<p>The concept of blood-based <i>multicancer early detection</i> (MCED) tests has generated much excitement, in part because of the potential of such tests to reduce cancer mortality by encompassing cancers for which screening is currently not available. A review in this issue of <i>CA: A Cancer Journal for Clinicians</i>, largely authored by members in the Division of Cancer Prevention at the National Cancer Institute (NCI), addresses the current status of the field.<span><sup>1</sup></span> The authors convey a reluctance to refer to the field as MCED. In their view and that of others, the evidence to date does not support substantial performance in detecting cancer at an early stage.<span><sup>2</sup></span> Therefore, instead, they use the designation <i>multicancer detection</i> (MCD) tests. The authors describe a strategy for MCD tests adopted by developers, consisting of first detecting a cancer signal based on shared biomarkers across cancer types, followed by assessment of the tissue of origin based on another set of biomarkers. The review includes a list of developers of MCD tests and the performance of tests for which data have become publicly available based on their positive and negative predictive values. The authors also provide details of the NCI Vanguard program aimed, in the short term, at testing the performance of MCD platforms they have selected among applicants and, in the longer term, at conducting prospective, randomized clinical studies.</p><p>Although the review provides an assessment of the current status of the MCD/MCED field, there is much that we do not know and that remains to be determined. From an effectiveness point of view, the optimal number of cancer types to be included may be debated. Currently, screening is available in the United States for lung, breast, colon, cervical, and prostate cancers. Screening is also available for gastric cancer in Asian countries, where the incidence is high. Although MCD tests have the potential to encompass a much broader range of cancers, notably including cancers for which screening is not available, it is clear that a relatively small number of cancers account for the vast majority of cancer deaths. American Cancer Society cancer statistics 2024 data for US cancer mortality project that five cancer types account for greater than 50% of cancer deaths.<span><sup>3</sup></span> For men, they include pancreas and hepatobiliary cancers and, for women, pancreas and ovarian cancers. Given that an MCD test may vary in its performance by cancer type in terms of sensitivity and specificity, overall test performance may degrade with attempts to universally cover a vast number of cancer types. Moreover, for common cancers for which screening strategies are recommended, should MCD tests result in improved positive predictive value of screening programs? For other malignancies, the underlying cancer biology or treatment approaches may obviate any benefit of an MCD test. For example, the
{"title":"Multicancer detection tests: What we know and what we don’t know","authors":"Sam M. Hanash MD, PhD, Peter P. Yu MD","doi":"10.3322/caac.21836","DOIUrl":"10.3322/caac.21836","url":null,"abstract":"<p>The concept of blood-based <i>multicancer early detection</i> (MCED) tests has generated much excitement, in part because of the potential of such tests to reduce cancer mortality by encompassing cancers for which screening is currently not available. A review in this issue of <i>CA: A Cancer Journal for Clinicians</i>, largely authored by members in the Division of Cancer Prevention at the National Cancer Institute (NCI), addresses the current status of the field.<span><sup>1</sup></span> The authors convey a reluctance to refer to the field as MCED. In their view and that of others, the evidence to date does not support substantial performance in detecting cancer at an early stage.<span><sup>2</sup></span> Therefore, instead, they use the designation <i>multicancer detection</i> (MCD) tests. The authors describe a strategy for MCD tests adopted by developers, consisting of first detecting a cancer signal based on shared biomarkers across cancer types, followed by assessment of the tissue of origin based on another set of biomarkers. The review includes a list of developers of MCD tests and the performance of tests for which data have become publicly available based on their positive and negative predictive values. The authors also provide details of the NCI Vanguard program aimed, in the short term, at testing the performance of MCD platforms they have selected among applicants and, in the longer term, at conducting prospective, randomized clinical studies.</p><p>Although the review provides an assessment of the current status of the MCD/MCED field, there is much that we do not know and that remains to be determined. From an effectiveness point of view, the optimal number of cancer types to be included may be debated. Currently, screening is available in the United States for lung, breast, colon, cervical, and prostate cancers. Screening is also available for gastric cancer in Asian countries, where the incidence is high. Although MCD tests have the potential to encompass a much broader range of cancers, notably including cancers for which screening is not available, it is clear that a relatively small number of cancers account for the vast majority of cancer deaths. American Cancer Society cancer statistics 2024 data for US cancer mortality project that five cancer types account for greater than 50% of cancer deaths.<span><sup>3</sup></span> For men, they include pancreas and hepatobiliary cancers and, for women, pancreas and ovarian cancers. Given that an MCD test may vary in its performance by cancer type in terms of sensitivity and specificity, overall test performance may degrade with attempts to universally cover a vast number of cancer types. Moreover, for common cancers for which screening strategies are recommended, should MCD tests result in improved positive predictive value of screening programs? For other malignancies, the underlying cancer biology or treatment approaches may obviate any benefit of an MCD test. For example, the ","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 4","pages":"339-340"},"PeriodicalIF":503.1,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21836","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wendy S. Rubinstein MD, PhD, Christos Patriotis PhD, MSc, Anthony Dickherber PhD, Paul K. J. Han MD, MA, MPH, Hormuzd A. Katki PhD, Elyse LeeVan MD, MPH, Paul F. Pinsky PhD, Philip C. Prorok PhD, Amanda L. Skarlupka PhD, Sarah M. Temkin MD, Philip E. Castle PhD, MPH, Lori M. Minasian MD
Multicancer detection (MCD) tests use a single, easily obtainable biospecimen, such as blood, to screen for more than one cancer concurrently. MCD tests can potentially be used to improve early cancer detection, including cancers that currently lack effective screening methods. However, these tests have unknown and unquantified benefits and harms. MCD tests differ from conventional cancer screening tests in that the organ responsible for a positive test is unknown, and a broad diagnostic workup may be necessary to confirm the location and type of underlying cancer. Among two prospective studies involving greater than 16,000 individuals, MCD tests identified those who had some cancers without currently recommended screening tests, including pancreas, ovary, liver, uterus, small intestine, oropharyngeal, bone, thyroid, and hematologic malignancies, at early stages. Reported MCD test sensitivities range from 27% to 95% but differ by organ and are lower for early stage cancers, for which treatment toxicity would be lowest and the potential for cure might be highest. False reassurance from a negative MCD result may reduce screening adherence, risking a loss in proven public health benefits from standard-of-care screening. Prospective clinical trials are needed to address uncertainties about MCD accuracy to detect different cancers in asymptomatic individuals, whether these tests can detect cancer sufficiently early for effective treatment and mortality reduction, the degree to which these tests may contribute to cancer overdiagnosis and overtreatment, whether MCD tests work equally well across all populations, and the appropriate diagnostic evaluation and follow-up for patients with a positive test.
