Suresh T Chari,Ziding Feng,Bechien Wu,William Fisher,Avinash Kambadakone,Ying-Qi Zhao,Anirban Maitra,Barbara Kenner,Lynn M Matrisian
Early detection is key to improving survival and mortality from pancreatic cancer. Traditional periodic screening for cancer in an asymptomatic population is infeasible and not recommended for this low-incidence disease. We describe a novel approach we call "heuriskance" (hyou-ris-kance) wherein a systematic search for and onetime workup of a "heurisk" (hyou-risk) leads to earlier detection of cancer. A heurisk is an early warning sign with three defining characteristics: i) indicates higher-than-threshold-probability of having prevalent invasive cancer, ii) is associated with a meaningful lead time to diagnosis, and iii) is identifiable by a systematic and scalable process in the population. Heuriskance aims to systematically detect cancer with clinically meaningful lead time to clinical diagnosis, minimize proportion of patients with advanced disease, and maximize treatment options leading to increases in lead time-adjusted 1-, 3- and eventually 5- year survival. A specific example of a heurisk for pancreatic cancer is glycemically defined new onset diabetes (GNOD) and the Early Detection Initiative (NCT04662879) an example of GNOD-based heuriskance. As heuriskance has no precedent, we provide i) a tiered risk stratification approach (Define-Enrich-Find), ii) metrics for choosing a heurisk, iii) success metrics for strategy and iv) Phases 1-5 for evaluating the strategy in retrospective and prospective studies. Like all current cancer therapies, heuriskance aims to iteratively improve survival from a fatal disease using a pragmatic, evidence-based systematic approach to its earlier detection. The concept of heuriskance is applied to pancreatic cancer but could be extended to other cancer types.
{"title":"Heuriskance: a novel paradigm for systematic earlier detection of sporadic pancreatic cancer.","authors":"Suresh T Chari,Ziding Feng,Bechien Wu,William Fisher,Avinash Kambadakone,Ying-Qi Zhao,Anirban Maitra,Barbara Kenner,Lynn M Matrisian","doi":"10.1093/jnci/djaf291","DOIUrl":"https://doi.org/10.1093/jnci/djaf291","url":null,"abstract":"Early detection is key to improving survival and mortality from pancreatic cancer. Traditional periodic screening for cancer in an asymptomatic population is infeasible and not recommended for this low-incidence disease. We describe a novel approach we call \"heuriskance\" (hyou-ris-kance) wherein a systematic search for and onetime workup of a \"heurisk\" (hyou-risk) leads to earlier detection of cancer. A heurisk is an early warning sign with three defining characteristics: i) indicates higher-than-threshold-probability of having prevalent invasive cancer, ii) is associated with a meaningful lead time to diagnosis, and iii) is identifiable by a systematic and scalable process in the population. Heuriskance aims to systematically detect cancer with clinically meaningful lead time to clinical diagnosis, minimize proportion of patients with advanced disease, and maximize treatment options leading to increases in lead time-adjusted 1-, 3- and eventually 5- year survival. A specific example of a heurisk for pancreatic cancer is glycemically defined new onset diabetes (GNOD) and the Early Detection Initiative (NCT04662879) an example of GNOD-based heuriskance. As heuriskance has no precedent, we provide i) a tiered risk stratification approach (Define-Enrich-Find), ii) metrics for choosing a heurisk, iii) success metrics for strategy and iv) Phases 1-5 for evaluating the strategy in retrospective and prospective studies. Like all current cancer therapies, heuriskance aims to iteratively improve survival from a fatal disease using a pragmatic, evidence-based systematic approach to its earlier detection. The concept of heuriskance is applied to pancreatic cancer but could be extended to other cancer types.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qinjin Fan,Jingxuan Zhao,Xuesong Han,K Robin Yabroff,Leticia M Nogueira
{"title":"Response to cheng, palesh, and hong.","authors":"Qinjin Fan,Jingxuan Zhao,Xuesong Han,K Robin Yabroff,Leticia M Nogueira","doi":"10.1093/jnci/djaf167","DOIUrl":"https://doi.org/10.1093/jnci/djaf167","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"RE: Evaluating benefit-to-burden ratios of the established and emerging colorectal cancer screening strategies.","authors":"Derek W Ebner,Chris Estes,Paul J Limburg","doi":"10.1093/jnci/djaf266","DOIUrl":"https://doi.org/10.1093/jnci/djaf266","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Derek W Ebner,A Mark Fendrick,John B Kisiel,Chris Estes,Vahab Vahdat,A Burak Ozbay,Paul J Limburg
