Mousumi Ghosh, Ying Huang, Heather K Basehore, Nathaniel H Boyd, Joseph A Flores-Toro, Subhashini Jagu, Freddie Pruitt, Brandon J Wright, Jaime M Guidry Auvil, Emily S Boja
The US federal government is committed to maximizing its return on biomedical research investment. This tenet is exemplified by policies that promote broad, responsible sharing of research products generated with public funds, including the recent National Institutes of Health (NIH) Final Data Management and Sharing (DMS) Policy and the NIH Updated Public Access Policy. Scientific data management and sharing must occur in a FAIR (findable, accessible, interoperable and reusable) manner for it to be broadly usable and thereby most impactful [1,2]. The NCI Office of Data Sharing (ODS) conducted a series of workshops to identify clinical features and profiles derived from patients and study participants that inform these respective basic, translational, clinical, and populational science research analyses. The workshop outputs lay the groundwork for developing best practice recommendations on high-value, impactful clinical data features to collect and share with the wider research community. The workshop also highlighted additional data types and methodologies represented across the NCI-funded research portfolio that need structured outputs to be better defined to similarly allow broad sharing in a FAIR manner. In this article we summarize the workshop discussions on data use challenges, present potential solutions, and outline attendee consensus on the minimum patient-derived clinical information needed to complete a wide spectrum of cancer research. We further propose preliminary guidance for policymakers and researchers to implement regarding collection and management of human derived clinical data in consistent and impactful ways that can improve the sharing process and outcomes for data end users.
{"title":"Making human derived data FAIR: feedback from NCI office of data sharing workshop","authors":"Mousumi Ghosh, Ying Huang, Heather K Basehore, Nathaniel H Boyd, Joseph A Flores-Toro, Subhashini Jagu, Freddie Pruitt, Brandon J Wright, Jaime M Guidry Auvil, Emily S Boja","doi":"10.1093/jnci/djaf379","DOIUrl":"https://doi.org/10.1093/jnci/djaf379","url":null,"abstract":"The US federal government is committed to maximizing its return on biomedical research investment. This tenet is exemplified by policies that promote broad, responsible sharing of research products generated with public funds, including the recent National Institutes of Health (NIH) Final Data Management and Sharing (DMS) Policy and the NIH Updated Public Access Policy. Scientific data management and sharing must occur in a FAIR (findable, accessible, interoperable and reusable) manner for it to be broadly usable and thereby most impactful [1,2]. The NCI Office of Data Sharing (ODS) conducted a series of workshops to identify clinical features and profiles derived from patients and study participants that inform these respective basic, translational, clinical, and populational science research analyses. The workshop outputs lay the groundwork for developing best practice recommendations on high-value, impactful clinical data features to collect and share with the wider research community. The workshop also highlighted additional data types and methodologies represented across the NCI-funded research portfolio that need structured outputs to be better defined to similarly allow broad sharing in a FAIR manner. In this article we summarize the workshop discussions on data use challenges, present potential solutions, and outline attendee consensus on the minimum patient-derived clinical information needed to complete a wide spectrum of cancer research. We further propose preliminary guidance for policymakers and researchers to implement regarding collection and management of human derived clinical data in consistent and impactful ways that can improve the sharing process and outcomes for data end users.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145836000","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}
Lawson Eng, Elizabeth Faour, Rinku Sutradhar, Yosuf Kaliwal, Yue Niu, Ning Liu, Ying Liu, Melanie Powis, Geoffrey Liu, Jeffrey M Peppercorn, Monika K Krzyzanowska, Shabbir M H Alibhai
Purpose Older and frail adults were under-represented in clinical trials evaluating ICIs, leading to a knowledge gap on their risk of acute care use and immune-related adverse events (irAEs). We performed a population-level study evaluating the impact of age and frailty among older adults receiving ICIs on acute care use and irAE-related hospitalizations. Methods Patients with cancer, age ≥ 65 initiating ICIs between June 2012-October 2018 (Ontario, Canada) were identified using systemic therapy administration data. The cohort was linked to other databases to obtain covariates and outcomes. Multivariable Cox proportional models evaluated the impact of age and frailty on acute care use and irAE-related hospitalizations. Results Among 2,737 patients, median age was 73 and 26% were pre-frail and 4% frail; 72% required acute care use, while 8% had an irAE-related hospitalization. Increasing frailty was associated with increased risk of acute care use (pre-frail vs robust, aHR = 1.20,95% CI[1.07-1.36], p = .003; frail vs robust, aHR = 1.45[1.12-1.86], p = .004), while age was not associated with acute care use. Increasing age was associated with reduced risk of irAE-related hospitalization (aHR = 0.97 per year[0.95-0.99], p = .01); patients age ≥ 80 compared to 65-69 had reduced risk of irAE-related hospitalization (aHR = 0.63[0.39-1.01], p = .05). Frailty was not associated with irAE-related hospitalizations. Associations remained consistent when evaluating age and frailty in the same models. Conclusions Age was associated with reduced risk of an irAE-related hospitalization but not acute care use, while increasing frailty was associated acute care use, but not irAE-related hospitalization. Age and frailty may need to be considered independently when evaluating their impact on toxicity among older adults receiving ICIs.
