Despite progress in the detection and treatment of bladder cancer (BC), it remains one of the common cancer diagnoses. Updated estimates of its epidemiology and mortality are needed to better understand the BC burden in Germany. This research aims to estimate the incidence/prevalence of BC in Germany and to describe trends in mortality in the last eleven years.

OBJECTIVES: To describe recent trends in lung cancer incidence, staging, morphology, and survival outcomes in Germany using comprehensive population-based data from the German Centre for Cancer Registry Data (ZfKD).

METHODS: This retrospective analysis included all lung cancer cases diagnosed from 2020 to 2023 in individuals aged 18 years or older. Anonymized data were sourced from the ZfKD, which compiles mandatory cancer notifications across the German federal states. Variables analyzed included patient demographics, tumor characteristics (histological subtype, stage), and Kaplan-Meier-based survival estimates stratified by cancer subtype and stage.

RESULTS: A total of 222,366 lung cancer cases were recorded, with incidence per 100 adults of 0.081, 0.082, 0.081, and 0.077 in 2020, 2021, 2022, and 2023, respectively. Non-small cell lung cancer (NSCLC) accounted for 82.6% of cases, while small cell lung cancer (SCLC) made up 13.8%. NSCLC patients were older at diagnosis than those with SCLC (mean 70.2 vs. 68.5 years). Stage IV was the most common at diagnosis (41% in NSCLC, 59% in SCLC). Median survival was 12.8 months for NSCLC and 8.1 months for SCLC, dropping to 6.5 and 6.8 months, respectively, in stage IV disease. Adenocarcinoma was the most frequent NSCLC subtype (40.5%), followed by squamous cell carcinoma (15.7%).

CONCLUSION: Late-stage lung cancer diagnosis remains common and contributes to poor short-term survival. These findings underscore the need for earlier detection strategies and continued research into treatment pathways and outcomes.

OBJECTIVES: To investigate whether social desirability bias contributes to the paradox of older adults reporting high medication adherence despite a greater risk of non-adherence due to polypharmacy and comorbidities.

METHODS: We analyzed cross-sectional data from 308 anonymized adults with atrial fibrillation (AF), surveyed via online panels in the UK and the US, and during outpatient visits at a specialized stroke center in a German hospital. Patients suffering from AF and undertaking long-term treatment were included independently of the type, treatment, or duration of the disease. Participants completed the Adherence Assessment Questionnaire (AAQ), a validated self-report instrument that includes a two-item social desirability scale. Binomial logistic regression was used to estimate associations between age, social desirability, and their interaction with self-reported non-adherence, adjusting for gender, country, and number of medications. Sensitivity analyses using ordinal and linear regression models, as well as moderation estimates, were conducted to assess robustness.

RESULTS: The sample had a mean age of 67.0 years (SD: 13.2), and 33.8% were female. Increasing age and higher social desirability scores were associated with lower odds of reporting non-adherence (OR = 0.97, 95% CI: 0.94-0.99, p = .009 and OR = 0.80, 95% CI: 0.64-1.00, p = .051, respectively). The age-by-social desirability interaction was marginal in the binomial model (OR = 0.98, 95% CI: 0.96-1.00, p = .105), but significant in ordinal (p < .001) and linear (p = .002) regressions. Older adults with higher social desirability scores were especially likely to report better adherence. The moderation analysis (p = .016) confirmed that social desirability bias strengthened the association between age and adherence. No country-level differences were observed.

CONCLUSION: The apparent increase in self-reported adherence with age may reflect response bias rather than true behavioral differences. The tendency of socially desirable response behavior should be considered when interpreting self-reported adherence data.

External control arms (ECAs) are used to generate comparative evidence (e.g., effectiveness) when only a single-arm trial has been conducted during the drug development process. However, key stakeholders often face substantial delays in determining the feasibility of an ECA; a responsive tool could streamline this process in a structured, rigorous manner.