European Journal of Cancer Prevention最新文献

Prostate cancer (PCa) is among the most common malignancies worldwide, with Black men experiencing significantly higher incidence, earlier onset, and more aggressive disease. These disparities reflect a complex interplay of factors. Adiposity, particularly visceral and periprostatic adipose tissue (PPAT), has emerged as a potential contributor to PCa progression, though its role in modifying racial disparities remains unclear. We conducted a narrative review to evaluate the relationship between obesity, visceral adiposity, PPAT, and PCa risk and aggressiveness, with attention to racial differences. A directed acyclic graph was developed to illustrate hypothesized pathways. Strong evidence supports associations between obesity, visceral fat, and aggressive PCa. Black men tend to have lower visceral and PPAT volumes than White men. However, these depots may exert greater biological effects in Black men, possibly due to differences in inflammatory signaling or fat composition. PPAT and waist-hip ratio may amplify aggressive PCa features in Black men while downplaying them in non-Black men. Adiposity may serve as a biomarker and modifier of racial disparities in PCa. An improved study design is needed to clarify mechanisms and inform targeted interventions. Understanding these interactions is essential to reducing PCa disparities in high-risk populations.

Physical activity plays a crucial role in cancer prevention and management, reducing the risk of colorectal, breast, lung, bladder, and gastric cancers by 10-20%. In patients with cancer, regular exercise not only alleviates treatment-related side effects such as fatigue, nausea, and muscle loss but also enhances overall survival, with studies showing a 40-50% reduction in cancer-specific mortality, particularly in breast, colorectal, and prostate cancers. These benefits are achieved through multiple biological mechanisms. Exercise modulates inflammation by reducing proinflammatory cytokines and inhibiting nuclear factor kappa B signaling, enhances antitumor immunity via activation of natural killer cells and CD8+ T lymphocytes, and improves metabolic regulation by increasing insulin sensitivity and lowering circulating insulin and insulin-like growth factor-1 levels. It also inhibits key oncogenic pathways, such as the phosphoinositide 3-kinase/protein kinase B (Akt)/mammalian target of rapamycin axis, which is crucial for tumor growth and survival. Additionally, exercise supports genomic stability by upregulating DNA repair enzymes and further strengthens antitumor immunity, potentially promoting M1 macrophage polarization and limiting immune evasion by tumors. These mechanisms may also synergize with immunotherapies, including immune checkpoint inhibitors, to improve treatment responses. Despite strong evidence supporting the beneficial effects of exercise in oncology, further research is needed to determine optimal exercise types, intensities, and timing, as well as their interactions with emerging therapies. This review will explore the role of exercise in cancer prevention and treatment, emphasizing its molecular mechanisms to improve clinical outcomes based on current evidence.

Managing cervical cancer prevention and colposcopy during pregnancy presents unique challenges. Despite existing literature on the topic, gaps in knowledge and inconsistent adherence to guidelines persist. This survey aimed to identify disparities in clinical practice, evaluate compliance with Italian and European recommendations, and assess the need for additional training among gynecologists and colposcopists. We conducted a nationwide, web-based cross-sectional survey among Italian colposcopists affiliated with the Italian Society for Colposcopy and Cervico-Vaginal Pathology. A 46-item questionnaire explored attitudes and practices related to cervical cancer screening, colposcopy, and diagnostic and therapeutic procedures during pregnancy. A comparative analysis was performed between junior and senior colposcopists. A total of 151 colposcopists completed the survey (response rate: 60.8%). While most supported screening during pregnancy, 17% considered endocervical brushing unsafe, and 14.5% questioned the reliability of screening tests. Colposcopy was universally regarded as safe; however, 96% described it as complex, and 87% recommended it be performed by experienced clinicians. Biopsies were typically limited to cases with suspected invasion, although 5% still reported performing endocervical curettage. Senior colposcopists demonstrated greater procedural confidence and adherence to guidelines, while junior practitioners expressed more concerns and were less likely to use pregnancy-specific informed consent. The survey showed a generally high level of adherence to current recommendations. Nevertheless, notable discrepancies remain, particularly in diagnostic approaches, informed consent practices, and pregnancy management. These findings highlight the need for targeted education and standardized protocols to support safe, evidence-based care during pregnancy.

