European Journal of Cancer Prevention最新文献

Colorectal cancer is the third most common malignancy in the USA and accounts for more than 1 million deaths worldwide with screening shown to reduce CRC mortality. This meta-analysis analyzed the use of stool DNA for screening average risk, asymptomatic subjects for colorectal cancer and advanced precancerous lesions and compared sDNA to FOBT tests (gFOBT and FIT). Eight studies were included from four different countries with a total of 39 665 subjects. Pooled sensitivity and specificity for sDNA for detecting CRC was 83.3% (95% CI: 60.8-94.2) and 92.4% (95% CI: 90.1-94.1), respectively, compared with FOBT, which had a lower sensitivity at 70.2% (95% CI: 45.5-86.9) but higher specificity 95.7% (95% CI: 95.1-96.2). Further analysis showed improved sensitivity of sDNA to 92.6% when only the studies employing sDNA tests that incorporate hemoglobin immunochemical test were used. Both sDNA and FOBT tests had low sensitivity for detecting advanced precancerous lesions. sDNA tests are sensitive and specific for the detection of CRC but show low sensitivity compared with colonoscopy for the detection of advanced precancerous lesions.

Despite significant advances in therapy, cancer remains the top cause of death in parts of the globe. For many types of cancer, the typical treatment is a combination of surgery, chemotherapy, and radiotherapy. However, this conventional treatment is not successful on its own. As a consequence, innovative approaches that improve treatment efficacy are urgently needed. The ketogenic diet is a high-fat, moderate protein, and low-carbohydrate diet that appears to sensitize most cancers to conventional therapies by exploiting cancer cells' altered metabolism, making it an effective adjuvant cancer treatment alternative. This diet could decrease glucose metabolism while enhancing lipid metabolism, interfering with the Warburg effect, and inhibiting tumor cell proliferation. The anticancer impact of ketogenic diet has been established in numerous animal trials and clinical investigations on a wide range of tumor types, including glioblastoma, pancreatic cancer, head and neck cancer, breast cancer, invasive rectal cancer, ovarian cancer, and endometrial cancer. In this review, we discussed the various types of ketogenic diets, the mechanism of action for ketogenic diet as a cancer therapy, and the data gathered from continuing preclinical and clinical studies, intending to establish a solid theoretical foundation for future research.

Human papillomavirus (HPV) coinfection remains common globally. However, its clinical significance compared to mono-infection remains controversial. Further, the epidemiology of HPV genotype combination in coinfection is not well studied in Kenya. . Between June and August 2023, a cross-sectional facility-based survey enrolled 434 women aged 16-68 years using purposive sampling strategy. Structured questionnaire was obtained from each woman regarding demographic and sexual behavior characteristics. Cervical specimen was collected from each participant and analyzed using RIATOL assay to determine HPV genotypes and viral load. Overall, HPV 52 was the most frequently detected HPV strain. The mean HPV viral load was elevated among coinfected women than those with mono-infection but there was no evidence to support differences in viral load in the two groups ( P  = 0.113). Mono-infection was common (58.52%). HPV 16 was noted to have a near equal presence both in mono-infection and coinfection (52.17% and 47. 83%), respectively. HPV 33 (alpha 9) and 45 (alpha 7) had the greatest preference for each other compared to all other HPV interactions. HPV 52 is the most prevalent HPV in the population supporting the need for the nonavalent HPV vaccine. Mono-infection with HPV 16 remains common corroborating the relevance of bivalent vaccine in resource limited setting where nonavalent vaccines may be unavailable. The frequent coinfection preference of HPV 33 and 45 (alpha 9 and alpha 7, respectively) pauses the need for further concurrent characterization. HPV vaccination and education on safe sexual behaviors is key in reducing HPV coinfection.

To investigate the effects of antibiotic exposure on the prognosis of patients with advanced metastatic non-small cell lung cancer (m-NSCLC) who received immune checkpoint inhibitors (ICIs). This study retrospectively included 199 patients diagnosed with m-NSCLC in Shandong Cancer Hospital and Institute from December 2017 to October 2021, all patients received ICIs for the first time. The basic clinical characteristics of patients before the first treatment of ICIs, whether antibiotics were used during treatment, progression-free survival (PFS), and overall survival (OS) were collected. The survival among different groups was compared by the Kaplan-Meier method. The median follow-up time of m-NSCLC patients was 33.79 months, mPFS was 11.67 months, and mOS was 21.55 months. Univariate analysis showed that antibiotic use, radiotherapy, and targeted drug resistance influenced PFS and OS ( P  < 0.05). Multivariate analysis showed that antibiotic use, radiotherapy, and targeted resistance remained independent factors of PFS, and targeted resistance was an independent factor of OS ( P  < 0.05). Subgroup analysis found that antibiotic use within 30 days before and after immunotherapy could decrease the PFS and OS ( P  < 0.05). Kaplan-Meier analysis showed that patients without radiotherapy had shorter PFS (mPFS, 12.89 vs. 8.13 months; P  = 0.0258) and OS (mOS, 26.94 vs. 16.43 months; P  = 0.0465). The mPFS (16.17 vs. 9.19 months; P  = 0.0151) and mOS (27.27 vs. 18.65 months; P  = 0.0437) of patients in the antibiotic group were shorter. Patients in the targeted drug-resistant group had shorter PFS (mPFS, 40.66 vs. 7.77 months, P  < 0.001) and OS (mOS, 41.98 vs. 16.89 months, P  < 0.001) compared with patients who did not receive targeted treatment. Antibiotics and radiation therapy are associated with the prognosis of m-NSCLC who are newly treated with ICIs. Effectively reducing antibiotic use in 1 month before and after ICIs treatment may help improve the immunotherapy efficacy of patients with m-NSCLC.