老年人和体弱的成年人在评估ICIs的临床试验中代表性不足，导致他们的急性护理使用风险和免疫相关不良事件（irAEs）的知识差距。我们进行了一项人口水平的研究，评估接受ICIs的老年人的年龄和虚弱对急性护理使用和irae相关住院的影响。方法选取2012年6月至2018年10月（加拿大安大略省）年龄≥65岁的癌症患者，使用全身治疗给药数据。该队列与其他数据库连接以获得协变量和结果。多变量Cox比例模型评估了年龄和虚弱对急性护理使用和irae相关住院的影响。结果2737例患者中位年龄为73岁，26%为体弱前期，4%为体弱；72%的人需要紧急护理，而8%的人因irae而住院。虚弱程度的增加与急性护理使用风险的增加相关（体弱前vs健在，aHR = 1.20,95% CI[1.07-1.36], p = 0.003；体弱vs健在，aHR = 1.45[1.12-1.86], p = 0.004），而年龄与急性护理使用无关。年龄增加与irae相关住院风险降低相关（aHR = 0.97 /年[0.95-0.99],p = 0.01）；年龄≥80岁的患者与65 ~ 69岁的患者相比，与irae相关的住院风险降低（aHR = 0.63[0.39-1.01], p = 0.05）。虚弱与irae相关的住院治疗无关。在相同的模型中评估年龄和虚弱时，关联保持一致。结论：年龄与irae相关住院风险降低相关，但与急性护理使用无关，而体弱增加与急性护理使用相关，但与irae相关住院无关。在评估年龄和虚弱对接受ICIs的老年人的毒性影响时，可能需要单独考虑它们。
{"title":"Impact of age and frailty on acute care use during immune checkpoint inhibitor treatment","authors":"Lawson Eng, Elizabeth Faour, Rinku Sutradhar, Yosuf Kaliwal, Yue Niu, Ning Liu, Ying Liu, Melanie Powis, Geoffrey Liu, Jeffrey M Peppercorn, Monika K Krzyzanowska, Shabbir M H Alibhai","doi":"10.1093/jnci/djaf373","DOIUrl":"https://doi.org/10.1093/jnci/djaf373","url":null,"abstract":"Purpose Older and frail adults were under-represented in clinical trials evaluating ICIs, leading to a knowledge gap on their risk of acute care use and immune-related adverse events (irAEs). We performed a population-level study evaluating the impact of age and frailty among older adults receiving ICIs on acute care use and irAE-related hospitalizations. Methods Patients with cancer, age ≥ 65 initiating ICIs between June 2012-October 2018 (Ontario, Canada) were identified using systemic therapy administration data. The cohort was linked to other databases to obtain covariates and outcomes. Multivariable Cox proportional models evaluated the impact of age and frailty on acute care use and irAE-related hospitalizations. Results Among 2,737 patients, median age was 73 and 26% were pre-frail and 4% frail; 72% required acute care use, while 8% had an irAE-related hospitalization. Increasing frailty was associated with increased risk of acute care use (pre-frail vs robust, aHR = 1.20,95% CI[1.07-1.36], p = .003; frail vs robust, aHR = 1.45[1.12-1.86], p = .004), while age was not associated with acute care use. Increasing age was associated with reduced risk of irAE-related hospitalization (aHR = 0.97 per year[0.95-0.99], p = .01); patients age ≥ 80 compared to 65-69 had reduced risk of irAE-related hospitalization (aHR = 0.63[0.39-1.01], p = .05). Frailty was not associated with irAE-related hospitalizations. Associations remained consistent when evaluating age and frailty in the same models. Conclusions Age was associated with reduced risk of an irAE-related hospitalization but not acute care use, while increasing frailty was associated acute care use, but not irAE-related hospitalization. Age and frailty may need to be considered independently when evaluating their impact on toxicity among older adults receiving ICIs.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835998","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}
Background Treatment advances have improved breast cancer survival, resulting in a growing population at risk for second primary cancers (SPCs). Although prior studies suggest racial heterogeneity in SPC risk, little is known about SPC patterns among diverse Asian American subgroups. Post-SPC survival outcomes by race/ethnicity and Asian subgroups remain underexplored. Methods We identified women with stage I–III breast cancer diagnosed between 2010–2020 in SEER. Primary outcomes included cumulative SPC incidence and post-SPC survival, stratified