Bulletin of the Lebedev Physics Institute最新文献

Bilateral mastectomy may not reduce mortality risk 双侧乳房切除术可能不会降低死亡风险

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-11-08 DOI: 10.3322/caac.21869

Mike Fillon

Although rates of contralateral prophylactic mastectomy and bilateral mastectomy are increasing among women with unilateral sporadic breast cancer, a new study reports that despite the procedure diminishing the risk of contralateral breast cancer, the patients experienced mortality rates similar to those of patients treated with lumpectomy or unilateral mastectomy.The primary goal of the study, appearing in JAMA Oncology (doi:10.1001/jamaoncol.2024.2212), was to determine the 20-year cumulative risk of breast cancer mortality among women with stage 0–III unilateral breast cancer divided by each patient’s initial surgical procedures.In an editorial accompanying the study, Seema A. Khan, MD, Bluhm Family Professor of Cancer Research at the Feinberg School of Medicine at Northwestern University in Chicago, Illinois, and Masha Kocherginsky, PhD, professor of biostatistics and director of the Quantitative Data Sciences Core at the Robert H. Lurie Comprehensive Cancer Center at Northwestern Medicine, wrote that although contralateral breast cancer is the most frequent second malignant tumor among women who have experienced a diagnosis of primary breast cancer, it is less frequent and less ominous than recurrence of the initial cancer. “Nevertheless,” they wrote, “for many patients with newly diagnosed unilateral breast cancer, it can be a prominent source of worry as they navigate their treatment decisions. This worry is accentuated among young patients and those with early-stage disease.”The cohort study included patients from the Surveillance, Epidemiology, and End Results Program registry database. The researchers identified 661,270 eligible women with unilateral breast cancer diagnosed from 2000 to 2019. The average age of the patients was 58.7 years. In each treatment group, approximately 83% were White, just over 8% were Black, approximately 2% were East Asian, and 2% were Southeast Asian. The remainder of the patients were American Indian/Alaska Native, Pacific Islander, South Asian, or “unknown” (approximately 1% in each category).The research team identified 564,062 cases of invasive breast cancer (85.3%) and 97,208 cases of ductal carcinoma in situ (14.7%). According to study author Steven A. Narod, MD, a professor in the Dalla Lana School of Public Health and the Department of Medicine at the University of Toronto, the researchers matched 90.7% of the patients with bilateral mastectomy into three surgical groups of equal size (36,028 women in each treatment group): lumpectomy, unilateral mastectomy, and bilateral mastectomy. All three groups were similar across demographic, clinical, and treatment variables and propensity scores. More than 70% of the cohort had undergone breast-conserving surgery, whereas 23.4% had undergone unilateral mastectomy, and 6.0% had undergone bilateral mastectomy.Nearly two-thirds of the patients underwent radiotherapy, whereas approximately 37% received chemotherapy. T

"虽然外科文献中早已知道双侧乳房切除术不会影响死亡率，但这项研究通过大样本量、长时间的前瞻性随访和周到的亚组分析，更清楚地证实了这一点。"尽管在单侧散发性乳腺癌女性患者中，对侧预防性乳房切除术和双侧乳房切除术的比例正在增加，但一项新的研究报告称，尽管手术降低了对侧乳腺癌的风险，但患者的死亡率与接受肿块切除术或单侧乳房切除术的患者相似。伊利诺伊州芝加哥市西北大学范伯格医学院布卢姆家族癌症研究教授、医学博士 Seema A. Khan 和罗伯特-H-卢里综合癌症中心生物统计学教授、定量数据科学核心主任 Masha Kocherginsky 博士在随研究发表的一篇社论中指出："乳腺癌是一种常见的恶性肿瘤。Lurie 综合癌症中心主任 Masha Kocherginsky 博士写道，虽然对侧乳腺癌是确诊为原发性乳腺癌的妇女中最常见的第二种恶性肿瘤，但与原发性癌症复发相比，对侧乳腺癌的发病率较低，也不那么可怕。"尽管如此，"他们写道，"对于许多新确诊的单侧乳腺癌患者来说，这可能是她们在做出治疗决定时最担心的问题。这种担忧在年轻患者和早期患者中更为突出"。

{"title":"Bilateral mastectomy may not reduce mortality risk","authors":"Mike Fillon","doi":"10.3322/caac.21869","DOIUrl":"10.3322/caac.21869","url":null,"abstract":"Although rates of contralateral prophylactic mastectomy and bilateral mastectomy are increasing among women with unilateral sporadic breast cancer, a new study reports that despite the procedure diminishing the risk of contralateral breast cancer, the patients experienced mortality rates similar to those of patients treated with lumpectomy or unilateral mastectomy.The primary goal of the study, appearing in JAMA Oncology (doi:10.1001/jamaoncol.2024.2212), was to determine the 20-year cumulative risk of breast cancer mortality among women with stage 0–III unilateral breast cancer divided by each patient’s initial surgical procedures.In an editorial accompanying the study, Seema A. Khan, MD, Bluhm Family Professor of Cancer Research at the Feinberg School of Medicine at Northwestern University in Chicago, Illinois, and Masha Kocherginsky, PhD, professor of biostatistics and director of the Quantitative Data Sciences Core at the Robert H. Lurie Comprehensive Cancer Center at Northwestern Medicine, wrote that although contralateral breast cancer is the most frequent second malignant tumor among women who have experienced a diagnosis of primary breast cancer, it is less frequent and less ominous than recurrence of the initial cancer. “Nevertheless,” they wrote, “for many patients with newly diagnosed unilateral breast cancer, it can be a prominent source of worry as they navigate their treatment decisions. This worry is accentuated among young patients and those with early-stage disease.”The cohort study included patients from the Surveillance, Epidemiology, and End Results Program registry database. The researchers identified 661,270 eligible women with unilateral breast cancer diagnosed from 2000 to 2019. The average age of the patients was 58.7 years. In each treatment group, approximately 83% were White, just over 8% were Black, approximately 2% were East Asian, and 2% were Southeast Asian. The remainder of the patients were American Indian/Alaska Native, Pacific Islander, South Asian, or “unknown” (approximately 1% in each category).The research team identified 564,062 cases of invasive breast cancer (85.3%) and 97,208 cases of ductal carcinoma in situ (14.7%). According to study author Steven A. Narod, MD, a professor in the Dalla Lana School of Public Health and the Department of Medicine at the University of Toronto, the researchers matched 90.7% of the patients with bilateral mastectomy into three surgical groups of equal size (36,028 women in each treatment group): lumpectomy, unilateral mastectomy, and bilateral mastectomy. All three groups were similar across demographic, clinical, and treatment variables and propensity scores. More than 70% of the cohort had undergone breast-conserving surgery, whereas 23.4% had undergone unilateral mastectomy, and 6.0% had undergone bilateral mastectomy.Nearly two-thirds of the patients underwent radiotherapy, whereas approximately 37% received chemotherapy. T","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 6","pages":"469-470"},"PeriodicalIF":503.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21869","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Most young female cancer survivors are at minimal risk for obstetric problems 大多数年轻女性癌症幸存者出现产科问题的风险极低

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-11-08 DOI: 10.3322/caac.21868

Mike Fillon

A study based in the United Kingdom reports that, in general, most women between the ages of 15 and 39 years who have survived a cancer diagnosis are at low risk for pregnancy complications later in their lives. The study appears in The Lancet Oncology (doi:10.1016/S1470-2045(24)00269-9).According to the study authors, limited data are available on the risks of obstetric complications among survivors of adolescent and young adult (AYA) cancer, and they noted that most earlier studies report risks only for all types of cancers combined. The purpose of this population-based cohort study—the Teenage and Young Adult Cancer Survivor Study—was to determine whether there was a negative impact on birth rates and risks of obstetric complications after treatment for one of 17 cancers in the AYA population. The authors compared the observed number of births affected to the number expected based on general population rates.The study included more than 200,000 5-year survivors of cancer from England and Wales who were initially diagnosed between the ages of 15 and 39 years. The cohort was based on cancer registrations obtained through the Office for National Statistics and the Welsh Cancer Registry. The investigators ascertained 27 specific obstetric complications among 96,947 female survivors. They compared the observed number of affected births in the cohort with the expected number in the general population of England.Specifically, the researchers found that between April 1, 1997 and March 31, 2022, 22,033 births occurred among 14,051 female survivors of AYA cancer from England. They also found that survivors of cervical cancer and leukemia had an increased risk for more than two specific complications from among the 27 complications investigated.Overall, the number of births was “lower than expected” (observed-to-expected ratio, 0.68; 95% CI, 0.67–0.69). Notably, the researchers reported that survivors of genitourinary, cervical, and breast cancers reported a birth rate that was less than 50% of that in the general population.When they focused on more common obstetric complications that were above normal, they discovered that survivors of cervical cancer were at risk of many serious pregnancy and labor complications: malpresentation of fetus, obstructed labor, amniotic fluid and membrane disorders, premature rupture of membranes, preterm birth, placental disorders (including placenta previa), and antepartum hemorrhage.Also of particular concern were patients with leukemia, who were at greater risk of preterm delivery, obstructed labor, postpartum hemorrhage, and retained placenta. By contrast, the other cancers observed had two or fewer obstetric complications that exceeded an “observed-to-expected ratio of 1:25 or greater.” Based on their data, the researchers concluded that survivors of cervical cancer and leukemia are at risk of several serious obstetric complications: “Therefore, any pregnancy in the

