Mean annual absolute number of new cases, crude and age-standardized (2013 European standard) incidence rates per 100'000, by age group (early- vs later-onset), sex, 5-year period, and cancer sites, 1982-1986 vs 2017-2021, Switzerland.

Cancer burden function. The cancer burden can be depicted as a function of demographic factors (that is, population growth and ageing) on the one hand and of cancer risk on the other hand. In our study, population growth and ageing determine Cdemographic, while exposure to carcinogenic factors, detection practices, and tumors classification determine Crisk.

The RECORD statement – checklist of items, extended from the STROBE statement, that should be reported in observational studies using routinely collected health data.

BACKGROUND:Pancreatic cancer incidence is increasing worldwide while survival remains poor. The incidence varies significantly across different regions. The aim of the present study was to analyse incidence, mortality and survival of patients diagnosed with pancreatic cancer in the canton of Zurich, Switzerland. METHODS:Population-based cancer registry data and cause of death statistics of the canton of Zurich from 1981 to 2021 were analysed. Age-standardised incidence and mortality rates per 100'000 person-years and net survival were calculated. Joinpoint regression analysis was conducted to identify significant changes in time trends while net survival was estimated using the Pohar-Perme method. RESULTS:Age-standardised incidence rate of pancreatic adenocarcinomas (PAC) remained stable between 1981 and 2000 and then increased from 2000 to 2021, while pancreatic neuroendocrine tumours (PNET) incidence increased throughout and pancreatic cancers non histologically or cytologically confirmed (PC Non-HC) decreased. Overall age-standardised mortality rate remained stable. Five-year net survival was moderate for PNET (54.8%), but poor for PAC (4.8%) and PC Non-HC (1.2%). Among patients with PAC, survival declined with increasing age, earlier diagnosis year and advanced stage. CONCLUSIONS:Over the past 40 years, PNET incidence slowly increased. In contrast, PAC incidence significantly increased within the last 20 years. The underlying causes of the observed increase in PAC incidence might be attributable to special risk factors, e.g. obesity, but other risk factors should also be considered. Mortality rates of pancreatic cancer were stable and net survival was poor.

The Prime Diet Quality Score (PDQS) is a global food-based metric for assessing diet quality. We evaluated PDQS-measured diet quality in relation to mortality and major chronic disease outcomes in the UK Biobank. This population-based cohort study included UK adults (40–69 years) recruited in 2006–2010 and followed until 2021. PDQS was derived from ≥ 2 dietary recalls. Multivariable Cox regression estimated hazard ratios (HRs) and 95

Mean annual age-standardized (2013 European standard) incidence rates among women, by main cancer sites (breast, colorectal, lung, skin melanoma) and age group (early- vs later-onset), and 5-year period, 1982-2021, Switzerland.

The burden of early-onset cancers is increasing, attracting scientific and media attention. There is, however, a need to disentangle the contribution of changes in risk, that is, age-standardized rate, due to changes in carcinogenic exposure or detection practices, from the contribution of population growth and aging, and to determine how these contributions differ for later-onset cancers. Using cancer registry data, we estimated these contributions in Switzerland between 1982 and 2021. Early-onset cancers include any cancer diagnosed in adults between 20 and 49 years, whereas later-onset cancers are those diagnosed at 50 years or older. To estimate the contribution of changes in risk, we computed the expected number of cases by applying the 1982 to 1986 (baseline) age-standardized rates to subsequent populations and calculated the difference between observed and expected cases. To estimate the contribution of population growth and aging, we subtracted the risk contribution from the total change in observed cases relative to 1982 to 1986. Between 1982 to 1986 and 2017 to 2021, the burden of early-onset cancers increased by 1,534 cases/year and that of later-onset cancers increased by 19,832. For early-onset cancers, population growth and aging explained 71% of the increase (men: 102%; women: 58%) and changes in risk explained the remaining 29% (men: -2%; women: 42%). These proportions differ by cancer site, with risk contributing to a higher proportion for prostate cancer, colorectal cancer, and melanoma. For later-onset cancers, population growth and aging explained 92% of the increase (men: 116%; women: 81%) and changes in risk explained the remaining 8% (men: -16%; women: 19%). Further research is needed to clarify whether risk changes are due to changes in carcinogenic exposure or in detection practices. SIGNIFICANCE:Although population growth and aging are known to contribute to increasing cancer burden, their relative contribution compared with risk changes has not been quantified for early-onset cancers. Using four decades of Swiss cancer registry data, we show that demographics explain about three quarters of the increase in early-onset cases, whereas risk changes account for the remaining quarter. Contributions vary by cancer site and sex, with implications for prevention and healthcare planning.