{"title":"Cancer screening with multicancer detection tests: A translational science review","authors":"Wendy S. Rubinstein MD, PhD, Christos Patriotis PhD, MSc, Anthony Dickherber PhD, Paul K. J. Han MD, MA, MPH, Hormuzd A. Katki PhD, Elyse LeeVan MD, MPH, Paul F. Pinsky PhD, Philip C. Prorok PhD, Amanda L. Skarlupka PhD, Sarah M. Temkin MD, Philip E. Castle PhD, MPH, Lori M. Minasian MD","doi":"10.3322/caac.21833","DOIUrl":"10.3322/caac.21833","url":null,"abstract":"<p>Multicancer detection (MCD) tests use a single, easily obtainable biospecimen, such as blood, to screen for more than one cancer concurrently. MCD tests can potentially be used to improve early cancer detection, including cancers that currently lack effective screening methods. However, these tests have unknown and unquantified benefits and harms. MCD tests differ from conventional cancer screening tests in that the organ responsible for a positive test is unknown, and a broad diagnostic workup may be necessary to confirm the location and type of underlying cancer. Among two prospective studies involving greater than 16,000 individuals, MCD tests identified those who had some cancers without currently recommended screening tests, including pancreas, ovary, liver, uterus, small intestine, oropharyngeal, bone, thyroid, and hematologic malignancies, at early stages. Reported MCD test sensitivities range from 27% to 95% but differ by organ and are lower for early stage cancers, for which treatment toxicity would be lowest and the potential for cure might be highest. False reassurance from a negative MCD result may reduce screening adherence, risking a loss in proven public health benefits from standard-of-care screening. Prospective clinical trials are needed to address uncertainties about MCD accuracy to detect different cancers in asymptomatic individuals, whether these tests can detect cancer sufficiently early for effective treatment and mortality reduction, the degree to which these tests may contribute to cancer overdiagnosis and overtreatment, whether MCD tests work equally well across all populations, and the appropriate diagnostic evaluation and follow-up for patients with a positive test.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 4","pages":"368-382"},"PeriodicalIF":503.1,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>A study using data from the Danish Cancer Registry has identified risk factors among cancer survivors that might help to prevent them from developing new primary cancers, which the study calls secondary cancers. The study also has investigated whether index and second cancers might be linked. The study, from the Danish Cancer Institute in Copenhagen, Denmark, appears in Lancet Oncology (doi:10.1016/S1470-2045(23)00538-7).</p><p>Although knowledge about risk factors for the development of a patient’s first cancer, including genetic, immune, and hormonal factors as well as environmental and lifestyle risks (including smoking and alcohol use), is advancing, whether or not these issues also lead to a different cancer diagnosis is understudied. The researchers, led by Trille Kristina Kjaer, PhD, wrote that this study “aimed to investigate absolute and relative incidence of second primary cancer and examine how common etiological exposures for the first cancer were associated with development of a second cancer.”</p><p>The study included a cohort of 457,334 patients across Denmark who were diagnosed with cancer between January 1, 1997, and December 31, 2014. Each patient included in the cohort was at least 40 years old. At the time of diagnosis, their year of diagnosis, cohabitation status, income, and comorbidity were also noted, as were their genders: 50.3% (230,150) were male, and 49.7% (227,184) were female. The median age at first primary cancer was 68.3 years. Follow-up for the patients lasted up to 24 years (up to December 31, 2020).</p><p>Each patient had survived at for least 1 year after their primary cancer diagnosis had been received.</p><p>There were 27 cancer types included for both primary and secondary cancers; the relative risk of developing a new primary cancer during follow-up for the survivors was calculated with Cox proportional hazards regression.</p><p>Dr Kjaer says that it is important to note that the study was conducted in a socialized medicine society where citizens have equal access to medical treatment. As for the make-up of the cohort, she adds, “The study includes only adult cancer patients as opposed to many other studies in this field that also include childhood cancer survivors or [feature] only childhood cancer survivors. Also, we were able to take into account the competing risk of death and adjust our results for important confounders such as socioeconomic status and comorbidity.”</p><p>The researchers found that for all survivors, the incidence of a new primary cancer increased over time, from 6.3% 5 years after diagnosis to 10.5% at 10 years to 13.5% at 15 years.</p><p>Researchers found that survivors of liver, pancreatic, and lung cancer had the lowest 10-year cumulative incidence of a new primary cancer. Lung cancer was also noted to be the most frequent or second most frequent new cancer in survivors of seven of the 10 first primary cancer types associated with the highest incidence of a new cancer diagnosis
{"title":"Study identifies risk factors that may lead to secondary cancers","authors":"Mike Fillon","doi":"10.3322/caac.21832","DOIUrl":"10.3322/caac.21832","url":null,"abstract":"<p>A study using data from the Danish Cancer Registry has identified risk factors among cancer survivors that might help to prevent them from developing new primary cancers, which the study calls secondary cancers. The study also has investigated whether index and second cancers might be linked. The study, from the Danish Cancer Institute in Copenhagen, Denmark, appears in Lancet Oncology (doi:10.1016/S1470-2045(23)00538-7).</p><p>Although knowledge about risk factors for the development of a patient’s first cancer, including genetic, immune, and hormonal factors as well as environmental and lifestyle risks (including smoking and alcohol use), is advancing, whether or not these issues also lead to a different cancer diagnosis is understudied. The researchers, led by Trille Kristina Kjaer, PhD, wrote that this study “aimed to investigate absolute and relative incidence of second primary cancer and examine how common etiological exposures for the first cancer were associated with development of a second cancer.”</p><p>The study included a cohort of 457,334 patients across Denmark who were diagnosed with cancer between January 1, 1997, and December 31, 2014. Each patient included in the cohort was at least 40 years old. At the time of diagnosis, their year of diagnosis, cohabitation status, income, and comorbidity were also noted, as were their genders: 50.3% (230,150) were male, and 49.7% (227,184) were female. The median age at first primary cancer was 68.3 years. Follow-up for the patients lasted up to 24 years (up to December 31, 2020).</p><p>Each patient had survived at for least 1 year after their primary cancer diagnosis had been received.</p><p>There were 27 cancer types included for both primary and secondary cancers; the relative risk of developing a new primary cancer during follow-up for the survivors was calculated with Cox proportional hazards regression.</p><p>Dr Kjaer says that it is important to note that the study was conducted in a socialized medicine society where citizens have equal access to medical treatment. As for the make-up of the cohort, she adds, “The study includes only adult cancer patients as opposed to many other studies in this field that also include childhood cancer survivors or [feature] only childhood cancer survivors. Also, we were able to take into account the competing risk of death and adjust our results for important confounders such as socioeconomic status and comorbidity.”