Cancer Control最新文献

Background and objectives: This study aimed to assess if extensive surgical resection enhances outcomes in wild-type Isocitrate Dehydrogenase (IDH) butterfly glioblastoma (B-GBM) patients, despite the presence of Telomerase Reverse Transcriptase (TERT) mutation and Epidermal Growth Factor Receptor (EGFR) amplification.

Methods: The study, retrospectively conducted from 2014 to 2022, involved 723 GBM patients, 41 of whom met the criteria for IDH wild-type B-GBM. Exclusion criteria comprised prior diagnoses or treatments for low-grade glial tumors. Surgeons, employing two approaches-partial and extensive surgery-categorized patients based on age, sex, tumor location, corpus callosum involvement, and genetic characteristics. The interval between initial surgery and tumor recurrence/tumor-free period (TR/TFP) and overall survival (OS) were recorded and compared between the partial and extensive resection groups, analyzing the impact of resection width on TR/TFP and OS. Preoperative assessments utilized thin-section cranial computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI). Intraoperatively, tumor excision was guided by sodium fluorescein, and margins were delineated via neuronavigation. Genetic alterations (TERT mutations and EGFR amplifications) were correlated with surgical type, TR/TFP, and OS. Karnofsky Performance Scale (KPS) evaluations were performed pre- and post-operatively and at key intervals, comparing outcomes between surgical groups. Standard radiotherapy and chemotherapy regimens were administered to all patients.

Results: Extensive resection yielded significantly longer TR/TFP compared to partial resection, despite TERT gene mutation and EGFR amplification being linked to shorter TR/TFP and OS. Its impact on OS, however, was not significant. KPS scores indicated a superior quality of life after extensive resection, with sustained improvement upon recurrence.

Conclusions: Extensive resection of B-GBM, even in the presence of adverse genetic alterations, may prolong TR/TFP, offering patients a period of improved comfort with minimal distress.

Background: Despite the relatively low breast cancer incidence in Estonia, mortality remains high, and participation in mammography screening is below the recommended 70%. The objective of this register-based study was to evaluate incidence-based (IB) breast cancer mortality before and after the introduction of organized mammography screening in 2004.

Methods: Breast cancer deaths individually linked to breast cancer diagnosis were obtained from the Estonian Cancer Registry and used for calculating IB mortality. We compared age-specific IB mortality rates across 5-year birth cohorts and 5-year periods. Poisson regression was used to compare IB mortality for one age group invited to screening (50-63) and three age groups not invited to screening (30-49, 65-69, and 70+) during two periods before and after screening initiation (1993-2003 and 2004-2014). Joinpoint regression was used for age-standardized incidence and IB mortality trends.

Results: Age-standardized IB mortality has been decreasing since 1997. Age-specific IB mortality for birth cohorts never exposed to screening showed a continuous increase with age, while in cohorts exposed to organized screening the mortality curve flattened or declined after the age of first invitation. Significant decreases in mortality from 1993-2003 to 2004-2014 were seen in the 30-49 (age-adjusted rate ratio 0.51, 95% CI 90.42-0.63) and 50-63 (0.65, 95% CI 0.56-0.74) age groups, while no decline was seen in the 65-69 and 70+ age groups.

Conclusions: The age specific IB mortality curves in birth cohorts exposed to screening and the significant mortality decline in the target age group after the initiation of the organized program suggest a beneficial effect of screening. Improved treatment without screening has not reduced mortality in older age groups. Our results support raising the upper screening age limit to 74 years.

Objectives: Cancer education has been promoted under the Basic Plan for Cancer Education in Japan. We conducted a repeated cross-sectional survey of Japanese students to determine changes in attitudes regarding cancer over time.

Methods: A nationwide survey of fifth-grade elementary students was conducted in February 2013. A repeated cross-sectional survey was conducted following previous studies with second-year high school students in February 2019, as second-year high school students in 2019 corresponded to the generation of fifth-grade students in 2013. The self-administered, multiple-choice questionnaire inquired about the awareness of cancer and its causes and sources of cancer information. Statistical analyses were performed by calculating the percentage of selections and 95% confidence intervals for each question.

Results: The differences between values in 2019 and 2013 were examined. Responses were received from 94 schools (44.1%) in 2013 and 114 schools (52.8%) in 2019. After excluding incomplete responses, valid responses from 2213 and 3822 respondents, respectively, were analyzed. Desirable changes over time were observed in awareness. Increasing age was associated with a rise in misperceptions and a decline in desirable rather than undesirable perceptions of the causes of cancer. The Internet was a common source of information among high school students, followed by health education at school.

Conclusion: Cancer education in schools should aim to counteract misconceptions and promote positive, evidence-based information. Improving perceptions of cancer screening could increase intentions of undergoing screening. Additionally, presenting cancer information using social networking sites could help promote cancer prevention among junior high and high school students.

