CA: A Cancer Journal for Clinicians最新文献

{"title":"Comprehensive management of vulvovaginal cancers","authors":"Angélica Nogueira-Rodrigues, Maaike H. M. Oonk, Domenica Lorusso, Brian Slomovitz, Mario M. Leitão, Glauco Baiocchi","doi":"10.3322/caac.70014","DOIUrl":"https://doi.org/10.3322/caac.70014","url":null,"abstract":"Vulvar and vaginal cancers represent rare malignancies, with an incidence of 2.7 per 100,000 women for vulvar cancer, predominantly affecting women older than 60 years, although rising rates are observed in younger demographics. Approximately 90% of vulvar cancers are squamous cell carcinoma and frequently are associated with human papillomavirus (HPV) infection. Vaginal cancer, constituting less than 1% of all female cancers, similarly exhibit HPV-related trends. This review delineates the etiology, histopathology, and treatment strategies for carcinomas and vulvovaginal melanomas and sarcomas. Surgical intervention remains the primary treatment modality for vulvar cancer, involving tumor resection and inguinofemoral lymph node staging. For locally advanced vulvar carcinoma, chemoradiation is advised when exenterative surgery would be indicated. Recurrence rates within 2 years after diagnosis range from 12% to 37%. Unfortunately, systemic treatments for recurrent or metastatic disease are limited, with 5-year survival rates at approximately 20%. Current evidence primarily derives from retrospective studies or small phase 2 trials or otherwise is extrapolated from the treatment of cervical cancer. Enrollment in clinical trials is strongly advocated, along with prompt access to best supportive care to mitigate the effect of locoregional progression on quality of life. Moreover, the psychosocial implications of treatment on body image and sexuality necessitate careful consideration. Future HPV vaccination initiatives may reduce cancer incidence, although significant effects of such vaccination will manifest over decades, underscoring the urgent need to enhance treatment efficacy and minimize morbidity in vulvar and vaginal cancers.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"130 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Livebirth rates significantly lower among women diagnosed with cancer","authors":"Carrie Printz","doi":"10.3322/caac.70012","DOIUrl":"https://doi.org/10.3322/caac.70012","url":null,"abstract":"<p>Women who are diagnosed with cancer during their reproductive years have significantly fewer livebirths than those without cancer, according to a Danish registry-based cohort study.</p><p>Researchers found that livebirth rates after a cancer diagnosis increasingly declined with age and varied with specific cancers. The rates of a first livebirth after cancer were lowest among women with leukemia, breast cancer, and cancers of the gynecological tract or central nervous system.</p><p>“The data affirms that most young people with cancer should be referred for fertility preservation counseling as soon as possible, even if they’re ambivalent about having children,” says Kutluk Oktay, MD, PhD, director of the Laboratory of Molecular Reproduction and Fertility Preservation at the Yale School of Medicine in New Haven, Connecticut. “I think we’ve made big progress in this area in the U.S., but around the world, and even here, there’s some heterogeneity.”</p><p>The study appears in the Journal of <i>Cancer Survivorship</i> (doi:10.1007/s11764-024-01720-1).</p><p>The study population came from the DANAC II cohort, which included women aged 18–39 years who were diagnosed with cancer between 1978 and 2016 and matched them with 60 women without a cancer diagnosis. Each woman came from a general population that included 21,596 women with cancer and 1,295,760 women without cancer.</p><p>The primary outcome was a livebirth after cancer with follow-up until death, emigration, or end of follow-up.</p><p>Findings showed that the 20-year cumulative incidence of livebirth after cancer was lower among women with cancer (0.22) than those without cancer (0.34).</p><p>The hazard ratio (HR) of a livebirth for all women diagnosed with cancer was 0.61 (95% CI, 0.59–0.63). Researchers excluded women with a livebirth within the 259 days after their cancer diagnosis and found that the HR of livebirth after cancer remained unchanged. It was highest among women aged 18–25 years (0.72) and lowest among women aged 33–39 years (0.50). The HR was lowest for women with breast, gynecological, and central nervous system cancers along with leukemia. In contrast, women with malignant melanoma had HRs of a first livebirth comparable to those of women who had not been diagnosed with cancer.</p><p>Women with and without cancer were comparable in terms of the initiation of assisted reproductive technology after their cancer diagnosis or study entry: 79% of the total population of women who initiated assisted reproductive technology after cancer had not had children, whereas 76% of the women not diagnosed with cancer had not had children. Only 21% of the women with a child or children before their cancer treatment initiated assistive reproductive technology after their diagnosis.