Objectives: The success of a breast cancer screening program is highly dependent on adherence. We aimed to compare the differential effect of participation in breast cancer screening program versus opportunistic screening or symptomatic detection on tumour characteristics.

Methods: We included women referred to our Breast Centre in 2015-2021: 321 from the breast cancer screening group (group 1) and 422 through opportunistic screening or due to symptomatic detection (group 2). We compared data on sociodemographics, breast cancer detection, clinical features and tumour characteristics.

Results: A total of 10.6% of women in group 1 had breast symptoms and 63.8% had breast signs, with group 2 presenting higher proportions (57.6 and 77.8%, respectively, P  < 0.001). The median tumour size in group 1 was smaller compared with group 2 (14 vs 17 mm, P  < 0.001). A total of 8.7% of women in group 1 had nodal involvement whereas in group 2 the proportion corresponded to 19.0% ( P  < 0.001). No women in group 1 were diagnosed with metastasis, while metastases were found in 2.4% of those from group 2 ( P  = 0.005). There were no significant differences in molecular subtype of invasive tumours between the two groups.

Conclusion: The tumour characteristics of women who participated in the breast cancer screening program showed in almost all characteristics more favourable results in comparison with the group who underwent opportunistic screening or sought care due to symptoms. The lower clinical stage observed in those referred from the organised program reaffirms that it is an effective measure for early detection, diagnosis, and treatment.

This study intends to investigate the performance of albumin, globulin, and albumin-globulin ratio (AGR) in predicting the prognosis of patients with cervical cancer. PubMed, Web of Science, Embase, and Cochrane Library databases were searched for relevant articles up to 1 March 2024. To elucidate the prognostic power of albumin, globulin, and AGR in cervical cancer patients, hazard ratios and 95% confidence intervals (CI) were computed. Subgroup analyses were performed to assess the association between albumin and the prognosis of cervical cancer patients. Ten studies involving 2394 cervical cancer patients were enrolled. Our results manifested that low albumin level was linked to poorer overall survival (OS) (hazard ratio = 2.01, 95% CI = 1.45-2.80, p  < 0.001), independent of progression-free survival (PFS), whereas high globulin and low AGR were not notably correlated with both OS and PFS. Subgroup analyses by tumor stages, and treatment measures noted that low albumin levels were linked to poorer OS in tumor stages I-II (hazard ratio = 1.96, 95% CI = 1.12-3.43, p  = 0.018), I-IV (hazard ratio = 1.96, 95% CI = 1.24-3.10, p  = 0.004), and IV (hazard ratio = 3.4, 95% CI = 1.39-8.29, p  = 0.007). Low albumin levels were associated with poorer OS in multifactorial analysis (hazard ratio = 1.94, 95% CI = 1.52-2.48, p  < 0.001) and survival curves (hazard ratio = 3.38, 95% CI = 1.94-5.88, p  < 0.001). In patients undergoing surgery only (hazard ratio = 2.32, 95% CI = 1.70-3.17, p  < 0.001) and those with radiotherapy (hazard ratio = 2.12, 95% CI = 1.41-3.2, p  < 0.001), low albumin levels were linked to poorer OS, but neither associated with PFS. Low albumin levels in cervical cancer patients are associated with poorer prognoses, and therefore can be viewed as a simple and economical prognostic index for cervical cancer.

Lynch syndrome accounts for 3-5% of all colorectal and endometrial cancer cases, and suboptimal management of Lynch syndrome in the Middle East resulted in the underdiagnosis of mutation carriers. Probands from 24 unrelated Iranian families with a history of cancer(s) suggestive of Lynch syndrome underwent microsatellite instability analysis or immunohistochemistry, multigene panel testing, copy number variation detection, or multiplex ligation-dependent probe amplification. Pathogenic variants were identified in five patients (21%), including three in MSH2 , one in MSH6 , and one in PMS2. Microsatellite instability analysis showed the lengths of the CAT25 marker in tumor and normal samples were 149 and 148 bp, respectively. Among 21 family members with Lynch syndrome in the MSH2 gene, identified from the three families who previously underwent cascade screening, colorectal and endometrial cancers were the most frequent. While 66% of patients had insurance that included coverage for mutation carrier screening, only one insurance provider extended coverage for next-generation sequencing. Special attention to probands and telematic management of at-risk relatives to organize blood sample collection at their convenience enhanced cascade testing 20-fold per proband. In conclusion, the age of onset and segregation analysis indicated that PMS1 may not be a cancer susceptibility gene, and the tumor spectrum in MSH2 pathogenic carriers is similar to Western countries. Collecting blood samples at patients' convenience is a possible strategy to reduce the cost of identifying Lynch syndrome through cascade testing. The genetic analysis of patients for inherited cancers would optimize the current management of Lynch syndrome in Iran by omitting noncarriers from surveillance programs.

