CA: A Cancer Journal for Clinicians最新文献

{"title":"Human papillomavirus self-collection: The long road from scientific evaluation to implementation in screening programs","authors":"Nicolas Wentzensen MD, PhD, MS, Armando Baena MSc, PhD","doi":"10.3322/caac.70047","DOIUrl":"10.3322/caac.70047","url":null,"abstract":"<p>The understanding that persistent infections with human papillomavirus (HPV) cause nearly all cervical cancers has led to important cervical cancer prevention approaches: HPV vaccination is highly efficacious at preventing HPV infection when administered before infection occurs. In cervical cancer screening, HPV testing has higher sensitivity, provides longer reassurance when a test is negative, and has an overall better tradeoff of benefits and harms compared with cytology.<span><sup>1</sup></span> Consequently, HPV testing is gradually replacing cytology as a primary screening test in screening programs worldwide.</p><p>An additional benefit of HPV testing is that it can be conducted from self-collected vaginal specimens, with high concordance to clinician collected specimens. The article by Perkins et al.<span><sup>2</sup></span> describes the adoption of clinical guidelines for HPV self-collection developed by the Enduring Guidelines effort<span><sup>3, 4</sup></span> for the American Cancer Society cervical cancer screening guideline.<span><sup>5</sup></span></p><p>Using self-collected specimens for cervical cancer screening has great promise to expand screening to unscreened and underscreened populations who may not have access to clinician-based sampling or who may decide not to participate in screening to avoid pelvic examinations.</p><p>HPV self-collection is not a new development—the first studies evaluating self-collection were conducted in the 1990s and focused on different sampling strategies, including vaginal lavages, tampon collections, and vaginal brush devices.<span><sup>6-9</sup></span> Of these, vaginal sampling devices were the most successful and have become the standard for HPV self-collection today. More recently, urine-based HPV testing has been evaluated as a possible alternative to clinician and brush-based self-collection, with heterogeneous efficacy results to date.<span><sup>10</sup></span></p><p>Since the initial proof-of-concept studies, HPV self-collection has been evaluated in many, mostly cross-sectional studies, as summarized in a series of systematic reviews.<span><sup>11-14</sup></span> The systematic reviews demonstrate that polymerase chain reaction (PCR)-based HPV tests have high agreement for detection of HPV and cervical precancer between clinician-collected and self-collected specimens. They have also demonstrated the high acceptability of HPV self-collection, with several studies indicating that screening participants prefer self-collection over clinician-collection. There is strong evidence that high sensitivity for precancer detection using self-collected samples is only achieved with PCR-based HPV DNA tests, as opposed to signal amplification or messenger RNA-based tests, which are not considered equivalent. Several components need to be considered when evaluating HPV self-collection, including the type of HPV assay, the type of collection device, the type of storage until processing (e.g., dry s","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664285","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":"Screening for cervical cancer","authors":"","doi":"10.3322/caac.70049","DOIUrl":"10.3322/caac.70049","url":null,"abstract":"<p>The American Cancer Society (ACS) has updated its guideline recommendations for cervical cancer screening. The <i>cervix</i> is the bottom part of the uterus that connects it to the vagina. Regular screening for precancerous changes can greatly lower your chances of developing cervical cancer. This update reflects new research and advances in medical testing, and it builds on the previous ACS cervical cancer screening guideline from 2020.</p><p>If any of these apply to you, talk to your health care provider about screening and the right test for you.</p><p>The goal of cervical cancer screening is to find any abnormal conditions early so they can be treated before they develop into cancer. Screening can also find cervical cancer at an early stage when it is easier to treat.</p><p>There are two types of tests for cervical cancer screening.