by race/ethnicity (Asian, Black, Hispanic, Pacific Islander, and White) and Asian subgroups (Chinese, Filipino, Indian/Pakistani, Japanese, Korean, Vietnamese). Cox models assessed the association between SPC and overall survival, treating SPC as a time-varying covariate to address immortal time bias. Results Among 430,823 survivors, 5-year SPC incidence was highest in White (6.2%, [6.1-6.3]) and lowest in Pacific Islander survivors (4.2%, [3.7-4.7]). Disaggregating Asian subgroups revealed notable heterogeneity Chinese survivors had the highest incidence (5.4%, [4.8-6.1]) and Indian/Pakistani survivors the lowest (3.7%, [2.9-4.4]). SPC development was associated with increased risk of mortality (adjusted hazard ratio [aHR]=3.85, [3.73-3.98]). The magnitude of this association was most pronounced among Pacific Islander (aHR = 5.85) and least among White survivors (aHR = 3.68; interaction P < .001). Within Asian subgroups, the effect was strongest in Vietnamese (aHR = 7.93) and attenuated in Korean survivors (aHR = 3.45; interaction P = .13). Conclusions White and Chinese survivors had the highest SPC risk, while Pacific Islander and Vietnamese survivors faced greater mortality impact from SPCs. Racially disaggregated analyses revealed heterogeneity, underscoring the need for tailored care in the diverse U.S. breast cancer survivor population.
{"title":"Second primary cancer in breast cancer survivors by race/ethnicity and asian subgroups: a descriptive epidemiologic study","authors":"Lizi Shao, Yuntong Wang, Yiwey Shieh, Rulla M Tamimi, Tammy Ju, Eunji Choi","doi":"10.1093/jnci/djaf372","DOIUrl":"https://doi.org/10.1093/jnci/djaf372","url":null,"abstract":"Background Treatment advances have improved breast cancer survival, resulting in a growing population at risk for second primary cancers (SPCs). Although prior studies suggest racial heterogeneity in SPC risk, little is known about SPC patterns among diverse Asian American subgroups. Post-SPC survival outcomes by race/ethnicity and Asian subgroups remain underexplored. Methods We identified women with stage I–III breast cancer diagnosed between 2010–2020 in SEER. Primary outcomes included cumulative SPC incidence and post-SPC survival, stratified by race/ethnicity (Asian, Black, Hispanic, Pacific Islander, and White) and Asian subgroups (Chinese, Filipino, Indian/Pakistani, Japanese, Korean, Vietnamese). Cox models assessed the association between SPC and overall survival, treating SPC as a time-varying covariate to address immortal time bias. Results Among 430,823 survivors, 5-year SPC incidence was highest in White (6.2%, [6.1-6.3]) and lowest in Pacific Islander survivors (4.2%, [3.7-4.7]). Disaggregating Asian subgroups revealed notable heterogeneity Chinese survivors had the highest incidence (5.4%, [4.8-6.1]) and Indian/Pakistani survivors the lowest (3.7%, [2.9-4.4]). SPC development was associated with increased risk of mortality (adjusted hazard ratio [aHR]=3.85, [3.73-3.98]). The magnitude of this association was most pronounced among Pacific Islander (aHR = 5.85) and least among White survivors (aHR = 3.68; interaction P &lt; .001). Within Asian subgroups, the effect was strongest in Vietnamese (aHR = 7.93) and attenuated in Korean survivors (aHR = 3.45; interaction P = .13). Conclusions White and Chinese survivors had the highest SPC risk, while Pacific Islander and Vietnamese survivors faced greater mortality impact from SPCs. Racially disaggregated analyses revealed heterogeneity, underscoring the need for tailored care in the diverse U.S. breast cancer survivor population.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812888","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}
