title: Demographic patterns of cutaneous T-cell lymphoma incidence in Texas based on two different cancer registries.
abstract: Cutaneous T-cell lymohomas (CTCLs) are rare, but potentially devastating malignancies, with Mycosis fungoides and Sézary Syndrome being the most common. In our previous study, we identified and described regions of geographic clustering of CTCL cases in Texas by analyzing ~1990 patients using two distinct cancer registries. In the current work, we describe in detail demographic patterns for this malignancy in our study population and apply logistic regression models to analyze the incidence of CTCL by sex, race, age, and clinical stage at the time of diagnosis. Furthermore, using Fisher's exact test, we analyze changes in incidence over time in the identified Houston communities with unusually high CTCL incidence. While CTCL primarily affects Caucasian individuals >55 years old, we confirm that it presents at a younger age and with more advanced disease stages in African-American and Hispanic individuals. Also, we demonstrate a significant increase in CTCL incidence over time in the identified communities. Spring, Katy, and Houston Memorial areas had high baseline rates. Furthermore, a statistically significant disease surge was observed in these areas after ~2005. This report supplements our initial study documenting the existence of geographic clustering of CTCL cases in Texas and in greater detail describes demographic trends for our patient population. The observed surge in CTCL incidence in the three identified communities further argues that this malignancy may be triggered by one or more external etiologic agents.
authors.affiliation: Division of Dermatology, McGill University, Montreal, Quebec, Canada.
authors.forename: Ivan V
authors.initials: IV
authors.lastname: Litvinov
authors.affiliation: Section of Dermatopathology, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Tetzlaff
authors.affiliation: Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada.
authors.forename: Elham
authors.initials: E
authors.lastname: Rahme
authors.affiliation: Section of Dermatopathology, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Jennings
authors.affiliation: Cancer Epidemiology and Surveillance Branch, Texas Cancer Registry, Department of State Health Services, Austin, Texas.
authors.forename: David R
authors.initials: DR
authors.lastname: Risser
authors.affiliation: Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Pamela
authors.initials: P
authors.lastname: Gangar
authors.affiliation: Division of Dermatology, McGill University, Montreal, Quebec, Canada.
authors.forename: Elena
authors.initials: E
authors.lastname: Netchiporouk
authors.affiliation: Division of Dermatology, McGill University, Montreal, Quebec, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Moreau
authors.affiliation: Section of Dermatopathology, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Victor G
authors.initials: VG
authors.lastname: Prieto
authors.affiliation: Division of Dermatology, McGill University, Montreal, Quebec, Canada.
authors.forename: Denis
authors.initials: D
authors.lastname: Sasseville
authors.affiliation: Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Duvic
mesh_terms: D000328:Adult; D000368:Aged; D005006:Ethnicity; D005260:Female; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D016410:Lymphoma, T-Cell, Cutaneous / Q000453:epidemiology* / Q000266:history; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012042:Registries; D013781:Texas / Q000453:epidemiology
keywords: Cutaneous T-cell lymphoma (CTCL); Sézary syndrome; demographic patterns; geographic clustering; mycosis fungoides