Cancer Control最新文献

IntroductionOropharyngeal Squamous Cell Carcinoma (OPSCC) etiology involves environmental and genetic factors, with Human Papillomavirus (HPV) being a key ecological driver. This study evaluated the relative importance of environmental factors, particularly HPV status, and the genetic polymorphism NKG2D rs1049174 in OPSCC among a Vietnamese population.MethodsA retrospective case-control study was conducted with 279 OPSCC patients and 250 healthy controls. HPV DNA was screened and typed using PCR and Sanger sequencing. Genotyping of NKG2D rs1049174 was performed using TaqMan assays. Logistic regression, Kaplan-Meier survival analysis, Cox proportional hazards regression, and Random Forest analysis were employed to assess associations between risk factors, genotype, clinical stage, survival, and HPV status.ResultsHPV status strongly predicted overall survival (OS), with HPV-positive patients exhibiting significantly longer survival (adjusted Hazard Ratio (aHR) = 0.32, P < 0.001). Univariate Kaplan-Meier analysis further suggested differential survival among specific HPV types, with HPV16 infection trending toward prolonging OS. In predicting advanced-stage OPSCC, Random Forest analysis identified HPV status as the most critical predictor (Mean Decrease Accuracy = 5.47). Males constituted the vast majority of OPSCC patients in both HPV-negative (97.4%) and HPV-positive (84.6%) subgroups. A statistically significant difference in alcohol consumption patterns was also observed between HPV-positive and HPV-negative patients. Furthermore, the NKG2D rs1049174 polymorphism was significantly associated with OPSCC risk, though not with advanced-stage disease or OS.ConclusionHPV infection plays a critical role in OPSCC in this Vietnamese cohort, influencing patient characteristics, clinical presentation, and survival outcomes. The NKG2D rs1049174 polymorphism was identified as a significant factor in OPSCC risk; however, it did not appear to be a significant factor in disease progression or survival in this population. Further research is needed to explore the complex interplay of environmental and genetic factors in OPSCC etiology in Vietnam.

IntroductionAchieving health literacy is a primary goal of Healthy People 2030 due to the increasing recognition of its role to improve the health and well-being of all populations. Shared decision-making (SDM), a recognized process between patients and health care providers to discuss which health care decision is best for the patient considering the pros and cons, patient preferences, and circumstances, can improve health outcomes. Specifically, SDM can increase patient knowledge and the quality of decision-making, resulting in patients feeling more empowered, demonstrating less decisional regret, and more motivation. Yet, limited health literacy (LHL) can hinder a patient's ability to engage in the SDM process. Patients' ability to engage in SDM can be helped by improving health literacy levels, and by the suitability of the tools available to support them. Decision aids (DA) are educational tools that can help with SDM. SDM provides patients with the necessary skills, which, when paired with DAs designed with and for populations with LHL, can improve communication with health care providers.MethodsGuided by elements of the Ottawa Decision Framework and principles of human-centered design, in this retrospective study we aimed to develop a novel and current brief colon cancer screening DA, "Making a Decision: Should I Stop or Continue Colon Cancer Screening - Ages 75-85," based on feedback from adults ≥75 years at risk for LHL in two focus groups and a comprehensive health literacy demand assessment of the "Making a Decision About Colon Cancer Screening" using four tools to determine its readability, understandability, and actionability.ResultsFindings include a DA that was viewed favorably by older adult participants who were at risk for LHL.ConclusionsWith feedback from older adults at risk for LHL, we have developed a DA that can be tested in a larger randomized control trial.