Shruthi R Perati, Sana M Mohayya, Ernie Shippey, Xiang Gao, Rachel Sachs, Howard S Hochster, Coral Omene, Anita Y Kinney, Henry A Pitt, Mariam F Eskander
Background Clinical trials drive novel cancer therapies, yet enrollment remains low and unrepresentative of vulnerable groups. Most clinical trial disparities literature examines demographics, excluding social determinants of health. We evaluated the association between social vulnerability and clinical trial enrollment among patients with the five leading causes of cancer death and examined how this association varies by race/ethnicity in the United States. Methods In this retrospective cohort study, the national Vizient Clinical Database was queried for patients with lung, breast, prostate, colorectal or pancreatic cancer from 2022-2023. The exposure was the Vizient Vulnerability Index (VVI), a novel, healthcare-specific tool assessing census tract-level social vulnerability. The primary outcome was clinical trial enrollment. Multivariable analysis evaluated the association of VVI with clinical trial enrollment, including tests for interaction by race. Results Of 2,660,566 patients, 36,456 (1.4%) enrolled in a clinical trial. Trial participants were more likely to be young, non-Hispanic (NH) white, privately insured, and to have metastases. Enrollment odds were lower for patients living in the most vulnerable census tracts (OR 0.80; 95% CI 0.77-0.89) and NH Black patients (OR 0.80, 95% CI 0.75-0.83). Vulnerability in education, transportation, and neighborhood resources was associated with decreased enrollment. High social vulnerability disproportionately impacted enrollment for NH Black patients (OR 0.48; 95% CI 0.41-0.62) compared to NH white patients (OR 0.82; 95% CI 0.73-0.92; p<.0001 for interaction). Conclusions Neighborhood social vulnerability is a barrier to cancer clinical trial enrollment, especially among NH Black patients. Focused interventions targeting education, transportation, and neighborhood resources may increase equity.
临床试验推动了新的癌症治疗方法，但入组人数仍然很低，而且不具有弱势群体的代表性。大多数临床试验差异文献检查人口统计学，排除健康的社会决定因素。我们评估了社会脆弱性与五种主要癌症死亡原因患者的临床试验入组之间的关系，并研究了这种关系在美国如何因种族/民族而变化。方法在这项回顾性队列研究中，查询国家Vizient临床数据库中2022-2023年肺癌、乳腺癌、前列腺癌、结直肠癌或胰腺癌患者。暴露是Vizient脆弱性指数（VVI），这是一种评估人口普查区层面社会脆弱性的新型医疗保健特定工具。主要结局是临床试验入组。多变量分析评估了VVI与临床试验入组的关系，包括种族相互作用的测试。结果在2,660,566例患者中，有36,456例（1.4%）入组临床试验。试验参与者更有可能是年轻人，非西班牙裔（NH）白人，私人保险，并有转移。生活在最脆弱人口普查区的患者（OR 0.80; 95% CI 0.77-0.89）和NH Black患者（OR 0.80, 95% CI 0.75-0.83）的入组几率较低。教育、交通和社区资源的脆弱性与入学率下降有关。与白人患者（OR 0.82; 95% CI 0.73-0.92）相比，高社会脆弱性不成比例地影响了NH黑人患者的入组（OR 0.48; 95% CI 0.41-0.62）。0001表示交互)。结论社区社会脆弱性是癌症临床试验入组的障碍，特别是在NH黑人患者中。针对教育、交通和社区资源的集中干预可能会增加公平性。
{"title":"Social vulnerability and clinical trial enrollment: the next frontier of health equity","authors":"Shruthi R Perati, Sana M Mohayya, Ernie Shippey, Xiang Gao, Rachel Sachs, Howard S Hochster, Coral Omene, Anita Y Kinney, Henry A Pitt, Mariam F Eskander","doi":"10.1093/jnci/djaf355","DOIUrl":"https://doi.org/10.1093/jnci/djaf355","url":null,"abstract":"Background Clinical trials drive novel cancer therapies, yet enrollment remains low and unrepresentative of vulnerable groups. Most clinical trial disparities literature examines demographics, excluding social determinants of health. We evaluated the association between social vulnerability and clinical trial enrollment among patients with the five leading causes of cancer death and examined how this association varies by