Matthew R. LeBlanc, Xi Zhou, Christopher D. Baggett, Jennifer L. Lund, Christopher E. Jensen, Tzy-Mey Kuo, Bradford E. Jackson, Mya L. Roberson, Sascha A. Tuchman, Samuel M. Rubinstein, Eben I. Lichtman, Laura E. Green, Katherine E. Reeder-Hayes
Background
This study aims to describe time to treatment initiation for Black and White older adults with multiple myeloma (MM), and to test the hypothesis that Black/White disparities in treatment initiation have increased over time.
Methods
Black and White older adults (65+) diagnosed with myeloma 2007–2017 were identified in the SEER-Medicare database. Continuous Medicare Parts A/B coverage 12 months before and after diagnosis or until death, and Part D coverage for 12 months following diagnosis or until death were required for inclusion. We explored time to treatment initiation by race across three diagnosis time periods (2007–10, 2011–2014, 2015–2017) using Cox proportional hazard models. We estimated cumulative incidence of treatment initiation by race at 3, 6, and 12 months after diagnosis for all time periods.
Results
White MM patients were more likely to initiate treatment than Black MM patients across time periods. Hazard ratios (HR) and 95% confidence intervals (CI) ranged from HR = 1.35 (95% CI: 1.25, 1.46) to HR = 1.36 (95% CI: 1.27, 1.44). Black/White differences in the cumulative incidence of treatment initiation at 3, 6, and 12 months were also significant and persistent across time periods, ranging from 0.09 (95% CI: 0.02, 0.15) to 0.11 (95% CI: 0.05, 0.17). Contrary to our hypothesis, Black/White disparities were not increasing over time.
Conclusion
Our results suggest that Black patients initiate MM treatment later than White patients and are less likely to ever initiate treatment. Contrary to our hypothesis, Black/White disparities are not increasing over time and have remained static.
{"title":"Treatment Initiation Among Black and White Older Adults With Multiple Myeloma: A SEER-Medicare Analysis","authors":"Matthew R. LeBlanc, Xi Zhou, Christopher D. Baggett, Jennifer L. Lund, Christopher E. Jensen, Tzy-Mey Kuo, Bradford E. Jackson, Mya L. Roberson, Sascha A. Tuchman, Samuel M. Rubinstein, Eben I. Lichtman, Laura E. Green, Katherine E. Reeder-Hayes","doi":"10.1002/cam4.71563","DOIUrl":"10.1002/cam4.71563","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aims to describe time to treatment initiation for Black and White older adults with multiple myeloma (MM), and to test the hypothesis that Black/White disparities in treatment initiation have increased over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Black and White older adults (65+) diagnosed with myeloma 2007–2017 were identified in the SEER-Medicare database. Continuous Medicare Parts A/B coverage 12 months before and after diagnosis or until death, and Part D coverage for 12 months following diagnosis or until death were required for inclusion. We explored time to treatment initiation by race across three diagnosis time periods (2007–10, 2011–2014, 2015–2017) using Cox proportional hazard models. We estimated cumulative incidence of treatment initiation by race at 3, 6, and 12 months after diagnosis for all time periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>White MM patients were more likely to initiate treatment than Black MM patients across time periods. Hazard ratios (HR) and 95% confidence intervals (CI) ranged from HR = 1.35 (95% CI: 1.25, 1.46) to HR = 1.36 (95% CI: 1.27, 1.44). Black/White differences in the cumulative incidence of treatment initiation at 3, 6, and 12 months were also significant and persistent across time periods, ranging from 0.09 (95% CI: 0.02, 0.15) to 0.11 (95% CI: 0.05, 0.17). Contrary to our hypothesis, Black/White disparities were not increasing over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results suggest that Black patients initiate MM treatment later than White patients and are less likely to ever initiate treatment. Contrary to our hypothesis, Black/White disparities are not increasing over time and have remained static.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Emerging studies indicate that microbes are present in tumor cells and immune cells. Intratumoral microbiota (ITM) constitute an important component of the tumor immune microenvironment (TIME) and have an important impact on tumor progression and treatment.</p> </section> <section> <h3> Objective</h3> <p>Through the general elaboration of ITM represented by bacteria and fungi and the overall summary of their correlation with TIME, we aim to provide new ideas and perspectives for the application of ITM in tumor therapy by this review.</p> </section> <section> <h3> Methods</h3> <p>This review conducted a literature search using the PubMed database, with no predefined restrictions on the publication time of the included literature. The search terms used included “intratumoral microbiota”, “intratumoral microbiome”, “intratumoral microbes”, “intratumoral microorganisms”, “tumor microbiota”, “tumor-associated microbiota”, “tumor microbiome”, “tumor-associated microbiome”, “tumor-associated microbes”, “intratumoral bacteria”, “intratumoral fungi”, “cancer”, “tumor”, “tumor microenvironment”, “tumor immune microenvironment”, “microbial metabolites”, “application”, “immunotherapy”, “treatment” and “microbial-based cancer therapy”. Relevant retrieved literature was screened, prioritizing studies that focused on the distribution characteristics of ITM across different tumors, the mechanistic insights and therapeutic potential.</p> </section> <section> <h3> Results</h3> <p>Studies indicate that bacteria and fungi exhibit distinct distribution patterns in different tumors and interact with the TIME in complex ways, demonstrating either pro-tumor or anti-tumor effects. Proposed hypotheses for the underlying mechanisms include: (1) Antigenic immune responses, including those induced by bacterial peptides or cross-immunity due to similarities between tumor and intratumoral microbial antigens; (2) The activation or inhibition of the function or infiltration of different immune cells; (3) Participating in pattern recognition receptor-mediated signaling pathways; (4) Regulation of immune checkpoints or their inhibitors. ITM can also influence the efficacy of various tumor treatments, including chemotherapy, radiotherapy, and immunotherapy. Several microbial-associated therapeutic approaches, such as engineered bacteria, have already entered clinical application. More treatment strategies are under investigation, although most current research remains at the level of establishing correlations between ITM and tumors, or is confi