</p><p>The researchers found that for all survivors, the incidence of a new primary cancer increased over time, from 6.3% 5 years after diagnosis to 10.5% at 10 years to 13.5% at 15 years.</p><p>Researchers found that survivors of liver, pancreatic, and lung cancer had the lowest 10-year cumulative incidence of a new primary cancer. Lung cancer was also noted to be the most frequent or second most frequent new cancer in survivors of seven of the 10 first primary cancer types associated with the highest incidence of a new cancer diagnosis","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 2","pages":"120-122"},"PeriodicalIF":254.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21832","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140118303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>With genetic testing becoming more readily available for cancer prevention and surveillance, a new study investigated whether skipping counseling—either before or after testing—is any worse than requiring counseling for patients with a family history of cancer or those known to be at genetic risk for cancer. The results of Making Genetic Testing Accessible (MAGENTA), a four-armed randomized clinical trial, appear in <i>JAMA Oncology</i> (doi:10.1001/jamaoncol.2023.3748).</p><p>What prompted researchers from the University of Washington to investigate this issue was their recognition that there was low awareness of the necessity of genetic counseling in the testing process. According to the lead study author, Elizabeth Swisher, MD, a professor in the Department of Obstetrics and Gynecology and coleader of the Breast and Ovarian Cancer Research Program at the Fred Hutchinson/University of Washington Cancer Consortium in Seattle, Washington, the investigation sought to establish if skipping the standard counseling increased posttest distress and whether that would affect completing the testing process.</p><p>According to Dr Swisher, the researchers believe that MAGENTA is the first large randomized clinical trial evaluating the effect of individualized preand posttest counseling for cancer risk assessment while providing electronic enrollment, remote testing, and counseling. “As a result, we hoped to identify more accessible options for patients to get cancer genetic risk assessments without negatively impacting their worries about cancer risk.”</p><p>Study participants in all of the cohorts were found through social media and advertisements in traditional media outlets. All were enrolled between April 27, 2017, and September 29, 2020. The data analysis was performed between December 13, 2020, and May 31, 2023.</p><p>Participants were limited to English-speaking female residents of the United States who were at least 30 years old and had a family or personal history of breast or ovarian cancer. Each had to have internet access and access to a licensed health care professional. Those who had previously undergone genetic counseling were not eligible. There was no financial incentive offered.</p><p>The participants were assigned to either a family history cohort or a familial pathogenic variant (PV) cohort. The family history cohort included participants with a personal or family history of breast or ovarian cancer. To qualify for the PV cohort, participants needed a minimum of one biological relative with a PV in <i>BRCA1, BRCA2, BRIP1, PALB2, RAD51C, RAD51D, BARD1, MSH2, MSH6, MLH1,</i> or <i>PMS2</i>. There were 3125 in the family history cohort and 714 in the familial PV cohort.</p><p>The participants then watched a video about genetic testing, signed consent forms, and completed baseline questionnaires. Genetic counseling was provided by phone appointments, and testing was performed with home-delivered saliva kits. There were follow-up question
{"title":"Is mandated genetic counseling needed?","authors":"Mike Fillon","doi":"10.3322/caac.21831","DOIUrl":"10.3322/caac.21831","url":null,"abstract":"<p>With genetic testing becoming more readily available for cancer prevention and surveillance, a new study investigated whether skipping counseling—either before or after testing—is any worse than requiring counseling for patients with a family history of cancer or those known to be at genetic risk for cancer. The results of Making Genetic Testing Accessible (MAGENTA), a four-armed randomized clinical trial, appear in <i>JAMA Oncology</i> (doi:10.1001/jamaoncol.2023.3748).</p><p>What prompted researchers from the University of Washington to investigate this issue was their recognition that there was low awareness of the necessity of genetic counseling in the testing process. According to the lead study author, Elizabeth Swisher, MD, a professor in the Department of Obstetrics and Gynecology and coleader of the Breast and Ovarian Cancer Research Program at the Fred Hutchinson/University of Washington Cancer Consortium in Seattle, Washington, the investigation sought to establish if skipping the standard counseling increased posttest distress and whether that would affect completing the testing process.</p><p>According to Dr Swisher, the researchers believe that MAGENTA is the first large randomized clinical trial evaluating the effect of individualized preand posttest counseling for cancer risk assessment while providing electronic enrollment, remote testing, and counseling. “As a result, we hoped to identify more accessible options for patients to get cancer genetic risk assessments without negatively impacting their worries about cancer risk.”</p><p>Study participants in all of the cohorts were found through social media and advertisements in traditional media outlets. All were enrolled between April 27, 2017, and September 29, 2020. The data analysis was performed between December 13, 2020, and May 31, 2023.</p><p>Participants were limited to English-speaking female residents of the United States who were at least 30 years old and had a family or personal history of breast or ovarian cancer. Each had to have internet access and access to a licensed health care professional. Those who had previously undergone genetic counseling were not eligible. There was no financial incentive offered.</p><p>The participants were assigned to either a family history cohort or a familial pathogenic variant (PV) cohort. The family history cohort included participants with a personal or family history of breast or ovarian cancer. To qualify for the PV cohort, participants needed a minimum of one biological relative with a PV in <i>BRCA1, BRCA2, BRIP1, PALB2, RAD51C, RAD51D, BARD1, MSH2, MSH6, MLH1,</i> or <i>PMS2</i>. There were 3125 in the family history cohort and 714 in the familial PV cohort.</p><p>The participants then watched a video about genetic testing, signed consent forms, and completed baseline questionnaires. Genetic counseling was provided by phone appointments, and testing was performed with home-delivered saliva kits. There were follow-up question","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 2","pages":"117-119"},"PeriodicalIF":254.7,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140118302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12-49. doi:10.3322/caac.21820
Multiple errors appear in Table 9. The first age column should be “1–19” (not “1–9” as originally published), and the second age column should be “20–39” (not “20–30”). Additionally, cancer was left off as the fourth leading cause of death among men aged 40–59 years.