BACKGROUNDRecommended noninvasive strategies for average-risk colorectal cancer (CRC) screening include multitarget stool DNA and fecal immunochemical test from ages 45 to 75 years. With new clinical trials, performance data for next-generation multitarget stool DNA, multitarget stool RNA, and blood-based screening tests are now available. This decision analytical model study evaluated the estimated benefit-to-burden ratio by means of efficient frontiers for noninvasive established and emerging CRC screening strategies.METHODSOutcomes were estimated using the Colorectal Cancer and Adenoma Incidence and Mortality microsimulation model for average-risk individuals in the United States. Screening strategies were next-generation multitarget stool DNA (an updated marker panel), fecal immunochemical tests, multitarget stool RNA, or blood-based tests every 1-3 years, over various age ranges. Test performance inputs were derived from recent large clinical trials. A strategy was deemed efficient if no other strategy provided more life-years gained with equivalent or fewer lifetime colonoscopies and near-efficient if within 3 days of life-years gained of the efficient frontier.RESULTSAll modeled screening strategies resulted in life-years gained vs no screening. No strategy using blood-based tests was efficient or near-efficient. Overall, 10 strategies were efficient (6 next-generation multitarget stool DNA and 4 fecal immunochemical tests), including 2 strategies among those ages 45-75 years (biennial and triennial next-generation multitarget stool DNA). Overall, 22 strategies were near-efficient, including 4 strategies among those ages 45-75 years (annual, biennial, or triennial fecal immunochemical test; annual next-generation multitarget stool DNA).CONCLUSIONBased on this modeling study, next-generation multitarget stool DNA was the only noninvasive screening test at guideline-endorsed interval and age-recommended ranges that was deemed efficient. Blood-based and multitarget stool RNA strategies were deemed not efficient for primary screening.
{"title":"Evaluating benefit-to-burden ratios of the established and emerging colorectal cancer screening strategies.","authors":"Derek W Ebner,A Mark Fendrick,John B Kisiel,Chris Estes,Vahab Vahdat,A Burak Ozbay,Paul J Limburg","doi":"10.1093/jnci/djaf209","DOIUrl":"https://doi.org/10.1093/jnci/djaf209","url":null,"abstract":"BACKGROUNDRecommended noninvasive strategies for average-risk colorectal cancer (CRC) screening include multitarget stool DNA and fecal immunochemical test from ages 45 to 75 years. With new clinical trials, performance data for next-generation multitarget stool DNA, multitarget stool RNA, and blood-based screening tests are now available. This decision analytical model study evaluated the estimated benefit-to-burden ratio by means of efficient frontiers for noninvasive established and emerging CRC screening strategies.METHODSOutcomes were estimated using the Colorectal Cancer and Adenoma Incidence and Mortality microsimulation model for average-risk individuals in the United States. Screening strategies were next-generation multitarget stool DNA (an updated marker panel), fecal immunochemical tests, multitarget stool RNA, or blood-based tests every 1-3 years, over various age ranges. Test performance inputs were derived from recent large clinical trials. A strategy was deemed efficient if no other strategy provided more life-years gained with equivalent or fewer lifetime colonoscopies and near-efficient if within 3 days of life-years gained of the efficient frontier.RESULTSAll modeled screening strategies resulted in life-years gained vs no screening. No strategy using blood-based tests was efficient or near-efficient. Overall, 10 strategies were efficient (6 next-generation multitarget stool DNA and 4 fecal immunochemical tests), including 2 strategies among those ages 45-75 years (biennial and triennial next-generation multitarget stool DNA). Overall, 22 strategies were near-efficient, including 4 strategies among those ages 45-75 years (annual, biennial, or triennial fecal immunochemical test; annual next-generation multitarget stool DNA).CONCLUSIONBased on this modeling study, next-generation multitarget stool DNA was the only noninvasive screening test at guideline-endorsed interval and age-recommended ranges that was deemed efficient. Blood-based and multitarget stool RNA strategies were deemed not efficient for primary screening.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reinier G S Meester, Andrew J Piscitello, Joseph A Duimstra, Peter S Liang, Aasma Shaukat, Theodore R Levin