英国的一项研究报告称，一般来说，大多数年龄在15至39岁之间、确诊癌症后幸存下来的妇女在以后的生活中出现妊娠并发症的风险较低。这项研究发表在《柳叶刀肿瘤学》上（doi:10.1016/S1470-2045(24)00269-9）。据研究报告的作者称，目前关于青少年和青年癌症幸存者产科并发症风险的数据很有限，而且他们指出，大多数早期研究只报告了所有类型癌症的合并风险。这项基于人群的队列研究--青少年和青年癌症幸存者研究--旨在确定青少年和青年癌症幸存者在接受 17 种癌症中的一种治疗后，是否会对出生率和产科并发症风险产生负面影响。作者将观察到的受影响出生人数与根据一般人口出生率预计的出生人数进行了比较。

{"title":"Most young female cancer survivors are at minimal risk for obstetric problems","authors":"Mike Fillon","doi":"10.3322/caac.21868","DOIUrl":"10.3322/caac.21868","url":null,"abstract":"A study based in the United Kingdom reports that, in general, most women between the ages of 15 and 39 years who have survived a cancer diagnosis are at low risk for pregnancy complications later in their lives. The study appears in The Lancet Oncology (doi:10.1016/S1470-2045(24)00269-9).According to the study authors, limited data are available on the risks of obstetric complications among survivors of adolescent and young adult (AYA) cancer, and they noted that most earlier studies report risks only for all types of cancers combined. The purpose of this population-based cohort study—the Teenage and Young Adult Cancer Survivor Study—was to determine whether there was a negative impact on birth rates and risks of obstetric complications after treatment for one of 17 cancers in the AYA population. The authors compared the observed number of births affected to the number expected based on general population rates.The study included more than 200,000 5-year survivors of cancer from England and Wales who were initially diagnosed between the ages of 15 and 39 years. The cohort was based on cancer registrations obtained through the Office for National Statistics and the Welsh Cancer Registry. The investigators ascertained 27 specific obstetric complications among 96,947 female survivors. They compared the observed number of affected births in the cohort with the expected number in the general population of England.Specifically, the researchers found that between April 1, 1997 and March 31, 2022, 22,033 births occurred among 14,051 female survivors of AYA cancer from England. They also found that survivors of cervical cancer and leukemia had an increased risk for more than two specific complications from among the 27 complications investigated.Overall, the number of births was “lower than expected” (observed-to-expected ratio, 0.68; 95% CI, 0.67–0.69). Notably, the researchers reported that survivors of genitourinary, cervical, and breast cancers reported a birth rate that was less than 50% of that in the general population.When they focused on more common obstetric complications that were above normal, they discovered that survivors of cervical cancer were at risk of many serious pregnancy and labor complications: malpresentation of fetus, obstructed labor, amniotic fluid and membrane disorders, premature rupture of membranes, preterm birth, placental disorders (including placenta previa), and antepartum hemorrhage.Also of particular concern were patients with leukemia, who were at greater risk of preterm delivery, obstructed labor, postpartum hemorrhage, and retained placenta. By contrast, the other cancers observed had two or fewer obstetric complications that exceeded an “observed-to-expected ratio of 1:25 or greater.” Based on their data, the researchers concluded that survivors of cervical cancer and leukemia are at risk of several serious obstetric complications: “Therefore, any pregnancy in the","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 6","pages":"467-468"},"PeriodicalIF":503.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21868","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breast cancer statistics 2024 2024 年乳腺癌统计数据。

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-10-01 DOI: 10.3322/caac.21863

Angela N. Giaquinto MSPH, Hyuna Sung PhD, Lisa A. Newman MD, MPH, Rachel A. Freedman MD, MPH, Robert A. Smith PhD, Jessica Star MA, MPH, Ahmedin Jemal DVM, PhD, Rebecca L. Siegel MPH

This is the American Cancer Society's biennial update of statistics on breast cancer among women based on high-quality incidence and mortality data from the National Cancer Institute and the Centers for Disease Control and Prevention. Breast cancer incidence continued an upward trend, rising by 1% annually during 2012–2021, largely confined to localized-stage and hormone receptor-positive disease. A steeper increase in women younger than 50 years (1.4% annually) versus 50 years and older (0.7%) overall was only significant among White women. Asian American/Pacific Islander women had the fastest increase in both age groups (2.7% and 2.5% per year, respectively); consequently, young Asian American/Pacific Islander women had the second lowest rate in 2000 (57.4 per 100,000) but the highest rate in 2021 (86.3 per 100,000) alongside White women (86.4 per 100,000), surpassing Black women (81.5 per 100,000). In contrast, the overall breast cancer death rate continuously declined during 1989–2022 by 44% overall, translating to 517,900 fewer breast cancer deaths during this time. However, not all women have experienced this progress; mortality remained unchanged since 1990 in American Indian/Alaska Native women, and Black women have 38% higher mortality than White women despite 5% lower incidence. Although the Black-White disparity partly reflects more triple-negative cancers, Black women have the lowest survival for every breast cancer subtype and stage except localized disease, with which they are 10% less likely to be diagnosed than White women (58% vs. 68%), highlighting disadvantages in social determinants of health. Progress against breast cancer could be accelerated by mitigating racial, ethnic, and social disparities through improved clinical trial representation and access to high-quality screening and treatment.

这是美国癌症协会根据国家癌症研究所和疾病控制与预防中心提供的高质量发病率和死亡率数据，每两年更新一次的女性乳腺癌统计数据。乳腺癌发病率继续呈上升趋势，2012-2021年间每年上升1%，主要局限于局部分期和激素受体阳性疾病。50岁以下女性的发病率（每年上升1.4%）与50岁及以上女性的发病率（每年上升0.7%）相比上升幅度更大，只有白人女性的发病率显著上升。在这两个年龄组中，亚裔美国人/太平洋岛民妇女的发病率增长最快（分别为每年 2.7% 和 2.5%）；因此，2000 年亚裔美国人/太平洋岛民年轻妇女的发病率仅次于白人妇女（每 100,000 人中有 57.4 人），但到 2021 年，亚裔美国人/太平洋岛民年轻妇女的发病率与白人妇女（每 100,000 人中有 86.4 人）并驾齐驱，超过了黑人妇女（每 100,000 人中有 81.5 人）。相比之下，1989 年至 2022 年期间，乳腺癌的总死亡率持续下降，总体下降了 44%，这期间乳腺癌死亡人数减少了 517 900 人。然而，并非所有妇女都取得了这一进展；自 1990 年以来，美国印第安人/阿拉斯加原住民妇女的死亡率保持不变，黑人妇女的死亡率比白人妇女高 38%，尽管发病率低 5%。虽然黑白之间的差距部分反映了更多的三阴性癌症，但除局部疾病外，黑人妇女在每一种乳腺癌亚型和分期中的存活率都是最低的，她们被确诊为局部疾病的几率比白人妇女低 10%（58% 对 68%），这凸显了社会健康决定因素中的不利因素。通过改善临床试验的代表性以及获得高质量筛查和治疗的机会，缩小种族、民族和社会差距，可以加快防治乳腺癌的进展。