The authors apologize for the oversight.
本勘误更正如下：Siegel RL, Giaquinto AN, Jemal A. 癌症统计，2024 年。CA Cancer J Clin.DOI:10.3322/CAAC.21820表 9 中出现多处错误。第一列年龄应为 "1-19"（而非最初公布的 "1-9"），第二列年龄应为 "20-39"（而非 "20-30"）。此外，癌症作为 40-59 岁男性的第四大死因被遗漏。
{"title":"Erratum to “Cancer statistics, 2024”","authors":"","doi":"10.3322/caac.21830","DOIUrl":"10.3322/caac.21830","url":null,"abstract":"<p>This erratum corrects the following:</p><p>Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. <i>CA Cancer J Clin.</i> 2024;74(1):12-49. doi:10.3322/caac.21820</p><p>Multiple errors appear in Table 9. The first age column should be “1–19” (not “1–9” as originally published), and the second age column should be “20–39” (not “20–30”). Additionally, cancer was left off as the fourth leading cause of death among men aged 40–59 years.</p><p>The authors apologize for the oversight.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 2","pages":"203"},"PeriodicalIF":254.7,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21830","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139739922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dan Yaniv MD, Tanguy Y. Seiwert MD, Danielle N. Margalit MD, MPH, Michelle D. Williams MD, Carly E. A. Barbon PhD, Rene D. Largo MD, Jon A. Smith, Neil D. Gross MD
Tanguy Y. Seiwert reports personal/consulting fees from AstraZeneca, EISAI INC., Inate Pharma Inc., iTeos, Merck, Regeneron Pharmaceuticals, Sanofi, and Vir; and service on a Data and Safety Monitoring Board at BioNTech outside the submitted work. Michelle D. Williams reports personal/consulting fees from Bayer Healthcare and support for other professional activities from Springer outside the submitted work. Neil D. Gross reports grants/contracts and personal/consulting fees from Regeneron Pharmaceuticals Inc.; personal/consulting fees from DragonFly Therapeutics Inc., Intuitive Surgical Inc., Merck, Replimune, and Sanofi/Genzyme US Companies; and support for other professional activities from PDS Biotechnology Corporation outside the submitted work. The remaining authors disclosed no conflicts of interest.
Tanguy Y. Seiwert 报告了阿斯利康、EISAI INC.、Inate Pharma Inc.米歇尔-D-威廉姆斯（Michelle D. Williams）报告了拜耳医药保健公司（Bayer Healthcare）提供的个人/咨询费，以及斯普林格公司（Springer）在所提交工作之外提供的其他专业活动支持。Neil D. Gross报告了Regeneron Pharmaceuticals Inc.的资助/合同和个人/咨询费；DragonFly Therapeutics Inc.、Intuitive Surgical Inc.、Merck、Replimune和Sanofi/Genzyme US Companies的个人/咨询费；以及PDS Biotechnology Corporation对提交工作之外的其他专业活动的支持。其余作者未披露任何利益冲突。
{"title":"Neoadjuvant chemotherapy for advanced oral cavity cancer","authors":"Dan Yaniv MD, Tanguy Y. Seiwert MD, Danielle N. Margalit MD, MPH, Michelle D. Williams MD, Carly E. A. Barbon PhD, Rene D. Largo MD, Jon A. Smith, Neil D. Gross MD","doi":"10.3322/caac.21829","DOIUrl":"10.3322/caac.21829","url":null,"abstract":"<p>Tanguy Y. Seiwert reports personal/consulting fees from AstraZeneca, EISAI INC., Inate Pharma Inc., iTeos, Merck, Regeneron Pharmaceuticals, Sanofi, and Vir; and service on a Data and Safety Monitoring Board at BioNTech outside the submitted work. Michelle D. Williams reports personal/consulting fees from Bayer Healthcare and support for other professional activities from Springer outside the submitted work. Neil D. Gross reports grants/contracts and personal/consulting fees from Regeneron Pharmaceuticals Inc.; personal/consulting fees from DragonFly Therapeutics Inc., Intuitive Surgical Inc., Merck, Replimune, and Sanofi/Genzyme US Companies; and support for other professional activities from PDS Biotechnology Corporation outside the submitted work. The remaining authors disclosed no conflicts of interest.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 3","pages":"213-223"},"PeriodicalIF":254.7,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21829","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139701330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><i>CA: A Cancer Journal for Clinicians (CA)</i> was not a journal I ever saw myself publishing in let alone leading; its impact factor and prestige seemed out of reach for me—such is the Imposter Syndrome. Still, I came across the opportunity to become its editor and I applied, thinking I would regret it if I did not at least try. To my delight, I was chosen to succeed Ted Gansler, who had led <i>CA</i> as its editor for 23 years. Unbeknownst to me, I would also be the first to lead the journal from outside of the American Cancer Society (ACS).</p><p><i>CA</i> holds a special place in medicine, and specifically in oncology. Best known for the annual publication of Cancer Statistics, it is also the reference for a diverse readership, from primary care providers to advanced practice practitioners, both within the United States and globally. Therefore, it remains important that what we publish is accessible to all—regardless of whether they are specialized in cancer medicine. With that in mind, we have instituted new instructions for our potential authors, and they are based in intentionality. Articles submitted need to be understandable to our audience, and this is an opportunity to translate technical concepts into much more accessible language. I’ve asked the authors to be cognizant that our readership includes not only diverse health professionals but also people who themselves have experienced cancer, their caregivers, and advocates. As such, patient-centric language should be used. As examples, cancer should not be used as an adjective (e.g., breast cancer patients) nor should progression on treatment be referred to as a failure. The patient experience is also one that it is important to acknowledge, and I have challenged those who intend to submit to <i>CA</i> to incorporate patients’ points of view in the construction and the writing of articles and to include them as authors wherever it makes sense.</p><p>As we move into the future, I hope to make use of <i>CA</i> to democratize the access to important information; and, in 2024, <i>CA</i> will begin considering publication of high-impact clinical trial results. I intend the process to be a collaboration from the start, from gaging the appropriateness of phase 3 research for <i>CA</i> to timely peer review and publication, while maintaining the standards set above. Although this is a major shift in the past content <i>CA</i> has accepted, our editorial group at ACS believe this is an important step for <i>CA</i>, not only because of its eminence in medical publishing but because it represents an opportunity for everyone to access information that may change the standards of care. These articles will not be restricted—they will be free and downloadable at our journal’s website, just as <i>CA</i> content has always been.</p><p>Most of all, I want to ensure all who read and contribute to <i>CA</i> that the rigorous care that Dr. Gansler provided will continue. Articles are personally reviewe
