European Journal of Cancer Prevention最新文献

Objectives: Whole-body MRI is increasingly used for preventive health screening; however, the prevalence and distribution of incidental oncologically relevant findings in asymptomatic individuals remain incompletely characterized. The primary objective of this multicentre study was to describe the frequency and anatomical distribution of clinically relevant findings detected by whole-body MRI in an asymptomatic adult population. As a secondary objective, we evaluated the feasibility of using a large language model (LLM) for retrospective extraction and structuring of radiology report data for research purposes.

Methods: Radiology reports from 327 asymptomatic adults who underwent MRI as part of a preventive screening program were retrospectively collected from four diagnostic centers. All MRI examinations were interpreted by subspecialist radiologists (neuroradiology, body imaging, and musculoskeletal imaging), and clinical findings were classified using the Oncologically Relevant Findings Reporting and Data System (ONCO-RADS). A senior radiologist analyzed the reports to extract only findings with ONCO-RADS values ≥3, creating a reference standard. In addition, an LLM (DeepSeek-R1-Llama3.3, Hangzhou DeepSeek Artificial Intelligence Basic Technology Research Co., Ltd., Hangzhou, Zhejiang, China) was subsequently applied to automatically extract all findings from free-text reports with associated ONCO-RADS categories (including also ONCO-RADS 1 and 2) and anatomical locations. LLM outputs were compared with the radiologist-defined ONCO-RADS to assess the performance.

Results: Among the 327 individuals (213 males, 114 females; median age 52 years), a total of 237 findings (5%) classified as ONCO-RADS ≥ 3 were extracted by the radiologist, affecting 138 individuals (42.2%). The majority of ONCO-RADS ≥ 3 findings were ONCO-RADS 3 (232, 97.9%). Three findings (1.3%) were ONCO-RADS 4, and two (0.8%) were ONCO-RADS 5. Three malignant lesions were confirmed (prostate cancer, renal cell carcinoma, and appendiceal carcinoma), corresponding to a cancer prevalence of 0.9% in the screened population. Regarding the performance of the LLM in extracting and structuring radiologist-reported findings, 207 (87.3%) ONCO-RADS were correctly extracted, 17 (7.2%) were missed, and 13 (5.5%) were incorrectly localized.

Conclusion: Whole-body MRI detected a small number of confirmed occult malignancies and a higher prevalence of oncologically relevant findings (ONCO-RADS ≥ 3). Regarding the LLM, results showed that it can support efficient and standardized retrospective extraction of structured information from heterogeneous radiology reports.

Prostate cancer (PCa) is the second most common cancer in men and the fourth worldwide. Diet has been suspected as a contributor to PCa onset and progression; however, evidence remains inconsistent, because many studies focus on individual foods and use heterogeneous methods to derive dietary patterns. This systematic review evaluates the association between empirically derived dietary patterns and overall PCa risk in prospective cohort studies. A literature search was conducted on PubMed, Web of Science, Embase, the Cochrane Library, and Food Science and Technology Abstracts, following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Risk estimates comparing the highest versus lowest adherence categories were extracted. A random-effects meta-analysis using restricted maximum likelihood estimation pooled hazard ratios for overall PCa risk. Six eligible cohort studies were included. Two main dietary patterns were identified: a 'western' pattern, characterized by high intakes of red and processed meats, sweets, desserts, and a 'prudent' pattern characterized by high intakes of fruits, vegetables, fish, and seafood. No significant association with overall PCa was observed: prudent, hazard ratioPooled = 0.98; confidence interval95% [0.91-1.06]; western, hazard ratioPooled = 1.07; confidence interval95% [0.93-1.22]. Empirically derived dietary patterns were not significantly associated with overall PCa risk. Some evidence suggested an association between western dietary pattern and localized and aggressive PCa in populations with limited prior exposure, highlighting the role of dietary shifts. However, these findings were based on a limited number of studies, reflecting the scarcity of prospective cohort data. Future research should aim to standardize dietary pattern derivation and confounder selection to improve comparability across studies.