{"title":"Crosstalk Between Intratumoral Microbes and Tumor Immunity: Implications for Tumor Therapy","authors":"Fengxue Li, Lili Qiao, Xinquan Liang, Yingying Zhang, Ning Liang, Jian Xie, Guodong Deng, Yuying Hao, Pingping Hu, Xue Wu, Fangjie Ding, Can Feng, Yiming Mu, Jiandong Zhang","doi":"10.1002/cam4.71575","DOIUrl":"10.1002/cam4.71575","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emerging studies indicate that microbes are present in tumor cells and immune cells. Intratumoral microbiota (ITM) constitute an important component of the tumor immune microenvironment (TIME) and have an important impact on tumor progression and treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Through the general elaboration of ITM represented by bacteria and fungi and the overall summary of their correlation with TIME, we aim to provide new ideas and perspectives for the application of ITM in tumor therapy by this review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review conducted a literature search using the PubMed database, with no predefined restrictions on the publication time of the included literature. The search terms used included “intratumoral microbiota”, “intratumoral microbiome”, “intratumoral microbes”, “intratumoral microorganisms”, “tumor microbiota”, “tumor-associated microbiota”, “tumor microbiome”, “tumor-associated microbiome”, “tumor-associated microbes”, “intratumoral bacteria”, “intratumoral fungi”, “cancer”, “tumor”, “tumor microenvironment”, “tumor immune microenvironment”, “microbial metabolites”, “application”, “immunotherapy”, “treatment” and “microbial-based cancer therapy”. Relevant retrieved literature was screened, prioritizing studies that focused on the distribution characteristics of ITM across different tumors, the mechanistic insights and therapeutic potential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Studies indicate that bacteria and fungi exhibit distinct distribution patterns in different tumors and interact with the TIME in complex ways, demonstrating either pro-tumor or anti-tumor effects. Proposed hypotheses for the underlying mechanisms include: (1) Antigenic immune responses, including those induced by bacterial peptides or cross-immunity due to similarities between tumor and intratumoral microbial antigens; (2) The activation or inhibition of the function or infiltration of different immune cells; (3) Participating in pattern recognition receptor-mediated signaling pathways; (4) Regulation of immune checkpoints or their inhibitors. ITM can also influence the efficacy of various tumor treatments, including chemotherapy, radiotherapy, and immunotherapy. Several microbial-associated therapeutic approaches, such as engineered bacteria, have already entered clinical application. More treatment strategies are under investigation, although most current research remains at the level of establishing correlations between ITM and tumors, or is confi","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Epidermal growth factor receptor (EGFR) inhibitors, including tyrosine kinase inhibitors (TKIs), are associated with paronychia and pyogenic granuloma–like lesions (PGLs) that significantly impair patients' quality of life. Topical beta-blockers emerge as a non-invasive and promising therapy for such adverse events. This meta-analysis evaluated the efficacy of topical beta-blockers for EGFR inhibitor-induced paronychia and PGLs.
Method
In accordance with the PRISMA 2020 guidelines, multiple databases were searched for relevant studies. The primary outcomes were overall response rate (ORR) and complete response rate (CRR) within 1 month. Secondary outcomes included safety outcomes and subgroup analyses, while meta-regression was performed to assess the moderating effects of baseline characteristics. R programming was used for analysis and plotting.
Results
Six studies involving 96 patients were included. Topical beta-blocker yielded a high pooled ORR of 0.94 (confidence interval, CI 0.81–1.00, I2 = 69%) and CRR of 0.34 (CI 0.15–0.57, I2 = 76%) within 1 month. Despite no significant between-group differences, lower CRR were found in lung cancer (0.35, 95% CI [0.12, 0.60]) and solution formation subgroup (0.30, 95% CI [0.06, 0.62]). Meta-regression identified negative trends in CRRs for female patients and TKI users (p < 0.1). No adverse event was reported.
Conclusion
Our research concluded that topical beta-blockers may be a well-tolerated and beneficial option for managing EGFR inhibitor-induced paronychia and PGL. Additional and large-scale randomized controlled trials are necessary to confirm these findings, standardize treatment protocols, and evaluate long-term effectiveness.
{"title":"Efficacy of Topical Beta-Blockers in Managing Epidermal Growth Factor Receptor Inhibitor-Related Paronychia and Pyogenic Granuloma-Like Lesion: A Systematic Review and Meta-Analysis","authors":"Po-Kai Chan, Wei-Ting Yen, Po-Huang Chen","doi":"10.1002/cam4.71476","DOIUrl":"10.1002/cam4.71476","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Epidermal growth factor receptor (EGFR) inhibitors, including tyrosine kinase inhibitors (TKIs), are associated with paronychia and pyogenic granuloma–like lesions (PGLs) that significantly impair patients' quality of life. Topical beta-blockers emerge as a non-invasive and promising therapy for such adverse events. This meta-analysis evaluated the efficacy of topical beta-blockers for EGFR inhibitor-induced paronychia and PGLs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>In accordance with the PRISMA 2020 guidelines, multiple databases were searched for relevant studies. The primary outcomes were overall response rate (ORR) and complete response rate (CRR) within 1 month. Secondary outcomes included safety outcomes and subgroup analyses, while meta-regression was performed to assess the moderating effects of baseline characteristics. R programming was used for analysis and plotting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies involving 96 patients were included. Topical beta-blocker yielded a high pooled ORR of 0.94 (confidence interval, CI 0.81–1.00, <i>I</i><sup>2</sup> = 69%) and CRR of 0.34 (CI 0.15–0.57, <i>I</i><sup>2</sup> = 76%) within 1 month. Despite no significant between-group differences, lower CRR were found in lung cancer (0.35, 95% CI [0.12, 0.60]) and solution formation subgroup (0.30, 95% CI [0.06, 0.62]). Meta-regression identified negative trends in CRRs for female patients and TKI users (<i>p</i> < 0.1). No adverse event was reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our research concluded that topical beta-blockers may be a well-tolerated and beneficial option for managing EGFR inhibitor-induced paronychia and PGL. Additional and large-scale randomized controlled trials are necessary to confirm these findings, standardize treatment protocols, and evaluate long-term effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The efficacy of anatomic resection (AR) versus non-anatomic resection (NAR) for hepatocellular carcinoma (HCC) remains controversial, particularly among patients with differing underlying liver conditions. This study aimed to compare the outcomes of AR and NAR in HCC patients with and without liver cirrhosis.
