JNCI Cancer Spectrum最新文献

{"title":"Association of breast cancer with quantitative mammographic density measures for women receiving contrast-enhanced mammography.","authors":"Gordon P. Watt, Krishna N Keshavamurthy, T. Nguyen, M. Lobbes, M. Jochelson, Janice S. Sung, C. Moskowitz, Prusha Patel, Xiaolin Liang, Meghan Woods, John L. Hopper, M. C. Pike, J. Bernstein","doi":"10.1093/jncics/pkae026","DOIUrl":"https://doi.org/10.1093/jncics/pkae026","url":null,"abstract":"Women with high mammographic density (MD) have an increased risk of breast cancer. They may be offered contrast-enhanced mammogram (CEM) to improve breast cancer screening performance. Using a cohort of women receiving CEM, we evaluated whether conventional and modified MD measures were associated with breast cancer. Sixty-six cases with newly diagnosed unilateral breast cancer were frequency-matched on age to 133 cancer-free controls. On low-energy cranio-caudal CEMs (equivalent to standard mammogram), we measured quantitative MD using CUMULUS software at the conventional intensity threshold (\"Cumulus\") and higher-than-conventional thresholds (\"Altocumulus\", \"Cirrocumulus\"). The measures were standardized to enable estimation of odds per age- and adiposity-adjusted standard deviation (OPERA). In multivariable logistic regression of case-control status, only the highest-intensity measure, Cirrocumulus, was statistically significantly associated with breast cancer (OPERA = 1.40, 95% CI 1.04-1.89). Conventional Cumulus did not contribute to model fit. For women receiving CEM, Cirrocumulus MD might better predict breast cancer than conventional quantitative MD.","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial differences in postpandemic trends in prostate-specific antigen screening.","authors":"Zhiyu Qian, Jameshisa Alexander, Danesha Daniels, Firas Abdollah, Alexander P Cole, Hari S Iyer, Quoc-Dien Trinh","doi":"10.1093/jncics/pkae016","DOIUrl":"10.1093/jncics/pkae016","url":null,"abstract":"<p><p>Our study investigates the trends in prostate cancer screening amid the COVID-19 pandemic, particularly focusing on racial disparities between Black and White men. Utilizing data from the Behavioral Risk Factor Surveillance System from 2018, 2020, and 2022, we analyzed prostate-specific antigen screening rates in men aged 45-75 years. Our findings reveal initial declines in screening rates for both groups during the pandemic, with subsequent recovery; however, the pace of rebound differed statistically significantly between races. Whereas White men showed a notable increase in screening rates postpandemic, Black men's rates recovered more slowly. This disparity underscores the impact of socioeconomic factors, health-care access, and possibly systemic biases affecting health-care delivery. Our study highlights the need for targeted interventions to address these inequalities and ensure equitable access to prostate cancer preventive care in the aftermath of COVID-19.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of an oncology urgent care center on health-care utilization.","authors":"Christopher D'Avella, Peter Whooley, Emily Milano, Brian Egleston, James Helstrom, Kenneth Patrick, Martin Edelman, Jessica Bauman","doi":"10.1093/jncics/pkae009","DOIUrl":"10.1093/jncics/pkae009","url":null,"abstract":"<p><strong>Introduction: </strong>Studies suggest that many emergency department (ED) visits and hospitalizations for patients with cancer may be preventable. The Centers for Medicare & Medicaid Services has implemented changes to the hospital outpatient reporting program that targets acute care in-treatment patients for preventable conditions. Oncology urgent care centers aim to streamline patient care. Our cancer center developed an urgent care center called the direct referral unit in 2011.</p><p><strong>Methods: </strong>We abstracted visits to our adjacent hospital ED and direct referral unit from January 2014 to June 2018. Patient demographics, cancer and visit diagnoses, visit charges, and 30-day therapy utilization were assessed.</p><p><strong>Results: </strong>An analysis of 13 114 visits demonstrated that increased direct referral unit utilization was associated with decreased monthly ED visits (P < .001). Common direct referral unit visit diagnoses were dehydration, nausea and vomiting, abdominal pain, and fever. Patients receiving active cancer treatment more frequently presented to the direct referral unit (P < .001). The average charges were $2221 for the direct referral unit and $10 261 for the ED.</p><p><strong>Conclusion: </strong>The association of decreased ED visits with increased direct referral unit utilization demonstrates the potential for urgent care centers to reduce acute care visits. Many patients presented to our direct referral unit with preventable conditions, and these visits were associated with considerable cost savings, supporting its use as a cost-effective method to reduce acute care costs.