IntroductionEmployment changes among cancer caregivers are common and can result in financial hardship. Lesbian, gay, bisexual, transgender, queer, and other identities outside of cisgender heterosexual (LGBTQ+) individuals are more likely to live in poverty and experience workplace discrimination than non-LGBTQ+ individuals. This study aimed to assess the impact of caregiving-related employment changes and anti-LGBTQ+ stigma on financial hardship and describe lived experiences with financial hardship and related employment changes among LGBTQ+ cancer caregivers.MethodsAn explanatory mixed-methods study was conducted and included a national survey and individual interviews with survey participants. Multivariable logistic regression models were used to test the association of employment changes with financial hardship. An inductive qualitative analysis guided by two of the three domains of financial hardship (ie, material and behavioral) was conducted. Quantitative and qualitative data were integrated throughout the study.ResultsA total of N = 332 LGBTQ+ cancer caregivers participated in the survey, and N = 14 participated in an interview. The average modified COmprehensive Score for financial Toxicity and Caregiver Reaction Assessment financial sub-scale were 25.6 (SD: 9.9, Range: 1-44) and 2.99 (SD: 1.0, Range: 1-5). Employment changes (OR: 3.32, 95% CI: 1.73-6.36) and anti-LGBTQ+ stigma (OR: 2.21, 95% CI: 1.47-3.32) were associated with high financial hardship. Three overarching themes from the qualitative analysis included: 1) Financial Hardship: Increased Costs, Strained Finances, and Lost Wages; 2) Caregiving as an LGBTQ+ Person: Stigma, Outness, and Expectations; and 3) Financial Unmet needs and Recommendations.ConclusionLGBTQ+ cancer caregivers experience substantial financial hardship that is associated with employment changes and anti-LGBTQ+ stigma. LGBTQ + cancer caregivers reported varying levels of outness and acceptance that directly influenced their access to financial support. Cancer-related financial hardship interventions tailored to the needs of LGBTQ+ individuals are needed.

Background: Macrophages are a critical component of the innate immune system, derived from monocytes, with significant roles in anti-inflammatory and anti-tumour activities. In the tumour microenvironment, however, macrophages are often reprogrammed into tumour-associated macrophages (TAMs), which promote tumour growth, metastasis, and therapeutic resistance.

Purpose: To review recent advancements in the understanding of macrophage polarisation and reprogramming, highlighting their role in tumour progression and potential as therapeutic targets.

Research design: This is a review article synthesising findings from recent studies on macrophage polarisation and reprogramming in tumour biology.

Study sample: Not applicable (review of existing literature).

Data collection and/or analysis: Key studies were identified and summarised to explore mechanisms of macrophage polarisation and reprogramming, focusing on M1/M2 polarisation, metabolic and epigenetic changes, and pathway regulation.

Results: Macrophage reprogramming in the tumour microenvironment involves complex mechanisms, including phenotypic and functional alterations. These processes are influenced by M1/M2 polarisation, metabolic and epigenetic reprogramming, and various signalling pathways. TAMs play a pivotal role in tumour progression, metastasis, and therapy resistance, making them prime targets for combination therapies.

Conclusions: Understanding the mechanisms underlying macrophage polarisation and reprogramming offers promising avenues for developing therapies to counteract tumour progression. Future research should focus on translating these insights into clinical applications for effective cancer treatment.

Objectives: This study aims to examine the correlation between four distinct Epstein-Barr virus (EBV) antibodies (EA-D, EBNA-1, VCA-p18, and ZEBRA) and the likelihood of developing prostate cancer (PCa) using the Mendelian Randomization (MR) technique. The primary objective is to determine whether a causal relationship exists between these EBV antibodies and prostate cancer.

Methods: Genome-wide association study (GWAS) data for EBV antibodies were sourced from the UK Biobank cohort, and prostate cancer data were obtained from the PRACTICAL consortium, which includes 79148 cases and 61106 controls. Univariable Mendelian Randomization (MR) analysis was conducted to evaluate the associations, while reverse Mendelian Randomization was employed to assess causality. Additionally, Multivariable Mendelian Randomization analysis was performed to identify independent risk factors.

Results: Univariable MR analysis revealed significant associations between EBV EA-D (OR = 1.084, 95% CI = 1.012-1.160, IVW_P = 0.021) and EBNA-1 (OR = 1.086, 95% CI = 1.025-1.150, IVW_P = 0.005) antibodies and an increased risk of prostate cancer. Reverse MR analysis did not establish a causal relationship. Multivariable MR analysis identified the EBV EBNA-1 antibody as an independent risk factor for prostate cancer (OR = 1.095, 95% CI = 1.042-1.151, IVW_P = 0.00036).