</p><p>Some HPV tests are approved to be used only as part of a <i>co-test</i>, that is, when an HPV test and a Pap test are done at the same time. Doing a co-test does not add much benefit compared with HPV testing alone. But a primary HPV test (HPV alone) may not be available in some settings, so co-testing every 5 years is still acceptable for screening. The sample for co-testing must be collected from the cervix by a health professional the same way it is done for a Pap test.</p><p>If none of the options for HPV testing are available, screening using only a Pap test is acceptable. Although all the screening tests are good at finding cancer and precancer, the primary HPV test finds more abnormal areas, and it finds them earlier than a Pap test done alone.</p><p>The most important thing to remember is to get screened regularly, no matter which test you get.</p><p>The US Food and Drug Administration (FDA) has now approved devices for people to collect their own samples from the vagina for HPV testing. Collecting vaginal samples can be done privately in a clinic setting, without the need for a health care provider present. An at-home self-collection kit is also available for use in some areas of the United States. If you choose to collect your own sample, a health care provider will need to order the test for you.</p><p><i>Note: An HPV test that you can order yourself off the internet may not be good quality. ACS recommends using only FDA-approved tests and collection devices, and these are only available through your health care provider.</i></p><p>Although some people may be more comfortable with collecting a vaginal sample for HPV testing, tests done using a sample collected by a healthcare professional are still preferred. This is because, if your HPV test is positive on a sample that your provider collected from the cervix, the lab can run more tests on that same sample to determine the next steps for you. But if a self-collected HPV test shows abnormal results, you’ll need to see a health care provider, who will collect a new sample from the cervix for more testing.</p><p>The goal of cervical cancer scree","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664533","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":"Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline","authors":"Rebecca B. Perkins MD, MSc,&nbsp;Andrew M. D. Wolf MD,&nbsp;Timothy R. Church PhD,&nbsp;Elena B. Elkin PhD, MPA,&nbsp;Steven J. Skates PhD,&nbsp;Ruth D. Etzioni PhD,&nbsp;Carmen E. Guerra MD, MSCE,&nbsp;Abbe Herzig PhD,&nbsp;Richard M. Hoffman MD, MPH,&nbsp;Kevin C. Oeffinger MD,&nbsp;Sana Raoof MD, PhD,&nbsp;Ya-Chen Tina Shih PhD,&nbsp;Louise C. Walter MD,&nbsp;Charnita Zeigler-Johnson PhD,&nbsp;Deana Manassaram-Baptiste PhD, MPH,&nbsp;Robert A. Smith PhD","doi":"10.3322/caac.70041","DOIUrl":"10.3322/caac.70041","url":null,"abstract":"<p>This update expands the 2020 American Cancer Society (ACS) cervical cancer screening guideline for average-risk women and individuals with a cervix who are at average risk, to include self-collection for human papillomavirus (HPV) testing and revised guidance for exiting cervical cancer screening. Self-collected vaginal specimens, a method of primary HPV testing, align with the ACS cervical cancer screening guideline. When clinician-collected cervical specimens are used for HPV testing, repeat screening is recommended every 5 years for those with a negative test. For self-collected vaginal specimens, the ACS endorses the following recommendations of the Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee (of which it is a member): (1) primary HPV screening using clinician-collected cervical specimens is preferred, and self-collected vaginal specimens are acceptable for average-risk individuals aged 25–65 years; and (2) repeat testing in 3 years is recommended after a negative result on a self-collected HPV screening test. These recommendations apply only to combinations of collection devices and HPV assays approved by the US Food and Drug Administration for HPV testing in a clinical setting or at home. The rationale notes that the use of self-collected vaginal specimens can overcome barriers to screening for many patients, but most patients who test HPV-positive will require extra follow-up steps, and data on long-term, real-world effectiveness are limited. For certain high-risk individuals, clinician-collected samples are still recommended. Furthermore, in response to high rates of cervical cancer among individuals older than 65 years and with poor implementation of current exiting screening criteria, ACS has amended the 2020 guideline to recommend HPV testing at ages 60 and 65 years, with the last HPV test at an age no younger than 65 years as a requisite to exiting screening. The revised recommendation states: <i>To qualify for discontinuation of screening, the ACS recommends an average-risk woman or an individual with a cervix at average risk have negative primary HPV tests (preferred) or negative co-testing using HPV tests and cytology (acceptable) at ages 60 and 65 years.