CA: A Cancer Journal for Clinicians》（《CA：临床医生癌症杂志》）并不是一本我认为自己能发表文章的杂志，更不用说领导了；它的影响因子和声望对我来说似乎遥不可及--这就是 "冒名顶替综合症"。不过，我还是得到了担任该杂志编辑的机会，于是我就申请了，心想如果不至少试一试，我会后悔的。令我欣喜的是，我被选中接替泰德-甘斯勒（Ted Gansler），他曾担任《CA》编辑长达 23 年。我并不知道，我也将是第一位在美国癌症协会（ACS）之外领导该杂志的人。《癌症》在医学，特别是肿瘤学中占有特殊的地位。美国癌症协会》因每年出版《癌症统计》而闻名，同时也是美国和全球从初级保健提供者到高级执业医师等不同读者群的参考资料。因此，重要的是，我们出版的内容要让所有人都能阅读，无论他们是否是癌症医学专业人员。有鉴于此，我们为潜在作者制定了新的指导原则，这些原则都是有目的性的。所提交的文章必须能为读者所理解，这是一个将技术概念转化为更通俗易懂的语言的机会。我要求作者们认识到，我们的读者群不仅包括各类医疗专业人士，还包括亲身经历过癌症的患者、他们的护理人员和倡导者。因此，应该使用以患者为中心的语言。例如，不应将癌症用作形容词（如乳腺癌患者），也不应将治疗进展称为失败。患者的经历也是必须承认的一点，我已经向那些打算向CA投稿的人提出挑战，要求他们在构思和撰写文章时纳入患者的观点，并在合理的情况下将患者列为作者。我希望这个过程从一开始就是一个合作的过程，从评估第 3 期研究是否适合 CA，到及时进行同行评审和发表，同时保持上述标准。虽然这与 CA 过去接受的内容有很大的不同，但我们 ACS 的编辑团队认为这对 CA 来说是重要的一步，这不仅是因为 CA 在医学出版界的声望，还因为这代表着每个人都有机会获取可能会改变医疗标准的信息。最重要的是，我希望向所有阅读和投稿《CA》的读者保证，甘斯勒医生提供的严谨医疗服务将继续下去。在正式投稿和同行评审之前，我将亲自审阅文章。这并不意味着繁琐，而是为了确保我们的期刊能体现出写作的一致性和质量，坚持我们上面提出的方向。在《CA》的第一年是非常美好的一年，我希望它能在一些小的方面和一些大的方面继续成为所有对肿瘤学感兴趣的人的源泉--从预防到治疗，再到生存和姑息治疗。这是美国癌症协会的旗舰期刊；展望未来，我们将在所有的出版工作中牢记这一点，确保肿瘤学的进步得到共享。向大家致以最崇高的敬意！Don S. Dizon，医学博士《CA.A Cancer Journal for Clinicians》编辑：临床医生癌症杂志
{"title":"Becoming the new editor for CA: The future is now","authors":"Don S. Dizon MD","doi":"10.3322/caac.21828","DOIUrl":"10.3322/caac.21828","url":null,"abstract":"<p><i>CA: A Cancer Journal for Clinicians (CA)</i> was not a journal I ever saw myself publishing in let alone leading; its impact factor and prestige seemed out of reach for me—such is the Imposter Syndrome. Still, I came across the opportunity to become its editor and I applied, thinking I would regret it if I did not at least try. To my delight, I was chosen to succeed Ted Gansler, who had led <i>CA</i> as its editor for 23 years. Unbeknownst to me, I would also be the first to lead the journal from outside of the American Cancer Society (ACS).</p><p><i>CA</i> holds a special place in medicine, and specifically in oncology. Best known for the annual publication of Cancer Statistics, it is also the reference for a diverse readership, from primary care providers to advanced practice practitioners, both within the United States and globally. Therefore, it remains important that what we publish is accessible to all—regardless of whether they are specialized in cancer medicine. With that in mind, we have instituted new instructions for our potential authors, and they are based in intentionality. Articles submitted need to be understandable to our audience, and this is an opportunity to translate technical concepts into much more accessible language. I’ve asked the authors to be cognizant that our readership includes not only diverse health professionals but also people who themselves have experienced cancer, their caregivers, and advocates. As such, patient-centric language should be used. As examples, cancer should not be used as an adjective (e.g., breast cancer patients) nor should progression on treatment be referred to as a failure. The patient experience is also one that it is important to acknowledge, and I have challenged those who intend to submit to <i>CA</i> to incorporate patients’ points of view in the construction and the writing of articles and to include them as authors wherever it makes sense.</p><p>As we move into the future, I hope to make use of <i>CA</i> to democratize the access to important information; and, in 2024, <i>CA</i> will begin considering publication of high-impact clinical trial results. I intend the process to be a collaboration from the start, from gaging the appropriateness of phase 3 research for <i>CA</i> to timely peer review and publication, while maintaining the standards set above. Although this is a major shift in the past content <i>CA</i> has accepted, our editorial group at ACS believe this is an important step for <i>CA</i>, not only because of its eminence in medical publishing but because it represents an opportunity for everyone to access information that may change the standards of care. These articles will not be restricted—they will be free and downloadable at our journal’s website, just as <i>CA</i> content has always been.</p><p>Most of all, I want to ensure all who read and contribute to <i>CA</i> that the rigorous care that Dr. Gansler provided will continue. Articles are personally reviewe","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 2","pages":"132"},"PeriodicalIF":254.7,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139568387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Science editor Amy H from Santa Clarita, California, was aware of her immediate family’s heavy cancer history so it came as no surprise to her when she was diagnosed with cancer—a stage 1 tumor in the transverse colon. However, nagging questions remained: Did lifestyle, environment, or other factors play a role in her diagnosis, or could her cancer possibly have been tied to a genetic history?</p><p>A new study has found that her uncertainty and anxiety are not uncommon: Most patients with cancer do not undergo germline testing to learn if their cancer may have been associated with an inherited gene mutation. The study appears in the <i>Journal of the American Medical Association</i> (doi:10.1001/jama.2023.9526).