race/ethnicity in the United States. Methods In this retrospective cohort study, the national Vizient Clinical Database was queried for patients with lung, breast, prostate, colorectal or pancreatic cancer from 2022-2023. The exposure was the Vizient Vulnerability Index (VVI), a novel, healthcare-specific tool assessing census tract-level social vulnerability. The primary outcome was clinical trial enrollment. Multivariable analysis evaluated the association of VVI with clinical trial enrollment, including tests for interaction by race. Results Of 2,660,566 patients, 36,456 (1.4%) enrolled in a clinical trial. Trial participants were more likely to be young, non-Hispanic (NH) white, privately insured, and to have metastases. Enrollment odds were lower for patients living in the most vulnerable census tracts (OR 0.80; 95% CI 0.77-0.89) and NH Black patients (OR 0.80, 95% CI 0.75-0.83). Vulnerability in education, transportation, and neighborhood resources was associated with decreased enrollment. High social vulnerability disproportionately impacted enrollment for NH Black patients (OR 0.48; 95% CI 0.41-0.62) compared to NH white patients (OR 0.82; 95% CI 0.73-0.92; p&lt;.0001 for interaction). Conclusions Neighborhood social vulnerability is a barrier to cancer clinical trial enrollment, especially among NH Black patients. Focused interventions targeting education, transportation, and neighborhood resources may increase equity.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145801123","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}
Christine L Hathaway,Michaela Hall,Daniël de Bondt,Cara J Broshkevitch,Darcy W Rao,Sydney Klein,Dorothy C Nyemba,Danielle Travill,Sinead Delany-Moretlwe,Karen Canfell,Jan Hontelez,Ruanne V Barnabas
BACKGROUNDAchieving cervical cancer (CC) elimination requires addressing disparities in CC burden for women living with HIV (WLHIV) and how disparities evolve in the context of antiretroviral therapy (ART) scale-up. To inform CC elimination for high HIV prevalence regions, we modeled the impact of HIV, HIV interventions, and CC interventions in KwaZulu-Natal, South Africa.METHODSWe used two independently developed, dynamic compartmental transmission models of HIV and HPV (DRIVE and Policy1-Cervix-HIV) calibrated to KwaZulu-Natal. We simulated a counterfactual without HIV but with observed CC screening and vaccination; and scenarios sequentially adding condom use and voluntary medical male circumcision (VMMC); HIV; observed HIV and CC interventions (status quo); achieving UNAIDS HIV treatment targets; and achieving WHO CC elimination targets. The impact of each scenario was measured as the difference in CC incidence from the previous scenario. Results were reported from 2024-2124 as a range between the two models; CC elimination was WHO-defined as incidence <4/100,000 women-years.RESULTSFor the status quo, CC incidence ranged from 61.30-78.96/100,000 women-years in 2024, with the highest incidence among WLHIV (126.8-192.0/100,000). HIV contributed an estimated 29.08-48.87 additional cases per 100,000. Neither model predicted elimination under status quo interventions, but achieving HIV treatment and CC elimination targets could reduce incidence to 1.42-6.25/100,000 women-years in 2124.CONCLUSIONSHIV is associated with a population-level increase in CC incidence. However, scaling up ART coverage and CC interventions is expected to significantly reduce the burden of CC overall and among WLHIV. These conclusions are consistent between both models and strengthened by the comparative modeling approach.