Introduction: We estimated cancer mortality figures for 2026 in five major Asian countries and Australia, with a specific focus on prostate cancer.

Methods: We computed country- and sex-specific annual age-standardized mortality rates (ASRs) for all cancers combined and for the 10 most common cancer sites, using data from the WHO and the United Nations Population Division up to 2022 or the most recent available year. We predicted figures for 2026 and estimated the number of avoided cancer deaths in 1994-2026.

Results: Predicted mortality rates for all cancers combined in 2026 are favourable across all considered countries and in both sexes, with the largest declines expected in the Republic of Korea (-20.5% in males and -10.2% in females compared with 2020-2022). In 2026, the lowest predicted male rate is expected in the Philippines (72.1 per 100 000), and the highest one in Australia (92.3 per 100 000). Among females, the lowest predicted ASR (42.2 per 100 000) is in the Republic of Korea, whereas the highest one (74.1 per 100 000) in the Philippines. Trends are generally favourable for lung, stomach, colorectum, and other major neoplasms considered, except pancreas. Predicted prostate cancer mortality is favourable in all countries and across all age groups. Rates are expected to remain low in Hong Kong SAR, Japan, and the Republic of Korea, with ASRs below 4 per 100 000 males. Since the 1993 observed peak rate, an estimated 132 000 total cancer deaths were avoided in Hong Kong SAR, 75 000 in Israel, 1 366 000 in Japan, 720 000 in the Republic of Korea, 328 000 in Australia, and 102 000 among men in the Philippines.

Conclusions: Declining cancer mortality is predicted in the countries considered. These trends largely reflect smoking cessation along with improvements in prevention, early detection, and treatment. However, substantial geographic disparities persist, highlighting the need for strengthened cancer control strategies, particularly in ageing populations.

Background: Soft tissue sarcomas (STSs) are rare malignancies with largely unknown etiology; the role of anthropometry and physical activity has been rarely explored.

Methods: We analyzed 2011-2019 data of an Italian, multicenter, hospital-based case-control study including 498 incident, histologically confirmed STS cases and 969 controls. Self-reported height, weight, and physical activity data were collected; hip and waist circumferences were measured in 76% of cases and 61% of controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple-adjusted logistic regression models.

Results: Compared with BMI < 25 kg/m 2 , the ORs for BMI one year prior to diagnosis/interview were 1.05 (95% CI: 0.80-1.37) for 25-29.9 kg/m 2 and 1.28 (95% CI: 0.90-1.83) for ≥30 kg/m 2 . The OR was increased for BMI 25-29.9 kg/m 2 at age 30; no association emerged for BMI at age 50 years. For waist circumference, the ORs were 1.93 (95% CI: 1.38-2.70) for >102 cm in males or >88 cm in females, and 3.54 (95% CI: 2.40-5.22) for the highest versus the lowest tertile. For waist-to-hip ratio, the ORs were 1.18 (95% CI: 0.81-1.71) for the intermediate, and 2.81 (95% CI: 1.95-4.03) for the highest tertile. Subjects reporting ≥5 h/week of total or intermediate/high intensity leisure-time physical activity at age 30-39 years had ORs of 0.63 (95% CI: 0.40-1.00) and 0.56 (95% CI: 0.32-1.00), respectively.

Conclusion: These findings show a positive association between abdominal adiposity and STS risk, and an inverse association with regular leisure-time physical activity.