Background: Epidermal growth factor receptor exon 20 insertion (EGFR ex20ins), an uncommon mutation in non-small cell lung cancer (NSCLC), can induce poor patient response to EGFR tyrosine kinase inhibitors (EGFR-TKI). However, the clinical features and prognosis of patients with EGFR ex20ins are not clearly understood. This study investigated the clinical characteristics and prognosis of advanced NSCLC patients with EGFR ex20ins.

Methods: Advanced NSCLC patients treated at Fujian Cancer Hospital were consecutively recruited from June 1, 2014 to December 20, 2021 and retrospectively examined. EGFR ex20ins was identified by polymerase chain reaction (PCR) or next-generation sequencing (NGS). The clinical characteristics, treatment methods, and patient outcomes were retrieved from the hospital database. The progression-free survival (PFS)  and overall survival (OS) were assessed by Kaplan-Meier analysis.

Results: Fourteen mutation subtypes of EGFR ex20ins were identified in the 24 enrolled patients, with EGFR ex20ins mutation more prevalent in non-smoking women. A763_Y764insFQEA and A767_V769dup (12.5% for both) were the most common mutation subtypes. Notably, no significant differences in PFS and OS were found between the first-line targeted therapy group [PFS: 257 days, 95% confidence interval (CI): 116-397 days; OS: not reached] and chemotherapy-based combination therapy group (PFS: 182 days, 95% CI: 156-207 days; OS: 998 days, 95% CI: 674-1321 days). TP53 mutation was the commonest concomitant mutation (62%), followed by EGFR amplification (25%). Chemotherapy combined with immunotherapy improved the prognosis of patients with high PD-L1 expression.

Conclusion: For NSCLC patients with EGFR ex20ins, limited therapeutic benefits can be gleaned from either EGFR-TKIs or chemotherapy-based combination therapy.

Background: Cancer is the second-leading cause of death in the United States. Most studies have reported rural versus urban and Black versus White cancer disparities. However, few studies have investigated racial disparities in rural areas.

Objective: We conducted a literature review to explore the current state of knowledge on racial and ethnic disparities in cancer attitudes, knowledge, occurrence, and outcomes in rural United States.

Methods: A systematic search of PubMed and Embase was performed. Peer-reviewed articles published in English from 2004-2023 were included. Three authors independently reviewed the articles and reached a consensus.

Results: After reviewing 993 articles, a total of 30 articles met the inclusion criteria and were included in the present review. Studies revealed that underrepresented racial and ethnic groups in rural areas were more likely to have low cancer-related knowledge, low screening, high incidence, less access to treatment, and high mortality compared to their White counterparts.

Conclusion: Underrepresented racial and ethnic groups in rural areas experienced a high burden of cancer. Improving social determinants of health may help reduce cancer disparities and promote health.

Introduction: Esophageal cancer was the eighth and sixth leading cause of morbidity of all cancers in the world, and the 15th and 12th in Ethiopia, respectively. There is a lack of comprehensive data regarding Ethiopia's esophageal cancer hotspot, treatment outcome clustering, and other factors.

Objective: This scoping review was designed to understand the extent and type of existing evidence regarding spatiotemporal distribution, time to treatment outcome clustering, and determinants of esophageal cancer in Ethiopia up to March 28, 2023.

Methods: Three-step search strategies were employed for the scoping review from March 15 to 28, 2023. Targeted databases included PubMed/Medline, PubMed Central (PMC), Google Scholar, Hinari, and Cochrane for published studies and different websites for unpublished studies for evidence synthesis. Data were extracted using the Joanna Briggs Institute (JBI) manual format.

Results: Our final analysis comprised 17 (16 quantitative and 1 qualitative) studies. Three studies attempted to depict the country's temporal distribution, whereas 12 studies showed the spatial distribution of esophageal cancer by proportion. The regional state of Oromia recorded a high percentage of cases. Numerous risk factors linked to the tumor have been identified in 8 investigations. Similarly, 5 studies went into detail regarding the likelihood of survival and the factors that contribute to malignancy, while 2 studies covered the results of disease-related treatments.

Conclusions: The substantial body of data that underpins this finding supports the fact that esophageal cancer has several risk factors and that its prevalence varies greatly across the country and among regions. Surgery, radiotherapy, or chemotherapy helped the patient live longer. However, no research has investigated which treatment is best for boosting patient survival and survival clustering. Therefore, research with robust models for regional distribution, clustering of time to treatment outcomes, and drivers of esophageal cancer will be needed.

Background: The goal of this study was to evaluate the global burden of malignant skin melanoma (MSM) from 1990 to 2019 using MSM-related data from the Global Burden of Disease study.