</p><p>The results were similar to findings from a 2011 Norwegian study of women with and without cancer who were 16–45 years old between 1967 and 2004 according to Dr Oktay. That study was published in the <i>Inter","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 3","pages":"171-173"},"PeriodicalIF":503.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active monitoring of DCIS shows promise in short-term study","authors":"Carrie Printz","doi":"10.3322/caac.70013","DOIUrl":"https://doi.org/10.3322/caac.70013","url":null,"abstract":"<p>Early results from the first study comparing active monitoring to surgery for patients with low-risk ductal carcinoma in situ (DCIS) support the short-term safety of active monitoring.</p><p>Researchers released the 2-year findings from a prospective, randomized clinical trial known as the Comparing an Operation to Monitoring With or Without Endocrine Therapy (COMET) study. Results showed that the rate of invasive cancer in both groups was low, but patients who had surgery (or guideline-concordant care) for DCIS had a slightly higher rate of invasive cancer than the group that underwent active monitoring. Although the study is a preliminary analysis, investigators are encouraged by the findings.</p><p>“I don’t think we have enough long-term data yet to offer active monitoring to DCIS patients, because two years is pretty short, but if these results are supported and durable at five years, we may be able to start offering it as a possible option,” says coprincipal investigator Shelley Hwang, MD, MPH, who is the vice-chair of research in the Department of Surgery at the Duke Cancer Institute in Durham, North Carolina. “The results are very provocative in terms of turning the assumption that we’ve always had on its head, and that’s why it’s such an important study—because it challenges dogma.”</p><p>Dr Hwang and her colleagues presented the COMET study results in December 2024 at the San Antonio Breast Cancer Symposium. Findings were concurrently published in the <i>Journal of the American Medical Association</i> (doi:10.1001/jama.2024.26698).</p><p>The trial enrolled 995 women aged 40 years or older with a new diagnosis of hormone receptor–positive grade 1 or 2 DCIS without invasive cancer. Participants were enrolled at 100 US Alliance Cooperative Group clinical trial sites from 2017 to 2023. They were randomized, with 484 participants assigned to active monitoring and 473 assigned to receive surgery. Participants will be followed for 10 years.</p><p>The main purpose is to determine if DCIS, which is also called stage 0 breast cancer, needs to be treated with surgery in every patient.</p><p>“We’ve never really put our treatments to that sort of test because everyone has been really fearful of doing anything less,” Dr Hwang says.</p><p>The study excluded patients who were hormone receptor–negative as well as those who had a physical finding such as a lump, bloody discharge, or changes in the skin. Patients were allowed to enter the study regardless of the size of their DCIS.</p><p>Active monitoring, with or without endocrine therapy, included follow-up breast imaging along with a physical examination every 6 months. Although endocrine therapy was not mandatory, more than 70% chose to receive it. Guidance-concordant care was surgery with or without radiation therapy and with or without endocrine therapy. This group also had 6-month follow-ups.</p><p>The primary outcome of the preliminary analysis was the 2-year cumulative risk of an invasive breas","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 3","pages":"174-176"},"PeriodicalIF":503.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143925738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming treatment paradigms: Focus on personalized medicine for high-grade serous ovarian cancer","authors":"Pawel Kordowitzki, Britta Lange, Kevin M. Elias, Marcia C. Haigis, Sylvia Mechsner, Ioana Elena Braicu, Jalid Sehouli","doi":"10.3322/caac.70008","DOIUrl":"https://doi.org/10.3322/caac.70008","url":null,"abstract":"High-grade serous ovarian cancer (HGSOC) is the most common and aggressive subtype of ovarian cancer, accounting for approximately 70% of all ovarian cancer cases and contributing significantly to the high mortality rates associated with this disease. Because of the asymptomatic nature of early stage disease, most patients are diagnosed at advanced stages when the cancer has already spread into the abdominal cavity, requiring complex and intensive surgical and chemotherapeutic interventions followed by maintenance therapies. Although a minority of cases are associated with well defined genetic syndromes, specific risk factors and a clear etiology in many cases remain elusive. HGSOC tumors are characterized by a high frequency of somatic gene copy number alterations, often associated with defects in homologous recombination repair of DNA. All attempts to introduce an effective screening for HGSOC to date have been unsuccessful. This review elucidates the complexities surrounding HGSOC and encompasses its etiology, epidemiology, classification, pathogenesis, and the current array of treatment strategies. Understanding molecular underpinnings is crucial for the development of targeted therapies and personalized multimodal treatment approaches in centralized therapeutic structures. This review also examines the importance of the tumor microenvironment. In addition, the authors' objective is to underscore the critical importance of placing the patient's perspective and diversity at the forefront of therapeutic strategies, thereby fostering a genuinely participatory decision-making process and ultimately improving patient quality of life.