Conclusion: The study highlights the association between EBV antibody levels, particularly EBNA-1, and prostate cancer risk, suggesting EBNA-1 as an independent risk factor. Future research is needed to elucidate the biological pathways linking EBV antibody levels to prostate cancer. These insights could be instrumental in developing targeted prevention strategies and therapeutic interventions for prostate cancer.

IntroductionDrug-induced myelosuppression (DIM) is a serious side effect of several medications, particularly chemotherapy, immunosuppressants, and targeted therapies, which can lead to infections, anemia, and bleeding. While these drugs are effective, their adverse effects can disrupt treatment plans and reduce quality of life. However, early identification of DIM remains challenging, as many associated drugs do not explicitly list this risk, complicating clinical monitoring.MethodsThis study utilized the FDA Adverse Event Reporting System (FAERS) database to perform signal mining and assess the risks of DIM. Reports from the first quarter of 2004 to the third quarter of 2024 were analyzed using signal detection algorithms such as Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM). These methods helped identify drug signals related to DIM and explore risk factors and occurrence patterns.ResultsThe study analyzed 21 380 adverse event reports related to DIM, showing a significant increase in the number of reports since 2019, peaking at 3501 in 2021. Among patients, 50.2% were female, 35.5% were male, and the majority (44.42%) were aged between 18 and 65. Breast cancer patients had the highest DIM incidence (10.6%). Geographically, China reported the most cases (57.4%), followed by Japan (12.4%), and the United States (6.76%). The drugs most frequently linked to DIM included trastuzumab, bevacizumab, venetoclax, methotrexate, and pertuzumab. Additionally, 12 new drug signals were identified that were not labeled for DIM risk, including PERTUZUMAB, SODIUM CHLORIDE, and MESNA, which showed particularly strong or unexpected associations.ConclusionThis study identifies new DIM-related drug signals and emphasizes the need for early detection to improve clinical management and optimize treatment regimens. The findings provide valuable evidence for drug safety monitoring and can help reduce DIM-related risks in cancer treatment.

ObjectiveTo develop a prognostic model for optimizing management of colorectal liver oligometastases (CLOM) patients with different primary tumor locations who underwent thermal ablation (TA).Materials and MethodsThe reporting of this retrospective study conforms to STROBE guidelines. A total of 525 CLOM patients who underwent TA from 3 hospitals between 2011 and 2021 were enrolled. Firstly, intra and extrahepatic disease-free survival (DFS) and overall survival (OS) for CLOM patients with different primary tumor locations were analyzed. Then, cox regression models were used to identify independent factors predicting OS. Finally, a prognostic score was developed to identify CLOM patients benefiting from TA. All patient details were de-identified.ResultsA total of 423 eligible patients were identified, with 762 CLOM (121 male, median age 59 years) and a median follow-up of 45.8 (IQR, 7.3-114.8) months. Independent predictors of OS were identified, including multiple liver metastases (P = .0085), right-sided colon cancer (P = .0210), tumor size ≥2 cm (P = .0273), and lymph node metastasis of primary colorectal cancer (P = .0302), termed as the "MRSL" score. On the basis of the best separation of MRSL score, patients were divided into high-risk (cutoff value ≥8) and low-risk groups (cutoff value <8). Further stratified analysis indicated that right-sided CLOM patients had shorter OS than left-sided patients in the high-risk group (54.9 vs 92.5 months, P = .0156). However, no significant difference in OS was observed between right-sided and left-sided CLOM patients in the low-risk group (97.7 vs 102.2 months, P = .28).ConclusionThe MRSL score-based model helps in selecting potential right-sided CLOM patients who benefit from TA.

