostic deficit that the first year brought with it: between 10% and 20% fewer were detected than “those who would have been diagnosed on a regular basis”, but the final figure will not be known until Not all records are ready.

“It was complicated in the first wave from March to June 2020, but then we have recovered,” the President of the SEOM, Enriqueta Felipwhich has emphasized the importance of prevention.

To measure the ravages of covid on cancer patients, the SEOM has proposed the working group created with the Spanish Association Against Cancer (AECC), the Spanish Society of Pathological Anatomy (SEAP), the Spanish Society of Oncology Nursing (SEEO) , the Spanish Society of Hematology and Hemotherapy (SEHH) and the Spanish Society of Radiation Oncology (SEOR) carry out a new study with multi-hospital data that gives an idea of ​​the magnitude.

risk factors

The age It is one of the main risk factors associated with this disease, especially from the age of 50: 166,127 cases will be detected in people over 65 years of age, 98,033 in people between 45 and 64, and 15,940 in those under that age group.

From birth to age 80, mens they have a risk of developing cancer of 40.9% and women of 27.6%. At 85 years of age, these values ​​are 48.6% and 32.2% in the women.

But also the tobacco, alcohol -the combination of these two factors triggers by 30 the risk of developing oral, oropharyngeal or esophageal carcinoma-, sedentary lifestyle and diet inadequate are: one in three cancer deaths in Europe are due to these preventable factors.

Cancer, the second leading cause of death from disease

Despite covid, cancer was the second cause of death in 2020: it was behind 22.8% of deaths, only surpassed by diseases of the circulatory system (24.3%). The most deadly, those of the lung, pancreas, breast and prostate.

All in all, it is estimated that mortality will increase from more than 113,000 cases in 2020 to more than 160,000 in 2040, although the figure has been falling in recent decades, reflecting the improvement in patient survival.

In fact, it is estimated that it has doubled in the last 40 years and it is likely that, albeit slowly, it will continue to increase in the coming years due to the development and application of new therapies such as early diagnosis programs.

The study analyzes the five-year net survival in the period 2008-2013; in men, age-standardized net survival was 90% for prostate and testicular cancers, and 86% for thyroid cancers, but 7% for pancreas, 12% for lung, 13% for esophagus and 18% in liver.

Meanwhile, in women, thyroid cancer had a net survival of 93%, cutaneous melanoma 89% and breast cancer 86%. Pancreas was 10%, liver and esophagus 16% and lung 18%.

Source: SEOM

The imprint of Precision Medicine

“In recent years we have experienced a true revolution in oncology at the hands of Precision Medicine thanks to an “increasingly deeper knowledge of cancer biology, through the identification of biomarkers”, which allow “subdividing and classifying the tumours, as well as selecting the most effective and safest treatments for patients”, explained the president of SEOMEnriqueta Felipe.

The Ministry of Health is already working together with the communities, scientific societies and the Carlos III Health Institute to specify and update the portfolio of services in the area of ​​genetics to adapt it to the current and future challenges of precision medicine and guarantee more homogeneous access.

The group of experts is preparing the corresponding catalog, including the area of ​​oncological biomarkers, “very good” news for the SEOM, because “the provision of biomarkers in the National Health System in an equitable manner is essential in view of the increase in cancer cases.”

The nocebo effect of the symptoms of anticovid vaccines

Sometimes, placebo effects can also be harmful, it is what is known as the nocebo effect. According to a large analysis using volunteer data from 12 clinical trials, more than two-thirds of adverse symptoms from covid-19 vaccines were due to them.

The symptoms of covid vaccines can also be due to the nocebo effect, according to a study. EFE/Jeffrey Arguedas

The nocebo effect of the symptoms of anticovid vaccines

The placebo effect is the supposed improvement in a person’s physical or mental health after a treatment with no pharmacological therapeutic benefit, a sugar pill or a syringe filled with serum, and it has an opposite version, the nocebo, which occurs when an individual experiences unpleasant side effects after also receiving this “lie treatment”.

The exact biological, psychological and genetic underpinnings of why they occur -placebo/nocebo effect- are not well understood, although there are theories that point to expectations as the main cause and others maintain that unconscious factors embedded in the doctor-patient relationship automatically lower the volume of symptoms.

To verify its role in covid-19 vaccines, the team from the BIDMC center, associated with the medical school of Harvard (EE.UU.), conducted a meta-analysis of 12 clinical trials.

The objective was to compare the rates of adverse events reported by the participants who received the vaccines with the rates of those who received a placebo injection – without any vaccine. The results are published in JAMA Network Open.

The 12 trials included reports of adverse events from 22,578 placebo recipients and 22,802 vaccine recipients.

nocebo effect, placebo effect

Although the scientists found that significantly more participants who received the vaccine reported adverse events, almost a third of the participants who received the placebo also reported at least one, with headache and fatigue being the most common.

Specifically, Julia W. Haas and her colleagues at the BIDMC found that after the first injection, more than 35% of placebo recipients experienced systemic adverse effects -symptoms that affect the entire body, such as fever-, the pain being headache and fatigue the most common, with 19.6% and 16.7%, respectively, the center reports in a statement.

16% of placebo recipients reported at least one local effect, such as injection site pain, redness, or swelling.

Haas reminds that adverse events after placebo treatment are common in randomized controlled trials.

“Gathering systematic evidence regarding these nocebo responses in vaccine trials is important for COVID-19 vaccination worldwide, especially as concerns about side effects are reported to be a reason for vaccine hesitation.” .

Compared to the placebo group, after the first injection, 46% of vaccine recipients experienced at least one systemic adverse event and two-thirds of them reported at least one local one.

Although this group received a pharmacologically active treatment, some of their adverse events are attributable to the placebo effect – or in this case, nocebo – since many of these effects also occurred in the placebo group, the researchers say.

The analysis suggests that nocebo accounted for 76% of all adverse events in the vaccine group and nearly a quarter of all reported local effects.

After the second dose, adverse effects in the placebo group decreased to 32% for systemic cases and 12% for local effects.

In contrast, participants who received the vaccine reported more side effects, with 61% systemic adverse events and 73% local adverse events.

The researchers calculated that nocebo accounted for nearly 52% of reported side effects after the second dose.

Ted J. Kaptchuk, another of the signatories, explains that “non-specific symptoms such as headache and fatigue – which we have shown to be especially sensitive to nocebo – are among the most common adverse reactions after vaccination in many information leaflets” .

Evidence suggests that this type of information may cause people to mistakenly attribute common everyday sensations as being from the vaccine, or cause anxiety and worry that make people hyper-alert to the bodily sensations of adverse events.

“Medicine is built on trust,” Kaptchuk stresses: “Our findings lead us to suggest that informing the public about the potential for nocebo responses could help reduce concerns about covid vaccination, which could decrease hesitancy.”