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"10 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of T-cell malignancies: Bench-to-bedside targeting of epigenetic biology","authors":"Ariana Sabzevari, Johnson Ung, Jeffrey W. Craig, Kallesh D. Jayappa, Ipsita Pal, David J. Feith, Thomas P. Loughran, Owen A. O’Connor","doi":"10.3322/caac.70001","DOIUrl":"https://doi.org/10.3322/caac.70001","url":null,"abstract":"The peripheral T-cell lymphomas (PTCL) are the only disease for which four histone deacetylase (HDAC) inhibitors have been approved globally as single agents. Although it is not clear why the PTCL exhibit such a vulnerability to these drugs, understanding the biological basis for this activity is essential. Many lines of data have established that the PTCL exhibit marked sensitivity to other epigenetically targeted drugs, including EZH2 and DNMT3 (DNA-methyltransferase 3) inhibitors. Even more compelling is the finding that combinations of drugs targeting the epigenetic biology of PTCL are beginning to produce provocative data, leading some to wonder if these agents can replace historical chemotherapy regimens routinely used for patients with the disease. Simultaneously, the field has identified a spectrum of mutations in genes governing epigenetic biology in many subtypes of PTCL, although the T follicular helper lymphomas, including angioimmunoblastic T-cell lymphoma, appear to be particularly enriched for these genetic features. While the direct relationship between the presence of any one of these mutations and responsiveness to a particular epigenetic drug has yet to be established, it is increasingly accepted that the PTCL may be the prototypical epigenetic disease as no other form of cancer has exhibited such a vulnerability to this diversity of epigenetically targeted agents. Herein, we comprehensively review this esoteric and rapidly evolving field to identify themes and lessons from these experiences that may guide efforts to improve outcomes of patients with T-cell neoplasms. Furthermore, we will discuss how these concepts might be applied to the broader field of cancer medicine.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"7 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143832099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From success to sustained action: Tobacco control must remain a priority","authors":"Vani N. Simmons PhD, Jhanelle E. Gray MD","doi":"10.3322/caac.70010","DOIUrl":"10.3322/caac.70010","url":null,"abstract":"<p>In this issue, Islami and colleagues present remarkable data estimating that 3.9 million lung cancer deaths have been averted over the past 5 decades, along with a compelling analysis revealing 75 person-years of life gained from avoided premature lung cancer deaths—both of which can be attributed to a major public health victory in tobacco control.<span><sup>1</sup></span> The consequence of the estimated number of averted lung cancer deaths on overall cancer mortality reductions was also analyzed. Findings revealed that these prevented deaths accounted for more than one half (51%) of the estimated declines in overall cancer deaths. With the inclusion of person-years of life gained, these results extend prior research and further highlight the striking contributions of tobacco control in reducing the overall cancer burden.</p><p>The decline in lung cancer mortality rates parallels the reduction in smoking that began after the landmark US Surgeon General's report in 1964 that confirmed the health risks of smoking and, most importantly, the causal relationship between smoking and lung cancer.<span><sup>2</sup></span> Since then, the adult smoking prevalence has dropped from an all-time high of 52.0% among men and 34.1% among women to 13.1% and 10.1%, respectively.<span><sup>3, 4</sup></span> Although the authors' analyses focused solely on reductions in smoking prevalence among adults, it is critical to acknowledge the profound implications of recent data on youth smoking trends and their potential to vastly reduce the future burden of lung cancer. One of most recent, greatest public health triumphs—which has received notably little attention—is the unprecedented shift in youth smoking to the lowest levels ever reported. In 1997, over one third of high school students were smoking, whereas, today, only 1.7% report smoking, making combustible cigarette use virtually nonexistent among youth.<span><sup>5</sup></span> The long-term effect of this decline should result in further dramatic reductions in lung cancer mortality and increasing person-years of life saved.</p><p>Just as the decline in lung cancer deaths is attributed by the authors to a reduction in combustible cigarette smoking, the decrease in smoking prevalence can be attributed primarily to changes in tobacco-control policies and regulations.