IntroductionLung adenocarcinoma is the leading cause of cancer-related mortality worldwide. Understanding the clinicopathological profiles and genomic drivers of its metastatic patterns is a crucial step for risk stratification. Herein, we investigated the clinicogenomic features of bone metastases in lung adenocarcinoma and their prognostic value.MethodsA retrospective cohort study with a total of 4064 patients with various metastatic patterns of lung adenocarcinoma were included, obtaining relevant clinical data and genomic profiles. Patients were categorized based on the presence or absence of bone metastases. A comparative analysis of both groups in terms of demographics, disease status, somatic mutations, and microsatellite instability was carried out. Significantly different variables were tested for their association with bone metastases. Cox regression analyses were utilized to identify independent survival prognostic variables in the bone metastases sub-cohort.ResultsGender, concomitant metastases (to adrenal gland, nervous system, lymph nodes, liver, lung, mediastinum, pleura, and skin), and aberrations in TP53, EGFR, KEAP1, and MYC were associated with bone metastases in lung adenocarcinoma. Survival analyses within the bone metastases sub-cohort have illustrated the following variables to possess poor prognostic signature including age > 75, female gender, White ethnicity, distant metastases (adrenal gland, central nervous system, intra-abdominal, and liver), EGFR (wild type), KEAP1 (mutant), MYC (mutant), KRAS (mutant), and SMARCA4 (mutant).ConclusionKey clinical and genomic factors associated with lung adenocarcinoma bone metastases have been highlighted, providing exploratory insights into high-risk individuals. Future studies should be directed to validate these prognostic variables in larger, more diverse cohorts to enhance generalizability.

IntroductionContrast-enhanced computed tomography (CT) is the primary imaging modality for accurate risk stratification in gastrointestinal stromal tumors (GISTs). However, contrast-enhanced CT may not always be accessible or suitable for all patients undergoing risk assessment of GISTs. Therefore, this study explored the use of non-enhanced CT imaging for assessing body composition in patients with GISTs to preoperatively predict risk stratification.MethodsWe retrospectively analyzed 233 patients with GISTs who met the inclusion criteria. Pretreatment complete abdominal CT images from these patients were processed and analyzed using the Siemens Syngo imaging system. The data were subsequently organized and analyzed using the SPSS software (version 26.0).ResultsThrough two independent samples t-tests, Mann-Whitney U tests, and chi-square tests (including corrected chi-square tests and Fisher's exact tests), the intermediate-high risk group exhibited a lower visceral fat index (VFI) and higher tumor volumes and proportions of necrosis (P < .05), compared to the low-risk group (P < .05). No statistically significant differences were observed in the other indicators. Our research demonstrates that tumor volume is positively correlated with the National Institutes of Health (NIH) classification and exhibits the highest specificity among the four models (specificity = 0.735). However, its sensitivity is lower than that of the combined model (sensitivity = 0.803) and the VFI model (sensitivity = 0.972).ConclusionBased on the vascular abundance index, tumor volume, and necrosis status observed in the CT plain scan images of patients with GIST, a comprehensive predictive model was developed. This model can accurately predict the NIH grade of stromal tumors, thereby providing a robust basis for formulating effective treatment strategies and improving the prognosis of patients with GISTs who cannot undergo contrast-enhanced CT.

IntroductionThe burden of prostate cancer (PCa) is disproportionately concentrated in low- and middle-income countries (LMICs). Abiraterone and enzalutamide have improved survival rates and quality of life for men with PCa. However, cost constraints limit access to these medications due to limited insurance coverage and out-of-pocket payments. The survey assessed the current practices and opinions of Nigerian clinical oncologists and urologists regarding the use of low dose abiraterone and enzalutamide for the management of metastatic PCa.MethodsThis survey consisted of twenty multiple-choice questions, distributed via Google Forms to urologists and oncologists in Nigeria from August to November 2024. It examined current practices, awareness of effective dose reduction strategies, and opinions on their cost-effectiveness. The collected data were entered into Microsoft Excel, and responses were presented using tables and charts.ResultsA total of 104 respondents completed the survey. Among them, 37 (36%) reported that 61%-80% of their patients initially presented with advanced PCa. Additionally, 55 respondents (53%) were unaware of studies and guidelines regarding low-dose abiraterone. Furthermore, 66% of clinicians indicated that fewer than 20% of their patients could afford abiraterone, and 91 (87.5%) noted that few could afford enzalutamide. Moreover, 92 (89%) respondents believed that low-dose abiraterone would improve compliance, while 76% felt that reducing the enzalutamide dose would also enhance compliance and decrease patient costs. Sixty percent (58%) of respondents were willing to switch to low-dose abiraterone.ConclusionThe survey revealed limited awareness of landmark studies on dose-reduction strategies for abiraterone and enzalutamide. These strategies have the potential to enhance affordability and compliance in the management of advanced PCa in Nigeria.