</i> If primary HPV tests or co-testing are not available, three consecutive negative cytology (Papanicolaou) tests at the recommended screening interval with the last test at age 65 years are acceptable. If self-collected vaginal specimens are used for HPV testing, the 3-year testing interval should be followed. Additional screening exit stipulations relate to women at higher risk because of prior abnormal test results or current immune suppression.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664286","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":"Global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2022","authors":"Harriet Rumgay PhD,&nbsp;Murielle Colombet MSc,&nbsp;Amanda Ramos da Cunha DDS, MSc, PhD,&nbsp;Adalberto M. Filho PhD,&nbsp;Saman Warnakulasuriya DSc,&nbsp;David I. Conway BDS, MPH, PhD,&nbsp;Anil Chaturvedi PhD,&nbsp;Shama Virani PhD,&nbsp;Beatrice Lauby-Secretan PhD,&nbsp;Andre L. Carvalho MD, PhD, MPH,&nbsp;Suzanne T. Nethan MDS, MPH,&nbsp;Ahmedin Jemal DVM, PhD,&nbsp;Freddie Bray BSc, MSc, PhD","doi":"10.3322/caac.70048","DOIUrl":"10.3322/caac.70048","url":null,"abstract":"<p>Cancers of the lip, oral cavity, and pharynx (LOCP) represent a substantial public health challenge worldwide. Using GLOBOCAN national estimates of incidence, detailed cancer registry data from <i>Cancer Incidence in Five Continents</i>, and population statistics from the United Nations, the authors report the distribution of new cases of LOCP cancers in 185 countries by sex in 2022. Age-standardized incidence rates were calculated. For countries lacking registry data, regional averages from high-quality registries were used to impute subsite-specific estimates. Worldwide, 758,000 people were diagnosed with LOCP cancers in 2022, with oral cavity cancer accounting for approximately 42% of cases, followed by oropharynx (19.3%), nasopharynx (15.9%), hypopharynx (11.4%), salivary gland (7.3%), and lip (4.2%) cancers. Oral cavity cancer was the most frequent LOCP subsite among women in 141 countries and among men in 93 countries, and incidence rates were highest in countries in South-Central Asia. Oropharyngeal cancer was the most frequent LOCP subsite among men in 44 countries and among women in five countries across Europe, Northern America, South America, Australia, and New Zealand. Nasopharyngeal cancer was the most common subsite among men in 39 countries and women in 23 countries, mainly in Northern Africa, Middle Africa, and Eastern and South-Eastern Asia. Rates of hypopharyngeal and salivary gland cancers were low globally, although the incidence burden was greater than that of lip cancer. The authors discuss incidence patterns in relation to disease etiology and the prospects of delivering effective cancer control measures, spanning primary prevention, early detection, cancer treatment, and survivorship.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658082","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":"Fuzuloparib with or without apatinib as maintenance therapy in newly diagnosed, advanced ovarian cancer (FZOCUS-1): A multicenter, randomized, double-blind, placebo-controlled phase 3 trial","authors":"Lingying Wu MD,&nbsp;Jing Wang MD,&nbsp;Qingshui Li BS,&nbsp;Danbo Wang PhD,&nbsp;Cuiying Zhang MM,&nbsp;Junying Tang MD,&nbsp;Guonan Zhang BS,&nbsp;Min Hao PhD,&nbsp;Desheng Yao MD, PhD,&nbsp;Qinglei Gao MD,&nbsp;Youzhong Zhang PhD,&nbsp;Ruifang An MD,&nbsp;Rutie Yin MD,&nbsp;Li Wang BS,&nbsp;Bairong Xia MD,&nbsp;Qi Zhou MS,&nbsp;Hongying Yang MM,&nbsp;Jianqing Zhu MD,&nbsp;Kui Jiang MM,&nbsp;Zhengzheng Chen MM,&nbsp;Qiang Wu MD,&nbsp;Wei Duan MM,&nbsp;Yi Huang MM,&nbsp;Hui Zhang PhD,&nbsp;Shuqing Wei MM,&nbsp;Guiling Li MD,&nbsp;Yuanguang Meng MD,&nbsp;Ke Wang MM,&nbsp;Xinfeng Yang BS,&nbsp;Xianghua Huang PhD,&nbsp;Lingya Pan MD,&nbsp;Jinjin Yu BS,&nbsp;Ge Lou PhD,&nbsp;Yu Zhang PhD,&nbsp;Huaijun Zhou MD,&nbsp;Xiaoqing Guo MD, PhD,&nbsp;Hong Yang PhD,&nbsp;Xiaodong Cheng MD,&nbsp;Xiumin Li MM,&nbsp;Wuliang Wang MD,&nbsp;Hongqin Zhao BS,&nbsp;Yunxia Li BS,&nbsp;Yingjie Yang PhD,&nbsp;An Lin BS,&nbsp;Wenjun Cheng MD,&nbsp;Lihong Chen MD,&nbsp;Xiaoying Xie BS,&nbsp;Wen Di MD, PhD,&nbsp;Yuanjing Hu MD,&nbsp;Mo Chen MD,&nbsp;Hongwu Wen MD,&nbsp;Liping Cai MM,&nbsp;Xiaohua Wu MD, PhD,&nbsp;Zhongqiu Lin MD, PhD,&nbsp;Quanren Wang PhD,&nbsp;Xinfeng Yang PhD,&nbsp;Ning Li MD","doi":"10.3322/caac.70042","DOIUrl":"https://doi.org/10.3322/caac.70042","url":null,"abstract":"<p>Although poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPis) and bevacizumab were approved as first-line maintenance for advanced ovarian cancer (OC), evidence comparing this combination with PARPi monotherapy, especially in <i>BRCA</i>-mutated/homologous recombination-deficient (HRD) patients, is lacking. This study compared combined fuzuloparib (a PARPi) plus apatinib (a vascular endothelial growth factor receptor-2 inhibitor) with either fuzuloparib or placebo as first-line maintenance in patients with advanced OC. Patients who had newly diagnosed, advanced OC and responded to first-line, platinum-based chemotherapy were randomized 2:2:1 to receive combined fuzuloparib (100 mg twice daily) plus apatinib (375 mg daily), fuzuloparib (150 mg twice daily) plus placebo, or double-placebo treatment. The primary end point was blinded independent review committee (BIRC)-assessed progression-free survival (PFS). Six hundred seventy-four patients were randomized to receive fuzuloparib plus apatinib (<i>n</i> = 269), fuzuloparib (<i>n</i> = 269), or placebo (<i>n</i> = 136). At the final analysis (November 1, 2024; 385 BIRC-assessed PFS events; median follow-up, 40 months), the median BIRC-assessed PFS was 26.9 months with the combination versus placebo (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.44–0.75; one-sided <i>p</i> &lt; .0001) and 29.9 months with fuzuloparib monotherapy versus placebo (HR, 0.58; 95% CI, 0.44–0.75; one-sided <i>p</i> &lt; .0001) compared with 11.1 months with placebo. A PFS benefit was observed regardless of germline <i>BRCA1/2</i> mutation status. In homologous recombination-deficient patients (including those with <i>BRCA1/2</i> mutations), combined fuzuloparib and apatinib produced a PFS similar to that of fuzuloparib (34.1 vs. 35.8 months, respectively); in homologous recombination-proficient patients, PFS had a trend favoring the combination (16.6 vs. 11.0 months; HR, 0.73; 95% CI, 0.45–1.19). Both treatments were well tolerated. Overall survival was immature. Both fuzuloparib and combination therapy improved PFS compared with placebo as maintenance therapy for patients who had newly diagnosed, advanced OC. Adding apatinib to fuzuloparib did not prolong PFS among homologous recombination-deficient patients. There was a PFS benefit trend among homologous recombination-proficient patients who received combination therapy compared with those who received monotherapy.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"76 1","pages":""},"PeriodicalIF":232.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585160","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":"Study assesses normal tissue effects after axillary radiotherapy for early breast cancer","authors":"Carrie Printz","doi":"10.3322/caac.70039","DOIUrl":"https://doi.org/10.3322/caac.70039","url":null,"abstract":"&lt;p&gt;In 2020, the multicenter, randomized, phase 3 FAST-Forward trial reported 5-year results showing that delivery of whole breast or chest wall adjuvant radiotherapy was a safe and effective alternative to the 3-week regimen. Current UK and European guidelines support 26 Gy in 5 daily fractions (Fr) as a standard of care for early breast cancer.&lt;/p&gt;&lt;p&gt;In a FAST-Forward substudy published in Radiotherapy &amp; Oncology (doi:10.1016/j.radonc.2025.110915), researchers sought to assess normal tissue effects on the axilla after the same 1- and 3-week radiotherapy dose schedules. Findings showed no patient-reported differences between the two protocols after 5 years and thus indicated that 26-Gy/5-Fr/1-week hypofractionation radiotherapy is safe for patients with breast cancer who need it.&lt;/p&gt;&lt;p&gt;This substudy followed the same design as the randomized, noninferiority, nonblinded FAST-Forward trial. The ongoing trial compares two 5-Fr schedules of adjuvant radiotherapy to the whole breast or chest wall delivered in 1 week with the 15-Fr/3-week schedule. A total of 469 patients with invasive breast cancer from 50 UK centers were included in the substudy. Participants had surgery (either lumpectomy or mastectomy) and required axillary radiotherapy (any or all levels [1–4]). The analysis compared 40 Gy and 5 Fr (3 weeks, control) to 26 Gy and 5 Fr (1 week). The primary endpoint was 5-year patient-reported moderate or marked arm or hand swelling. The median age was 61 years.&lt;/p&gt;&lt;p&gt;In the group, 54% and 39% of the patients had grade 2 and 3 tumors, respectively, and 56% of the patients had axillary dissection. Patients were randomized to either the 3-week control group (&lt;i&gt;n&lt;/i&gt; = 182) or the 1-week treatment group (&lt;i&gt;n&lt;/i&gt; = 183). A third arm (27 Gy and 5 Fr) that enrolled 104 patients was stopped early because increased toxicity was detected.