{"title":"Breast cancer statistics 2024","authors":"Angela N. Giaquinto MSPH, Hyuna Sung PhD, Lisa A. Newman MD, MPH, Rachel A. Freedman MD, MPH, Robert A. Smith PhD, Jessica Star MA, MPH, Ahmedin Jemal DVM, PhD, Rebecca L. Siegel MPH","doi":"10.3322/caac.21863","DOIUrl":"10.3322/caac.21863","url":null,"abstract":"This is the American Cancer Society's biennial update of statistics on breast cancer among women based on high-quality incidence and mortality data from the National Cancer Institute and the Centers for Disease Control and Prevention. Breast cancer incidence continued an upward trend, rising by 1% annually during 2012–2021, largely confined to localized-stage and hormone receptor-positive disease. A steeper increase in women younger than 50 years (1.4% annually) versus 50 years and older (0.7%) overall was only significant among White women. Asian American/Pacific Islander women had the fastest increase in both age groups (2.7% and 2.5% per year, respectively); consequently, young Asian American/Pacific Islander women had the second lowest rate in 2000 (57.4 per 100,000) but the highest rate in 2021 (86.3 per 100,000) alongside White women (86.4 per 100,000), surpassing Black women (81.5 per 100,000). In contrast, the overall breast cancer death rate continuously declined during 1989–2022 by 44% overall, translating to 517,900 fewer breast cancer deaths during this time. However, not all women have experienced this progress; mortality remained unchanged since 1990 in American Indian/Alaska Native women, and Black women have 38% higher mortality than White women despite 5% lower incidence. Although the Black-White disparity partly reflects more triple-negative cancers, Black women have the lowest survival for every breast cancer subtype and stage except localized disease, with which they are 10% less likely to be diagnosed than White women (58% vs. 68%), highlighting disadvantages in social determinants of health. Progress against breast cancer could be accelerated by mitigating racial, ethnic, and social disparities through improved clinical trial representation and access to high-quality screening and treatment.","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 6","pages":"477-495"},"PeriodicalIF":503.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breast cancer: The good, the bad, and an important call to effective risk reduction strategies 乳腺癌：好与坏，以及对有效降低风险战略的重要呼吁。

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-10-01 DOI: 10.3322/caac.21867

Virginia G. Kaklamani MD, DSc, Carlos L. Arteaga MD

The 2024 Breast Cancer Statistics highlight a few interesting trends: breast cancer incidence is increasing, there is a greater increase in younger women, and most of this increase is driven by early stage diagnosis and hormone receptor (HR)-positive disease.1 In addition, compared with other racial groups, women with Asian American/Pacific Islander (AAPI) heritage have a greater increase in breast cancer; and, despite overall declining death rates from breast cancer, Black women continue to have higher mortality compared with White women. Let us consider these findings in more detail.Breast cancer incidence in the United States briefly decreased in the early 2000s, possibly related to a decline in the use of hormone-replacement therapy, but it has since shown an increase of approximately 1% per year. This increase is associated with HR-positive breast cancers and is mostly seen in younger women. A potential contributing factor for this association may be a decrease in the number of live births.2 Another possibility may be the greater incidence of young-onset HR-positive breast cancer in Indian and Chinese women.3-5AAPI women have a greater increase in breast cancer incidence, which is largely noted in Asian women immigrating to the United States rather than Asian women born in the United States.6 Compared with Asian American women born in the United States, Asian American women who have immigrated to the United States and have lived more than 50% of their life in the United States, on average, are three times more likely to be diagnosed with breast cancer.6 Specifically for Indian women, there has been a rise in breast cancer incidence by almost 50% between 1965 and 1985,4 and Chinese women are projected to have a rise in breast cancer incidence by greater than 11% by 2030.7In the past 35 years, breast cancer mortality rates have decreased by 44%. This decrease is attributed to early diagnosis stemming from nationwide screening recommendations as well as treatment advances in all disease stages.8 Based on simulation models, 25% of the reduction in mortality rates comes from screening mammography, 29% comes from treatment advances in metastatic disease, and 47% comes from treatment advances in early stage disease. The addition of trastuzumab has increased survival in metastatic HER2-positive breast cancer by 16 months9 and, in early stage disease, by 26%–37%.10-12 Most recently, the addition of CDK4/6 inhibitors has broken the 5-year barrier in median overall survival in metastatic HR-positive breast cancer,13 suggesting that mortality rates will continue to show an improvement in patient survival in subsequent iterations of the breast cancer statistics.Non

22 在 2019 年冠状病毒疾病大流行期间，乳房 X 线照相筛查减少了 44%，23 有数据表明，这可能会对未来乳腺癌死亡率产生微小影响。24 虽然已有筛查指南，但基于风险评估的个性化筛查是关键。例如，鉴于 TNBC 在黑人妇女中的发病率较高，她们可能会从较早的乳腺癌筛查中获益，25 而且由于黑人妇女的乳腺密度高于白人妇女，因此可能需要考虑筛查方式的类型。26 目前已开发出几种风险评估模型，但其准确性一般，即使纳入多基因风险评分，其曲线下面积也小于 0.8。人们对使用人工智能改进风险评估模型的兴趣日益浓厚，提高其准确性势在必行28。29, 30 遗憾的是，普及基因检测的呼声并未得到响应31 。降低风险可通过应对可改变的风险因素和投资于化学预防来实现。可改变的风险因素包括绝经后肥胖、32-34 使用激素替代疗法、35 饮酒、36 吸烟、37 以及缺乏锻炼。38 以教育、税收和价格监管为重点的公共卫生政策可对其中几个因素产生积极影响。此外，胸壁电离辐射和蒽环类药物等治疗方法也与乳腺癌风险增加有关。40, 41 医学界一直在努力避免使用具有此类长期毒性的治疗方法，根据现有的治疗指南，尽量减少这些方法的使用，并提倡使用毒性较小的替代疗法。口服雌激素靶向药物，如他莫昔芬和芳香化酶抑制剂，可将乳腺癌发病率降低 50%；但它们只能预防 HR 阳性乳腺癌，对总生存率没有影响。因此，应努力确定替代终点，以便在乳腺癌高危患者中开展时间更短、成本效益更高的临床试验。剂量优化也是评估的关键。我们不能假定治疗和预防的剂量应该相同。我们已经在这一领域做出了努力，低剂量他莫昔芬已被证明是一种有效的化学预防策略。47 目前还缺乏针对 TNBC 和 HER2 阳性乳腺癌的化学预防策略，不过正在进行的几项试验可能会在未来改变这一局面。临床试验中缺乏不同种族群体的参与、护理中的不公平现象以及在降低风险方面进展甚微都影响着乳腺癌的治疗效果。随着乳腺癌发病率以每年 1% 的速度上升，西班牙裔和亚太裔妇女的发病率更是不成比例，作为一个社区，我们应该更加聪明地工作，从过去的成功和失败中吸取教训，改善对所有患者的护理。Kaklamani 报告了来自卫材的研究资助；以及来自阿斯利康、第一三共公司、礼来公司、基因泰克、吉利德科学（又名吉利德基金会）、美纳里尼、诺华、彪马生物技术公司、辉瑞加拿大公司、Seilead 基金会的个人/咨询费、辉瑞加拿大公司（Pfizer Canada Inc.）、Seagen Inc.Carlos L. Arteaga 报告获得了 Eli Lilly & Company、Laboratorios Pfizer Ltda.、Novartis 和 Takeda Oncology 的研究资助；并从 Arvinas、AstraZeneca、Athenex Pharmaceutical Division LLC、Daiichi Sankyo Company、Ely Lilly & Company、Immunomedics Inc、默克（Merck）、诺华（Novartis）、OrigiMed、赛诺菲巴斯德公司（Sanofi Pasteur Inc：乳腺癌研究基金会，资助/奖励编号：DRC-20-001；美国国家癌症研究所，资助/奖励编号：P30 CA142543、P30 CA142543、P30 CA142543：P30 CA142543, P50 CA098131, R01CA224899, R01CA277498-02; Susan G. Komen, Grant/Award Number：SAB1800010; Cancer Prevention and Research Institute of Texas, Grant/Award Number：RR170061