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10946649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A \"call to bear the burden of a long twilight struggle\": a special issue on social determinants of health assessment and intervention.","authors":"Matthew F Hudson","doi":"10.1093/jncics/pkae028","DOIUrl":"10.1093/jncics/pkae028","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11042872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical financial hardship between young adult cancer survivors and matched individuals without cancer in the United States.","authors":"Lihua Li, Donglan Zhang, Yan Li, Mayuri Jain, Xingyu Lin, Rebecca Hu, Junxiu Liu, Janani Thapa, Lan Mu, Zhuo Chen, Bian Liu, José A Pagán","doi":"10.1093/jncics/pkae007","DOIUrl":"10.1093/jncics/pkae007","url":null,"abstract":"<p><strong>Background: </strong>Young adult cancer survivors face medical financial hardships that may lead to delaying or forgoing medical care. This study describes the medical financial difficulties young adult cancer survivors in the United States experience in the post-Patient Protection and Affordable Care Act period.</p><p><strong>Method: </strong>We identified 1009 cancer survivors aged 18 to 39 years from the National Health Interview Survey (2015-2022) and matched 963 (95%) cancer survivors to 2733 control individuals using nearest-neighbor matching. We used conditional logistic regression to examine the association between cancer history and medical financial hardship and to assess whether this association varied by age, sex, race and ethnicity, and region of residence.</p><p><strong>Results: </strong>Compared with those who did not have a history of cancer, young adult cancer survivors were more likely to report material financial hardship (22.8% vs 15.2%; odds ratio = 1.65, 95% confidence interval = 1.50 to 1.81) and behavior-related financial hardship (34.3% vs 24.4%; odds ratio = 1.62, 95% confidence interval = 1.49 to 1.76) but not psychological financial hardship (52.6% vs 50.9%; odds ratio = 1.07, 95% confidence interval = 0.99 to 1.16). Young adult cancer survivors who were Hispanic or lived in the Midwest and South were more likely to report psychological financial hardship than their counterparts.</p><p><strong>Conclusions: </strong>We found that young adult cancer survivors were more likely to experience material and behavior-related financial hardship than young adults without a history of cancer. We also identified specific subgroups of young adult cancer survivors that may benefit from targeted policies and interventions to alleviate medical financial hardship.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139746629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of cognitive decline in older breast cancer survivors: the Thinking and Living with Cancer study.","authors":"Arthur Patrick McDeed, Kathleen Van Dyk, Xingtao Zhou, Wanting Zhai, Tim A Ahles, Traci N Bethea, Judith E Carroll, Harvey Jay Cohen, Zev M Nakamura, Kelly E Rentscher, Andrew J Saykin, Brent J Small, James C Root, Heather Jim, Sunita K Patel, Brenna C Mcdonald, Jeanne S Mandelblatt, Jaeil Ahn","doi":"10.1093/jncics/pkae019","DOIUrl":"10.1093/jncics/pkae019","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer survivors commonly report cognitive declines after cancer therapy. Due to the complex etiology of cancer-related cognitive decline (CRCD), predicting who will be at risk of CRCD remains a clinical challenge. We developed a model to predict breast cancer survivors who would experience CRCD after systematic treatment.</p><p><strong>Methods: </strong>We used the Thinking and Living with Cancer study, a large ongoing multisite prospective study of older breast cancer survivors with complete assessments pre-systemic therapy, 12 months and 24 months after initiation of systemic therapy. Cognition was measured using neuropsychological testing of attention, processing speed, and executive function (APE). CRCD was defined as a 0.25 SD (of observed changes from baseline to 12 months in matched controls) decline or greater in APE score from baseline to 12 months (transient) or persistent as a decline 0.25 SD or greater sustained to 24 months. We used machine learning approaches to predict CRCD using baseline demographics, tumor characteristics and treatment, genotypes, comorbidity, and self-reported physical, psychosocial, and cognitive function.</p><p><strong>Results: </strong>Thirty-two percent of survivors had transient cognitive decline, and 41% of these women experienced persistent decline. Prediction of CRCD was good: yielding an area under the curve of 0.75 and 0.79 for transient and persistent decline, respectively. Variables most informative in predicting CRCD included apolipoprotein E4 positivity, tumor HER2 positivity, obesity, cardiovascular comorbidities, more prescription medications, and higher baseline APE score.</p><p><strong>Conclusions: </strong>Our proof-of-concept tool demonstrates our prediction models are potentially useful to predict risk of CRCD. Future research is needed to validate this approach for predicting CRCD in routine practice settings.