{"title":"The impact of HIV on cervical cancer elimination in Kwazulu-Natal: a comparative modeling analysis.","authors":"Christine L Hathaway,Michaela Hall,Daniël de Bondt,Cara J Broshkevitch,Darcy W Rao,Sydney Klein,Dorothy C Nyemba,Danielle Travill,Sinead Delany-Moretlwe,Karen Canfell,Jan Hontelez,Ruanne V Barnabas","doi":"10.1093/jnci/djaf364","DOIUrl":"https://doi.org/10.1093/jnci/djaf364","url":null,"abstract":"BACKGROUNDAchieving cervical cancer (CC) elimination requires addressing disparities in CC burden for women living with HIV (WLHIV) and how disparities evolve in the context of antiretroviral therapy (ART) scale-up. To inform CC elimination for high HIV prevalence regions, we modeled the impact of HIV, HIV interventions, and CC interventions in KwaZulu-Natal, South Africa.METHODSWe used two independently developed, dynamic compartmental transmission models of HIV and HPV (DRIVE and Policy1-Cervix-HIV) calibrated to KwaZulu-Natal. We simulated a counterfactual without HIV but with observed CC screening and vaccination; and scenarios sequentially adding condom use and voluntary medical male circumcision (VMMC); HIV; observed HIV and CC interventions (status quo); achieving UNAIDS HIV treatment targets; and achieving WHO CC elimination targets. The impact of each scenario was measured as the difference in CC incidence from the previous scenario. Results were reported from 2024-2124 as a range between the two models; CC elimination was WHO-defined as incidence <4/100,000 women-years.RESULTSFor the status quo, CC incidence ranged from 61.30-78.96/100,000 women-years in 2024, with the highest incidence among WLHIV (126.8-192.0/100,000). HIV contributed an estimated 29.08-48.87 additional cases per 100,000. Neither model predicted elimination under status quo interventions, but achieving HIV treatment and CC elimination targets could reduce incidence to 1.42-6.25/100,000 women-years in 2124.CONCLUSIONSHIV is associated with a population-level increase in CC incidence. However, scaling up ART coverage and CC interventions is expected to significantly reduce the burden of CC overall and among WLHIV. These conclusions are consistent between both models and strengthened by the comparative modeling approach.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"155 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777326","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}
Caroline H Hemmingsen, Lina S Mørch, Jasmin Arvedsen, Emma O Dahl, Amani Meaidi, Henrik Hjalgrim, Marie Hargreave, Susanne K Kjaer
Background Lymphomas occur less frequently in women than men, but the causes remain unclear. Given the immunomodulatory potential of female hormones, hormonal contraceptive use could influence lymphoma risk, yet existing research is inconclusive. Methods We investigated the relationship between contemporary hormonal contraceptive use and lymphoma risk in a nationwide Danish cohort of women aged 15–49 years (1995–2021). Women with prior cancer, hysterectomy, oophorectomy, or sterilization were excluded. Data on hormonal contraceptive use, lymphomas, and confounders were retrieved from national registries. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were estimated for any hormonal contraceptive use and lymphoma risk, including lymphoma subtypes, contraceptive types, duration of use, and time since last use. All statistical tests were two-sided. Results During 24.5 million person-years of follow-up, 1777 lymphomas (686 Hodgkin, 1091 non-Hodgkin) occurred among 1,957,490 women. Ever using hormonal contraception was associated with reduced lymphoma risk (IRR 0.84, 95%CI 0.75–0.94), with similar IRRs across lymphoma types. This was driven by current/recent use of both combined products (IRR 0.80, 95%CI 0.70–0.91) and progestin-only products (IRR 0.81, 95%CI 0.67–0.97), especially oral combined and non-oral progestin-only products. Risk decreased with longer use, with the lowest risk for use >10 years (IRR 0.53, 95%CI 0.33–0.85), but no long-term sustained protective effect was seen after cessation. Conclusion The findings indicate that hormonal contraceptive use may have a role in lymphoma etiology and confer protective effects, underscoring the need to explore hormonal pathways in both a preventive and therapeutic context.