Background Emerging blood tests may improve colorectal cancer (CRC) screening uptake and outcomes but are less sensitive for advanced precancerous lesions than some currently recommended tests. We examine whether these tests meet expectations for U.S. Preventive Services Task Force (USPSTF) recommendation. Methods A decision-analytic model that informed USPSTF was replicated and used to estimate the lifetime benefits (averted CRC cases & deaths, life-years gained [LYG]), burdens (required screening tests & colonoscopies), and harms (colonoscopy-related complications) for annual, biennial or triennial blood testing through age 45-75 years vs a benchmark of recommended and contemporary stool-based strategies, with colonoscopy screening as the reference. Base-case analyses assumed 100% adherence. Sensitivity analyses evaluated more realistic scenarios. Results Among benchmark strategies, colonoscopy screening had the most benefit, with an estimated 30 CRC deaths averted, 356 LYG, 4270 colonoscopies required and 15 complications per 1000 adults; stool-based strategies resulted in 81–88% of LYG for colonoscopy, 6829–19,476 screening tests, 1523–1880 colonoscopies, and 9–10 complications. By comparison, annual blood testing resulted in 85–87% of LYG for colonoscopy and an intermediate number of screenings, colonoscopies and complications. Biennial and triennial blood testing provided 57–72% of LYG for colonoscopy but resulted in net population benefit under plausible scenarios for increased utilization vs existing strategies. Conclusions The estimated benefits, burdens and harms of annual blood testing are within the range of current CRC screening strategies. Biennial and triennial testing should also be considered for recommendation given potential for increased utilization and net population benefit.
{"title":"Comparative benefits, burdens and harms of emerging blood-based tests for colorectal cancer screening","authors":"Reinier G S Meester, Andrew J Piscitello, Joseph A Duimstra, Peter S Liang, Aasma Shaukat, Theodore R Levin","doi":"10.1093/jnci/djaf277","DOIUrl":"https://doi.org/10.1093/jnci/djaf277","url":null,"abstract":"Background Emerging blood tests may improve colorectal cancer (CRC) screening uptake and outcomes but are less sensitive for advanced precancerous lesions than some currently recommended tests. We examine whether these tests meet expectations for U.S. Preventive Services Task Force (USPSTF) recommendation. Methods A decision-analytic model that informed USPSTF was replicated and used to estimate the lifetime benefits (averted CRC cases & deaths, life-years gained [LYG]), burdens (required screening tests & colonoscopies), and harms (colonoscopy-related complications) for annual, biennial or triennial blood testing through age 45-75 years vs a benchmark of recommended and contemporary stool-based strategies, with colonoscopy screening as the reference. Base-case analyses assumed 100% adherence. Sensitivity analyses evaluated more realistic scenarios. Results Among benchmark strategies, colonoscopy screening had the most benefit, with an estimated 30 CRC deaths averted, 356 LYG, 4270 colonoscopies required and 15 complications per 1000 adults; stool-based strategies resulted in 81–88% of LYG for colonoscopy, 6829–19,476 screening tests, 1523–1880 colonoscopies, and 9–10 complications. By comparison, annual blood testing resulted in 85–87% of LYG for colonoscopy and an intermediate number of screenings, colonoscopies and complications. Biennial and triennial blood testing provided 57–72% of LYG for colonoscopy but resulted in net population benefit under plausible scenarios for increased utilization vs existing strategies. Conclusions The estimated benefits, burdens and harms of annual blood testing are within the range of current CRC screening strategies. Biennial and triennial testing should also be considered for recommendation given potential for increased utilization and net population benefit.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shuo Wang,Zexi Rao,Anne H Blaes,Josef Coresh,Corinne E Joshu,James S Pankow,Bharat Thyagarajan,Ruth Dubin,Rajat Deo,Seamus P Whelton,Michael J Blaha,Catherine H Marshall,Jerome I Rotter,Peter Ganz,Weihua Guan,Elizabeth A Platz,Anna Prizment
