European Journal of Cancer Prevention最新文献

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide, with smoking being a significant risk factor. Understanding the temporal and spatial patterns of the CRC burden attributable to smoking is crucial for global public health strategies. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were used to calculate the number of deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR) per 100 000 population, and age-standardized disability-adjusted life year rate (ASDR). The average annual percentage change (AAPC) was calculated from 1990 to 2021 to analyze disease burden trends. Frontier analysis was conducted to assess efficiency, and predictions were made for the next decade. In 2021, the global death toll and DALYs attributable to smoking were 47 613 and 1 235 667, respectively. From 1990 to 2021, the absolute number of deaths and DALYs increased, while ASMR (AAPC: -1.20) and ASDR (AAPC: -1.22) showed a significant decline. The disease burden was notably higher in males than females. Analysis by the Social Development Index revealed that more developed regions had a higher burden than less developed areas. China ranked first in the number of deaths and DALYs, while Greenland had the highest ASMR and ASDR. From 1990 to 2021, the age-standardized burden of CRC attributable to smoking decreased globally. However, the absolute burden remains a significant public health challenge, requiring sustained and targeted interventions.

This study aimed to evaluate the ability of the preoperative Hemoglobin, Albumin, Lymphocyte count, and Platelet (HALP) score to predict lymph node metastasis (LNM) in patients with rectal cancer (RC) and improve prediction accuracy by incorporating clinical parameters. Data from 263 patients with RC were analyzed. The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value (OCV) for the HALP score in predicting LNM. Based on this cutoff value, patients were divided into two groups. A baseline analysis was conducted to identify independent factors linked to LNM. A support vector machine (SVM) prediction model was developed, and its performance was evaluated using ROC, calibration curves, decision curve analysis, and Kolmogorov-Smirnov curve. The OCV for HALP score was 45.979. Patients were then classified into a low HALP group ( n  = 182) and a high HALP group ( n  = 81). The analysis found 21 clinical factors significantly associated with LNM. Among them, the key risk factors included high inflammatory status, poor nutritional condition, and a low HALP score. The SVM model incorporated these factors and showed robust predictive performance, with area under the curve values of 0.897, 0.813, and 0.750 for the training, validation, and testing datasets, respectively. The HALP score was significantly associated with LNM in RC patients. A machine learning model integrating the HALP score and inflammatory markers may be an effective tool for predicting LNM in RC.

Deuterium is a natural heavy isotope of hydrogen, containing a neutron and a proton. This gives it distinct biophysical and biochemical properties, compared with hydrogen. Deuterium alters enzymatic activity in significant ways. Human metabolic processes minimize the amount of deuterium in mitochondrial water, because it causes a dysfunction in mitochondrial ATPase pumps, leading to excessive reactive oxygen species (ROS) and loss of ATP production. Mitochondrial dysfunction is a characteristic feature of cancer and many other diseases. Lactate plays an important role in cancer progression, and a central role holds also for vacuolar ATPases (V-ATPases). In the presence of excess deuterium, cancer cells show a remarkably altered metabolic policy, enabling invasion and proliferation. Cancer cells protect their mitochondria from excessive ROS by minimizing the use of ATPase to synthesize ATP. Instead, they rely on glycolysis to supply ATP and support the massive synthesis of lactate, which is excreted into the microenvironment. They also use V-ATPases in an unusual way at the plasma membrane to pump deuterium-depleted protons out of the cell, enriching cytoplasmic deuterium. These complex processes suggest that cancer cells are able to sense deuterium levels in the medium and commit apoptosis when deuterium levels are low or proliferate when they are high. Tumorigenesis involves a metabolic switch that supports increased cellular deuterium levels, decreasing the deuterium burden overall in the organism. Strong clinical evidence supports deuterium-depleted water (DDW) as an anticancer treatment. More investigations on cancer autophagic behavior are needed to guide DDW clinical use.