<span><sup>3</sup></span> As noted by the authors, the most significant decline in smoking occurred because of cigarette price increases, taxation, and the implementation of clear indoor air laws. Other key factors that contribute to a comprehensive approach to tobacco control include mass media campaigns, restrictions on marketing and advertising, access to quitting resources (e.g., tobacco quitlines available in all states at no cost), and evidence-based interventions for quitting smoking, including counseling and US Food and Drug Administration (FDA)-approved medications.<span><sup>3</sup></span></p><p>Beyond established tobacco-control policies","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 3","pages":"180-182"},"PeriodicalIF":503.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143798494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond fluorodeoxyglucose: Molecular imaging of cancer in precision medicine","authors":"Malik E. Juweid MD,&nbsp;Soud F. Al-Qasem MD,&nbsp;Fadlo R. Khuri MD,&nbsp;Andrea Gallamini MD,&nbsp;Philipp Lohmann PhD,&nbsp;Hans-Joachim Ziellenbach Dipl Päd,&nbsp;Felix M. Mottaghy MD","doi":"10.3322/caac.70007","DOIUrl":"10.3322/caac.70007","url":null,"abstract":"<p>Cancer molecular imaging is the noninvasive visualization of a process unique to or altered in neoplasia, such as proliferation, glucose metabolism, and receptor expression, which is relevant to patient management. Several molecular imaging modalities are now available, including magnetic resonance, optical, and nuclear imaging. Nuclear imaging, particularly using fluorine-18–fluorodeoxyglucose positron emission tomography, is widely used in the staging and response assessment of multiple cancer types. However, at this writing, new nuclear medicine probes, especially positron emission tomography tracers, are increasingly used or are being investigated for cancer evaluation. This review focuses on these probes, their biologic targets, and the applications or potential applications for their use in the assessment of various neoplasms, including both probes available for commercial use—such as somatostatin receptor ligands in neuroendocrine tumors, prostate-specific membrane antigen ligands in prostate cancer, norepinephrine analogs in neural crest tumors like neuroblastoma, and estrogen analogs in breast cancer—and others in clinical development, such as fibroblast-activating protein inhibitors, C-X-C chemokine receptor type 4 ligands, and monoclonal antibodies targeting receptor tyrosine kinases, CD4-positive or CD8-positive tumor-infiltrating lymphocytes, tumor-associated macrophages, and cancer stem cell biomarkers. These developments represent a major step toward the integration of molecular imaging as a powerful tool in precision medicine, with an expectedly significant impact on patient management and outcome.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 3","pages":"226-242"},"PeriodicalIF":503.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer in rural America: Improving access to clinical trials and quality of oncologic care","authors":"Joseph M. Unger, Barbara L. McAneny, Raymond U. Osarogiagbon","doi":"10.3322/caac.70006","DOIUrl":"https://doi.org/10.3322/caac.70006","url":null,"abstract":"Individuals from rural areas in the United States suffer higher rates of morbidity and mortality from cancer than their urban counterparts. This review is based on the idea that equity—the elimination of unnecessary and preventable differences between groups of individuals—should underlie access to cancer care resources for patients from rural areas. Access to cancer clinical trials serves as the framework for identifying and understanding barriers in access to quality oncologic care. The authors discuss the interplay between rural living, socioeconomic status, culture, and health; and they highlight how economic considerations in rural areas often limit access to clinical trials and oncologic care because economies of scale do not apply in these regions given the requirement for high-quality oncology care even with lower patient volumes. The authors propose solutions to enhance access to clinical trials and improve the quality of oncologic care in rural areas, viewing these aims as ethical and moral imperatives.","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"86 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering the hidden drivers of rural health care disparities","authors":"Banu E. Symington","doi":"10.3322/caac.70009","DOIUrl":"https://doi.org/10.3322/caac.70009","url":null,"abstract":"&lt;p&gt;Patients living in rural communities who have chronic diseases, including cancer, have inferior survival compared to those living in urban areas. In this issue, Unger et al. provide an excellent overview of factors that challenge rural patients while highlighting how clinical trial availability can improve rural outcomes.