{"title":"Breast cancer: The good, the bad, and an important call to effective risk reduction strategies","authors":"Virginia G. Kaklamani MD, DSc, Carlos L. Arteaga MD","doi":"10.3322/caac.21867","DOIUrl":"10.3322/caac.21867","url":null,"abstract":"The 2024 Breast Cancer Statistics highlight a few interesting trends: breast cancer incidence is increasing, there is a greater increase in younger women, and most of this increase is driven by early stage diagnosis and hormone receptor (HR)-positive disease.1 In addition, compared with other racial groups, women with Asian American/Pacific Islander (AAPI) heritage have a greater increase in breast cancer; and, despite overall declining death rates from breast cancer, Black women continue to have higher mortality compared with White women. Let us consider these findings in more detail.Breast cancer incidence in the United States briefly decreased in the early 2000s, possibly related to a decline in the use of hormone-replacement therapy, but it has since shown an increase of approximately 1% per year. This increase is associated with HR-positive breast cancers and is mostly seen in younger women. A potential contributing factor for this association may be a decrease in the number of live births.2 Another possibility may be the greater incidence of young-onset HR-positive breast cancer in Indian and Chinese women.3-5AAPI women have a greater increase in breast cancer incidence, which is largely noted in Asian women immigrating to the United States rather than Asian women born in the United States.6 Compared with Asian American women born in the United States, Asian American women who have immigrated to the United States and have lived more than 50% of their life in the United States, on average, are three times more likely to be diagnosed with breast cancer.6 Specifically for Indian women, there has been a rise in breast cancer incidence by almost 50% between 1965 and 1985,4 and Chinese women are projected to have a rise in breast cancer incidence by greater than 11% by 2030.7In the past 35 years, breast cancer mortality rates have decreased by 44%. This decrease is attributed to early diagnosis stemming from nationwide screening recommendations as well as treatment advances in all disease stages.8 Based on simulation models, 25% of the reduction in mortality rates comes from screening mammography, 29% comes from treatment advances in metastatic disease, and 47% comes from treatment advances in early stage disease. The addition of trastuzumab has increased survival in metastatic HER2-positive breast cancer by 16 months9 and, in early stage disease, by 26%–37%.10-12 Most recently, the addition of CDK4/6 inhibitors has broken the 5-year barrier in median overall survival in metastatic HR-positive breast cancer,13 suggesting that mortality rates will continue to show an improvement in patient survival in subsequent iterations of the breast cancer statistics.Non","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 6","pages":"471-474"},"PeriodicalIF":503.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reviewer acknowledgement 2024 审稿人确认 2024

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-09-18 DOI: 10.3322/caac.21866

In order to maintain the high standards of CA’s content, the Editors of CA rely on the knowledge and dedication of many experts in deciding which topics to pursue, which manuscripts to publish, and what modifications to make to ensure medical and scientific accuracy and suitability for our readers. We thank our Associate Editors and our Editorial Advisory Board, who continue to provide these services for us time and time again.

We are also greatly indebted to the effort and expertise of the following individuals for reviewing manuscripts for the journal from July 1, 2023, to June 30, 2024. These individuals go beyond expectations by consistently and expeditiously delivering comprehensive, discerning reviews. Peer review is an essential component of scholarly publishing, and we sincerely appreciate the time and expertise volunteered by these participants.

Dina Amin

Eric Bernicker

Chao Cao

Raymond Chan

Paul Daeninck

Fernando Diaz

Tanya Dorff

Georges Gebrael

Samir Hanash

Vida Henderson

Hormuzd Katki

Shumei Kato

Amir Khan

Allison J. Lazard

Mark Lewis

Kim Margolin

Joaquin Mateo

Justin Moyers

Maria Pisu

Gwendolyn Quinn

Paul Riviere

Jason Sicklick

Zbyslaw Sondka

Conor Steuer

Kristine Swartz

Randy Sweis

Peter Yu

Xue Qin Yu

为了保持CA内容的高标准，CA的编辑们依靠许多专家的知识和奉献精神来决定哪些主题需要探讨、哪些稿件需要发表、哪些稿件需要修改以确保医学和科学的准确性并适合我们的读者。我们感谢我们的副主编和编辑顾问委员会，他们一次又一次地为我们提供这些服务。我们还非常感谢以下人员在 2023 年 7 月 1 日至 2024 年 6 月 30 日期间为本刊审稿所付出的努力和专业知识。这些人始终如一地迅速提供全面、独到的审稿意见，超出了我们的预期。Dina AminEric BernickerChao CaoRaymond ChanPaul DaeninckFernando DiazTanya DorffGeorges GebraelSamir HanashVida HendersonHormuzd KatkiShumei KatoAmir KhanAllison J．LazardMark LewisKim MargolinJoaquin MateoJustin MoyersMaria PisuGwendolyn QuinnPaul RiviereJason SicklickZbyslaw SondkaConor SteuerKristine SwartzRandy SweisPeter Yu薛勤宇

{"title":"Reviewer acknowledgement 2024","authors":"","doi":"10.3322/caac.21866","DOIUrl":"10.3322/caac.21866","url":null,"abstract":"In order to maintain the high standards of CA’s content, the Editors of CA rely on the knowledge and dedication of many experts in deciding which topics to pursue, which manuscripts to publish, and what modifications to make to ensure medical and scientific accuracy and suitability for our readers. We thank our Associate Editors and our Editorial Advisory Board, who continue to provide these services for us time and time again.We are also greatly indebted to the effort and expertise of the following individuals for reviewing manuscripts for the journal from July 1, 2023, to June 30, 2024. These individuals go beyond expectations by consistently and expeditiously delivering comprehensive, discerning reviews. Peer review is an essential component of scholarly publishing, and we sincerely appreciate the time and expertise volunteered by these participants.Dina AminEric BernickerChao CaoRaymond ChanPaul DaeninckFernando DiazTanya DorffGeorges GebraelSamir HanashVida HendersonHormuzd KatkiShumei KatoAmir KhanAllison J. LazardMark LewisKim MargolinJoaquin MateoJustin MoyersMaria PisuGwendolyn QuinnPaul RiviereJason SicklickZbyslaw SondkaConor SteuerKristine SwartzRandy SweisPeter YuXue Qin Yu","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 6","pages":"519"},"PeriodicalIF":503.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21866","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142237013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cancer disparities for LGBTQ+ patients identified more fully 更全面地确定 LGBTQ+ 患者的癌症差异。

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-09-02 DOI: 10.3322/caac.21861

Mike Fillon

It has been widely reported that patients who identify as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, or other gender-diverse characteristic) have more health risks than the cisgender and/or heterosexual population. According to previous studies, most of the disparity has been attributed to the minority stress theory: Members of these communities disproportionally experience discrimination, and this results in mistrust in medical settings—further increasing stress.Regarding cancer specifically, these society-derived stressors have been reported to lead to lower rates of timely screening, higher rates of infection with cancer-causing viruses, and higher rates of health risk behaviors—increasing the potential risk for various cancers in the LGBTQ+ community. Another issue builds on the aforementioned minority stress theory, which can result in avoidance because of the fear that a health care provider will refuse to care for them. Importantly, the LGBTQ+ communities are diverse, and cancer incidences may differ within specific gender identities and/or sexual orientations (SOs). Because of insufficient details from previous studies, accurate data regarding cancer incidence in specific groups have been lacking.A study appearing in Cancer (doi: 10.1002/cncr.35356) adds new evidence of the disproportional cancer burden faced by sexual minoritized people. Study author Aimee K. Huang, MD, MPH, a junior faculty member at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts, says that most prior studies relied on indirect approximations of incidence and prevalence. “However, for studies that were able to directly measure incidence, the scopes of their investigations were often limited to the most common cancers, unidimensional SO measurements, or had other methodological challenges due to data limitations,” she says.For the study, researchers culled SO and cancer diagnosis data (from 1989 to 2017) from the Nurses’ Health Study II (NHSII), a longitudinal cohort of 101,543 nurses across the United States. The mean ages and race/ethnicity compositions were similar across all the groups.The primary outcome was the self-disclosed and electronic health record–verified incidences of cancer among four different sexual minority groups: heterosexual with a past same-sex attraction/behavior/identity (n = 5034), mostly heterosexual (n = 1825), bisexual (n = 394), and lesbian (n = 996). These groups were compared to a “reference” group that self-identified as lifelong heterosexual (n = 93,294). The researchers also determined the case numbers, incidence rates, and age-adjusted incidence rate ratios (aIRRs) of 21 site-specific cancers for each group. Using aIRRs, they compared incidence rates between the reference group and the four SO subgroups.The researchers reported that the cancer incidence rate (cases per 100,000 person-years) was highest for those