Methods
We retrospectively analyzed data from HCC patients who underwent hepatectomy at West China Hospital between 2010 and 2022. Patients were stratified based on the presence of liver cirrhosis. Propensity score matching (PSM) was then applied separately within each stratum (cirrhotic and non-cirrhotic) to compare perioperative outcomes and long-term prognosis between AR and NAR.
Results
A total of 1699 patients were enrolled, including 866 with cirrhosis and 833 without cirrhosis. Before PSM, AR was associated with significantly superior overall survival (OS) and recurrence-free survival (RFS) compared to NAR. Following PSM (1:1 matching based on resection type within each cirrhosis stratum), similar survival advantages for AR were observed. In the matched cirrhotic cohort (255 patients per group), the AR group exhibited significantly better OS (median: 36.5 vs. 25.2 months; p < 0.001) and RFS (median: 26.9 vs. 17.4 months; p < 0.001) compared to the NAR group. Similarly, in the matched non-cirrhotic cohort (284 patients per group), the AR group showed significantly improved OS (median: 36.3 vs. 23.9 months; p < 0.001) and RFS (median: 27.8 vs. 18.5 months; p < 0.001) compared to the NAR group. No significant differences were observed in perioperative outcomes, including postoperative complications and hospital length of stay.
Conclusions
Compared to NAR, AR improved long-term prognosis in HCC patients. This survival benefit was evident even in cirrhotic patients and was not associated with increased perioperative risks.
背景：解剖切除（AR）与非解剖切除（NAR）治疗肝细胞癌（HCC）的疗效仍然存在争议，特别是在具有不同潜在肝脏疾病的患者中。本研究旨在比较伴有和不伴有肝硬化的HCC患者的AR和NAR的预后。方法：我们回顾性分析2010年至2022年在华西医院行肝切除术的HCC患者的资料。根据是否存在肝硬化对患者进行分层。然后在每个层（肝硬化和非肝硬化）中分别应用倾向评分匹配（PSM）来比较AR和NAR的围手术期结局和长期预后。结果：共纳入1699例患者，其中肝硬化患者866例，无肝硬化患者833例。在PSM之前，与NAR相比，AR的总生存期（OS）和无复发生存期（RFS）显著优于NAR。采用PSM（每个肝硬化层内基于切除类型的1:1匹配），观察到类似的AR生存优势。在匹配的肝硬化队列中（每组255例患者），AR组表现出明显更好的OS（中位数：36.5 vs 25.2个月；p）结论：与NAR相比，AR改善了HCC患者的长期预后。即使在肝硬化患者中，这种生存获益也很明显，并且与围手术期风险增加无关。
{"title":"Survival Benefit and Safety of Anatomic Resection in Cirrhotic Hepatocellular Carcinoma: Propensity-Matched Analysis of 1699 Patients","authors":"Ao Du, Hongwei Xu, Chuang Jiang, Kefei Yuan","doi":"10.1002/cam4.71537","DOIUrl":"10.1002/cam4.71537","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The efficacy of anatomic resection (AR) versus non-anatomic resection (NAR) for hepatocellular carcinoma (HCC) remains controversial, particularly among patients with differing underlying liver conditions. This study aimed to compare the outcomes of AR and NAR in HCC patients with and without liver cirrhosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from HCC patients who underwent hepatectomy at West China Hospital between 2010 and 2022. Patients were stratified based on the presence of liver cirrhosis. Propensity score matching (PSM) was then applied separately within each stratum (cirrhotic and non-cirrhotic) to compare perioperative outcomes and long-term prognosis between AR and NAR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1699 patients were enrolled, including 866 with cirrhosis and 833 without cirrhosis. Before PSM, AR was associated with significantly superior overall survival (OS) and recurrence-free survival (RFS) compared to NAR. Following PSM (1:1 matching based on resection type within each cirrhosis stratum), similar survival advantages for AR were observed. In the matched cirrhotic cohort (255 patients per group), the AR group exhibited significantly better OS (median: 36.5 vs. 25.2 months; <i>p</i> < 0.001) and RFS (median: 26.9 vs. 17.4 months; <i>p</i> < 0.001) compared to the NAR group. Similarly, in the matched non-cirrhotic cohort (284 patients per group), the AR group showed significantly improved OS (median: 36.3 vs. 23.9 months; <i>p</i> < 0.001) and RFS (median: 27.8 vs. 18.5 months; <i>p</i> < 0.001) compared to the NAR group. No significant differences were observed in perioperative outcomes, including postoperative complications and hospital length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared to NAR, AR improved long-term prognosis in HCC patients. This survival benefit was evident even in cirrhotic patients and was not associated with increased perioperative risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146027924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oindrila Bhattacharyya, Mohamed I. Elsaid, Brittany E. Punches, Andy Ni, Ashley S. Felix, Macarius M. Donneyong
Introduction
Pain is common among cancer survivors and often managed with medication; however, racial-ethnic disparities persist in pain treatment. Given inadequate data on pharmacologic and non-pharmacologic pain management among minoritized cancer survivors, we investigated these patterns using the SEER-Medicare claims linked database.