The growing number of cancer survivors has led to an increase in the frequency of multiple primary cancers. This study aimed to describe the temporal trends in the incidence rates and standardized incidence ratios (SIRs) of second primary cancers (SPCs) among patients diagnosed with a first primary cancer (FPC) in 2000-03, 2004-07 and 2008-11 in Northern Portugal. Population-based samples of patients diagnosed with an FPC (excluding skin non-melanoma) in 3 periods of 4 years, between 1 January 2000 and 31 December 2011, and registered in the Portuguese North Region Cancer Registry were followed for the diagnosis of an SPC or death until 31 December 2013. Incidence rates and SIRs were estimated for each period by sex, and considering the time between FPC and SPC diagnosis (synchronous and metachronous). During follow-up, 10 119 (7.4%) SPCs were identified among patients diagnosed with an FPC in 2000-11 ( n  = 136 382). The incidence rate of SPCs was over 10-fold higher in the first few months, remaining stable over the follow-up. Higher rates were observed in 2004-07 and 2008-11. Overall, a greater proportion of SPCs was diagnosed among males than females. The proportion of SPCs diagnosed increased with age. Increases in SIRs of SPCs were observed from 2000-03 to 2008-11, ranging from 1.16 to 1.77 and from 1.54 to 2.33, among males and females, respectively. This was particularly evident for FPCs and SPCs of the lip, oral cavity, pharynx, oesophagus and larynx among males, and colon and rectum, lung, ovary and cervix among females. Survivors of cancer in Northern Portugal had higher incidence rates of cancer than the general population, which have increased over time. Our findings highlight the need for enhanced surveillance and tailored strategies for survivors of cancer, emphasizing the challenges of their heightened cancer risk, patient expectations, and associated economic burden.

Objectives: The prognostic significance of microsatellite instability (MSI) and HER2 status in advanced gastric cancer (AGC) treated with neoadjuvant or conversion chemotherapy (NAC) remains unclear. This study aimed to evaluate their impact on pathological response and survival outcomes in AGC patients undergoing NAC followed by surgery.

Methods: This single-center, retrospective observational study included 121 patients with gastric adenocarcinoma at clinical stage >cT2N0, defined as tumor invasion beyond the muscularis propria, nodal involvement, or both. Eligible patients received at least two cycles of NAC and underwent surgical resection. Adults without other malignancies and with biopsy samples available for molecular analysis were included. Data were obtained from a prospectively maintained surgical database. Imaging studies were reviewed by expert radiologists, and molecular analyses were performed in the pathology department.

Results: Among the 121 patients, MSI was identified in 6.6% and HER2 positivity in 9.9%. All MSI tumors were HER2 negative ( P  < 0.001). HER2 positivity was more frequent in intestinal-type tumors ( P  = 0.034) and was associated with better pathological response ( P  = 0.048). The 5-year overall survival (OS) rate was 44.7%, with a median OS of 42.6 months. Multivariate Cox regression identified tumor location in the upper third, residual tumor, nodal stage, Lauren diffuse-mixed histotype, and negative HER2 status as independent prognostic factors ( P  < 0.05). MSI status was not significantly associated with OS ( P  = 0.786), although a trend toward improved survival was observed in MSI-H patients.

Conclusions: HER2 overexpression correlated with better pathological response and independently predicted improved OS. MSI and HER2 status may serve as biomarkers to guide preoperative treatment strategies in AGC.

It is often reported that participation in the German colorectal cancer (CRC) screening program is low. However, it must be considered that fecal occult blood testing (FOBT) and colonoscopy are offered in parallel and both are also used for diagnostic purposes. We aimed to quantify and characterize the uptake of these colorectal examinations in Germany. Using the claims database German Pharmacoepidemiological Research Database (~20% of the German population), we included persons aged 50 in 2011 in cohort 1 (cohort 2: age 55) and assessed whether they utilized FOBT or colonoscopy for screening or diagnostic purposes until age 59 (cohort 2: age 64). We have stratified the analyses, i.e. by gender and educational level. Among 185 949 50-year olds, 80% of women and 63% of men had ≥1 colorectal examination (i.e. FOBT or colonoscopy) until age 59; 25% of women and 31% of men had ≥1 colonoscopy (among those, 76 and 62% had a screening colonoscopy). In women with lower vs higher education, 79 vs 82% had any colorectal examination; in men, these proportions were 60 vs 67%. Among 156 258 55-year olds, 78% of women and 69% of men had ≥1 colorectal examination until age 64. Our study demonstrates a high utilization of colorectal examinations in Germany. It also illustrates the value of health claims data to monitor CRC screening in Germany due to their longitudinal character and because they include information on screening, on examinations done for diagnostic reasons as well as information suitable to characterize users and nonusers.

Objective: Atypical glandular cells (AGC) in cervical cytology are often ignored, and the malignancy risk associated with AGC remains uncertain. This study aims to evaluate the histopathology and clinical correlations in patients diagnosed with AGC through cervical cytology.

Methods: This study was retrospectively analyzed 402 patients who diagnosed with AGC using cervical cytology in our hospital between March 2017 and June 2024. Among these, high-risk human papillomavirus (hrHPV) results and histopathological findings within 1-year follow-up were included.