Abstract The global prevalence of chronic kidney disease (CKD) is rising and initial studies suggest that diets predominantly based on greater inclusion of plant foods may be associated with lower CKD risk. As population-based studies are lacking, we investigated the association between habitual plant-based diets and CKD in the UK Biobank cohort. The UK Biobank is a large prospective cohort study of participants aged 40–69 years. Habitual diet was assessed using a baseline food frequency questionnaire, and participants were classified into five dietary groups: high meat eaters, low meat eaters, poultry eaters, pescatarians, and vegetarians. To assess the risk of CKD across these groups, we conducted multivariable Cox proportional hazards regression analyses. During follow up of 12.9 years 23,084 out of 416,584 developed CKD. Compared to high meat eaters, the strongest association was observed among vegetarians which had a statistically significant lower risk of CKD [HR = 0.81, 95% CI: 0.71– 0.93]. Our population-based study on plant-based diet types and CKD risk suggests that vegetarian diets are associated with a lower risk of CKD. Future research is needed to assess the feasibility and acceptability of plant-based diets for the prevention of CKD and other chronic diseases.

Mean annual age-standardized (2013 European standard) incidence rates among men, by main cancer sites (prostate, colorectal, lung, skin melanoma) and age group (early- vs later-onset), and 5-year period, 1982-2021, Switzerland.

Diets low in quality represent a large risk for global mortality, morbidity, and environmental deterioration. In 2019, the EAT-Lancet commission published a universal reference diet, the ‘planetary health diet’ (PHD), focusing on human health and sustainability. We aimed to compare the average Swiss diet, four Swiss dietary patterns, and the sex- and language-specific dietary habits with the PHD with respect to adherence and sustainability. Data of the cross-sectional population-based National Nutrition Survey menuCH (2014–2015, n = 2057) were used. Food consumption was assessed with 24-hours dietary recalls. Using the multiple source method, the usual dietary intake was determined. Sustainability impacts were examined by determining Greenhouse Gas emissions, total land and grassland use, the Social Hotspots Index, and diet’s costs. Adherence and sustainability of the Swiss diet were analyzed descriptively. Participants consumed on average more red meat, dairy products, and added sugar and less whole grains, vegetables, legumes, nuts, and unsaturated fats than recommended by the PHD. None or few of the participants adhered to the whole grains (0.0

Importance:Prostate cancer (PCa) incidence and prognosis have changed substantially worldwide in recent decades, driven in part by early detection recommendations. Some countries such as the US have shown a rise in metastatic PCa incidence following recommendations against routine PCa screening around 2012. Objective:To evaluate trends in PCa incidence, mortality, and relative survival across age and prognostic groups and guide policy and practice in Switzerland. Design, Setting, and Participants:This cohort study included all registered cases of primary PCa based on data from the Swiss National Agency for Cancer Registration and the Swiss Federal Statistical Office from January 1, 1980, to December 31, 2021. Data were analyzed from January 8, 2024, until February 20, 2026. Exposure:Diagnosis of PCa. Main Outcomes and Measures:Age-standardized incidence and mortality rates and relative survival to 10 years after diagnosis were estimated. Subgroup analyses were conducted by age, Surveillance, Epidemiology, and End Results stage, Union for International Cancer Control stage, and Gleason score. Results:The study included 142 665 cases of primary PCa registered in Switzerland between 1980 and 2021, 100 102 (70.2%) of which were men aged 60 to 79 years. From 1980 to 2004, PCa incidence increased to 226.6 (95% CI, 218.8-234.7) per 100 000 men; it decreased markedly to 173.5 (95% CI, 168.9-178.2) per 100 000 men between 2011 and 2014, then increased again to 220.6 (95% CI, 216.0-225.3) per 100 000 men in 2021. These trends were primarily observed for localized, stage I to II PCa and PCa with a Gleason score of 7 or less in men aged 50 to 79 years. Incidence of distant and stage IV PCa increased after 2011, while incidence of PCa with a Gleason score of 8 to 10 remained relatively stable. PCa mortality declined continuously from the early 1990s to 34.8 (95% CI, 32.9-36.8) per 100 000 men in 2021, while 10-year relative survival increased from 46.2% (95% CI, 43.7%-48.8%) in 1982 to 1991 to 88.5% (95% CI, 86.6%-90.5%) in 2012 to 2021. The 10-year relative survival among men with localized PCa (99.2%; 95% CI, 96.0%-102.4%) was similar compared with men from the general population. Conclusions and Relevance:In this population-based cohort study, trends in PCa incidence in Switzerland suggest that overdiagnosis of lower-risk PCa increased and that there was a concurrent rise in cancers diagnosed in advanced stages alongside improvements in overall prognosis. These findings further suggest substantial potential for optimizing early detection of PCa.