Gastric intestinal metaplasia (GIM) is a key precursor lesion to gastric cancer. Its early identification is essential for implementing timely surveillance and intervention strategies. Its prevalence and associated risk factors vary across populations. The use of International Classification of Diseases, 10th Revision (ICD-10) codes provides a standardized and stratified approach to classify GIM, enhancing the quality of epidemiologic studies. All consecutive upper endoscopic procedures with reflux-like symptoms or dyspepsia from a gastroenterology referral center in Tehran, Iran, between 1 March 2024 and 30 August 2024, were reviewed. Gastric biopsy pathology reports were retrieved using ICD-10 codes, and demographic and clinical data, including age, gender, and Helicobacter pylori infection status, were analyzed. Key outcomes were stratified using ICD-10 anatomical and dysplasia-related codes. Logistic regression models were employed to determine the association between GIM and potential risk factors. Among 4100 cases, the overall prevalence of GIM was 18.06%, with a higher occurrence in men (20.2%) compared with women (16.4%). Age was a significant risk factor, with individuals aged 70 and above having over nine times the odds of GIM compared to those under 30 [adjusted odds ratio (OR): 9.25, 95% confidence interval (CI): 5.4-15.8, P < 0.001]. H. pylori infection was more prevalent in patients with non-GIM (19.8%) compared to those with GIM (15.0%), suggesting an inverse association (adjusted OR: 0.78, 95% CI: 0.6-1.0, P = 0.025). The most common ICD-10 subtype was GIM without dysplasia in the antrum (69.55%), followed by body involvement (12.48%) and multiple-site GIM (12.75%). The lower prevalence of H. pylori in patients with GIM is most likely because of gastric atrophy, which is present in almost all patients with GIM. Early detection and stratification of GIM using ICD-10 codes may improve targeted surveillance and prevention of gastric cancer.

Weight loss is a common symptom among patients with pancreatic cancer, often indicating tumor progression or poor nutritional status. This meta-analysis aimed to investigate the association between weight loss and overall survival in individuals with pancreatic cancer, synthesizing evidence from observational studies. A thorough search of the PubMed, Embase, and Web of Science databases was conducted up to 18 May 2025. Eligible studies must have reported quantitative associations between percent weight loss and overall survival in patients with pancreatic cancer. The adjusted hazard ratios with 95% confidence intervals (CIs) were pooled using a random-effects model to account for clinical heterogeneity. Eleven observational studies, comprising 1649 patients with pancreatic cancer were included. The pooled result showed that weight loss was significantly associated with reduced overall survival (hazard ratio: 1.55, 95% CI: 1.29-1.85). Subgroup analyses revealed stronger associations in patients aged 65 years or over (hazard ratio: 1.64, 95% CI: 1.28-2.10) and those assessed for weight loss during treatment (hazard ratio: 2.20, 95% CI: 1.68-2.89), compared with their counterparts; however, there was no clear association between weight loss and overall survival (hazard ratio: 1.27, 95% CI: 0.99-1.61) in pancreatic ductal adenocarcinoma subgroup. Weight loss serves as an independent prognostic factor for reduced overall survival in pancreatic cancer. Clinicians should prioritize nutritional assessment in patients with weight loss to inform personalized care strategies; however, further prospective studies are needed to validate these findings and elucidate underlying mechanisms.