BACKGROUNDTo estimate biological age, we developed a proteomic aging clock in cancer-free participants (CaPAC) and examined its association with mortality in long-term cancer survivors (LTCS, >2 years between cancer diagnosis and blood collection) and cancer-free participants in the Atherosclerosis Risk in Communities (ARIC) and Multi-Ethnic Study of Atherosclerosis (MESA) studies.METHODSARIC measured 4,712 proteins using SomaScan in plasma samples collected at three visits, including Visit 5 (2011-13) from 806 LTCS and 3,699 cancer-free participants, all aged 66-90. Among 2,466 randomly selected cancer-free participants, we developed CaPAC using elastic net regression. Age acceleration was calculated as residuals from CaPAC regressed on chronological age (CaPACAccel). We used multivariable Cox proportional hazards regression to calculate hazard ratios (HRs) for the associations of CaPACAccel with all-cause and cancer mortality in LTCS and all-cause mortality in the remaining cancer-free participants. We replicated the analysis of all-cause mortality in MESA.RESULTSIn LCTS, CaPACAccel was associated with increased all-cause mortality in both ARIC [HR (95% CI) per 1 SD = 1.42 (1.24-1.62), p < .001] and MESA [1.62 (1.12-2.33), p = .009]. Also, in ARIC, CaPACAccel was associated with all-cause mortality in breast [1.54 (1.05-2.25), p = .028] and colorectal LTCS [1.96 (1.19-3.22), p = .008]. Additionally, CaPACAccel was associated with cancer mortality in LTCS [1.34 (1.09-1.64), p = .005] in ARIC. In MESA, limited sample size precluded us from examining individual cancers and cause-specific mortality. In cancer-free participants, the associations of CaPACAccel with all-cause mortality were similar across studies.CONCLUSIONProteomic aging clocks hold promise as a predictor of all-cause and cancer mortality in LTCS.
背景：为了估计生物年龄，我们在无癌参与者（CaPAC）中开发了一种蛋白质组老化时钟，并在社区动脉粥样硬化风险（ARIC）和多种族动脉粥样硬化研究（MESA）中研究了其与长期癌症幸存者（LTCS，癌症诊断和血液采集之间的20年）和无癌参与者的死亡率的关系。方法saric使用SomaScan检测了三次访问收集的血浆样本中的4,712种蛋白质，包括访问5(2011-13)，来自806名LTCS和3,699名无癌症参与者，年龄均为66-90岁。在2466名随机选择的无癌参与者中，我们使用弹性网络回归开发了CaPAC。年龄加速计算为CaPAC对实足年龄回归的残差（CaPACAccel）。我们使用多变量Cox比例风险回归来计算CaPACAccel与LTCS患者的全因死亡率和癌症死亡率以及其余无癌症患者的全因死亡率相关的风险比（hr）。我们重复了MESA的全因死亡率分析。结果在LCTS中，CaPACAccel与两种ARIC患者的全因死亡率升高相关[HR (95% CI) / 1 SD = 1.42 (1.24-1.62), p <。[1.62 (1.12-2.33), p = .009]。此外，在ARIC中，CaPACAccel与乳腺全因死亡率相关[1.54 (1.05-2.25),p =。[028]和结直肠LTCS [1.96 (1.19-3.22), p = 0.008]。此外，CaPACAccel与LTCS的癌症死亡率相关[1.34 (1.09-1.64),p =。[05]在ARIC。在MESA中，有限的样本量使我们无法检查个体癌症和病因特异性死亡率。在无癌症的参与者中，CaPACAccel与全因死亡率的关联在研究中是相似的。结论：蛋白质组学衰老时钟有望预测LTCS的全因死亡率和癌症死亡率。
{"title":"Proteomic aging clocks and the risk of mortality among long-term cancer survivors.","authors":"Shuo Wang,Zexi Rao,Anne H Blaes,Josef Coresh,Corinne E Joshu,James S Pankow,Bharat Thyagarajan,Ruth Dubin,Rajat Deo,Seamus P Whelton,Michael J Blaha,Catherine H Marshall,Jerome I Rotter,Peter Ganz,Weihua Guan,Elizabeth A Platz,Anna Prizment","doi":"10.1093/jnci/djaf286","DOIUrl":"https://doi.org/10.1093/jnci/djaf286","url":null,"abstract":"BACKGROUNDTo estimate biological age, we developed a proteomic aging clock in cancer-free participants (CaPAC) and examined its association with mortality in long-term cancer survivors (LTCS, >2 years between cancer diagnosis and blood collection) and cancer-free participants in the Atherosclerosis Risk in Communities (ARIC) and Multi-Ethnic Study of Atherosclerosis (MESA) studies.METHODSARIC measured 4,712 proteins using SomaScan in plasma samples collected at three visits, including Visit 5 (2011-13) from 806 LTCS and 3,699 cancer-free participants, all aged 66-90. Among 2,466 randomly selected cancer-free participants, we developed CaPAC using elastic net regression. Age acceleration was calculated as residuals from CaPAC regressed on chronological age (CaPACAccel). We used multivariable Cox proportional hazards regression to calculate hazard ratios (HRs) for the associations of CaPACAccel with all-cause and cancer mortality in LTCS and all-cause mortality in the remaining cancer-free participants. We replicated the analysis of all-cause mortality in MESA.RESULTSIn LCTS, CaPACAccel was associated with increased all-cause mortality in both ARIC [HR (95% CI) per 1 SD = 1.42 (1.24-1.62), p < .001] and MESA [1.62 (1.12-2.33), p = .009]. Also, in ARIC, CaPACAccel was associated with all-cause mortality in breast [1.54 (1.05-2.25), p = .028] and colorectal LTCS [1.96 (1.19-3.22), p = .008]. Additionally, CaPACAccel was associated with cancer mortality in LTCS [1.34 (1.09-1.64), p = .005] in ARIC. In MESA, limited sample size precluded us from examining individual cancers and cause-specific mortality. In cancer-free participants, the associations of CaPACAccel with all-cause mortality were similar across studies.CONCLUSIONProteomic aging clocks hold promise as a predictor of all-cause and cancer mortality in LTCS.