据广泛报道，被认定为 LGBTQ+（女同性恋、男同性恋、双性恋、变性人、同性恋者或其他具有不同性别特征的人）的患者比同性和/或异性恋人群面临更多的健康风险。根据以往的研究，这种差异大多归因于少数群体压力理论：具体到癌症，据报道，这些来自社会的压力导致 LGBTQ+ 群体及时筛查的比例较低、感染致癌病毒的比例较高以及健康风险行为的比例较高，从而增加了他们罹患各种癌症的潜在风险。另一个问题建立在上述少数群体压力理论的基础上，由于担心医疗服务提供者会拒绝为他们提供医疗服务，这可能会导致他们回避。重要的是，LGBTQ+ 群体具有多样性，在特定的性别认同和/或性倾向（SOs）中，癌症发病率可能有所不同。癌症》（Cancer）杂志刊登的一项研究（doi: 10.1002/cncr.35356）为性取向少数群体面临的不成比例的癌症负担提供了新的证据。该研究的作者、马萨诸塞州波士顿马萨诸塞州总医院和哈佛大学医学院青年教师 Aimee K. Huang（医学博士、公共卫生硕士）说，之前的大多数研究都依赖于对发病率和流行率的间接近似值。她说："然而，对于那些能够直接测量发病率的研究，其调查范围往往局限于最常见的癌症、单维SO测量，或者由于数据限制而面临其他方法上的挑战，"在这项研究中，研究人员从护士健康研究II（NHSII）中收集了SO和癌症诊断数据（从1989年到2017年），NHSII是一个由全美101,543名护士组成的纵向队列。主要结果是四个不同的性少数群体自我披露和电子健康记录核实的癌症发病率：过去有同性吸引/行为/身份的异性恋（n = 5034）、大部分为异性恋（n = 1825）、双性恋（n = 394）和女同性恋（n = 996）。这些群体与自我认同为终身异性恋的 "参照 "群体（n = 93 294）进行了比较。研究人员还确定了每个群体的病例数、发病率以及 21 种特定部位癌症的年龄调整发病率比（aIRRs）。研究人员报告说，自我描述为女同性恋者的癌症发病率（每 10 万人年的病例数）最高（516 例）。参照组参与者的发病率为 428 例，略低于有过去同性吸引/伴侣/身份的异性恋女性（449 例）和大多数异性恋人群（439 例）。那些自我描述为双性恋的人构成了最小的群体，研究人员认为无法得出准确的结论。他们发现，女同性恋者被诊断出三种癌症的几率大约是男同性恋者的两倍：甲状腺癌（aIRR，1.87）、基底细胞癌（aIRR，1.85）和非霍奇金淋巴瘤（aIRR，2.13）。研究发现，性少数群体妇女被诊断出肺癌的风险较低，尽管之前的研究报告称这些群体中吸烟和患肺癌的比例较高。研究还发现女同性恋者中没有肺癌病例，并发现有同性性行为史的异性恋女性肺癌发病率较低。研究作者认为，NHSII 队列中的这些发现可能是由于这一护理人群的吸烟率低于普通公众。"他们写道："因此，我们发现性少数群体女性的肺癌发病率较低，但病例数较少，对此应谨慎解释。(纽约州罗切斯特市罗切斯特大学医学系多元化、公平与包容副主任、医学博士 Chunkit Fung 说，美国的这项大型纵向研究非常重要，因为它的详细报告显示，性少数群体女性的所有癌症发病率都高于异性恋女性。他说，一个特别重要的发现是，女同性恋者的癌症负担最重。

{"title":"Cancer disparities for LGBTQ+ patients identified more fully","authors":"Mike Fillon","doi":"10.3322/caac.21861","DOIUrl":"10.3322/caac.21861","url":null,"abstract":"It has been widely reported that patients who identify as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, or other gender-diverse characteristic) have more health risks than the cisgender and/or heterosexual population. According to previous studies, most of the disparity has been attributed to the minority stress theory: Members of these communities disproportionally experience discrimination, and this results in mistrust in medical settings—further increasing stress.Regarding cancer specifically, these society-derived stressors have been reported to lead to lower rates of timely screening, higher rates of infection with cancer-causing viruses, and higher rates of health risk behaviors—increasing the potential risk for various cancers in the LGBTQ+ community. Another issue builds on the aforementioned minority stress theory, which can result in avoidance because of the fear that a health care provider will refuse to care for them. Importantly, the LGBTQ+ communities are diverse, and cancer incidences may differ within specific gender identities and/or sexual orientations (SOs). Because of insufficient details from previous studies, accurate data regarding cancer incidence in specific groups have been lacking.A study appearing in Cancer (doi: 10.1002/cncr.35356) adds new evidence of the disproportional cancer burden faced by sexual minoritized people. Study author Aimee K. Huang, MD, MPH, a junior faculty member at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts, says that most prior studies relied on indirect approximations of incidence and prevalence. “However, for studies that were able to directly measure incidence, the scopes of their investigations were often limited to the most common cancers, unidimensional SO measurements, or had other methodological challenges due to data limitations,” she says.For the study, researchers culled SO and cancer diagnosis data (from 1989 to 2017) from the Nurses’ Health Study II (NHSII), a longitudinal cohort of 101,543 nurses across the United States. The mean ages and race/ethnicity compositions were similar across all the groups.The primary outcome was the self-disclosed and electronic health record–verified incidences of cancer among four different sexual minority groups: heterosexual with a past same-sex attraction/behavior/identity (n = 5034), mostly heterosexual (n = 1825), bisexual (n = 394), and lesbian (n = 996). These groups were compared to a “reference” group that self-identified as lifelong heterosexual (n = 93,294). The researchers also determined the case numbers, incidence rates, and age-adjusted incidence rate ratios (aIRRs) of 21 site-specific cancers for each group. Using aIRRs, they compared incidence rates between the reference group and the four SO subgroups.The researchers reported that the cancer incidence rate (cases per 100,000 person-years) was highest for those ","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 5","pages":"399-401"},"PeriodicalIF":503.1,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21861","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Osimertinib prolongs progression-free lung cancer survival after chemotherapy 奥希替尼延长肺癌化疗后的无进展生存期

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-09-02 DOI: 10.3322/caac.21862

Mike Fillon

Investigators for the phase 3 LAURA trial reported that for patients with unresectable stage III non–small cell lung cancer (NSCLC) harboring an EGFR mutation after chemoradiotherapy, osimertinib significantly prolonged progression-free survival (PFS) versus a placebo. The study appears in The New England Journal of Medicine (doi:10.1056/NEJMoa2402614).“This is the first randomized trial conducted specifically for patients with unresectable stage III lung cancer with EGFR mutation,” says Suresh S. Ramalingam, MD, professor of hematology and medical oncology and executive director of the Winship Cancer Institute at the Emory University School of Medicine and LAURA trial investigator. “The study shows a clear benefit with osimertinib compared to placebo in terms of progression-free survival and lower risk of brain progression.”Study results show that treatment with osimertinib reduced the risk of progression or death by 84% in comparison with the placebo. The study was presented during a press briefing at the 2024 annual meeting of the American Society of Clinical Oncology held in Chicago, Illinois.The LAURA trial included patients at least 18 years old (20 years old in Japan) with locally advanced and unresectable stage III NSCLC harboring an EGFR exon 19 deletion or L858R mutation from August 2018 through July 2022. None of the patients had disease progression after definitive chemoradiotherapy. A total of 216 patients underwent randomization; 143 were assigned to receive osimertinib, and 73 received the placebo.The median age of the patients was 62 years in the osimertinib arm and 64 years in the placebo group. Most were male (63% in the osimertinib arm and 58% in the placebo arm). The majority never smoked (71% and 67%, respectively).Both groups included enrollment from Asian countries (81% in the osimertinib arm vs. 85% in the placebo arm), had stage IIIB disease (47% vs. 52%) and adenocarcinoma (97% vs. 95%), and harbored EGFR exon 19 deletions (52% vs. 59%). Also, most received concurrent chemoradiotherapy: 92% in the osimertinib group and 85% in the placebo group.Patients needed to have a World Health Organization (WHO) performance-status score of 0 or 1. (Note that this was based on a scale of 0–5, with a higher number indicating more disability.) Six weeks was the maximum interval between the last dose of chemoradiotherapy and randomization. At the baseline, patients were largely balanced between the two groups, although there were more patients with a WHO performance-status score of 0 in the osimertinib group versus the placebo group (56% vs. 42%).The patients were randomly assigned 2:1 to receive 80 mg of oral osimertinib or the placebo once per day. Blinded independent central review (BICR) of PFS per the Response Evaluation Criteria in Solid Tumors (Version 1.1) was the trial’s primary end point. Secondary end points included overall survival (OS),