Methods
An incident cancer diagnosis cohort (≥ 66 years) was created from 2007 to 2016. The primary outcome was incidence of pain treatment (pharmacologic and non-pharmacologic) within 90 days post-diagnosis. Racial disparities were measured as adjusted incidence ratios for treatment using Poisson regression and adjusted differences in supply days and doses using linear regression, comparing non-Hispanic Black (nHB), Hispanic-Latino (LatinX), Asian/Pacific Islander (API), and Others to non-Hispanic White (nHW). Models were adjusted for demographic and clinical variables.
Results
Among 300,048 survivors—nHW (72.9%), nHB (9.6%), LatinX (8.8%), API (7.3%), Others (1.4%)—nHB (aIR = 0.96, 95% CI, 0.95–0.98), API (aIR = 0.96, 95% CI, 0.95–0.98) and Others (aIR = 0.91, 95% CI, 0.87–0.94) used less pain treatment overall than nHW. Opioids (80% of treatments) were less frequently utilized by males of the Other race-ethnicity group (aIR = 0.75, 95% CI, 0.70–0.81), compared to nHW males. For non-opioids, nHB males (aIR: 0.84, 95% CI, 0.79–0.88) were less likely to use these therapies as compared to nHW males. Non-pharmacological treatments were less utilized by nHB (aIR = 0.65, 95% CI, 0.62–0.69) and LatinX survivors (aIR = 0.69, 95% CI, 0.65–0.73), as compared to nHWs. Minority survivors received lower opioid doses for longer durations, but higher non-opioid doses for shorter durations.
Conclusion
There are considerable racial-ethnic disparities in the utilization of pharmacologic and non-pharmacologic pain treatments among cancer survivors. Future research should explore the drivers of these inequities.
{"title":"Racial and Ethnic Disparities in Pharmacologic and Non-Pharmacologic Pain Management Among Older Cancer Survivors","authors":"Oindrila Bhattacharyya, Mohamed I. Elsaid, Brittany E. Punches, Andy Ni, Ashley S. Felix, Macarius M. Donneyong","doi":"10.1002/cam4.71536","DOIUrl":"10.1002/cam4.71536","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pain is common among cancer survivors and often managed with medication; however, racial-ethnic disparities persist in pain treatment. Given inadequate data on pharmacologic and non-pharmacologic pain management among minoritized cancer survivors, we investigated these patterns using the SEER-Medicare claims linked database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An incident cancer diagnosis cohort (≥ 66 years) was created from 2007 to 2016. The primary outcome was incidence of pain treatment (pharmacologic and non-pharmacologic) within 90 days post-diagnosis. Racial disparities were measured as adjusted incidence ratios for treatment using Poisson regression and adjusted differences in supply days and doses using linear regression, comparing non-Hispanic Black (nHB), Hispanic-Latino (LatinX), Asian/Pacific Islander (API), and Others to non-Hispanic White (nHW). Models were adjusted for demographic and clinical variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 300,048 survivors—nHW (72.9%), nHB (9.6%), LatinX (8.8%), API (7.3%), Others (1.4%)—nHB (aIR = 0.96, 95% CI, 0.95–0.98), API (aIR = 0.96, 95% CI, 0.95–0.98) and Others (aIR = 0.91, 95% CI, 0.87–0.94) used less pain treatment overall than nHW. Opioids (80% of treatments) were less frequently utilized by males of the Other race-ethnicity group (aIR = 0.75, 95% CI, 0.70–0.81), compared to nHW males. For non-opioids, nHB males (aIR: 0.84, 95% CI, 0.79–0.88) were less likely to use these therapies as compared to nHW males. Non-pharmacological treatments were less utilized by nHB (aIR = 0.65, 95% CI, 0.62–0.69) and LatinX survivors (aIR = 0.69, 95% CI, 0.65–0.73), as compared to nHWs. Minority survivors received lower opioid doses for longer durations, but higher non-opioid doses for shorter durations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There are considerable racial-ethnic disparities in the utilization of pharmacologic and non-pharmacologic pain treatments among cancer survivors. Future research should explore the drivers of these inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146027832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yifu Ma, Shuying Zhang, Jiayan Ma, An Gao, Jiale Liu, He Ma, Qiyi Zhou, Jianjun Qian, Liyuan Zhang
Background
The spleen dose-volume threshold for lymphopenia in abdominal radiotherapy has not yet reached a consensus. Our previous research indicated a correlation between these factors, but the threshold has not been determined. Therefore, we investigated the dynamic changes in lymphocytes during radiotherapy (RT), identified the spleen dose threshold, and examined how these factors affect patient prognosis.
Methods
The absolute lymphocyte counts (ALC) of gastric cancer patients were collected before, during, and after RT. Lymphocyte recovery status was assessed using the lymphocyte recovery index (LRI). LRI cut off was considered as insufficient recovery. Splenic dosimetric parameters were collected, and their impact on predicting grade 4 (G4) lymphopenia was evaluated using logistic regression analysis. Cox regression analysis was used to evaluate the relationship between lymphocyte depletion and recovery status and prognosis.
Results
159 patients were enrolled. The median ALC dropped by 85.71% after RT. The occurrence of G4 and G1-3 lymphopenia was observed in 30.2% and 69.8% of cases, respectively. There were 12.6% of patients whose ALC had recovered at 120 days after RT, while the remaining 87.4% were still accompanied by lymphopenia. Cox multivariable analysis showed that pTNM stage and LRI were independent prognostic factors affecting overall survival, and the independent prognostic factors for disease-free survival were pTNM stage and change in ALC. Splenic Dmean and V5 were related to G4 lymphopenia and eventually V5 affected prognosis. Constraining the spleen V5 to < 180.6 cm3 and < 272.2 cm3 may reduce the incidence of G4 lymphopenia and further decrease the risk of death by 60.9%.
