JNCI Journal of the National Cancer Institute最新文献

Background: Various studies have reported on the impact of human papillomavirus (HPV) vaccines. Here we present the largest population-based investigation of genotype-specific distributions over the decade following implementation of the 4-valent HPV vaccine (HPV6/11/16/18) in the United States.

Methods: Liquid-based cervical cytology samples from individuals aged 15-30 years undergoing cervical screening throughout New Mexico were tested by broad-spectrum HPV genotyping. Weighted relative differences in HPV type-specific prevalence (RDP) and 95% confidence intervals (95%CI) were calculated comparing individuals screened in 2007-2009 (n = 95,915) to those screened in 2013-2016 (n = 103,371). Weighted logistic regression was used to estimate relative risk of type-specific HPV infections. Tests of significance were 2-sided.

Results: Genotype-specific prevalence reduced significantly for HPV16 (RDP=-52.6%, 95%CI -56.9 to -48.3), HPV18 (RDP=-62.1%, 95%CI -68.5 to -55.8), HPV31 (RDP=-34.2%, 95%CI -42.1 to -26.3) and HPV33 (RDP=-31.8%, 95%CI -48.4 to -15.1). The RDP increased for other carcinogenic HPV types by 19.5% (95%CI +14.3 to + 24.6) when excluding HPV16/18. Large reductions in HPV6/11 RDP were observed but overall, non-carcinogenic, non-vaccine types increased. Comparing females born in 1996 to those born in 1989, risk of infection with HPV6/11/16/18 decreased by 80.0% among individuals aged 21-25 years. High-grade squamous intraepithelial lesions or worse (HSIL+) decreased by 49.4% when extending the evaluation from 2007 to 2018.

Conclusion(s): HSIL+ incidence is decreasing with large reductions in the prevalence of 4-valent HPV vaccine types and non-vaccine types HPV31 and 33, reflecting vaccine cross-protection. Increases in non-vaccine HPVs may attenuate anticipated reductions in HPV-related abnormalities including cancers however the benefits of HPV vaccination remain substantial.

The recent cisplatin and carboplatin ("platinum") chemotherapy shortage, first announced on February 10, 2023, has impacted cancer patients nationwide. Here, we quantify the extent to which the shortage affected platinum chemotherapy prescribing and short-term mortality. This cohort study included 11 797 adults with advanced solid cancers who initiated first-line therapy during the 1-year period before (February 1, 2022-February 9, 2023) or during (February 10, 2023-January 31, 2024) the platinum shortage. During the shortage, there was a 2.7% absolute reduction in platinum use (95% CI = -4.4% to -0.9%) compared to the previous year. At the peak of the shortage, there was a 15.1% absolute reduction in platinum prescribing (June 2023: 57.8% [95% CI = 53.6% to 62.0%]) compared to 1 year prior (June 2022: 72.9% [95% CI = 70.7% to 75.2%]). There was no difference in mortality before vs during the shortage (adjusted hazard ratio 1.00; 95% CI = 0.94 to 1.07) with median follow-up time of 7.6 months. Further research is required to study shortage impacts on long-term mortality.

Research conducted over the past 15+ years has identified hundreds of common germline genetic variants associated with cancer risk, but understanding the biological impact of these primarily non-protein coding variants has been challenging. The National Cancer Institute sought to better understand and address those challenges by requesting input from the scientific community via a survey and a 2-day virtual meeting, which focused on discussions among participants. Here, we discuss challenges identified through the survey as important to advancing functional analysis of common cancer risk variants: 1) When is a variant truly characterized; 2) Developing and standardizing databases and computational tools; 3) Optimization and implementation of high-throughput assays; 4) Use of model organisms for understanding variant function; 5) Diversity in data and assays; and 6) Creating and improving large multidisciplinary collaborations. We define these 6 challenges, describe how success in addressing them may look, propose potential solutions, and note issues that span all the challenges. Implementation of these ideas could help develop a framework for methodically analyzing common cancer risk variants to understand their function and make effective and efficient use of the wealth of existing genomic association data.