3期LAURA试验的研究人员报告说，对于化放疗后不可切除的携带表皮生长因子受体突变的III期非小细胞肺癌（NSCLC）患者，与安慰剂相比，奥希替尼能显著延长无进展生存期（PFS）。这项研究发表在《新英格兰医学杂志》上（doi:10.1056/NEJMoa2402614）。"这是第一项专门针对EGFR突变的不可切除III期肺癌患者进行的随机试验，"埃默里大学医学院血液学和肿瘤内科学教授、温希普癌症研究所执行主任、LAURA试验研究者Suresh S. Ramalingam医学博士说。"研究结果显示，与安慰剂相比，使用奥希替尼治疗可将病情恶化或死亡风险降低84%。这项研究是在伊利诺伊州芝加哥市举行的美国临床肿瘤学会2024年年会上的新闻发布会上公布的。"LAURA "试验纳入了2018年8月至2022年7月期间年满18岁（日本为20岁）、携带表皮生长因子受体外显子19缺失或L858R突变的局部晚期和不可切除的III期NSCLC患者。这些患者在接受明确的化放疗后均没有出现疾病进展。共有216名患者接受了随机分配，其中143人被分配接受奥希替尼治疗，73人接受安慰剂治疗。大多数患者为男性（奥希莫替尼组为63%，安慰剂组为58%）。两组患者均来自亚洲国家（奥西替尼组为81%，安慰剂组为85%），均为IIIB期疾病（47%对52%）和腺癌（97%对95%），均携带表皮生长因子受体外显子19缺失（52%对59%）。此外，大多数患者同时接受了化疗放疗：奥西美替尼组为92%，安慰剂组为85%。患者的世界卫生组织（WHO）表现状态评分需为0或1分（请注意，评分标准为0-5分，数字越大表示残疾程度越高）。最后一次化放疗剂量与随机化之间的最长间隔为六周。在基线时，两组患者的情况基本平衡，但奥希替尼组与安慰剂组相比，WHO表现状态评分为0分的患者更多（56%对42%）。患者按2:1的比例随机分配，每天一次口服80毫克奥希替尼或安慰剂。根据《实体瘤反应评价标准》（1.1版）进行的盲法独立中央审查（BICR）是该试验的主要终点。次要终点包括总生存期（OS）、中枢神经系统 PFS 和安全性。治疗一直持续到 BICR 确定的疾病进展、不可接受的毒性或事先商定的其他终止标准出现为止。肿瘤评估最初通过胸部CT/MRI和脑部MRI进行，第48周之前每8周评估一次，之后每12周评估一次，直到BICR确认病情进展。在两组患者中，只有8%的患者无法进行评估。奥西替尼组的中位应答持续时间为36.9个月，安慰剂组为6.5个月。其他数据显示，奥西替尼组有22名患者出现了新病灶，而安慰剂组有68名患者出现了新病灶。出现新病变的部位包括大脑（8 名奥希替尼患者对 29 名安慰剂患者）、肺部（6 名患者对 29 名患者）和肝脏（3 名患者对 7 名患者）。Ramalingam 博士说，化放疗后奥希替尼的研究结果符合 EGFR 抑制剂已知的安全性特征，而且副作用是可控的。他补充说，大多数不良反应都很轻微（1/2级），不会导致治疗中断，而且与之前的研究结果一致。至少有10%的患者出现了任何级别的不良反应，其中最常见的不良反应包括放射性肺炎（奥西替尼组48%的患者与安慰剂组38%的患者）。在至少10%的患者中，最常见的任何级别的不良反应包括放射性肺炎（奥希莫替尼组48%的患者对安慰剂组38%的患者）、腹泻（36%对14%）、皮疹（24%对14%）、COVID-19（20%对8%）、副癣（17%对1%）和咳嗽（16%对10%）。此外，奥希替尼组和安慰剂组还出现了食欲下降（15% vs. 5%）、皮肤干燥（13% vs. 5%）、瘙痒（13% vs. 7%）、口腔炎（12% vs. 3%）、白细胞计数下降（12% vs. 3%）、肺炎（11% vs. 8%）、贫血（10% vs. 4%）和肌肉骨骼胸痛（3% vs. 12%）。

{"title":"Osimertinib prolongs progression-free lung cancer survival after chemotherapy","authors":"Mike Fillon","doi":"10.3322/caac.21862","DOIUrl":"10.3322/caac.21862","url":null,"abstract":"Investigators for the phase 3 LAURA trial reported that for patients with unresectable stage III non–small cell lung cancer (NSCLC) harboring an EGFR mutation after chemoradiotherapy, osimertinib significantly prolonged progression-free survival (PFS) versus a placebo. The study appears in The New England Journal of Medicine (doi:10.1056/NEJMoa2402614).“This is the first randomized trial conducted specifically for patients with unresectable stage III lung cancer with EGFR mutation,” says Suresh S. Ramalingam, MD, professor of hematology and medical oncology and executive director of the Winship Cancer Institute at the Emory University School of Medicine and LAURA trial investigator. “The study shows a clear benefit with osimertinib compared to placebo in terms of progression-free survival and lower risk of brain progression.”Study results show that treatment with osimertinib reduced the risk of progression or death by 84% in comparison with the placebo. The study was presented during a press briefing at the 2024 annual meeting of the American Society of Clinical Oncology held in Chicago, Illinois.The LAURA trial included patients at least 18 years old (20 years old in Japan) with locally advanced and unresectable stage III NSCLC harboring an EGFR exon 19 deletion or L858R mutation from August 2018 through July 2022. None of the patients had disease progression after definitive chemoradiotherapy. A total of 216 patients underwent randomization; 143 were assigned to receive osimertinib, and 73 received the placebo.The median age of the patients was 62 years in the osimertinib arm and 64 years in the placebo group. Most were male (63% in the osimertinib arm and 58% in the placebo arm). The majority never smoked (71% and 67%, respectively).Both groups included enrollment from Asian countries (81% in the osimertinib arm vs. 85% in the placebo arm), had stage IIIB disease (47% vs. 52%) and adenocarcinoma (97% vs. 95%), and harbored EGFR exon 19 deletions (52% vs. 59%). Also, most received concurrent chemoradiotherapy: 92% in the osimertinib group and 85% in the placebo group.Patients needed to have a World Health Organization (WHO) performance-status score of 0 or 1. (Note that this was based on a scale of 0–5, with a higher number indicating more disability.) Six weeks was the maximum interval between the last dose of chemoradiotherapy and randomization. At the baseline, patients were largely balanced between the two groups, although there were more patients with a WHO performance-status score of 0 in the osimertinib group versus the placebo group (56% vs. 42%).The patients were randomly assigned 2:1 to receive 80 mg of oral osimertinib or the placebo once per day. Blinded independent central review (BICR) of PFS per the Response Evaluation Criteria in Solid Tumors (Version 1.1) was the trial’s primary end point. Secondary end points included overall survival (OS), ","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 5","pages":"402-404"},"PeriodicalIF":503.1,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Overlooked barriers to implementation of geriatric assessment 被忽视的实施老年评估的障碍

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-08-29 DOI: 10.3322/caac.21865

Banu E. Symington MD, Paul G. Montgomery MD

In this issue of the journal, Magnuson et al. provide a comprehensive review of available geriatric assessment (GA) tools and their impact on outcomes for solid tumors and hematologic malignancies. In addition, the authors provide a clear guide for clinicians to help understand the importance of GA and management.1An assumption inherent in the GA is that improvement in outcomes is driven by modifications in treatment delivery or implementation of features to make activities of daily living safer. In other words, GA-guided management2 or GA-driven intervention,3 rather than simply performing the GA, is what leads to outcome improvement. These modifications are implemented using a multidisciplinary team of geriatric trained specialists. Examples include occupational therapists to improve home safety, physical therapists to improve gait and balance, pharmacists to review home medications and adjust based on anticipated adverse drug interactions, dietitians to improve nutrition, etc. Most of the studies included showed benefit, either in survival, reduced toxicity, improved quality of life, or cost effectiveness.These observations led to the development of an American Society of Clinical Oncology guideline recommending GA-guided management of cancer treatment in elderly adults.4 However, it is widely recognized that this tool is underused by practicing oncologists.5 The whys have been explored by Magnuson et al. and others5, 6 and included the belief that the GA was too cumbersome in addition to the perception that it added little or no value. Based on these assumptions, making assessment tools more efficient and educating providers about their evidence-generated benefits have been the focus of efforts to improve GA use. To encourage greater uptake of the tool, Magnuson and co-authors detail ways to educate providers and simplify the GA.What is not discussed that may be an important root cause of poor uptake of GA is resource scarcity, which takes two forms. The first is the lack of available services to support GA-modified treatment. Substantial numbers of communities, particularly in rural sites, do not have consistent—if any—access to the specialists required to modify treatment in a GA-guided manner. These practices almost certainly do not have geriatricians or geriatric-trained nurse practitioners; and they may not have physical therapists, occupational therapists, chemotherapy-dedicated pharmacists, or even social workers. Rural sites particularly often have one oncology provider whose job is to meet all the needs of every oncology patient in their practice. This distributive inequity of resources7 has always existed and will continue to plague rural communities. In this context, even if one performed a GA, opportunities to make care delivery safer