Oral cancer is a public health problem worldwide. Late diagnosis results in a low survival rate. However, this tumor can arise from oral precancerous lesions and identification of biomarkers in precursor lesions has the potential for early diagnosis, improving patient survival. In this context, proteins involved in the cell cycle control are potentially promising. This study aimed to evaluate the importance of immunohistochemical expression of BUBR1, MCM2, and GMNN as biomarkers of oral carcinogenesis considering different oral sites. Sixty-six samples of oral epithelial dysplasia (from 33 males and 33 females) and 63 samples of oral squamous cell carcinoma (from 44 males and 19 females) were subjected to immunohistochemistry to detect some human proteins. Ki67 expression was included as a marker of cell proliferation. Marker expression was quantified by manually counting at least 1000 cells, and the labeling index was used in all statistical analyses. GMNN, MCM2, BUBR1 (nuclear and cytoplasmic labeling), and Ki67 expression levels were higher in carcinomas than in dysplasia ( P  < 0.05). Cytoplasmic BUBR1 was a good marker of malignancy (AUC = 0.8525, P  < 0.05), but Ki67 was not (AUC = 0.5943, P  = 0.0713). GMNN, MCM2, BUBR1, and Ki67 had higher expression in carcinoma than in dysplasia, regardless of the site of the lesion. Cytoplasmic BUBR1 has the potential to be used as a marker of tumor progression.

Leading societies have established guidelines that vary significantly regarding recommendations for the surgical management of pulmonary carcinoids (PC). We aimed to assess current guidelines and recommendations for PC surgical management, benchmark their methodological quality, and identify factors that may influence their effectiveness in guiding surgical practice. Literature was sought to identify relevant guidelines for the management of PC. Each guideline was evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool and rated on a seven-point scale for items and domains. Five observers assessed four guidelines (developed by ENETS in 2015, ESMO in 2021, NANETS in 2021, and NCCN in 2020). In Scope and Purpose and Stakeholder Involvement, the NCCN guideline achieved the highest score. In Rigor of Development, NANETS and ENETS achieved the highest score. In Clarity of Presentation, ENETS guidelines scored the highest score. For applicability, NCCN received the highest score. All guidelines got the highest score in the Rigor of Development and Clarity of Presentation domains, whereas the Applicability domain received the lowest score. The methodological quality of guidelines on the surgical management of PC varies significantly. The findings underscore the need for future guidelines to prioritize practical implementation in clinical and surgical practice, ensuring that recommendations reflect best practices and effectively meet surgeons' needs. Based on our AGREE II appraisal, the ENETS and ESMO guidelines might be recommended as a model for developing future recommendations and guidelines.

Observational studies indicated that the overall inflammatory potential of diets has been implicated in cancer etiology; however, the results were inconsistent. We aimed to estimate the dose-response association of dietary inflammatory potential with cancer outcomes based on prospective cohort studies. PubMed, Embase and Web of Science databases were searched up to 11 November 2023 for prospective cohort studies. The dietary inflammatory potential was assessed by the dietary inflammatory index (DII) or energy-adjusted DII (E-DII). Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Restricted cubic splines were used to illustrate the possible linear or nonlinear associations. Ultimately, 30 articles including 33 studies with 4 090 977 participants were included. As compared the highest to the lowest DII category, the pooled RRs (95% CIs) for overall cancer, colorectal cancer, lung cancer, and renal cancer were 1.19 (1.11-1.27), 1.30 (1.16-1.44), 1.13 (1.04-1.23), and 1.45 (1.14-1.83), respectively; for E-DII, the RRs (95% CIs) was 1.08 (1.01-1.16) for overall cancer and 1.23 (1.13-1.33) for colorectal cancer. For each 1-unit increase in DII, the risk increased by 3% (RR = 1.03, 95% CI: 1.02-1.04) for overall cancer, 3% (RR = 1.03, 95% CI: 1.02-1.05) for colorectal cancer, and 7% (RR = 1.07, 95% CI: 1.03-1.12) for renal cancer; for E-DII, the risk increased by 1% (RR = 1.01, 95% CI: 1.00-1.02) for overall cancer and 3% (RR = 1.03, 95% CI: 1.02-1.05) for colorectal cancer. Additionally, restricted cubic splines showed linear relationships of DII (Pnonlinearity = 0.080) and E-DII (Pnonlinearity = 0.273) with overall cancer risk. The higher dietary inflammatory potential was associated with an increased risk of cancer.