Head and neck cancers (HNCs) represent a major global health burden. While smoking, alcohol consumption, and human papillomavirus infection are established risk factors, the association between coffee intake and HNC risk remains inconclusive. This study evaluated the relationship between coffee consumption and HNC risk, with consideration of consumption levels and anatomical tumor subsites. A systematic search of four databases was conducted through March 2025. Two reviewers independently extracted data on study characteristics, coffee consumption (cups/day), and tumor subsites. Adjusted odds ratios (ORs) were pooled using meta-analytic methods, and analyses were stratified according to coffee intake levels. Thirty studies were included. Stratified analyses adjusted for confounders demonstrated protective effects at 3-4 cups/day [OR: 0.83, 95% confidence interval (CI): 0.70-0.99], more than 3 cups/day (OR: 0.63, 95% CI: 0.52-0.74), and more than 4 cups/day (OR: 0.71, 95% CI: 0.55-0.92), with an overall protective effect against HNC (OR: 0.78, 95% CI: 0.72-0.86, P = 0.0044). Site-specific analyses showed reduced risk for oral cancer (OR: 0.71, 95% CI: 0.63-0.80, P < 0.0001), pharyngeal cancer (OR: 0.80, 95% CI: 0.73-0.87, P < 0.0001), and upper aerodigestive tract cancer (OR: 0.78, 95% CI: 0.64-0.94, P = 0.0107), particularly among individuals consuming more than 3 cups/day; however, coffee consumption was associated with increased laryngeal cancer risk (OR: 1.13, 95% CI: 1.04-1.24, P = 0.0065). Higher coffee intake (≥3 cups/day) may reduce overall HNC risk while demonstrating important site-specific differences.

Objective: Lung cancer remains a highly prevalent and lethal disease, with the majority of tumors identified at advanced stages. Screening with low-dose CT was shown to be effective in reducing mortality through early diagnosis. Administrative data are increasingly utilized in clinical settings and research for identifying metastatic lung cancer, yet their accuracy and limitations require thorough evaluation.

Methods: This study evaluated the use of administrative data to identify lung cancer metastases within the population-based cancer registry (CR) of Reggio Emilia by cross-referencing registry data with administrative hospital discharge records (HDRs). Distant metastases were identified using specific International Classification of Diseases, 9th revision codes, with medical records reviewed to validate and refine the identification process. Standardized incidence and mortality rates were calculated and analyzed using joinpoint regression.

Results: Between 2018 and 2021, 1391 lung cancers exhibiting at least one HDR were identified. Of these, 383 (27.5%) cases had distant metastases, 80 (6%) had a second tumor, and 12 (1.5%) had unknown tumor sites. After a manual review of cases with codes 196 (secondary and unspecified malignant neoplasm of lymph nodes) and code 199 (malignant neoplasm without specification of the site), the number of identified metastatic tumors increased to 30.5%. Lung cancer metastases identified by the CR showed an HDR sensitivity equal to 32.6%.

Conclusion: Administrative data, even with manual verification, achieved a positive predictive value of 30.5 for metastatic tumors. The scientific community and policymakers must be aware of these limitations and the need for additional resources to accurately screen to evaluate lung cancer.

Background: The aim of the present study was to evaluate the factors associated with a higher or lower likelihood of being early diagnosed with melanoma at stage I in Germany.

Methods: This retrospective cross-sectional study utilizes data from the German skin cancer registry (Arbeitsgemeinschaft Dermatologische Onkologie Registry) and included 12 648 patients with a first melanoma diagnosis in 80 hospitals between 1 January 2018 and 30 November 2024. Multivariable logistic regression analyses were conducted to assess the associations between demographic and clinical variables and the likelihood of being early diagnosed with stage I melanoma.

Results: This study included 4138 patients with stage I and 8510 patients with stages II-IV melanoma. Factors including older age [adjusted odds ratio (aOR): 0.61] for age group 71-80 years and 0.54 for age group > 80 years, compared to the age group 18-40 year, male sex (aOR: 0.73), Celtic (aOR: 0.66), mixed (aOR: 0.58), and Mediterranean (aOR: 0.31) skin types, melanomas located on the gluteal region (aOR: 0.35), scalp and neck (aOR: 0.44), lower limb (aOR: 0.51), upper limb (aOR: 0.67), and back (aOR: 0.72) and being single (aOR: 0.81) were negatively associated with an early diagnosis of stage I melanoma. Finally, a positive association was observed between a family history of skin cancer and the likelihood of being diagnosed with stage I melanoma (aOR: 1.50).

Conclusion: This study provides important insights into the demographic and clinical factors associated with early-stage melanoma diagnosis in Germany and underscores the importance of targeted interventions aimed at increasing melanoma awareness.