远程医疗在肿瘤学的许多方面都取得了成功，从监测到毒性监测，并可用于老年病咨询和管理。我们的全国性组织（如美国临床肿瘤学会和美国癌症学会）可以帮助建立一个由全国认证的老年病学专家组成的小组，提供远程会诊，以解决老年病这方面的问题。不过，这要假定有足够多的老年病学专家愿意并能够满足日益增长的老年人口不断扩大的需求。一个更难解决的问题是，如何组建一个多学科团队来实现老年医学的建议，包括更广泛地获得职业和物理治疗的评估和管理，这需要亲临现场、亲力亲为的访问。解决这一人力问题的新方法或许是帮助创建一个新的辅助专业领域，即老年评估实施技术人员（GAITs）。这种老年评估实施技术员将由非专业人员担任，他们将接受相对短暂的集中培训，然后获得认证，类似于非专业导航员。这些人经过培训后，可以进行居家评估，为安全实施化疗做出必要的改变，并可部署到服务不足的社区和农村地区。如果设计得当，在缺乏经济机会的社区，这可能是一个有吸引力且有用的职业选择，并能为老龄化人口所代表的日益增长的需求提供解决方案。这两个要素，即支持当地医生的远程保健老年医学和补充远程保健职业治疗/物理治疗的 GAIT，将需要额外的资金，并需要实施研究，以确定这些增强措施是否和/或如何改善结果。设想支持这些举措所需的资源似乎令人生畏。如果我们想改善 GA 在所有肿瘤治疗实践中的应用，仅仅教育肿瘤学家和简化工具是不够的。我们必须帮助资源不足的诊疗机构实施基于 GA 的变革，我们需要将所需的专科诊疗带到农村环境中。牢记服务不足社区的需求对于继续推出的所有指南取得成功至关重要。

{"title":"Overlooked barriers to implementation of geriatric assessment","authors":"Banu E. Symington MD, Paul G. Montgomery MD","doi":"10.3322/caac.21865","DOIUrl":"10.3322/caac.21865","url":null,"abstract":"In this issue of the journal, Magnuson et al. provide a comprehensive review of available geriatric assessment (GA) tools and their impact on outcomes for solid tumors and hematologic malignancies. In addition, the authors provide a clear guide for clinicians to help understand the importance of GA and management.1An assumption inherent in the GA is that improvement in outcomes is driven by modifications in treatment delivery or implementation of features to make activities of daily living safer. In other words, GA-guided management2 or GA-driven intervention,3 rather than simply performing the GA, is what leads to outcome improvement. These modifications are implemented using a multidisciplinary team of geriatric trained specialists. Examples include occupational therapists to improve home safety, physical therapists to improve gait and balance, pharmacists to review home medications and adjust based on anticipated adverse drug interactions, dietitians to improve nutrition, etc. Most of the studies included showed benefit, either in survival, reduced toxicity, improved quality of life, or cost effectiveness.These observations led to the development of an American Society of Clinical Oncology guideline recommending GA-guided management of cancer treatment in elderly adults.4 However, it is widely recognized that this tool is underused by practicing oncologists.5 The whys have been explored by Magnuson et al. and others5, 6 and included the belief that the GA was too cumbersome in addition to the perception that it added little or no value. Based on these assumptions, making assessment tools more efficient and educating providers about their evidence-generated benefits have been the focus of efforts to improve GA use. To encourage greater uptake of the tool, Magnuson and co-authors detail ways to educate providers and simplify the GA.What is not discussed that may be an important root cause of poor uptake of GA is resource scarcity, which takes two forms. The first is the lack of available services to support GA-modified treatment. Substantial numbers of communities, particularly in rural sites, do not have consistent—if any—access to the specialists required to modify treatment in a GA-guided manner. These practices almost certainly do not have geriatricians or geriatric-trained nurse practitioners; and they may not have physical therapists, occupational therapists, chemotherapy-dedicated pharmacists, or even social workers. Rural sites particularly often have one oncology provider whose job is to meet all the needs of every oncology patient in their practice. This distributive inequity of resources7 has always existed and will continue to plague rural communities. In this context, even if one performed a GA, opportunities to make care delivery safer ","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 6","pages":"475-476"},"PeriodicalIF":503.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21865","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Geriatric assessment for the practicing clinician: The why, what, and how 临床执业医师的老年病评估：为什么、做什么、怎么做

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-08-29 DOI: 10.3322/caac.21864

Allison Magnuson DO, MS, Kah Poh Loh MBBCh BAO, MS, Fiona Stauffer MS, William Dale MD, PhD, Nikesha Gilmore PhD, MS, Sindhuja Kadambi MD, Heidi D. Klepin MD, MS, Kaitlin Kyi MD, Lisa M. Lowenstein PhD, Tanyanika Phillips MD, MPH, Erika Ramsdale MD, MS, Melody K. Schiaffino PhD, MPH, John F. Simmons Jr MD, Grant R. Williams MD, MSPH, Jason Zittel MD, Supriya Mohile MD, MS

Older adults with cancer heterogeneously experience health care, treatment, and symptoms. Geriatric assessment (GA) offers a comprehensive evaluation of an older individual's health status and can predict cancer-related outcomes in individuals with solid tumors and those with hematologic malignancies. In the last decade, randomized controlled trials have demonstrated the benefits of GA and GA management (GAM), which uses GA information to provide tailored intervention strategies to address GA impairments (e.g., implementing physical therapy for impaired physical function). Multiple phase 3 clinical trials in older adults with solid tumors and hematologic malignancies have demonstrated that GAM improves treatment completion, quality of life, communication, and advance care planning while reducing treatment-related toxicity, falls, and polypharmacy. Nonetheless, implementation and uptake of GAM remain challenging. Various strategies have been proposed, including the use of GA screening tools, to identify patients most likely to benefit from GAM, the systematic engagement of the oncology workforce in the delivery of GAM, and the integration of technologies like telemedicine and mobile health to enhance the availability of GA and GAM interventions. Health inequities in minoritized groups persist, and systematic GA implementation has the potential to capture social determinants of health that are relevant to equitable care. Caregivers play an important role in cancer care and experience burden themselves. GA can guide dyadic supportive care interventions, ultimately helping both patients and caregivers achieve optimal health.

老年癌症患者在医疗保健、治疗和症状方面的经历各不相同。老年医学评估（GA）可对老年人的健康状况进行全面评估，并可预测实体瘤患者和血液恶性肿瘤患者的癌症相关预后。在过去的十年中，随机对照试验证明了老年医学评估和老年医学管理（GAM）的益处，老年医学管理利用老年医学评估信息提供量身定制的干预策略，以解决老年医学评估的缺陷（例如，针对受损的身体功能实施物理治疗）。在患有实体瘤和血液系统恶性肿瘤的老年人中开展的多项三期临床试验表明，GAM 可改善治疗完成度、生活质量、沟通和预先护理计划，同时减少治疗相关毒性、跌倒和多重用药。然而，GAM 的实施和普及仍面临挑战。人们提出了各种策略，包括使用GA筛查工具来识别最有可能从GAM中获益的患者，让肿瘤科工作人员系统地参与GAM的实施，以及整合远程医疗和移动医疗等技术来提高GA和GAM干预措施的可用性。少数群体的健康不平等现象依然存在，系统性地实施性别问题评估有可能捕捉到与公平护理相关的健康社会决定因素。护理人员在癌症护理中扮演着重要角色，他们自身也承受着负担。性别问题可以指导双向支持性护理干预，最终帮助患者和护理人员达到最佳健康状态。