Conclusions
Patients with severe lymphocyte decline during RT and insufficient lymphocyte recovery afterward have a worse prognosis. It is important not only to prevent severe lymphopenia during RT but also to focus on improving lymphocyte recovery after RT. Constraining the spleen V5 is a key approach.
{"title":"Clinical Considerations of Splenic Dose Constraints to Mitigate Radiation-Induced Lymphopenia","authors":"Yifu Ma, Shuying Zhang, Jiayan Ma, An Gao, Jiale Liu, He Ma, Qiyi Zhou, Jianjun Qian, Liyuan Zhang","doi":"10.1002/cam4.71553","DOIUrl":"10.1002/cam4.71553","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The spleen dose-volume threshold for lymphopenia in abdominal radiotherapy has not yet reached a consensus. Our previous research indicated a correlation between these factors, but the threshold has not been determined. Therefore, we investigated the dynamic changes in lymphocytes during radiotherapy (RT), identified the spleen dose threshold, and examined how these factors affect patient prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The absolute lymphocyte counts (ALC) of gastric cancer patients were collected before, during, and after RT. Lymphocyte recovery status was assessed using the lymphocyte recovery index (LRI). LRI cut off was considered as insufficient recovery. Splenic dosimetric parameters were collected, and their impact on predicting grade 4 (G4) lymphopenia was evaluated using logistic regression analysis. Cox regression analysis was used to evaluate the relationship between lymphocyte depletion and recovery status and prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>159 patients were enrolled. The median ALC dropped by 85.71% after RT. The occurrence of G4 and G1-3 lymphopenia was observed in 30.2% and 69.8% of cases, respectively. There were 12.6% of patients whose ALC had recovered at 120 days after RT, while the remaining 87.4% were still accompanied by lymphopenia. Cox multivariable analysis showed that pTNM stage and LRI were independent prognostic factors affecting overall survival, and the independent prognostic factors for disease-free survival were pTNM stage and change in ALC. Splenic D<sub>mean</sub> and V<sub>5</sub> were related to G4 lymphopenia and eventually V<sub>5</sub> affected prognosis. Constraining the spleen V<sub>5</sub> to < 180.6 cm<sup>3</sup> and < 272.2 cm<sup>3</sup> may reduce the incidence of G4 lymphopenia and further decrease the risk of death by 60.9%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with severe lymphocyte decline during RT and insufficient lymphocyte recovery afterward have a worse prognosis. It is important not only to prevent severe lymphopenia during RT but also to focus on improving lymphocyte recovery after RT. Constraining the spleen V<sub>5</sub> is a key approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12824635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146016768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenlei Zhao, Yuxuan Qiu, Na Bai, Chunhong He, Jiani C. Yin, Qianru Xu, Kaiyu Jian, Baolei Jia, Lin Jiang, Feng Liang
Background
Colorectal cancer (CRC) isthe third most common cancer and the second leading cause of cancer-relateddeath worldwide. Its genetic heterogeneity complicates treatment. This studyaimed to compare clinicopathological, molecular, and prognostic factors betweenleft-sided (LCC) and right-sided (RCC) CRC.
Methods
We retrospectively analyzed 48 CRCpatients who received next-generation sequencing (NGS) of tumor tissue andmatched leukocytes using a 425-gene panel. Clinicopathological, molecular, andprognostic factors were compared between LCC and RCC.
Results
RCC exhibited a higher frequencyof BRAF mutations (33.3% vs. 7.1%, p = 0.042) and more frequent alterations in PI3K (p = 0.033), homology-dependent recombination (HDR, p = 0.018), and mismatch repair (MMR, p = 0.002) pathways than LCC. Multivariate analysis identified SMAD4 mutation as an independentpredictor of worse overall survival (OS) (HR = 3.88, 95% CI 1.05–14.29, p = 0.042), which was confirmed in an external cohort of 1796 CRCpatients. In subgroup analyses, SETD2 mutationswere associated with poor prognosis in LCC (HR = 2.20, 95% CI 0.80–6.06, p = 0.026), while ARID1A (p = 0.040) and PRDM1 (p = 0.021) mutations correlated with shorter progression-free survival in RCC. Patients harboring both SMAD4 and SETD2 mutationshad the shortest OS (median: 17.7 months, p < 0.0001).
Conclusions
These findings reveal criticalmolecular and prognostic differences between LCC and RCC and highlight SMAD4 and SETD2 asimportant prognostic biomarkers, suggesting the potential value of location-and mutation-guided precision therapies in CRC.