Background/Objectives: More than half of Swiss adults exceed the World Health Organization's recommended limit for free sugar intake, with sugar-sweetened beverage (SSB) as a major contributor. SSB intake may be associated with other dietary risk factors, but little is known about diet quality excluding SSB intake. Therefore, the objective of this study was to investigate the association of SSB intake with the non-SSB diet quality in Swiss adults. Methods: Data from the cross-sectional, national nutrition survey menuCH (2014-2015, n = 2057, 18-75 years) were analyzed. Dietary intake was assessed via two 24 h dietary recalls. Participants were categorized as non-, low-, or high-SSB consumers based on the Swiss dietary guideline for free sugar intake. Diet quality excluding SSB was evaluated using the Alternative Healthy Eating Index (AHEI) scoring system (non-SSB AHEI). Results: Non-SSB consumers had higher non-SSB AHEI scores compared to low-SSB consumers, indicating healthier food choices beyond SSB intake, while high-SSB consumers had substantially poorer non-SSB diet quality. Despite these differences, non-SSB AHEI scores were only moderate across all SSB consumer types, suggesting that reducing SSB alone may not suffice to achieve optimal diet quality. Conclusions: In addition to population-based strategies to reduce SSB intake, future policies should aim to improve overall diet quality, including higher consumption of vegetables, fruits, whole grains and unsaturated fats. Prospective studies are needed to clarify which alternative food choices individuals make when reducing SSB intake.

Indication for visceral surgical procedures should be based on clinical reasoning only and independent of financial incentives. Yet, there is a lack of studies investigating whether insurance type (basic vs. supplementary private) is associated with surgical procedure rates. In this study we assessed whether incidence rates in adults with supplementary private insurance undergoing visceral surgical, non-emergency, in-patient procedures from 2012 to 2020 are higher compared to those with basic insurance only in Switzerland. We assessed incidence rates (IR) for basic only and supplementary private insurance stratified over time and by different age groups, and we fitted negative binomial regression models adjusted by inverse probability weights for specific visceral surgical procedures. We used primary or secondary discharge procedure codes for one of the following procedures: cholecystectomy, fundoplication, sigmoidectomy, rectopexy, haemorrhoidectomy, inguinal, femoral, and umbilical hernia repair. Of 1,954,119 surgical admissions (median age 63, 53.3

Contributions of population growth and aging and of risk to the changes in the number of new cases of early- and later-onset cancers among men, by main cancer sites (prostate, colorectum, lung, and skin), 1982–2021, Switzerland. Dotted line shows the difference in the annual number of new cases compared with the period 1982–1986.

Contributions of population growth and aging and of risk to the changes in the number of new cases of early- and later-onset cancers among women, by main cancer sites (breast, colorectum, lung, and skin), 1982–2021, Switzerland. Dotted line shows the difference in the annual number of new cases compared with the period 1982–1986.

BACKGROUND:The burden of early-onset cancers increases globally, raising major concerns. There is, however, confusion between trends in the number of cases and in age-standardized rates, and a lack of comparison with later-onset cancers. We described trends in cancer burden and risk in early- and later-onset cancers in Switzerland between 1982 and 2021. METHODS:We used data from the Swiss National Institute for Cancer Epidemiology and Registration, including all primary cancers between 1982 and 2021. A cancer was early-onset if diagnosed between ages 20-49 and later-onset at 50 or older. We calculated mean annual number of cases and deaths, crude and age-standardized incidence and mortality rates per 100,000, by 5-year period, sex, and cancer site. We estimated absolute and relative changes between 1982-1986 and 2017-2021. RESULTS:Between 1982 and 2021, the mean annual number of early-onset cancers increased by 1534 (+48%) and of later-onset cancers by 19,832 (+91%). Age-standardized incidence rates of early-onset cancers increased by 13/100,000 (+11%) and of later-onset by 92/100,000 (+8%). Population growth and ageing explained 73% of the increase of early-onset and 90% of the increase of later-onset cancers. The incidence increased in women (early-onset: +19%; later-onset: +9%) but not in men. For main cancer sites, early- and later-onset incidence showed parallel trends, except for colorectal (early-onset increased while later-onset decreased) and for lung in women (early-onset decreased while later-onset increased). All sites together, age-standardized mortality rates declined substantially (early-onset: -59%; later-onset: -38%). CONCLUSIONS:The increase in the burden of early-onset cancers was driven mainly by population growth and ageing, and to a lesser extent by an increased risk, also observed in later-onset cancers.

Mean annual age-standardized (2013 European standard) incidence rates for all cancers (C00-43, C45-97), by age group (early- vs later-onset), sex, and 5-year period, 1982-2021, Switzerland.