</p><p>For the study, researchers included patients from California and Georgia in the Surveillance, Epidemiology, and End Results (SEER) registries, who were at least age 20 years, and diagnosed with any cancer between January 1, 2013, and March 31, 2019. Genes were grouped by cancer types and recommended for testing according to the National Comprehensive Cancer Network’s practice guidelines. Four laboratories submitted gene-level interpretations while also checking nationwide for patients who may have moved to other states.</p><p>There were 1,369,602 patients selected for the study. Patient variables included sex, cancer stage at diagnosis, age at diagnosis, ethnicity, and race. They also included companion genetic testing resulted comprising 107 genes of interest. The results were classified as pathogenic, benign, or uncertain.</p><p>The patients who underwent testing varied by the following cancer types: 50% had male breast cancer, 38.6% had ovarian cancer, 26% had female breast cancer, 7.5 had more than one cancer type, 6.4% had endometrial cancer, 5.6% had pancreatic cancer, 5.6% had colorectal cancer, 1.1% had prostate cancer, and 0.3% had lung cancer.</p><p>The researchers also found that testing overall increased during the time of the study. Of particular note, they found that testing in patients with pancreatic cancer increased from 1.2% in 2013 to 18.6% in 2019. This increase was not even, however; testing for patients with lung cancer remained low, increasing only from 0.1% in 2013 to 0.8% in 2019. They also found lower rates of genetic testing in older patients; although 18% of patients age 40 years were tested, only 2% of patients at age 80 years were tested.</p><p>The study authors noted that of all the pathogenic results, 67.5% to 94.9% of gene variants were in those genes that practice guidelines recommend testing. They also found that 68.3% to 83.8% of variants identified were in genes that have been linked to cancer type. “Gastrointestinal cancer–associated genes represented 68.3% of pathogenic results in colorectal cancer and 71.8% of pathogenic results in endometrial cancer,” they wrote. “Breast and ovarian cancer–associated genes represented 79.5% of pathogenic results in female breast cancer, 83.8% in male brea
{"title":"Most patients with cancer are not undergoing germline genetic testing","authors":"Mike Fillon","doi":"10.3322/caac.21827","DOIUrl":"10.3322/caac.21827","url":null,"abstract":"<p>Science editor Amy H from Santa Clarita, California, was aware of her immediate family’s heavy cancer history so it came as no surprise to her when she was diagnosed with cancer—a stage 1 tumor in the transverse colon. However, nagging questions remained: Did lifestyle, environment, or other factors play a role in her diagnosis, or could her cancer possibly have been tied to a genetic history?</p><p>A new study has found that her uncertainty and anxiety are not uncommon: Most patients with cancer do not undergo germline testing to learn if their cancer may have been associated with an inherited gene mutation. The study appears in the <i>Journal of the American Medical Association</i> (doi:10.1001/jama.2023.9526).</p><p>For the study, researchers included patients from California and Georgia in the Surveillance, Epidemiology, and End Results (SEER) registries, who were at least age 20 years, and diagnosed with any cancer between January 1, 2013, and March 31, 2019. Genes were grouped by cancer types and recommended for testing according to the National Comprehensive Cancer Network’s practice guidelines. Four laboratories submitted gene-level interpretations while also checking nationwide for patients who may have moved to other states.</p><p>There were 1,369,602 patients selected for the study. Patient variables included sex, cancer stage at diagnosis, age at diagnosis, ethnicity, and race. They also included companion genetic testing resulted comprising 107 genes of interest. The results were classified as pathogenic, benign, or uncertain.</p><p>The patients who underwent testing varied by the following cancer types: 50% had male breast cancer, 38.6% had ovarian cancer, 26% had female breast cancer, 7.5 had more than one cancer type, 6.4% had endometrial cancer, 5.6% had pancreatic cancer, 5.6% had colorectal cancer, 1.1% had prostate cancer, and 0.3% had lung cancer.</p><p>The researchers also found that testing overall increased during the time of the study. Of particular note, they found that testing in patients with pancreatic cancer increased from 1.2% in 2013 to 18.6% in 2019. This increase was not even, however; testing for patients with lung cancer remained low, increasing only from 0.1% in 2013 to 0.8% in 2019. They also found lower rates of genetic testing in older patients; although 18% of patients age 40 years were tested, only 2% of patients at age 80 years were tested.</p><p>The study authors noted that of all the pathogenic results, 67.5% to 94.9% of gene variants were in those genes that practice guidelines recommend testing. They also found that 68.3% to 83.8% of variants identified were in genes that have been linked to cancer type. “Gastrointestinal cancer–associated genes represented 68.3% of pathogenic results in colorectal cancer and 71.8% of pathogenic results in endometrial cancer,” they wrote. “Breast and ovarian cancer–associated genes represented 79.5% of pathogenic results in female breast cancer, 83.8% in male brea","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 1","pages":"6-7"},"PeriodicalIF":254.7,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139490190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>W then ophthalmologist and co-founder of Glaucomflecken LLC, William Flanary, MD, suffered two separate, unrelated bouts of cancer and then cardiac arrest, his wife served as his primary caregiver. While Dr Flanary received the medical attention he needed, Kristin Flanary, also known as Lady Glaucomflecken, co-founder and marketing director of Glaucomflecken LLC in Portland, Oregon, was left frazzled and worn down. “We discovered there’s a big discrepancy between how closely we look at how patients are doing in terms of distress versus how closely we look at how caregivers are doing.”