背景：结直肠癌（CRC）是全球第三大常见癌症和第二大癌症相关死亡原因。其遗传异质性使治疗复杂化。本研究旨在比较左侧（LCC）和右侧（RCC）结直肠癌的临床病理、分子和预后因素。方法：我们回顾性分析了48例接受肿瘤组织和匹配白细胞的新一代测序（NGS）的crc患者，使用425基因面板。比较小细胞癌和小细胞癌的临床病理、分子和预后因素。结果：与LCC相比，RCC表现出更高的BRAF突变频率（33.3%比7.1%,p = 0.042）和更频繁的PI3K （p = 0.033）、同源依赖性重组（HDR, p = 0.018）和错配修复（MMR, p = 0.002）途径的改变。多因素分析发现SMAD4突变是总生存期（OS）较差的独立预测因子（HR = 3.88, 95% CI 1.05-14.29, p = 0.042），这在1796例crc患者的外部队列中得到证实。在亚组分析中，SETD2突变与LCC的不良预后相关（HR = 2.20, 95% CI 0.80-6.06, p = 0.026），而ARID1A （p = 0.040）和PRDM1 （p = 0.021）突变与RCC较短的无进展生存期相关。同时携带SMAD4和SETD2突变的患者生存期最短（中位：17.7个月）。结论：这些发现揭示了LCC和RCC之间的关键分子和预后差异，并强调SMAD4和SETD2是重要的预后生物标志物，提示定位和突变导向的CRC精准治疗的潜在价值。
{"title":"Distinct Molecular and Prognostic Profiles of Left- and Right-Sided Colorectal Cancer Revealed by NGS Analysis: The Role of SMAD4 and SETD2 Mutations","authors":"Wenlei Zhao, Yuxuan Qiu, Na Bai, Chunhong He, Jiani C. Yin, Qianru Xu, Kaiyu Jian, Baolei Jia, Lin Jiang, Feng Liang","doi":"10.1002/cam4.71534","DOIUrl":"10.1002/cam4.71534","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Colorectal cancer (CRC) isthe third most common cancer and the second leading cause of cancer-relateddeath worldwide. Its genetic heterogeneity complicates treatment. This studyaimed to compare clinicopathological, molecular, and prognostic factors betweenleft-sided (LCC) and right-sided (RCC) CRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 48 CRCpatients who received next-generation sequencing (NGS) of tumor tissue andmatched leukocytes using a 425-gene panel. Clinicopathological, molecular, andprognostic factors were compared between LCC and RCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RCC exhibited a higher frequencyof BRAF mutations (33.3% vs. 7.1%, <i>p</i> = 0.042) and more frequent alterations in PI3K (<i>p</i> = 0.033), homology-dependent recombination (HDR, <i>p</i> = 0.018), and mismatch repair (MMR, <i>p</i> = 0.002) pathways than LCC. Multivariate analysis identified SMAD4 mutation as an independentpredictor of worse overall survival (OS) (HR = 3.88, 95% CI 1.05–14.29, <i>p</i> = 0.042), which was confirmed in an external cohort of 1796 CRCpatients. In subgroup analyses, SETD2 mutationswere associated with poor prognosis in LCC (HR = 2.20, 95% CI 0.80–6.06, <i>p</i> = 0.026), while ARID1A (<i>p</i> = 0.040) and PRDM1 (<i>p</i> = 0.021) mutations correlated with shorter progression-free survival in RCC. Patients harboring both SMAD4 and SETD2 mutationshad the shortest OS (median: 17.7 months, <i>p</i> < 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings reveal criticalmolecular and prognostic differences between LCC and RCC and highlight SMAD4 and SETD2 asimportant prognostic biomarkers, suggesting the potential value of location-and mutation-guided precision therapies in CRC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dib Sassine, Yongmei Huang, Chin Hur, Elena B. Elkin, Jennifer S. Ferris, Alex Melamed, Chung Yin Kong, Evan R. Myers, Nina A. Bickell, William D. Hazelton, Tracy M. Layne, Brandy Heckman-Stoddard, Goli Samimi, Laura J. Havrilesky, Stephanie V. Blank, Xiao Xu, Jason D. Wright
Objective
To evaluate the pattern of use and clinical outcomes associated with neoadjuvant chemotherapy (NACT) compared with primary debulking surgery (PDS) in patients with stage IV endometrial cancer.
Methods
We utilized the National Cancer Database to identify individuals diagnosed with stage IV endometrial cancer, and categorized them according to receipt of NACT or PDS. Propensity score weighting using inverse probability of treatment weighting was applied. Survival outcomes were evaluated using both an intention-to-treat (ITT) analysis, which included all eligible patients, and a per-protocol (PP) analysis restricted to those who underwent chemotherapy and surgery.
Results
Among 18,205 patients, NACT utilization rose from 30.3% in 2010 to 73.8% in 2021 (p < 0.0001). In the multivariable analysis, patients diagnosed in more recent years, Black and Hispanic race and ethnicity, Medicaid insurance, serous histology, and greater comorbidities were associated with NACT (p < 0.05). In the ITT analysis, there was no mortality difference within 4 months after diagnosis between NACT patients and PDS patients (aHR = 1.03; 95% CI: 0.96–1.11); however, after 4 months, patients treated with NACT experienced higher mortality than those undergoing PDS (aHR = 1.58; 95% CI: 1.51–1.64). In the PP analysis, NACT patients had lower mortality compared to PDS patients within 24 months after diagnosis (aHR = 0.93; 95% CI, 0.88–0.99) but a 34% higher mortality after 24 months (aHR = 1.34; 95% CI, 1.23–1.47).
Conclusion
Utilization of NACT has expanded among patients with metastatic endometrial cancer. Primary debulking surgery with postoperative chemotherapy is linked to higher early mortality but improved long-term outcomes relative to treatment strategies beginning with NACT followed by surgery.