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The National Cancer Institute's (NCI) Cancer Information Service (CIS) was founded in 1975 in accordance with a Congressional mandate requiring NCI to provide accurate, timely, and reliable cancer information to the American public as part of the National Cancer Act. For 50 years, the CIS has provided cancer patients, caregivers, healthcare professionals, and the public with high-quality information and resources on topics across the cancer control continuum, cancer clinical trials, and tobacco use cessation. Throughout its history, the CIS has adapted to changes in the health communication environment and evolving consumer needs, for example, by implementing additional access channels and launching a Spanish-language service to better serve the public. In addition to being a premiere cancer information resource, the CIS is a unique laboratory for health communication research as data collected from the program is routinely used to monitor the public's emerging cancer information needs and to study information seeking patterns across a variety of cancer control topics. This commentary aims to spotlight the role of the CIS as a federal health information resource that has been addressing the public's real-time cancer information needs and responding to national cancer research and public health priorities for over five decades.
{"title":"The National Cancer Institute's Cancer Information Service: 50 years of service to the nation.","authors":"Robin C Vanderpool","doi":"10.1093/jnci/djaf285","DOIUrl":"https://doi.org/10.1093/jnci/djaf285","url":null,"abstract":"The National Cancer Institute's (NCI) Cancer Information Service (CIS) was founded in 1975 in accordance with a Congressional mandate requiring NCI to provide accurate, timely, and reliable cancer information to the American public as part of the National Cancer Act. For 50 years, the CIS has provided cancer patients, caregivers, healthcare professionals, and the public with high-quality information and resources on topics across the cancer control continuum, cancer clinical trials, and tobacco use cessation. Throughout its history, the CIS has adapted to changes in the health communication environment and evolving consumer needs, for example, by implementing additional access channels and launching a Spanish-language service to better serve the public. In addition to being a premiere cancer information resource, the CIS is a unique laboratory for health communication research as data collected from the program is routinely used to monitor the public's emerging cancer information needs and to study information seeking patterns across a variety of cancer control topics. This commentary aims to spotlight the role of the CIS as a federal health information resource that has been addressing the public's real-time cancer information needs and responding to national cancer research and public health priorities for over five decades.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jared T Bailey,Che-Jung Chang,Symielle A Gaston,Chandra L Jackson,Dale P Sandler,Katie M O'Brien,Alexandra J White
BACKGROUNDUse of hair straighteners and chemical relaxers has been associated with increased incidence of breast, uterine, and ovarian cancers. However, their potential association with non-reproductive cancers remains unknown, despite evidence that some ingredients in these products may be genotoxic. We therefore examined use of hair straighteners/chemical relaxers in relation to the incidence of non-reproductive cancers.MATERIAL AND METHODSWe analyzed data from 46,287 cancer-free women from the Sister Study, a U.S.-wide cohort enrolled between 2003-2009 (ages 35-74). Participants reported frequency of hair straightener/chemical relaxer use in the 12 months prior to enrollment. Incident cancers (melanoma, thyroid, lung, non-Hodgkin's lymphoma, leukemia, pancreatic, colorectal, and kidney cancers) were self-reported and confirmed with pathology reports when possible. We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for hair straighteners/chemical relaxer use and incident cancers, adjusting age, race and ethnicity, educational attainment, and smoking status.RESULTSDuring a median follow-up of 13.1 years, use of hair straighteners/chemical relaxers was associated with a higher incidence of thyroid cancer (n = 225 cases; HR:1.71, 95% CI : 1.01-2.89), non-Hodgkin's lymphoma (n = 313 cases; HR : 1.62, 95% CI : 0.94- 2.80), and pancreatic cancer (n = 138 cases; HR : 2.66, 95% CI: 1.25-5.66). There was little evidence of dose-response with increasing frequency of use. We observed negligible or imprecise associations for the remaining cancer types.CONCLUSIONS AND RELEVANCEUse of hair straighteners/chemical relaxers may be associated with a higher incidence of thyroid cancer, non-Hodgkin's lymphoma, and pancreatic cancer. Further research is needed to confirm these findings.