</p><p>She is not alone in her view. It is well-accepted that cancer causes many physical, emotional, and financial burdens not only for patients, but for their caregivers as well. A new observational study has confirmed that caregivers’ needs are often overlooked, making them vulnerable.</p><p>The study by researchers at Wake Forest School of Medicine in Winston-Salem, North Carolina, appears in the <i>Journal of the National Cancer Institute</i> (doi:10.1093/jnci/djad198).</p><p>According to study authors, what prompted the creation of this study was the growing recognition that there was a need for better integration of caregivers into patient-centered cancer care, but to do so research was needed to evaluate the most pressing caregiving burdens and to develop strategies to ease these burdens. They noted that caregivers’ experience symptoms of at least moderate depression, anxiety, worry, and stress that can hinder their ability to help with the patient’s coping and functioning. “The practice of clinic-level distress screening may be one opportunity to improve the assessment and management of caregiver concerns,” they wrote.</p><p>For the study, the researchers worked with Wake Forest University’s NCI Community Oncology Research Program (WF NCORP) Research Base in Winston-Salem, North Carolina. NCORPs are part of a network for clinical trials and cancer care delivery research in community oncology clinics nationwide. “There are approximately 1,000 distinct sub-affiliates within 46 NCORP affiliates, many of which cluster together in organizational units or practice groups with common resources, providers, and operations,” they wrote. Data collection took place between January 2019 and June 2020.</p><p>The surveys were given to the staff member identified as the most knowledgeable about supportive care services, distress screening, and management for oncology patients at their institution. For this study, the researchers referred to them as supportive care leaders (SCLs.)</p><p>Key factors the researchers collected included the number of oncology providers, academic affiliations, the practice setting (in-patient, outpatient, freestanding outpatient, or private clinic) whether it was single or multi-specialty group, hospital affiliations, patient demographics (including age, sex, race, and ethnicity), and whether patients were enrolled in Medicaid and/or Medicare.
{"title":"More care needed for cancer caregivers","authors":"Mike Fillon","doi":"10.3322/caac.21826","DOIUrl":"10.3322/caac.21826","url":null,"abstract":"<p>W then ophthalmologist and co-founder of Glaucomflecken LLC, William Flanary, MD, suffered two separate, unrelated bouts of cancer and then cardiac arrest, his wife served as his primary caregiver. While Dr Flanary received the medical attention he needed, Kristin Flanary, also known as Lady Glaucomflecken, co-founder and marketing director of Glaucomflecken LLC in Portland, Oregon, was left frazzled and worn down. “We discovered there’s a big discrepancy between how closely we look at how patients are doing in terms of distress versus how closely we look at how caregivers are doing.”</p><p>She is not alone in her view. It is well-accepted that cancer causes many physical, emotional, and financial burdens not only for patients, but for their caregivers as well. A new observational study has confirmed that caregivers’ needs are often overlooked, making them vulnerable.</p><p>The study by researchers at Wake Forest School of Medicine in Winston-Salem, North Carolina, appears in the <i>Journal of the National Cancer Institute</i> (doi:10.1093/jnci/djad198).</p><p>According to study authors, what prompted the creation of this study was the growing recognition that there was a need for better integration of caregivers into patient-centered cancer care, but to do so research was needed to evaluate the most pressing caregiving burdens and to develop strategies to ease these burdens. They noted that caregivers’ experience symptoms of at least moderate depression, anxiety, worry, and stress that can hinder their ability to help with the patient’s coping and functioning. “The practice of clinic-level distress screening may be one opportunity to improve the assessment and management of caregiver concerns,” they wrote.</p><p>For the study, the researchers worked with Wake Forest University’s NCI Community Oncology Research Program (WF NCORP) Research Base in Winston-Salem, North Carolina. NCORPs are part of a network for clinical trials and cancer care delivery research in community oncology clinics nationwide. “There are approximately 1,000 distinct sub-affiliates within 46 NCORP affiliates, many of which cluster together in organizational units or practice groups with common resources, providers, and operations,” they wrote. Data collection took place between January 2019 and June 2020.</p><p>The surveys were given to the staff member identified as the most knowledgeable about supportive care services, distress screening, and management for oncology patients at their institution. For this study, the researchers referred to them as supportive care leaders (SCLs.)</p><p>Key factors the researchers collected included the number of oncology providers, academic affiliations, the practice setting (in-patient, outpatient, freestanding outpatient, or private clinic) whether it was single or multi-specialty group, hospital affiliations, patient demographics (including age, sex, race, and ethnicity), and whether patients were enrolled in Medicaid and/or Medicare.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 1","pages":"3-5"},"PeriodicalIF":254.7,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21826","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139490179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The 2024 update to Cancer Statistics from the American Cancer Society estimates that over 2,000,000 people this year will hear the words, “you have cancer.”