Triple-negative breast cancer (TNBC) is a complex and diverse group of malignancies. Invasive ductal carcinoma (IDC) is the predominant pathological subtype and is closely linked to the ominous potential for distant metastasis, a pivotal factor that significantly influences patient outcomes. In light of these considerations, the present study was conceived with the objective of developing a nomogram model. This model was designed to predict the prognosis observed in IDC with distant metastasis in TNBC. This was a retrospective study based on the SEER database. Data of 9739 IDC-TNBC patients diagnosed from 2010 to 2020 were included in our study. Independent risk factors were screened by univariate and multivariate Cox regression analyses successively, which were used to develop a nomogram model predicting for prognosis. Cox multivariable analysis showed statistical significance in bone metastasis, liver metastasis, surgery, and chemotherapy. Incorporating statistically significant variables, as well as clinically significant age, lung metastasis, and brain metastasis into the construction of the prediction model, the C-indexes of the training group and validation group were 0.702 (0.663-0.741) and 0.667 (0.600-0.734), respectively, while the calibration curves were all close to the eideal 45° reference line, and decision curve analysis curves show excellent net benefit in the predictive model. The prognostic prediction model developed in this study demonstrated enhanced predictive accuracy, enabling a more precise evaluation of mortality risks associated with IDC with distant metastasis in TNBC.

Lack of efficient biomarkers and clinical translation of molecular typing impedes the implementation of targeted therapy for hepatocellular carcinoma (HCC). High-throughput sequencing techniques represented by next-generation sequencing (NGS) are tools for detecting targetable genes. The objective of this study is to explore the genetic alterations associated with clinicopathological features and the risk of recurrence/metastasis in HCC. NGS analysis was conducted on formalin-fixed paraffin-embedded tissues from 164 resected liver samples obtained from Chinese patients. Morphologic subtypes were reviewed based on hematoxylin-eosin and immunohistochemistry staining, Correlation to the acquired molecular features were analyzed with clinicopathological information. We also retrieved follow-up information of the 123 transplanted cases from 2017 to 2019 to screen recurrence/metastasis-associated factors by univariate analysis. Generally, the most frequently mutated genes include TP53 and CTNNB1 which showed a trend of mutually exclusive mutation. Copy-number variant with the highest frequency was detected in TAF1 and CCND1 in 11q13.3 loci. Correlation analysis showed that various genetic alterations were associated with morphologic subtypes and other pathologic features. While gene signatures of proliferation/nonproliferation class were correlated with differentiation, satellite foci and other invasive morphological features. Macrotrabecular-massive subtype, TSC2 (tuberous sclerosis complex 2) mutation, Ki-67 expression, and other six factors were found to be associated with recurrence/metastasis after liver transplantation. Genetic alterations detected by NGS show correlation with not only pathological and clinical features, but also with recurrence/metastasis after liver transplantation. Further gene-level molecular typing will be practical for targeted therapy and individual recurrence risk assessment in HCC patients.

Human papillomavirus (HPV) is a factor in oropharyngeal cancer, but data regarding other head and neck locations are scarce in France. The main objective of the study was to determine the prevalence of HPV in head and neck cancers at all locations. As a secondary objective, we aimed to investigate the HPV genotypes. We retrospectively included in a tertiary center between 2014 and 2020 mucosal squamous cell carcinomas of the head and neck in adult. First outcome was the prevalence of HPV cancer. Secondary outcomes were overall survival (OS) at 2 and 5 years and disease-free survival (DFS). A total of 508 patients were enrolled, resulting in 537 cases of mucous squamous cell carcinoma of the head and neck ( n  = 29 synchronous carcinomas). Clinical, pathological, and survival data were collected, and a double PCR for HPV with genotyping was performed on most of the samples. The HPV prevalence in the cohort was 28.2%, with HPV 16 being the predominant genotype (87%). However, HPV-positive status did not significantly improve OS at 2 and 5 years or DFS ( P  = 0.1, P  = 0.64, and P  = 0.07, respectively). It was also observed that HPV-positive patients had significantly fewer second tumor localizations ( P  < 0.01). The prevalence of HPV continues to rise, and the complexities surrounding HPV status and its association with clinical outcomes in head and neck squamous cell carcinoma highlight the impact of vaccination.