Results: The distribution of AGC subcategories were as follows: atypical endocervical cells (AEC), 13.4%; atypical endometrial cells, 10.9%; AGC, not otherwise specified, 49.8%; AEC, favor neoplastic, 6.7%; AGC, favor neoplastic, 19.2%. Precancerous lesions and malignancies were diagnosed in 58.9% of cases, with endometrial carcinoma being the most common (24.4%), followed by adenocarcinoma (10.0%). A total of 358 patients underwent hrHPV testing, with a positive rate of 35.2%, hrHPV positivity significantly increased the risk of cervical lesions, while endometrial lesions and pelvic malignancies were more common in hrHPV-negative patients.

Conclusion: This study showed that cytological diagnosis of AGC has high predictive value for cervical lesions, endometrial lesions, and pelvic malignancies. A more detailed triage procedure based on the AGC subcategory can reduce the possibility of missed diagnoses of reproductive tract tumors. The combination of hrHPV detection and age can serve as an important basis for the further diagnosis and management of AGC.

Background: Colorectal cancer (CRC) poses a significant health burden in Europe, but comprehensive studies on this region are limited.

Methods: Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2021, we analyzed the regional distribution and temporal trends of the CRC and early-onset CRC burden in Europe from 1990 to 2021. Decomposition analysis was applied to quantify the contributions of population growth, aging, and epidemiological changes. The research also evaluated major risk factors associated with CRC and early-onset CRC.

Results: The burden of CRC in Europe was found to be higher than the global average. While the age-standardized incidence rate (ASIR) increased, both the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) decreased. Early-onset CRC exhibits similar distribution characteristics and patterns of change. Males had a significantly higher CRC burden than females. Population aging was the primary driver of increased burden in Europe. Risk factor analysis revealed that low whole grain intake and high red meat consumption were the primary contributors to the elevated ASMR and ASDR of CRC and early-onset CRC. Additionally, the CRC and early-onset CRC burden associated with high BMI and high fasting plasma glucose showed an increasing trend.

Conclusion: The overall burden of CRC and early-onset CRC in Europe remains higher than the global level, with increasing ASIR and decreasing ASMR and ASDR. Targeted prevention and control strategies should be developed based on the major risk factors for CRC. Older adults and men should be prioritized for interventions.

Monitoring the evolving global and regional burden of kidney cancer attributable to high BMI is vital for informing prevention and healthcare policies. This study aimed to evaluate historical trends in the global and regional burden of kidney cancer attributable to high BMI from 1990 to 2021 and to predict future trends through 2036 for individuals aged 20 years and older. We conducted a retrospective analysis using the Global Burden of Disease 2021 database. We analyzed data on mortality and disability-adjusted life years (DALYs) linked to kidney cancer from high BMI. Stratifications included sociodemographic index (SDI), region, sex, and age. Temporal trends were assessed using joinpoint regression models, while the relationship between SDI and regional burden was examined. Projections were generated using Bayesian age-period-cohort models. In 2021, high BMI contributed to 19.86% of global kidney cancer deaths (0.032 million) and 19.00% of DALYs (0.782 million), representing an increase since 1990. Globally, age-standardized mortality rate and age-standardized disability rate have declined in recent years. However, rates have risen in developing regions such as South Asia and East Asia. Projections indicate stable global rates with slight fluctuations through 2036. The global kidney cancer burden attributable to high BMI shows signs of decline but continues to rise in some developing regions. Addressing this disparity requires strengthening obesity prevention and control strategies tailored to regional needs.

Interest in human papillomavirus (HPV)-related anal cancer screening among high-risk groups like men-who-have-sex-with-men living with HIV (MSMLWH) is high. Yet, the psychosocial impact of screening is not yet clear. We reviewed literature on patient-reported outcomes (PROs) associated with anal precancer screening among MSMLWH to identify current research priorities. In this scoping review, inclusion criteria were peer-reviewed studies of any type published in English since 2000 reporting PROs after anal precancer screening in MSMLWH. A database search (MEDLINE, EMBASE, and APA PsycINFO) was conducted in December 2024. Data were extracted independently by two authors using a standardised form. Eleven papers (nine cohorts) met the inclusion criteria, mostly from high-income countries. Participants were generally over 40 and had lived with HIV for greater than or equal to 10 years. All were involved in anal precancer screening studies; none were part of routine screening programmes. Ethnicity data were inconsistently reported. Papers covered four PRO domains: health-related quality of life (HRQoL), psychological impact, experience of screening procedures, and physical health. Screening was well-tolerated with minimal psychological or HRQoL impact. Negative impact related to screening procedures did not persist beyond receiving results. Low levels of pain and discomfort (≤11%) were reported. Some reported increased cancer-related worry, especially when further examination was needed. Systematic collection of PROs in this context remains uncommon. Existing evidence suggests screening is generally well tolerated with minimal psychological burden, though some studies note psychosocial effects. Using validated PRO measures can guide targeted support and inform the development of screening programmes that minimise psychological adverse effects.