<span><sup>1</sup></span> This amounts to nearly 5500 people each day, or the equivalent to one person experiencing this every 15 seconds. This marks the first time incidence has eclipsed 2 million Americans, with more people being diagnosed at earlier stages of these diseases, when cure rates are the highest. Consequently, cancer mortality continues to decline, with an estimated 4.1 million lives saved since 1991, because of significant investments in research and screening by the National Institutes of Health, the Centers for Disease Control and Prevention, the American Cancer Society, and others. To us, four parts of the report particularly stand out.</p><p>First, historically, cancer has been a disease that disproportionally affects men. However, this report demonstrates that, whereas the cancer incidence in men has been stable since the 2013, the incidence in women has ticked up since the late 1990s, attributed to higher rates of breast and uterine corpus cancers and melanoma. Thus cancer is becoming more gender-indiscriminate, with a male-to-female incidence ratio of 1.14 (95% CI, 1.136–1.143) in all ages. Many have hypothesized that differential lifestyle and risk-taking behaviors, alongside environmental exposures, resulted in higher cancer rates in men. However, as the incidence gap between genders closes, signs may point to risk factors (e.g., obesity, sedentary lifestyle) that are similarly affecting both groups, highlighting the need for a better understanding of this phenomenon.</p><p>Second, although the overall cancer incidence is increasing, there are particular cancers and populations disproportionately affected. For example, whereas the rise in uterine corpus cancers in White women has increased by about 1% per year since the mid-2000s, the increase is in excess of 2% in Black, Hispanic, Asian American, and Pacific Islander people. Colorectal cancer (CRC) too shows a variability when age is considered; the declines noted in CRC are largely because of a lower rate in people older than 65 years; among those younger than 55 years, the rate continues to increase by 1% to 2% per year. Finally, men saw their rates stabilize for liver cancer and, potentially, for melanoma between 2015 and 2019, yet women saw their rates increase by 2% per year. Taken together, the report highlights how cancer cannot be over-simplified to one diagnosis, nor can we generalize these trends in a short bullet.</p><p>Third, although the report highlights the tremendous advances in the treatment of hematologic and advanced solid tumor malignancies, the impact of disparities cannot be overstated. Compared with White women, for example, more Black women are diagnosed at a more advanced stage (44% vs. 23%) and have a poorer prognosis (5-year survival rate estimates of 63% vs. 84%, respectively). As the aut
{"title":"Cancer statistics 2024: All hands on deck","authors":"Don S. Dizon MD, Arif H. Kamal MD, MBA, MHS","doi":"10.3322/caac.21824","DOIUrl":"10.3322/caac.21824","url":null,"abstract":"<p>The 2024 update to Cancer Statistics from the American Cancer Society estimates that over 2,000,000 people this year will hear the words, “you have cancer.”<span><sup>1</sup></span> This amounts to nearly 5500 people each day, or the equivalent to one person experiencing this every 15 seconds. This marks the first time incidence has eclipsed 2 million Americans, with more people being diagnosed at earlier stages of these diseases, when cure rates are the highest. Consequently, cancer mortality continues to decline, with an estimated 4.1 million lives saved since 1991, because of significant investments in research and screening by the National Institutes of Health, the Centers for Disease Control and Prevention, the American Cancer Society, and others. To us, four parts of the report particularly stand out.</p><p>First, historically, cancer has been a disease that disproportionally affects men. However, this report demonstrates that, whereas the cancer incidence in men has been stable since the 2013, the incidence in women has ticked up since the late 1990s, attributed to higher rates of breast and uterine corpus cancers and melanoma. Thus cancer is becoming more gender-indiscriminate, with a male-to-female incidence ratio of 1.14 (95% CI, 1.136–1.143) in all ages. Many have hypothesized that differential lifestyle and risk-taking behaviors, alongside environmental exposures, resulted in higher cancer rates in men. However, as the incidence gap between genders closes, signs may point to risk factors (e.g., obesity, sedentary lifestyle) that are similarly affecting both groups, highlighting the need for a better understanding of this phenomenon.</p><p>Second, although the overall cancer incidence is increasing, there are particular cancers and populations disproportionately affected. For example, whereas the rise in uterine corpus cancers in White women has increased by about 1% per year since the mid-2000s, the increase is in excess of 2% in Black, Hispanic, Asian American, and Pacific Islander people. Colorectal cancer (CRC) too shows a variability when age is considered; the declines noted in CRC are largely because of a lower rate in people older than 65 years; among those younger than 55 years, the rate continues to increase by 1% to 2% per year. Finally, men saw their rates stabilize for liver cancer and, potentially, for melanoma between 2015 and 2019, yet women saw their rates increase by 2% per year. Taken together, the report highlights how cancer cannot be over-simplified to one diagnosis, nor can we generalize these trends in a short bullet.</p><p>Third, although the report highlights the tremendous advances in the treatment of hematologic and advanced solid tumor malignancies, the impact of disparities cannot be overstated. Compared with White women, for example, more Black women are diagnosed at a more advanced stage (44% vs. 23%) and have a poorer prognosis (5-year survival rate estimates of 63% vs. 84%, respectively). As the aut","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"74 1","pages":"8-9"},"PeriodicalIF":254.7,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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