Abstract Background Updated and validated tools are crucial for assessing dietary intake. In French-speaking Switzerland, the only validated food frequency questionnaire (FFQ) was a paper-based version developed using data collected in 1990s. A new Swiss electronic FFQ (eFFQ) has recently been developed based on nationally representative dietary data from 2010s. The eFFQ has been recently validated and is intended for adoption in future studies among French-speaking adults living in Switzerland. Both FFQs differ in format (paper vs. electronic), food lists, frequency categories, portion sizes, and food composition databases. We aimed to compare dietary intake estimates from the recently developed eFFQ vs. the paper-based FFQ. Methods We recruited 75 volunteers aged 18 to 75 years (54.7% female) who completed both FFQs in random order. Intakes of energy, 10 macronutrients, four micronutrients and 28 food groups were estimated using each FFQ and compared using multiple statistical tests. Results Group-level estimates of energy and most nutrients showed good agreement between FFQs, with differences in median intakes < 10% for 8 of 14 nutrients, including energy, protein, carbohydrates, total sugars, total fat, and saturated fatty acids (SFAs). Largest differences were observed for alcohol (+ 119% in the eFFQ), fibre (+ 37%), polyunsaturated fatty acids (+ 27%), and cholesterol (+ 26%). Spearman’s correlation coefficients (SCCs) were ≥ 0.50 for 12 of 14 nutrients, and misclassification into opposite tertiles (> 10% of participants) was observed only for SFAs (13%). Bland-Altman analysis confirmed acceptable agreement for energy and macronutrient intakes. At the food group level, the eFFQ yielded significantly higher median intakes for 14 of 28 food groups – most notably plant-based protein-rich foods and cream, fatty sauces & other fats – and lower median intakes for four groups, including vegetables and fish. Ranking agreement was acceptable for most food groups (SCCs = 0.57–0.91) but weaker for water (0.07); vegetable oil (0.42); cream, fatty sauces & other fats (0.33); and mixed dishes & soups (0.47). Conclusions The new eFFQ demonstrated good relative agreement with the previous paper-based FFQ, particularly for ranking individuals. These findings provide valuable information for researchers and policy makers comparing results of both FFQs over time and across populations.

Objectives: menuCH-Kids was launched to generate the first Swiss nationwide children's dietary data, assess food contaminant exposure, and inform nutrition policies. This paper describes the methods, data quality, and participants characteristics. Methods: In 2023-2024, a cross-sectional population-based survey in six Swiss centres collected dietary data via two non-consecutive 24-hour recalls/records and a Food Propensity Questionnaire; lifestyle, health, eating behaviours and sociodemographic information via online questionnaires; anthropometrics, urine, and voluntary blood samples by trained professionals with standardized procedures in 6-17-year-olds. Area-based socioeconomic position (Swiss-SEP) was linked to home addresses. Statistical weights corrected for unequal selection probabilities and non-response. Factors associated with participation were explored using logistic regressions. Results: 1,852 participants attended the visit (participation rate = 11.9%). Data quality was high (<6% missing values, 15.1% dietary under-reporters, and 98% of biosamples processed on time). Non-participants were older, male, non-Swiss, from lower socioeconomic neighbourhoods, and smaller household. Adding socioeconomic position improved participation prediction models. Conclusion: menuCH-Kids provides high-quality dietary and health data on Swiss youth. Low participation highlights the need for a weighting strategy including socioeconomic position to compensate biases.

PURPOSE:The COVID-19 pandemic and associated measures negatively impacted health outcomes of patients with severe diseases. This study investigated the short- and intermediate-term impact of the pandemic on cancer survival. METHODS:This study was based on cancer registry data of the Swiss cantons of Zurich and Zug from 2018 to 2021. Observed and relative one- and three-year survival were calculated based on lifetables for the population covered by the registry. Multivariable Royston Parmar survival regression models were fitted to compare survival before (2018/2019) and during the pandemic (2020, 2021). For patients diagnosed during the pandemic, a counterfactual analysis was conducted. Analyses were performed for overall cancer and the five most common cancer types. RESULTS:Overall, 32 826 cancer cases were included. One- and three-year survival for all-cancer continuously increased from 2018 to 2021. Compared to pre-pandemic, the hazard of death was lower for all-cancer during the pandemic (2020: Hazard Ratio 0.93 [95% Confidence Interval 0.89, 0.96]; 2021: 0.91 [0.87, 0.94]) and for skin melanoma in 2021 (0.79 [0.62, 0.98]), but higher for colorectal cancer during the pandemic (2020: 1.17 [1.03, 1.32]; 2021: 1.24 [1.09, 1.40]). Observed one-year survival for all-cancer, female breast, and prostate cancer was higher in 2021 than predicted. In 2020, observed one-year survival of colorectal cancer and three-year survival of female breast cancer were lower than predicted. CONCLUSION:The COVID-19 pandemic appears to have had only a minimal impact on the overall increasing cancer survival trend in Switzerland, reflecting the robustness and resilience of the healthcare system.