{"title":"Use of hair straighteners and chemical relaxers and incidence of non-reproductive cancers.","authors":"Jared T Bailey,Che-Jung Chang,Symielle A Gaston,Chandra L Jackson,Dale P Sandler,Katie M O'Brien,Alexandra J White","doi":"10.1093/jnci/djaf280","DOIUrl":"https://doi.org/10.1093/jnci/djaf280","url":null,"abstract":"BACKGROUNDUse of hair straighteners and chemical relaxers has been associated with increased incidence of breast, uterine, and ovarian cancers. However, their potential association with non-reproductive cancers remains unknown, despite evidence that some ingredients in these products may be genotoxic. We therefore examined use of hair straighteners/chemical relaxers in relation to the incidence of non-reproductive cancers.MATERIAL AND METHODSWe analyzed data from 46,287 cancer-free women from the Sister Study, a U.S.-wide cohort enrolled between 2003-2009 (ages 35-74). Participants reported frequency of hair straightener/chemical relaxer use in the 12 months prior to enrollment. Incident cancers (melanoma, thyroid, lung, non-Hodgkin's lymphoma, leukemia, pancreatic, colorectal, and kidney cancers) were self-reported and confirmed with pathology reports when possible. We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for hair straighteners/chemical relaxer use and incident cancers, adjusting age, race and ethnicity, educational attainment, and smoking status.RESULTSDuring a median follow-up of 13.1 years, use of hair straighteners/chemical relaxers was associated with a higher incidence of thyroid cancer (n = 225 cases; HR:1.71, 95% CI : 1.01-2.89), non-Hodgkin's lymphoma (n = 313 cases; HR : 1.62, 95% CI : 0.94- 2.80), and pancreatic cancer (n = 138 cases; HR : 2.66, 95% CI: 1.25-5.66). There was little evidence of dose-response with increasing frequency of use. We observed negligible or imprecise associations for the remaining cancer types.CONCLUSIONS AND RELEVANCEUse of hair straighteners/chemical relaxers may be associated with a higher incidence of thyroid cancer, non-Hodgkin's lymphoma, and pancreatic cancer. Further research is needed to confirm these findings.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"RecOVARY? Using anti-Müllerian hormone to predict ovarian function after anti-HER2 therapy for early breast cancer.","authors":"Lynn K Symonds,Nancy E Davidson","doi":"10.1093/jnci/djaf247","DOIUrl":"https://doi.org/10.1093/jnci/djaf247","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ilana B Richman,Meghan E Lindsay,Jessica B Long,Eliza Epstein,Meera Sheffrin,Elizabeth R Berger
BACKGROUNDMammographic surveillance is common among older women with a history of breast cancer, but little is known about imaging outcomes in this population. The goal of this study was to describe short-term outcomes after surveillance mammography among older women, including use of subsequent imaging, cancer diagnosis, and positive predictive value.METHODSThis was a longitudinal cohort study using SEER-Medicare data. We followed women diagnosed with breast cancer between 2003-2007 at age 67 or older until diagnosis of a second primary breast cancer, death, or end of follow up (2019). We used claims to identify surveillance mammograms. Outcomes included subsequent imaging, second primary breast cancer diagnosis, and positive predictive value after surveillance. Outcomes were identified based on proximity to surveillance mammography. We stratified analyses by age and time since diagnosis.RESULTSThe cohort included 33, 607 women who received 160,637 mammograms over a median 12.1 years. Subsequent imaging was performed after 115 per 1000 mammograms (95% CI 114-117) and was similar across ages and time since diagnosis. Second primary breast cancer was diagnosed after 7.1 per 1000 mammograms (95% CI 6.7-7.5) and was similar across ages but generally higher beginning 5 years post diagnosis. Positive predictive value among women with subsequent imaging ranged from 3.7 to 9.2%. Most second primary breast cancers were either in-situ (23.3%) or stage I (57.0%).CONCLUSIONSAlthough surveillance mammography may detect breast cancer even years after diagnosis, surveillance also leads to substantial subsequent testing. Whether continued surveillance at older ages improves health outcomes is uncertain.