{"title":"Neoadjuvant Chemotherapy Versus Primary Cytoreductive Surgery for Metastatic Endometrial Cancer","authors":"Dib Sassine, Yongmei Huang, Chin Hur, Elena B. Elkin, Jennifer S. Ferris, Alex Melamed, Chung Yin Kong, Evan R. Myers, Nina A. Bickell, William D. Hazelton, Tracy M. Layne, Brandy Heckman-Stoddard, Goli Samimi, Laura J. Havrilesky, Stephanie V. Blank, Xiao Xu, Jason D. Wright","doi":"10.1002/cam4.71539","DOIUrl":"10.1002/cam4.71539","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the pattern of use and clinical outcomes associated with neoadjuvant chemotherapy (NACT) compared with primary debulking surgery (PDS) in patients with stage IV endometrial cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilized the National Cancer Database to identify individuals diagnosed with stage IV endometrial cancer, and categorized them according to receipt of NACT or PDS. Propensity score weighting using inverse probability of treatment weighting was applied. Survival outcomes were evaluated using both an intention-to-treat (ITT) analysis, which included all eligible patients, and a per-protocol (PP) analysis restricted to those who underwent chemotherapy and surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 18,205 patients, NACT utilization rose from 30.3% in 2010 to 73.8% in 2021 (<i>p</i> < 0.0001). In the multivariable analysis, patients diagnosed in more recent years, Black and Hispanic race and ethnicity, Medicaid insurance, serous histology, and greater comorbidities were associated with NACT (<i>p</i> < 0.05). In the ITT analysis, there was no mortality difference within 4 months after diagnosis between NACT patients and PDS patients (aHR = 1.03; 95% CI: 0.96–1.11); however, after 4 months, patients treated with NACT experienced higher mortality than those undergoing PDS (aHR = 1.58; 95% CI: 1.51–1.64). In the PP analysis, NACT patients had lower mortality compared to PDS patients within 24 months after diagnosis (aHR = 0.93; 95% CI, 0.88–0.99) but a 34% higher mortality after 24 months (aHR = 1.34; 95% CI, 1.23–1.47).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Utilization of NACT has expanded among patients with metastatic endometrial cancer. Primary debulking surgery with postoperative chemotherapy is linked to higher early mortality but improved long-term outcomes relative to treatment strategies beginning with NACT followed by surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12819165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Ajrouch, Yara Khalifeh, Amir F. Beirat, Dana Alhaffar, Ahmad Karkash, Razan Aljaras, Adel Hajj Ali, Nicholas Pettit, Deanna R. Willis, Victoria L. Champion, Lisa Carter-Bawa, Amrou Awaysheh, Kolawole S. Okuyemi
Introduction
Lung cancer (LC) is the top cancer killer in women, yet lung cancer screening (LCS) uptake is substantially lower than mammography. Leveraging the reach of mammography programs may improve LCS uptake, but the potential gain in LC detection from this approach is unknown. This study aimed to determine the proportion of women with LC eligible for both screenings, potential LC detection via integrated screening, and factors influencing each screening uptake among those dually eligible.
Methods
This retrospective cross-sectional study included 345 women newly diagnosed with LC presenting at a Midwestern Comprehensive Cancer Center (2019–2020). Pre-diagnosis LCS-eligibility was determined per 2013 and 2021 USPSTF criteria, LCS-uptake per 2013 criteria, and mammography-eligibility per 2016 criteria. We assessed sociodemographic variables associated with screening uptake among dually eligible women.
Results
Among 345 women (mean [SD] age 64.8 [11.35] years), 73.3% were eligible for mammography, while 43.5% were eligible for LCS (2013), increasing to 49.3% (2021). Mammography uptake (41.5%) substantially exceeded LCS uptake (13.9%). Overall, 45.2% were eligible for both screenings, representing 92.4% (157/170) of all LCS-eligible (2021) cases. Notably, 20.3% were LCS-eligible (2021) and received mammography, that is, 41.2% (70/170) of LCS-eligible cases. Among dually eligible women, rural residency correlated with lower LCS uptake (odds ratio [OR], 0.42; 95% CI = 0.19–0.94; p = 0.031), whereas receiving mammography correlated with higher LCS uptake (OR, 2.67; 95% CI = 1.21–5.87; p = 0.013).
Conclusion
A substantial proportion of women with LC who are LCS-eligible underwent mammography, representing a missed opportunity for earlier LC detection. Integrating these screenings could enhance LC detection, especially for rural residents who experience disparities in LCS but not mammography uptake.
简介：肺癌（LC）是女性的头号癌症杀手，但肺癌筛查（LCS）的吸收率大大低于乳房x光检查。利用乳房x光检查项目的覆盖范围可能会提高LCS的吸收，但这种方法在LC检测方面的潜在收益尚不清楚。本研究旨在确定具有LC的女性同时接受两种筛查的比例，通过综合筛查发现潜在的LC，以及在具有双重筛查资格的女性中影响每种筛查的因素。方法：这项回顾性横断面研究包括345名在中西部综合癌症中心（2019-2020）新诊断为LC的女性。根据2013年和2021年USPSTF标准确定诊断前lcs资格，根据2013年标准确定lcs摄取，根据2016年标准确定乳房x光检查资格。我们评估了与双重符合条件的妇女接受筛查相关的社会人口学变量。结果：345名女性（平均[SD]年龄64.8[11.35]岁）中，73.3%符合乳房x光检查，43.5%符合LCS检查（2013年），增加到49.3%（2021年）。乳房x光检查的使用率（41.5%）大大超过LCS的使用率（13.9%）。总体而言，45.2%的患者符合两项筛查的条件，占所有符合lcs条件（2021）病例的92.4%（157/170）。值得注意的是，20.3%的患者符合lcs条件（2021年）并接受了乳房x光检查，即41.2%（70/170）的患者符合lcs条件。在符合双重条件的妇女中，农村居住与较低的LCS摄取相关（比值比[OR]， 0.42; 95% CI = 0.19-0.94; p = 0.031），而接受乳房x光检查与较高的LCS摄取相关（比值比[OR]， 2.67; 95% CI = 1.21-5.87; p = 0.013）。结论：相当大比例的符合lcs条件的LC患者接受了乳房x光检查，这意味着错过了早期LC检测的机会。整合这些筛查可以提高LC的检测，特别是对于那些经历LCS差异但未接受乳房x光检查的农村居民。
{"title":"Bridging Mammography and Lung Cancer Screening: Eligibility, Uptake and Potential Impact","authors":"Ali Ajrouch, Yara Khalifeh, Amir F. Beirat, Dana Alhaffar, Ahmad Karkash, Razan Aljaras, Adel Hajj Ali, Nicholas Pettit, Deanna R. Willis, Victoria L. Champion, Lisa Carter-Bawa, Amrou Awaysheh, Kolawole S. Okuyemi","doi":"10.1002/cam4.71528","DOIUrl":"10.1002/cam4.71528","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Lung cancer (LC) is the top cancer killer in women, yet lung cancer screening (LCS) uptake is substantially lower than mammography. Leveraging the reach of mammography programs may improve LCS uptake, but the potential gain in LC detection from this approach is unknown. This study aimed to determine the proportion of women with LC eligible for both screenings, potential LC detection via integrated screening, and factors influencing each screening uptake among those dually eligible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study included 345 women newly diagnosed