&lt;/p&gt;&lt;p&gt;Participants completed questionnaires at the baseline and 3, 6, 12, 24, and 60 months after randomization. These included the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life tool, a breast cancer module, a body image scale, and fatigue questionnaires. In addition, patients were asked protocol-specific questions about the adverse effects of radiotherapy and were clinically assessed.&lt;/p&gt;&lt;p&gt;The primary endpoint was 5-year patient-reported moderate or marked arm or hand swelling reported via the EORTC Quality of Life questionnaire. Secondary endpoints included patient- and clinician-reported outcomes for late radiotherapy adverse effects. A composite endpoint consisted of the worst grade for problems and other adverse effects such as breast distortion, shrinkage, induration, and lymphedema.&lt;/p&gt;&lt;p&gt;The 5-year questionnaires were returned by 307 patients, with 300 including data on the primary endpoint. Clinicians provided 5-year assessments for 376 patients. At 5 years, moderate or marked hand or arm swelling was reported by 11 of 107 patients (10%) in the 3-week radiotherapy group ","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"466-468"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145449814","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":"Frailty in patients undergoing cancer treatment linked to significantly more adverse outcomes","authors":"Carrie Printz","doi":"10.3322/caac.70038","DOIUrl":"https://doi.org/10.3322/caac.70038","url":null,"abstract":"<p>Researchers have long known that frailty is associated with worse cancer outcomes. Half of older adults with cancer as well as some young patients with cancer have frailty, which is defined as a loss of biological reserves that makes people more vulnerable to physical stressors. Previous research has shown that frailty often is associated with increased risks of toxicity and death related to cancer treatment.</p><p>Clinicians need effective screening tools to determine which patients with cancer are at risk for frailty and poor outcomes. This information can help them to determine the best protocol for each patient.</p><p>Although several frailty screening tools exist, the Geriatric 8 (G8) geriatric screening tool is the only one that has been evaluated and undergone systematic reviews for its prognostic ability. The G8 assesses eight areas: age, food intake, mobility, weight loss, body mass index, number of prescription drug medications, neuropsychological condition, and self-reported health.</p><p>In a study published in the <i>Journal of the National Cancer Institute</i> (doi:10.1093/jnci/djaf017), researchers conducted a meta-analysis of 58 studies that synthesizes and summarizes current evidence on the association between frailty assessment tools and cancer treatment outcomes in adults with cancer.</p><p>“I think the findings synthesize a lot of what we already know,” says Mina Sedrak, MD, an associate professor and director of the Cancer and Aging Program at the David Geffen School of Medicine of the University of California, Los Angeles. “Ultimately, these tools are just as important as the biomarkers we use to test for tumor biology in determining treatment.”</p><p>Screening tools such as the G8 can identify some of the subtle changes that cannot be seen with eye tests to identify patients who require more in-depth frailty assessment, he adds.</p><p>Researchers searched five databases from inception to January 2023 to identify 58 prognostic-factor studies for this meta-analysis. These studies reported on the associations between validated pre-treatment frailty assessments and outcomes in adults with solid-organ cancers who were undergoing treatment. Outcomes included survival, toxicity, treatment tolerance, functional decline/quality of life, and hospitalization.</p><p>The research occurred for a range of tumor sites and mainly in older patients and in advanced and/or palliative disease settings. Nine frailty assessment tools were evaluated. The meta-analysis showed the prognostic value of two screening tools: the G8 and the Vulnerable Elders Survey 13 (VES-13). The latter helps to identify seniors who are at greater risk of functional decline or death during the next 2 years. Its score is based on age, self-reported health, and physical and functional ability limitations. Both tools are simple and quick to administer.