{"title":"Hormonal contraception and lymphoma risk in danish women 15–49 years: a nationwide cohort study","authors":"Caroline H Hemmingsen, Lina S Mørch, Jasmin Arvedsen, Emma O Dahl, Amani Meaidi, Henrik Hjalgrim, Marie Hargreave, Susanne K Kjaer","doi":"10.1093/jnci/djaf371","DOIUrl":"https://doi.org/10.1093/jnci/djaf371","url":null,"abstract":"Background Lymphomas occur less frequently in women than men, but the causes remain unclear. Given the immunomodulatory potential of female hormones, hormonal contraceptive use could influence lymphoma risk, yet existing research is inconclusive. Methods We investigated the relationship between contemporary hormonal contraceptive use and lymphoma risk in a nationwide Danish cohort of women aged 15–49 years (1995–2021). Women with prior cancer, hysterectomy, oophorectomy, or sterilization were excluded. Data on hormonal contraceptive use, lymphomas, and confounders were retrieved from national registries. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were estimated for any hormonal contraceptive use and lymphoma risk, including lymphoma subtypes, contraceptive types, duration of use, and time since last use. All statistical tests were two-sided. Results During 24.5 million person-years of follow-up, 1777 lymphomas (686 Hodgkin, 1091 non-Hodgkin) occurred among 1,957,490 women. Ever using hormonal contraception was associated with reduced lymphoma risk (IRR 0.84, 95%CI 0.75–0.94), with similar IRRs across lymphoma types. This was driven by current/recent use of both combined products (IRR 0.80, 95%CI 0.70–0.91) and progestin-only products (IRR 0.81, 95%CI 0.67–0.97), especially oral combined and non-oral progestin-only products. Risk decreased with longer use, with the lowest risk for use &gt;10 years (IRR 0.53, 95%CI 0.33–0.85), but no long-term sustained protective effect was seen after cessation. Conclusion The findings indicate that hormonal contraceptive use may have a role in lymphoma etiology and confer protective effects, underscoring the need to explore hormonal pathways in both a preventive and therapeutic context.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807673","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}
BACKGROUNDCardiovascular-kidney-metabolic (CKM) syndrome significantly increases cancer and mortality risks, but the combined effects of CKM syndrome and physical activity (PA) on these outcomes remain poorly understood.METHODSThis prospective study included 66,650 UK Biobank participants with accelerometry data. CKM syndrome was classified into five stages based on metabolic, kidney, and cardiovascular health. PA was categorized by intensity into light (LPA), moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA) levels, and further divided into tertiles by daily duration. Multivariable Cox models were used to estimate hazard ratios.RESULTSOver a median follow-up of 8.03 years, 4,301 incident cancer cases and 2,442 deaths occurred. Advancing CKM stages were associated with elevated risks of both cancer incidence and all cause mortality, while increasing PA levels reduced these risks. Significant interactions were observed between CKM syndrome and both MPA and MVPA on cancer and mortality risks (P interaction < 0.05). In participants with the lowest tertile of MPA or MVPA, those in stages 2 and 4 had higher cancer risk, while in the highest tertile, this risk was no longer elevated. For all-cause mortality, in participants with the lowest tertile of MPA or MVPA, CKM stage 3 exhibited higher risks, while those in the highest tertile did not. CKM stage 4 remained associated with higher mortality across all PA intensity levels, but risks decreased with increasing MVPA levels.CONCLUSIONSHigher levels of MPA and MVPA may mitigate the elevated risks of both cancer incidence and all-cause mortality associated with CKM stages 2 to 4.
{"title":"Joint associations of accelerometer-measured physical activity and cardiovascular-kidney-metabolic syndrome stages with the risks of cancer and all-cause mortality.","authors":"Jia-Cheng Liu,Rui Yang,Zan-Fei Feng,Bang-Quan Liu,Yu Li,Yu-Han Chen,Dong-Run Li,Wen-Rui Zheng,Ning Liu,Shan-Yan Gao,Qi-Jun Wu,Ting-Ting Gong","doi":"10.1093/jnci/djaf365","DOIUrl":"https://doi.org/10.1093/jnci/djaf365","url":null,"abstract":"BACKGROUNDCardiovascular-kidney-metabolic (CKM) syndrome significantly increases cancer and mortality risks, but the combined effects of CKM syndrome and physical activity (PA) on these outcomes remain poorly understood.METHODSThis prospective study included 66,650 UK Biobank participants with accelerometry data. CKM syndrome was classified into five stages based on metabolic, kidney, and cardiovascular health. PA was categorized by intensity into light (LPA), moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA) levels, and further divided into tertiles by daily duration. Multivariable Cox models were used to estimate hazard ratios.RESULTSOver a median follow-up of 8.03 years, 4,301 incident cancer cases and 2,442 deaths occurred. Advancing CKM stages were associated with elevated risks of both cancer incidence and all cause mortality, while increasing PA levels reduced these risks. Significant interactions were observed between CKM syndrome and both MPA and MVPA on cancer and mortality risks (P interaction < 0.05). In participants with the lowest tertile of MPA or MVPA, those in stages 2 and 4 had higher cancer risk, while in the highest tertile, this risk was no longer elevated. For all-cause mortality, in participants with the lowest tertile of MPA or MVPA, CKM stage 3 exhibited higher risks, while those in the highest tertile did not. CKM stage 4 remained associated with higher mortality across all PA intensity levels, but risks decreased with increasing MVPA levels.CONCLUSIONSHigher levels of MPA and MVPA may mitigate the elevated risks of both cancer incidence and all-cause mortality associated with CKM stages 2 to 4.