Background: Per- and poly-fluoroalkyl substances (PFASs) are a group of synthetic chemicals used since the 1940s in industrial and consumer applications. These substances are known or suspected to cause cancer, particularly kidney and testicular cancer. However, their association with other types of cancer is not well understood. This review aims to investigate the link between PFAS exposure and the risks of other cancers, including gastrointestinal cancers such as esophageal, gastric, colorectal, and pancreatic cancer.

Methods: We conducted a systematic review of literature from the International Agency for Research on Cancer Monographs, Agency for Toxic Substances and Disease Registry documents, and PubMed (up to January 2024) focusing on the association between PFAS exposure and gastrointestinal cancers. Four independent reviewers screened the studies, extracted the information, and evaluated the quality of the studies using a modified Newcastle-Ottawa Scale. Meta-analyses were performed with random-effects models, including stratified analyses and dose-response assessments.

Results: The meta-analysis included 17 studies. The summary relative risks (RR) of esophageal cancer for perfluorooctanoic acid (PFOA) exposure was 0.75 (95% confidence interval [CI], 0.35-1.60; n  = 2), and for perfluorooctane sulfonic acid (PFOS) was 1.76 (95% CI, 0.32-9.68; n  = 1). The RR for gastric cancer and PFOA was 0.59 (95% CI, 0.28-1.21; n  = 2) and PFAS was 0.96 (95% CI, 0.83-1.12; n  = 2). The RR for colorectal cancer and PFOA was 0.83 (95% CI, 0.65-1.06; n  = 6) and PFOS was 0.71 (95% CI, 0.22-2.27; n  = 4). The RR for pancreatic cancer was 1.02 (95% CI, 0.90-1.15; n  = 9) and PFOS was 0.92 (95% CI, 0.76-1.11; n  = 2). Stratified analyses by geographical region, study design, quality score, year of publication, gender, and outcome revealed no associations for colorectal and pancreatic cancers. No dose-response trends were identified. Publication bias was suggested for gastric cancer.

Conclusion: Our study suggested no association between PFAS exposure and esophageal, gastric, colorectal, or pancreatic cancer. More rigorous research is needed to investigate this relationship in different settings, with precise PFAS quantification, a wider range of compounds, larger sample sizes for specific cancers, and better control for potential confounders. Our meta-analysis suggests inconclusive evidence, highlighting the need for further research.

Lung cancer is the leading cause of cancer-related mortality worldwide, and understanding its pathological patterns and trends is of interest for clinical and public health interventions. This study investigates the trends in lung cancer incidence rates from 1995 to 2021 in the Friuli Venezia Giulia (FVG) region in northeastern Italy, focusing on histological subtypes and sex-specific differences. Data were obtained from the population-based FVG Cancer Registry. Data on histological types of lung cancer were analyzed. Using census-based population estimates, age-standardized incidence rates (ASIRs) were calculated for three calendar periods (1995-2003, 2004-2012, 2013-2021). Joinpoint regression analysis was used to assess significant changes in trends, estimating annual percent change and average annual percent change (AAPC). A total of 24 519 lung cancer cases were recorded between 1995 and 2021, 70% in males. During 2013-2021, ASIRs were 31.9/100 000 males and 16.9/100 000 females. Adenocarcinoma accounted for the highest ASIRs in both sexes (15.2/100 000 males and 9.9/100 000 females). Over the 1995-2021 period, the overall incidence of lung cancer decreased in males (AAPC: -3.2%), whereas it increased in females (AAPC: +1.0%). Trends in adenocarcinoma were inconsistent formales but continued to rise in females. Squamous and small cell lung cancer incidence declined in males, while both increased in females. These trends underscore the importance of targeted prevention strategies, especially addressing smoking cessation in middle-aged females.