背景：乳房x线摄影监测在有乳腺癌病史的老年妇女中很常见，但对这一人群的影像学结果知之甚少。本研究的目的是描述老年妇女监测乳房x光检查后的短期结果，包括后续成像的使用、癌症诊断和阳性预测价值。方法采用SEER-Medicare数据进行纵向队列研究。我们跟踪了2003-2007年期间67岁或以上被诊断患有乳腺癌的女性，直到诊断出第二原发性乳腺癌、死亡或随访结束（2019年）。我们使用索赔来识别监视乳房x线照片。结果包括随后的影像学检查、第二原发性乳腺癌诊断和监测后的阳性预测值。结果是根据接近监测乳房x光检查确定的。我们按年龄和诊断后的时间进行分层分析。结果该队列包括33,607名妇女，她们在平均12.1年的时间里接受了160,637次乳房x光检查。每1000次乳房x光检查中有115次进行后续影像学检查（95% CI 114-117），并且自诊断以来年龄和时间相似。第二原发性乳腺癌的诊断是每1000个乳房x线照片中有7.1个（95% CI 6.7-7.5），不同年龄的乳腺癌诊断率相似，但通常在诊断后5年开始较高。在随后的影像学检查中，阳性预测值在3.7 - 9.2%之间。大多数第二原发性乳腺癌为原位（23.3%）或I期（57.0%）。结论：尽管乳房x光检查可以在诊断后数年发现乳腺癌，但监测也会导致大量的后续检查。老年人继续监测是否能改善健康结果尚不确定。
{"title":"Diagnostic yield of surveillance mammography among older women.","authors":"Ilana B Richman,Meghan E Lindsay,Jessica B Long,Eliza Epstein,Meera Sheffrin,Elizabeth R Berger","doi":"10.1093/jnci/djaf270","DOIUrl":"https://doi.org/10.1093/jnci/djaf270","url":null,"abstract":"BACKGROUNDMammographic surveillance is common among older women with a history of breast cancer, but little is known about imaging outcomes in this population. The goal of this study was to describe short-term outcomes after surveillance mammography among older women, including use of subsequent imaging, cancer diagnosis, and positive predictive value.METHODSThis was a longitudinal cohort study using SEER-Medicare data. We followed women diagnosed with breast cancer between 2003-2007 at age 67 or older until diagnosis of a second primary breast cancer, death, or end of follow up (2019). We used claims to identify surveillance mammograms. Outcomes included subsequent imaging, second primary breast cancer diagnosis, and positive predictive value after surveillance. Outcomes were identified based on proximity to surveillance mammography. We stratified analyses by age and time since diagnosis.RESULTSThe cohort included 33, 607 women who received 160,637 mammograms over a median 12.1 years. Subsequent imaging was performed after 115 per 1000 mammograms (95% CI 114-117) and was similar across ages and time since diagnosis. Second primary breast cancer was diagnosed after 7.1 per 1000 mammograms (95% CI 6.7-7.5) and was similar across ages but generally higher beginning 5 years post diagnosis. Positive predictive value among women with subsequent imaging ranged from 3.7 to 9.2%. Most second primary breast cancers were either in-situ (23.3%) or stage I (57.0%).CONCLUSIONSAlthough surveillance mammography may detect breast cancer even years after diagnosis, surveillance also leads to substantial subsequent testing. Whether continued surveillance at older ages improves health outcomes is uncertain.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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