</p><p>Pooled estimates show that frailty is associated with an increased risk of mortality (hazard ratio, 1.68; 95% co","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"463-465"},"PeriodicalIF":232.4,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145449849","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":"CA turns 75: Looking at the future but never forgetting the roots","authors":"Don S. Dizon MD,&nbsp;Sumanta Kumar Pal MD,&nbsp;Banu E. Symington MD, MACP,&nbsp;Razelle Kurzrock MD,&nbsp;Arif H. Kamal MD,&nbsp;Christina M. Annunziata MD, PhD,&nbsp;Shanthi Sivendran MD, MSCR, MBA,&nbsp;Ahmedin Jemal DVM, MPH,&nbsp;William L. Dahut MD","doi":"10.3322/caac.70040","DOIUrl":"10.3322/caac.70040","url":null,"abstract":"&lt;p&gt;&lt;i&gt;CA: A Cancer Journal for Clinicians&lt;/i&gt; (&lt;i&gt;CA&lt;/i&gt;) began in 1950 as &lt;i&gt;CA: A Bulletin of Cancer Progress&lt;/i&gt; (Figure 1) and, in 2025, celebrates its 75th year in continuous publication. Today, it is the flagship journal of the American Cancer Society (ACS) and is associated with the highest impact factor of any medical or scientific journal, inside and outside of oncology—a testament to its value, not only to professionals in this space but to the wider public at large. The core reason for its domestic and global reach is &lt;i&gt;cancer statistics&lt;/i&gt;, a continuous and evolving effort to describe the incidence and mortality of cancers and how changes in exposures, diagnosis, and treatment affect them. We would be remiss if not acknowledging the 14 years of significant contributions made to the intellectual rigor and refined analyses of these reports, assembled under the guidance of Dr Ahmedin Jemal, Senior Vice President of the Surveillance and Health Equity Science Department.&lt;/p&gt;&lt;p&gt;Beyond cancer statistics, &lt;i&gt;CA&lt;/i&gt; fulfills a major role: the dissemination of information about cancer across its continuum. It has provided our peers and the public contemporary and updated, expert, open-access reviews, at no cost, actively demonstrating a core value of the ACS on the widespread dissemination of cancer practice, research, and education. Reflecting the collaboration of the editorial team and authors, these reviews serve as a resource for everyone and do not require specialization in oncology to comprehend them.&lt;/p&gt;&lt;p&gt;As &lt;i&gt;CA&lt;/i&gt; celebrated its 60th year, the editorial team led by Dr Ted Gansler reflected on seminal publications during its first decade, from the Papanicolaou smear for the early detection of cervical cancer to prognostic disclosure in clinician–patient communication.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; It seems fitting then that, as members of the editorial board, we offer our own perspective as we highlight significant publications since that first decade. Finally, we collectively reflect on our mission as we move into the future.&lt;/p&gt;&lt;p&gt;Colorectal cancer (CRC) is the fourth most common diagnosed cancer and the second leading cause of cancer death in the United States, effecting over 150,000 people and accounting for over 50,000 deaths.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In 2017, Siegel et al. reported increased CRC incidence rates in both men and women younger than 55 years, whereas rates continued to decline in aged 55 years or older.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Consequently, the proportion of CRC being diagnosed in people younger than 55 years rose from 11% of all cases in 1995 to 20% in 2019.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The increase in young-onset CRC is a global phenomenon, with rates rising in parts of Europe, South America, Oceania, and Asia as well as in Canada.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; Work is underway to understand the biologic and systemic factors that account for early onset CRC and ways to improve early detection and treatment.&lt;/p&gt;&lt;p&gt;A testa","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"469-472"},"PeriodicalIF":232.4,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428275","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":"The contemporary management of prostate cancer.","authors":"Deep Chakrabarti, Peter Albertsen, Aidan Adkins, Amar Kishan, Vedang Murthy, Chris Parker, Angela Pathmanathan, Alison Reid, Oliver Sartor, Nicholas Van As, Jochen Walz, Alison Tree","doi":"10.3322/caac.70020","DOIUrl":"10.3322/caac.70020","url":null,"abstract":"<p><p>Prostate cancer is the most common cancer in two thirds of the world, with an expected doubling in both incidence and mortality in the next two decades. No