{"title":"Geriatric assessment for the practicing clinician: The why, what, and how","authors":"Allison Magnuson DO, MS, Kah Poh Loh MBBCh BAO, MS, Fiona Stauffer MS, William Dale MD, PhD, Nikesha Gilmore PhD, MS, Sindhuja Kadambi MD, Heidi D. Klepin MD, MS, Kaitlin Kyi MD, Lisa M. Lowenstein PhD, Tanyanika Phillips MD, MPH, Erika Ramsdale MD, MS, Melody K. Schiaffino PhD, MPH, John F. Simmons Jr MD, Grant R. Williams MD, MSPH, Jason Zittel MD, Supriya Mohile MD, MS","doi":"10.3322/caac.21864","DOIUrl":"10.3322/caac.21864","url":null,"abstract":"Older adults with cancer heterogeneously experience health care, treatment, and symptoms. Geriatric assessment (GA) offers a comprehensive evaluation of an older individual's health status and can predict cancer-related outcomes in individuals with solid tumors and those with hematologic malignancies. In the last decade, randomized controlled trials have demonstrated the benefits of GA and GA management (GAM), which uses GA information to provide tailored intervention strategies to address GA impairments (e.g., implementing physical therapy for impaired physical function). Multiple phase 3 clinical trials in older adults with solid tumors and hematologic malignancies have demonstrated that GAM improves treatment completion, quality of life, communication, and advance care planning while reducing treatment-related toxicity, falls, and polypharmacy. Nonetheless, implementation and uptake of GAM remain challenging. Various strategies have been proposed, including the use of GA screening tools, to identify patients most likely to benefit from GAM, the systematic engagement of the oncology workforce in the delivery of GAM, and the integration of technologies like telemedicine and mobile health to enhance the availability of GA and GAM interventions. Health inequities in minoritized groups persist, and systematic GA implementation has the potential to capture social determinants of health that are relevant to equitable care. Caregivers play an important role in cancer care and experience burden themselves. GA can guide dyadic supportive care interventions, ultimately helping both patients and caregivers achieve optimal health.","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 6","pages":"496-518"},"PeriodicalIF":503.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21864","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States, 2019 2019 年美国可归因于潜在可改变风险因素的癌症病例和死亡病例的比例和数量。

IF 503.1 4区物理与天体物理 Q4 PHYSICS, MULTIDISCIPLINARY

Bulletin of the Lebedev Physics Institute

Pub Date : 2024-07-11 DOI: 10.3322/caac.21858

Farhad Islami MD, PhD, Emily C. Marlow PhD, Blake Thomson DPhil, MPhil, Marjorie L. McCullough ScD, RD, Harriet Rumgay PhD, Susan M. Gapstur PhD, MPH, Alpa V. Patel PhD, Isabelle Soerjomataram MD, PhD, MSc, Ahmedin Jemal DVM, PhD

In 2018, the authors reported estimates of the number and proportion of cancers attributable to potentially modifiable risk factors in 2014 in the United States. These data are useful for advocating for and informing cancer prevention and control. Herein, based on up-to-date relative risk and cancer occurrence data, the authors estimated the proportion and number of invasive cancer cases (excluding nonmelanoma skin cancers) and deaths, overall and for 30 cancer types among adults who were aged 30 years and older in 2019 in the United States, that were attributable to potentially modifiable risk factors. These included cigarette smoking; second-hand smoke; excess body weight; alcohol consumption; consumption of red and processed meat; low consumption of fruits and vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and seven carcinogenic infections. Numbers of cancer cases and deaths were obtained from data sources with complete national coverage, risk factor prevalence estimates from nationally representative surveys, and associated relative risks of cancer from published large-scale pooled or meta-analyses. In 2019, an estimated 40.0% (713,340 of 1,781,649) of all incident cancers (excluding nonmelanoma skin cancers) and 44.0% (262,120 of 595,737) of all cancer deaths in adults aged 30 years and older in the United States were attributable to the evaluated risk factors. Cigarette smoking was the leading risk factor contributing to cancer cases and deaths overall (19.3% and 28.5%, respectively), followed by excess body weight (7.6% and 7.3%, respectively), and alcohol consumption (5.4% and 4.1%, respectively). For 19 of 30 evaluated cancer types, more than one half of the cancer cases and deaths were attributable to the potentially modifiable risk factors considered in this study. Lung cancer had the highest number of cancer cases (201,660) and deaths (122,740) attributable to evaluated risk factors, followed by female breast cancer (83,840 cases), skin melanoma (82,710), and colorectal cancer (78,440) for attributable cases and by colorectal (25,800 deaths), liver (14,720), and esophageal (13,600) cancer for attributable deaths. Large numbers of cancer cases and deaths in the United States are attributable to potentially modifiable risk factors, underscoring the potential to substantially reduce the cancer burden through broad and equitable implementation of preventive initiatives.

2018 年，作者报告了美国 2014 年可归因于潜在可改变风险因素的癌症数量和比例的估计值。这些数据有助于倡导癌症预防和控制并为其提供信息。在此，作者根据最新的相对风险和癌症发生率数据，估算了2019年美国30岁及以上成年人中，可归因于潜在可改变风险因素的浸润性癌症病例（不包括非黑色素瘤皮肤癌）和死亡病例的比例和数量。这些因素包括吸烟、二手烟、体重超标、饮酒、食用红肉和加工肉类、水果和蔬菜、膳食纤维和膳食钙摄入量低、缺乏运动、紫外线辐射以及七种致癌感染。癌症病例和死亡人数来自覆盖全国的数据源、全国代表性调查得出的风险因素流行率估计值，以及已发表的大规模汇总分析或荟萃分析得出的相关癌症相对风险系数。2019年，在美国30岁及以上成年人中，估计有40.0%（1,781,649人中的713,340人）的癌症发病率（不包括非黑色素瘤皮肤癌）和44.0%（595,737人中的262,120人）的癌症死亡率可归因于所评估的风险因素。吸烟是导致癌症病例和死亡的首要风险因素（分别为 19.3% 和 28.5%），其次是超重（分别为 7.6% 和 7.3%）和饮酒（分别为 5.4% 和 4.1%）。在 30 种被评估的癌症类型中，有 19 种癌症的病例和死亡人数的一半以上可归因于本研究中考虑的潜在可改变风险因素。肺癌的病例数（201,660 例）和死亡数（122,740 例）最高，其次是女性乳腺癌（83,840 例）、皮肤黑色素瘤（82,710 例）和结直肠癌（78,440 例），死亡数依次为结直肠癌（25,800 例死亡）、肝癌（14,720 例）和食道癌（13,600 例）。在美国，大量癌症病例和死亡病例可归因于潜在的可改变风险因素，这凸显了通过广泛而公平地实施预防措施来大幅减轻癌症负担的潜力。

{"title":"Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States, 2019","authors":"Farhad Islami MD, PhD, Emily C. Marlow PhD, Blake Thomson DPhil, MPhil, Marjorie L. McCullough ScD, RD, Harriet Rumgay PhD, Susan M. Gapstur PhD, MPH, Alpa V. Patel PhD, Isabelle Soerjomataram MD, PhD, MSc, Ahmedin Jemal DVM, PhD","doi":"10.3322/caac.21858","DOIUrl":"10.3322/caac.21858","url":null,"abstract":"In 2018, the authors reported estimates of the number and proportion of cancers attributable to potentially modifiable risk factors in 2014 in the United States. These data are useful for advocating for and informing cancer prevention and control. Herein, based on up-to-date relative risk and cancer occurrence data, the authors estimated the proportion and number of invasive cancer cases (excluding nonmelanoma skin cancers) and deaths, overall and for 30 cancer types among adults who were aged 30 years and older in 2019 in the United States, that were attributable to potentially modifiable risk factors. These included cigarette smoking; second-hand smoke; excess body weight; alcohol consumption; consumption of red and processed meat; low consumption of fruits and vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and seven carcinogenic infections. Numbers of cancer cases and deaths were obtained from data sources with complete national coverage, risk factor prevalence estimates from nationally representative surveys, and associated relative risks of cancer from published large-scale pooled or meta-analyses. In 2019, an estimated 40.0% (713,340 of 1,781,649) of all incident cancers (excluding nonmelanoma skin cancers) and 44.0% (262,120 of 595,737) of all cancer deaths in adults aged 30 years and older in the United States were attributable to the evaluated risk factors. Cigarette smoking was the leading risk factor contributing to cancer cases and deaths overall (19.3% and 28.5%, respectively), followed by excess body weight (7.6% and 7.3%, respectively), and alcohol consumption (5.4% and 4.1%, respectively). For 19 of 30 evaluated cancer types, more than one half of the cancer cases and deaths were attributable to the potentially modifiable risk factors considered in this study. Lung cancer had the highest number of cancer cases (201,660) and deaths (122,740) attributable to evaluated risk factors, followed by female breast cancer (83,840 cases), skin melanoma (82,710), and colorectal cancer (78,440) for attributable cases and by colorectal (25,800 deaths), liver (14,720), and esophageal (13,600) cancer for attributable deaths. Large numbers of cancer cases and deaths in the United States are attributable to potentially modifiable risk factors, underscoring the potential to substantially reduce the cancer burden through broad and equitable implementation of preventive initiatives.","PeriodicalId":503,"journal":{"name":"Bulletin of the Lebedev Physics Institute","volume":"74 5","pages":"405-432"},"PeriodicalIF":503.1,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.21858","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0