{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:57:24Z","timestamp":1791565044759,"version":"4.3.4"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Immune checkpoint inhibitors (ICIs) were introduced at different times across cancer types, but whether early approvals coincided with cancer-specific changes in national mortality remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an ecological observational comparative time-series study using CDC WONDER United States Cancer Statistics mortality data from 1999\u20132019. We analyzed CDC-calculated age-adjusted mortality rates (AAMRs) for melanoma of the skin, lung and bronchus, kidney and renal pelvis, urinary bladder, and Hodgkin lymphoma. Cancer-specific synthetic-control models used each site\u2019s first major ICI approval year, preperiod-centered log AAMR trajectories, mutually exclusive solid or hematologic comparison sites, and a common 0\u20133-year postapproval estimand. Placebo analyses and staggered-adoption difference-in-differences (DiD) were robustness checks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Observed AAMRs averaged 3.44%, 13.05%, 4.73%, 3.60%, and 3.68% below synthetic estimates for melanoma, lung, kidney, bladder, and Hodgkin lymphoma, respectively. Conditional placebo-rank pseudo-P values were .40, .23, .25, .20, and 1.00. Temporal-placebo models showed earlier divergence for several sites. The balanced 0\u20133-year DiD estimate was \u22120.96 deaths per 100,000 (95% pointwise CI, \u22122.99 to 1.06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cancer-specific mortality patterns were directionally compatible with lower mortality during early ICI approval eras, but placebo benchmarking, heterogeneous temporal specificity, and an imprecise DiD estimate precluded firm causal attribution. These ecological findings do not estimate individual treatment effectiveness or current ICI practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748261492471","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:11:41Z","timestamp":1791403901000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["U.S. Cancer-Specific Mortality Trends After Early Immune Checkpoint Inhibitor Approvals: An Ecological Synthetic-Control Study, 1999\u20132019"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6323-3192","authenticated-orcid":false,"given":"Woo Joo","family":"Lee","sequence":"first","affiliation":[{"name":"AdventHealth Sebring"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon Hye","family":"Won","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Dongguk University Ilsan Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Park","sequence":"additional","affiliation":[{"name":"Moffitt Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Sohaib","family":"Asghar","sequence":"additional","affiliation":[{"name":"AdventHealth Sebring"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moazzam","family":"Shahzad","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Moffitt Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Shimshak","sequence":"additional","affiliation":[{"name":"AdventHealth Sebring"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3239"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1003466"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503093"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1501824"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504627"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1510665"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00561-4"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.0793"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.01207"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910836"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21763"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31551"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.25459"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1916623"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.2535"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1198\/jasa.2009.ap08746"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeconom.2020.12.001"},{"key":"e_1_3_8_19_2","volume-title":"WONDER Online Database","author":"Centers for Disease Control and Prevention","unstructured":"Centers for Disease Control and Prevention. United States Cancer Statistics\u2014Mortality: 1999\u20132021. In: WONDER Online Database. https:\/\/wonder.cdc.gov\/cancermort-v2021.html. Accessed 8 August 2026."},{"key":"e_1_3_8_20_2","unstructured":"Centers for Disease Control and Prevention. United States Cancer Statistics data visualizations and data access. https:\/\/www.cdc.gov\/united-states-cancer-statistics\/. Accessed 8 August 2026."},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"issue":"20","key":"e_1_3_8_22_2","first-page":"1","article-title":"Age adjustment using the 2000 projected U.S. population","author":"Klein RJ","year":"2001","unstructured":"Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. 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