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; They discuss delayed diagnosis, underinsurance, provider shortages, the higher incidence of comorbid illness and poverty, and other factors. All of these are commonly recognized factors that contribute to inferior outcomes for patients with cancer in rural communities. However, there are less well known challenges facing both patients and providers in rural areas that may result in persistent and poorer outcomes, even when more well known factors may be overcome. These factors are important not only because they contribute to cancer care decisions and outcomes but because they also compound the reluctance of patients living in rural areas to participate in clinical trials.&lt;/p&gt;\u0000&lt;p&gt;Rural practices exist in densely populated states like New York, Washington, and Pennsylvania and in large, underpopulated states like Wyoming, Alaska, and the Dakotas. Patients from these latter locations face chronic provider shortages as well as the challenge of long drives for routine care. Both of these result in patients tending to ignore early signs and symptoms that may appear minor but contribute to delayed diagnosis.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; What is under-recognized is the lack of public transportation in these rural states to help patients get to and from chemotherapy appointments, whether in outlying communities or in rural towns. Finding rides for treatment, especially because of post-treatment malaise, fatigue, or nausea (which can make driving home unsafe), is a challenge that leads many to abandon cancer care. The long drives often required in rural areas go beyond a barrier for patient access. There exists an increased risk of road closure because of wind, snow, poor visibility, or accidents, leading to more frequently interrupted care. Closed roads affect the ability of courier and mail services to deliver necessary chemotherapy drugs to patients or even to the hospital. The lack of neighboring hospitals means one cannot tap another facility for a loan (&lt;i&gt;a cup of chemo&lt;/i&gt;, as it were) to tide a patient over. This also results in delayed and often repeated cycles of interrupted chemotherapy. The effect on clinical trials is felt in the delayed delivery of trial drugs, delayed visits for time-sensitive clinical trial toxicity assessments, and even on-study required blood draws.&lt;/p&gt;\u0000&lt;p&gt;Local free housing close to treatment areas is offered in some rural sites, but this housing may not allow relatives or pets and results in a sense of isolation of patients from their sources of emotional support. Thus, even when available, free local housing is underused.&lt;/p&gt;\u0000&lt;p&gt;Although a hub-and-spoke model of decentralized","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"33 1","pages":""},"PeriodicalIF":254.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Averted lung cancer deaths due to reductions in cigarette smoking in the United States, 1970–2022","authors":"Farhad Islami MD, PhD,&nbsp;Nigar Nargis PhD,&nbsp;Qinran Liu PhD,&nbsp;Priti Bandi PhD,&nbsp;Rebecca L. Siegel MPH,&nbsp;Parichoy Pal Choudhury PhD,&nbsp;Neal D. Freedman PhD,&nbsp;Kenneth E. Warner PhD,&nbsp;Ahmedin Jemal DVM, PhD","doi":"10.3322/caac.70005","DOIUrl":"10.3322/caac.70005","url":null,"abstract":"<p>Lung cancer mortality rates in the United States have declined steeply in recent decades, largely because of substantial reductions in smoking prevalence, as approximately 85% of lung cancer deaths are attributable to cigarette smoking. In this study, the authors estimate the number of averted lung cancer deaths and corresponding person-years of life gained during 1970–2022 as a measure of progress in cancer prevention through tobacco control. By using the 1970–2022 National Center for Health Statistics mortality data (with national coverage), the authors calculated the expected number of deaths for each year, age, sex, race, and age group based on the expected lung cancer death rate multiplied by the population at risk in that group. The number of averted lung cancer deaths were calculated by subtracting the observed number of deaths from the expected number in each group. Person-years of life gained were estimated as a measure of avoided premature mortality based on the average additional years a person would have lived if they had not died from lung cancer. The authors estimated that 3,856,240 lung cancer deaths (2,246,610 in men, 1,609,630 in women) were averted, and 76,275,550 person-years of life (40,277,690 in men, 35,997,860 in women) were gained during 1970–2022, with an average of 19.8 person-years of life gained (17.9 in men, 22.4 in women) per averted death. The number of averted lung cancer deaths accounted for 51.4% of the estimated declines in overall cancer deaths and was substantially greater in men (60.1%) than in women (42.7%). By race, this proportion was 53.6% in the White population (62.8% in men, 44.6% in women) and 40.0% in the Black population (44.4% in men, 34.7% in women). The substantial estimated numbers of averted lung cancer deaths and person-years of life gained highlight the remarkable effect of progress against smoking on reducing premature mortality from lung cancer.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 3","pages":"216-225"},"PeriodicalIF":503.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}