with LC presenting at a Midwestern Comprehensive Cancer Center (2019–2020). Pre-diagnosis LCS-eligibility was determined per 2013 and 2021 USPSTF criteria, LCS-uptake per 2013 criteria, and mammography-eligibility per 2016 criteria. We assessed sociodemographic variables associated with screening uptake among dually eligible women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 345 women (mean [SD] age 64.8 [11.35] years), 73.3% were eligible for mammography, while 43.5% were eligible for LCS (2013), increasing to 49.3% (2021). Mammography uptake (41.5%) substantially exceeded LCS uptake (13.9%). Overall, 45.2% were eligible for both screenings, representing 92.4% (157/170) of all LCS-eligible (2021) cases. Notably, 20.3% were LCS-eligible (2021) and received mammography, that is, 41.2% (70/170) of LCS-eligible cases. Among dually eligible women, rural residency correlated with lower LCS uptake (odds ratio [OR], 0.42; 95% CI = 0.19–0.94; <i>p</i> = 0.031), whereas receiving mammography correlated with higher LCS uptake (OR, 2.67; 95% CI = 1.21–5.87; <i>p</i> = 0.013).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A substantial proportion of women with LC who are LCS-eligible underwent mammography, representing a missed opportunity for earlier LC detection. Integrating these screenings could enhance LC detection, especially for rural residents who experience disparities in LCS but not mammography uptake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Li Deng, Xiao-Meng Hao, Zhe Shu, Tong Liu, Qing-Song Zhang, Hong-Tao Wang, Han-Ping Shi
Background
The Life's Essential 8 (LE8) framework, designed to prevent cardiovascular disease, is also linked to cancer risk, but the direct association between LE8 adherence and cancer incidence remains underexplored. Each LE8 component may affect cancer risk differently across organ systems, warranting further investigation into these relationships.
Methods
This prospective cohort study utilized data from the Kailuan Study, comprising 94,239 participants from Tangshan, China. LE8 scores were calculated based on lifestyle and physiological measures, including diet, physical activity, and biomarkers such as blood glucose and cholesterol levels. Incident cancer cases were monitored through biennial health assessments and verified through multiple data sources until December 31, 2022. Cox proportional hazards models and competing risk models adjusted for confounders like age, sex, and lifestyle factors were used to analyze the impact of LE8 as well as each LE8 component on various cancer types.
Results
During a median follow-up of 14.99 years, 5124 incident cancer cases were identified. Compared to poor LE8 adherence, intermediate and ideal adherence groups showed a 13% (HR = 0.87; 95% CI: 0.80–0.96) and 26% (HR = 0.74; 95% CI: 0.65–0.85) decrease in overall cancer incidence, respectively. Improvements in LE8 scores were linked to reduced risks of specific cancers: lung (9%), breast (12%), kidney (18%), colorectal (7%), and endometrial (31%), with hazard ratios of 0.91, 0.88, 0.82, 0.93, and 0.69, respectively. Ideal blood pressure and non-smoking were protective against cancer, while ideal body weight increased the risk. Non-smoking reduced lung and kidney cancer risk, while ideal BMI had mixed effects.
Conclusions
Our findings support the LE8 framework as an effective tool for cancer prevention, with higher adherence linked to lower cancer incidence across various types. The results advocate for the integration of LE8 into broader public health and clinical strategies.
Trial Registration
Kailuan study, ChiCTR–TNRC–11001489. Registered August 24, 2011-Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=8050
{"title":"Life's Essential 8 and the Risk of Overall and Specific-Site Cancer Types: A Large-Scale Prospective Cohort Study","authors":"Li Deng, Xiao-Meng Hao, Zhe Shu, Tong Liu, Qing-Song Zhang, Hong-Tao Wang, Han-Ping Shi","doi":"10.1002/cam4.71518","DOIUrl":"10.1002/cam4.71518","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Life's Essential 8 (LE8) framework, designed to prevent cardiovascular disease, is also linked to cancer risk, but the direct association between LE8 adherence and cancer incidence remains underexplored. Each LE8 component may affect cancer risk differently across organ systems, warranting further investigation into these relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort study utilized data from the Kailuan Study, comprising 94,239 participants from Tangshan, China. LE8 scores were calculated based on lifestyle and physiological measures, including diet, physical activity, and biomarkers such as blood glucose and cholesterol levels. Incident cancer cases were monitored through biennial health assessments and verified through multiple data sources until December 31, 2022. Cox proportional hazards models and competing risk models adjusted for confounders like age, sex, and lifestyle factors were used to analyze the impact of LE8 as well as each LE8 component on various cancer types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a median follow-up of 14.99 years, 5124 incident cancer cases were identified. Compared to poor LE8 adherence, intermediate and ideal adherence groups showed a 13% (HR = 0.87; 95% CI: 0.80–0.96) and 26% (HR = 0.74; 95% CI: 0.65–0.85) decrease in overall cancer incidence, respectively. Improvements in LE8 scores were linked to reduced risks of specific cancers: lung (9%), breast (12%), kidney (18%), colorectal (7%), and endometrial (31%), with hazard ratios of 0.91, 0.88, 0.82, 0.93, and 0.69, respectively. Ideal blood pressure and non-smoking were protective against cancer, while ideal body weight increased the risk. Non-smoking reduced lung and kidney cancer risk, while ideal BMI had mixed effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings support the LE8 framework as an effective tool for cancer prevention, with higher adherence linked to lower cancer incidence across various types. The results advocate for the integration of LE8 into broader public health and clinical strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Kailuan study, ChiCTR–TNRC–11001489. Registered August 24, 2011-Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=8050</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12815607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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