Methods: The incidences' relationships with the social-demographic index (SDI) and human developmental index (HDI) were investigated. To determine significant changes in incidence trends, the joinpoint regression model was used. To demonstrate trends in MSM mortality rates, an Age-Period-Cohort framework was conducted. For the projection of new cases and the age-standardized incidence rate (ASR) of MSM incidence to 2034, the Nordpred method was used.

Results: In 2019, the ASR incidence per 100, 000 people for MSM was 3.6 (95% UI, 2.6-4.2). MSM prevalence increased in most countries between 1990 and 2019 (average annual percentage change >0). HDI and annual percentage change (APC) (ρ = .63, P < .001), as well as SDI and ASR, had a positive correlation. The total MSM mortality rate declined globally, with an APC of -.61%. Likewise, the mortality rate for the age group of people with ages <77.5 years declined. Predictive analysis demonstrated a declining trend in ASR incidence and a growing number of MSM.

Conclusion: There are significant differences in ASR incidence among regions and countries. Despite decreases in ASR incidence and fatality, MSM remains one of the leading sources of cancer mortality and morbidity globally. MSM necessitates more primary prevention measures and screening in high-risk areas.

Background: Acute lymphocytic leukemia is a cancer affecting the blood and bone marrow and is the most frequently diagnosed cancer among children. In Ethiopia, it represents the predominant form of childhood leukemia, comprising approximately 80% of cases and serving as a leading cause of childhood cancer-related deaths. Therefore, the objective of this study is to examine the survival status and factors that may predict mortality in children admitted with acute lymphocytic leukemia at cancer treatment hospitals in Addis Ababa, Ethiopia.

Methods: A retrospective follow-up study was conducted at cancer treatment hospitals in Addis Ababa, focusing on children diagnosed with acute lymphocytic leukemia. The investigation covered records from January 1, 2017, to December 30, 2023, encompassing a sample of 230 study records. Variables with a P-value below 0.25 in the bivariate analysis were selected for entry into the multivariable analysis. Subsequently, variables demonstrating a P-value less than 0.05 in the multivariable Cox proportional hazards model were deemed statistically significant.

Results: The cumulative proportion of survival was 98.3% (95%CI: 94.8, 99.5), 89.2% (95%CI: 82.0, 93.6), and 24.1% (95%CI: 8.43, 44.1) at the end of the 20^th, 40^th, and 60^th month, respectively. The incidence rate of mortality among cohort of children admitted with acute lymphocytic leukemia was 0.45 per 100 child months. History of relapse (AHR: 2.48; 95%CI: 1.01, 6.08) and infection (AHR: 2.34; 95%CI: 1.03, 5.31) were independent predictors of mortality among children admitted with acute lymphocytic leukemia.

Conclusion: The likelihood of mortality increased in the later stages of follow-up for children admitted with acute lymphocytic leukemia, and the incidence density rate of mortality in this group was lower compared to previous reports from other regions. Furthermore, independent predictors of mortality among children with acute lymphocytic leukemia included a history of relapse and infection.

Objectives: The incidence of pancreatic ductal adenocarcinoma (PDAC) increases with age and is frequently diagnosed at an inoperable stage, which limits treatment options. There is limited evidence concerning patients over 75 years old, and clinical practice often lacks clear guidance regarding the choice of first-line therapy. The primary objective of this retrospective study was to assess overall survival (OS) in elderly patients receiving first-line monochemotherapy vs combination therapy. Secondary objectives included evaluating progression-free survival (PFS) and safety.

Methods: This retrospective study analyzed the records of 150 patients aged 75 or older with confirmed PDAC treated with first-line chemotherapy at Piacenza General Hospital, Italy. Of these, 72 patients received monotherapy, while 78 underwent polychemotherapy. The majority of patients (93.3%) were administered reduced doses, and within this group, 67.9% had their doses reduced by more than 20%. Most patients (80%) presented with comorbidities, predominantly hypertension and diabetes.

Results: The median overall survival was significantly higher in the polychemotherapy group (8.2 months) compared to the monotherapy group (4.7 months), with a P-value of 0.0022. The median PFS was 5.7 months for polychemotherapy and 2.8 months for monotherapy, showing a statistically significant difference (P = 0.004). In the multivariate analysis, poor performance status, high CA19.9 levels, and monotherapy were significantly associated with worse OS. Patients treated with polychemotherapy had a 37% lower likelihood of death within the year compared to those treated with monotherapy (HR 0.58, P = 0.009).

Conclusion: Polychemotherapy may provide a survival advantage over monotherapy in the late-elderly population, although considerations for dose adjustments due to comorbidities and polypharmacy are necessary. These findings suggest that, when feasible, polychemotherapy could offer a balance between effectiveness and tolerability, potentially improving outcomes in this age group.