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145771383","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}
Luis Eduardo Bravo,M Constanza Camargo,M Blanca Piazuelo,Nubia Muñoz
{"title":"In memoriam: Pelayo Correa, MD (1927-2025).","authors":"Luis Eduardo Bravo,M Constanza Camargo,M Blanca Piazuelo,Nubia Muñoz","doi":"10.1093/jnci/djaf362","DOIUrl":"https://doi.org/10.1093/jnci/djaf362","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765519","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}
Nyall R London,Glenn J Hanna,Neal S Akhave,Garret Choby,Lot A Devriese,François R Ferrand,Gary L Gallia,Lifeng Li,Antoine Moya-Plana,Umar Rehman,Teppei Takeda,Juliette Thariat,Robbie S R Woods,Benjamin Verillaud,Matt Lechner
Development of evidence-based treatment recommendations for rare cancers is challenging due to limited funding opportunities, spread of small numbers of patients across multiple institutions, and other obstacles. Malignancies of the sinonasal cavity are particularly rare with an overall incidence of approximately 0.56 cases per 100,000 population per year. Additionally, clinical behavior varies with a reported 5-year overall survival rate ranging from 22% - 67%. Here we describe our initial efforts including formation of an international network dedicated to sinonasal cancer research and highlight keys for successful study of rare tumors. This network first began with large multi-institutional retrospective collaborations of rare sinonasal tumors leading to improvements in staging for olfactory neuroblastoma and sinonasal melanoma. These efforts have been followed by a new emphasis on development of collaborative interventional trials as well as the development of position statements and recommendations to guide use of emerging molecularly targeted therapies. In order to be successful in studying rare malignancies, collaboration and teamwork is key along with an unrelenting drive for development of evidence to help guide treatment for rare cancers. This manuscript serves as an outline that may be applied by other interested groups to improve the study of other tumors in the human body.
{"title":"International network for sinonasal cancer research (INSICA): a collaborative group to advance research and clinical trials for rare sinonasal malignancies.","authors":"Nyall R London,Glenn J Hanna,Neal S Akhave,Garret Choby,Lot A Devriese,François R Ferrand,Gary L Gallia,Lifeng Li,Antoine Moya-Plana,Umar Rehman,Teppei Takeda,Juliette Thariat,Robbie S R Woods,Benjamin Verillaud,Matt Lechner","doi":"10.1093/jnci/djaf366","DOIUrl":"https://doi.org/10.1093/jnci/djaf366","url":null,"abstract":"Development of evidence-based treatment recommendations for rare cancers is challenging due to limited funding opportunities, spread of small numbers of patients across multiple institutions, and other obstacles. Malignancies of the sinonasal cavity are particularly rare with an overall incidence of approximately 0.56 cases per 100,000 population per year. Additionally, clinical behavior varies with a reported 5-year overall survival rate ranging from 22% - 67%. Here we describe our initial efforts including formation of an international network dedicated to sinonasal cancer research and highlight keys for successful study of rare tumors. This network first began with large multi-institutional retrospective collaborations of rare sinonasal tumors leading to improvements in staging for olfactory neuroblastoma and sinonasal melanoma. These efforts have been followed by a new emphasis on development of collaborative interventional trials as well as the development of position statements and recommendations to guide use of emerging molecularly targeted therapies. In order to be successful in studying rare malignancies, collaboration and teamwork is key along with an unrelenting drive for development of evidence to help guide treatment for rare cancers. This manuscript serves as an outline that may be applied by other interested groups to improve the study of other tumors in the human body.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765518","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: Ambient air pollution and mortality in older patients with breast cancer.","authors":"Jason Semprini","doi":"10.1093/jnci/djaf369","DOIUrl":"https://doi.org/10.1093/jnci/djaf369","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145771545","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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