Breast cancer survivors often face persistent physical and emotional challenges. Evidence suggests that physical exercise and group psychological interventions can improve well-being and illness adjustment. This pilot study examined the effectiveness of a combined intervention delivered in a natural environment. Sixty female breast cancer survivors (Mage = 51.0; SD = 5.5) participated in a 1-week program consisting of daily sailing lessons and group psychological sessions designed to address cancer-related issues. Assessments were conducted 1 week before and 1 week after the intervention using the Functional Assessment of Cancer Therapy-Breast (FACT-B) to assess quality of life and the State-Trait Anxiety Inventory. Linear mixed-effects models tested changes over time in quality of life and anxiety and whether previous psychotherapy or physical activity influenced these outcomes. FACT-B total scores significantly improved over time (P = 0.004), with gains in physical well-being (P < 0.001), emotional well-being (P < 0.001), and breast cancer-specific concerns (P = 0.018). No changes over time were observed in social or functional well-being. Anxiety levels remained moderate and stable (P = 0.250). Previous psychotherapy and physical activity did not significantly influence changes in quality of life or anxiety. A short-term group intervention combining sailing lessons and psychological sessions in a natural environment may enhance quality of life in breast cancer survivors, particularly in physical and emotional domains. These findings suggest that integrative approaches addressing both physical and psychological health are feasible and warrant further investigation in larger controlled studies.

This study aimed to identify predictive factors for response to neoadjuvant treatment in patients with stage II and III breast cancer. A cross-sectional study evaluated the medical records of 440 patients treated in the Oncology Department of a University Hospital in Brazil between 2007 and 2022. Response to neoadjuvant treatment was classified into three groups: pathological complete response (pCR), partial response, and no response. Predictive factors were analyzed using multinomial regression. Most patients showed partial response (73.9%). Patients aged 39 years or younger were three times more likely to achieve pCR [relative risk (RR) = 3.04, 95% confidence interval (CI): 1.51-6.15]. Conversely, patients with luminal A and B subtypes had a lower likelihood of pCR (RR = 0.09, 95% CI: 0.04-0.18). The presence of diabetes (RR = 7.18, 95% CI: 2.43-21.1) and stage IIIB and IIIC (RR = 7.41, 95% CI: 1.48-37.0) increased the risk of no response by at least 7.4-fold. Besides age, molecular subtype, and staging, diabetes was significantly associated with the response to neoadjuvant chemotherapy, highlighting the importance of elucidating the mechanism by which diabetes may impair the response to neoadjuvant treatment, as well as the importance of prevention and management of diabetes before and during oncologic treatment.

Background: Cervical (CC), ovarian (OC), and uterine (UC) cancers are major contributors to global gynecological cancer (GC) burden. This research intended to update trends in disease burden and care quality for these cancers and quantify cross-country inequalities between 1990 and 2021.

Methods: We performed a secondary analysis utilizing the Global Burden of Disease 2021 database. Disease burden and care quality were evaluated through age-standardized incidence rates (ASIR), age-standardized years lived with disability rates (ASYR), and quality-of-care index (QCI). Trends were analyzed using estimated annual percentage changes, while absolute and relative cross-country inequalities were quantified using the slope index of inequality and concentration index.

Results: From 1990 to 2021, global ASIR and ASYR for CC and OC declined, whereas UC showed an increase in both rates. Concurrently, a general uptrend in QCI was observed for all three GCs. Across the WHO regions, the European region reported the highest ASIR and ASYR for OC and UC in 2021, and the African region recorded the highest for CC. In both 1990 and 2021, countries/territories with higher socio-demographic index (SDI) experienced a higher ASYR for OC and UC, while CC primarily concentrated in lower SDI countries/territories. Significant healthcare inequalities in age-standardized QCI were observed, with higher SDI countries/territories generally exhibiting better QCI.

Conclusion: Trends in the burden and QCI for gynecological cancers demonstrated significant disparities among WHO regions and 204 countries/territories, with global inequalities persisting. Urgent action is needed to develop geographically tailored strategies for equitable access to high-quality healthcare.