strong environmental associations exist for the development of prostate cancer; therefore, lifestyle measures are unlikely to mitigate this increasing burden. The last three decades have seen rapid developments in the diagnostic and therapeutic landscape of prostate cancer, including multiparametric magnetic resonance imaging, positron emission tomography, robotic surgery, image-guided hypofractionated and stereotactic radiotherapy, novel anti-androgens and radioligand therapies. Prostate cancer is unique in that not everyone with a diagnosis needs treatment, and active surveillance is the preferred option for some. This review discusses the contemporary management of all stages of prostate cancer in the light of these modern developments, enabling holistic individualization of treatment, and describes the promise of future research to further improve outcomes.</p>","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":" ","pages":"552-586"},"PeriodicalIF":232.4,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504317","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":"Learning from prostate cancer statistics","authors":"Ruth Etzioni PhD,&nbsp;Lukas Owens BA","doi":"10.3322/caac.70037","DOIUrl":"10.3322/caac.70037","url":null,"abstract":"&lt;p&gt;The population represents the ultimate uncontrolled experiment, yet data on cancer statistics provide an opportunity to learn about real-world outcomes of cancer control activities and policies. In the case of prostate cancer, population data have been critically important in generating and confirming hypotheses about the impacts of screening and treatment advances on the population burden of the disease. Tracking prostate cancer statistics—incidence, mortality, and survival—and how they change over time is thus a prerequisite for understanding the success (or lack thereof) of efforts to control this most common cancer in American men. But population statistics are multifactorial; explaining them requires also considering their many potential drivers and the mechanisms by which disease control efforts play out in the population.&lt;/p&gt;&lt;p&gt;Consider the example of prostate cancer incidence, prominently reported in this issue’s update on prostate cancer statistics.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Prostate cancer incidence is influenced by prostate-specific antigen (PSA) screening rates in the population. Incidence increased dramatically during the early years of the PSA screening era, prompting concerns that screening was leading to overdiagnosis. Although overdiagnosis did indeed turn out to be a problematic outcome of screening, work by Feuer and Wun&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; in the early 1990s assured that increases in disease incidence were to be expected when a new screening test was adopted at the population level. The mechanism—initial depletion of the prevalent pool of cases by the screening test—leads to a predicted peak in incidence followed by declines because of the absence in the prevalent pool of those previously detected cases. Feuer and Wun demonstrated that the height and duration of the peak would be driven by the lead time, which is the time by which screening advances disease diagnosis. The lead time is critical not only in the timing of incidence swings after the adoption of screening but also in the delay until any effects of screening on disease mortality are observed. And the average lead time associated with prostate cancer screening is not short—estimates based on the first decade of PSA screening place the mean lead time between 5 and 7 years.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The update of prostate cancer statistics in this issue of &lt;i&gt;CA: A Cancer Journal for Clinicians&lt;/i&gt; highlights more recent incidence trends, specifically the persistence of recent increases overall and in advanced-stage disease. These trends have generated concern because they are what one would expect in a population abandoning screening. Indeed, studies tracking both incidence and screening patterns have been on the alert for such trends, particularly after the issuance of the D recommendation against routine prostate cancer screening for all ages by the US Preventive Services Task Force in 2012.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Although some modest reductions in pro","PeriodicalId":137,"journal":{"name":"CA: A Cancer Journal for Clinicians","volume":"75 6","pages":"473-474"},"PeriodicalIF":232.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183267","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}