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11031271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using clinical and genetic risk factors for risk prediction of 8 cancers in the UK Biobank.","authors":"Jiaqi Hu, Yixuan Ye, Geyu Zhou, Hongyu Zhao","doi":"10.1093/jncics/pkae008","DOIUrl":"10.1093/jncics/pkae008","url":null,"abstract":"<p><strong>Background: </strong>Models with polygenic risk scores and clinical factors to predict risk of different cancers have been developed, but these models have been limited by the polygenic risk score-derivation methods and the incomplete selection of clinical variables.</p><p><strong>Methods: </strong>We used UK Biobank to train the best polygenic risk scores for 8 cancers (bladder, breast, colorectal, kidney, lung, ovarian, pancreatic, and prostate cancers) and select relevant clinical variables from 733 baseline traits through extreme gradient boosting (XGBoost). Combining polygenic risk scores and clinical variables, we developed Cox proportional hazards models for risk prediction in these cancers.</p><p><strong>Results: </strong>Our models achieved high prediction accuracy for 8 cancers, with areas under the curve ranging from 0.618 (95% confidence interval = 0.581 to 0.655) for ovarian cancer to 0.831 (95% confidence interval = 0.817 to 0.845) for lung cancer. Additionally, our models could identify individuals at a high risk for developing cancer. For example, the risk of breast cancer for individuals in the top 5% score quantile was nearly 13 times greater than for individuals in the lowest 10%. Furthermore, we observed a higher proportion of individuals with high polygenic risk scores in the early-onset group but a higher proportion of individuals at high clinical risk in the late-onset group.</p><p><strong>Conclusion: </strong>Our models demonstrated the potential to predict cancer risk and identify high-risk individuals with great generalizability to different cancers. Our findings suggested that the polygenic risk score model is more predictive for the cancer risk of early-onset patients than for late-onset patients, while the clinical risk model is more predictive for late-onset patients. Meanwhile, combining polygenic risk scores and clinical risk factors has overall better predictive performance than using polygenic risk scores or clinical risk factors alone.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10919929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139746627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel insights on multilevel factors that affect the dynamic course of financial toxicity in cancer patients.","authors":"Grace L Smith","doi":"10.1093/jncics/pkae020","DOIUrl":"https://doi.org/10.1093/jncics/pkae020","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of sleep disturbances in long-term cancer survivors: a childhood cancer survivor study report.","authors":"Lauren C Daniel, Huiqi Wang, Tara M Brinkman, Kathy Ruble, Eric S Zhou, Oxana Palesh, Robyn Stremler, Rebecca Howell, Daniel A Mulrooney, Valerie M Crabtree, Sogol Mostoufi-Moab, Kevin Oeffinger, Joseph Neglia, Yutaka Yasui, Gregory T Armstrong, Kevin Krull","doi":"10.1093/jncics/pkae010","DOIUrl":"10.1093/jncics/pkae010","url":null,"abstract":"<p><strong>Background: </strong>Sleep problems following childhood cancer treatment may persist into adulthood, exacerbating cancer-related late effects and putting survivors at risk for poor physical and psychosocial functioning. This study examines sleep in long-term survivors and their siblings to identify risk factors and disease correlates.</p><p><strong>Methods: </strong>Childhood cancer survivors (≥5 years from diagnosis; n = 12 340; 51.5% female; mean [SD] age = 39.4 [9.6] years) and siblings (n = 2395; 57.1% female; age = 44.6 [10.5] years) participating in the Childhood Cancer Survivor Study completed the Pittsburgh Sleep Quality Index (PSQI). Multivariable Poisson-error generalized estimating equation compared prevalence of binary sleep outcomes between survivors and siblings and evaluated cancer history and chronic health conditions (CHC) for associations with sleep outcomes, adjusting for age (at diagnosis and current), sex, race/ethnicity, and body mass index.</p><p><strong>Results: </strong>Survivors were more likely to report clinically elevated composite PSQI scores (>5; 45.1% vs 40.0%, adjusted prevalence ratio [PR] = 1.20, 95% CI = 1.13 to 1.27), symptoms of insomnia (38.8% vs 32.0%, PR = 1.26, 95% CI = 1.18 to 1.35), snoring (18.0% vs 17.4%, PR = 1.11, 95% CI = 1.01 to 1.23), and sleep medication use (13.2% vs 11.5%, PR = 1.28, 95% CI = 1.12 to 1.45) compared with siblings. Within cancer survivors, PSQI scores were similar across diagnoses. Anthracycline exposure (PR = 1.13, 95% CI = 1.03 to 1.25), abdominal radiation (PR = 1.16, 95% CI = 1.04 to 1.29), and increasing CHC burden were associated with elevated PSQI scores (PRs = 1.21-1.48).</p><p><strong>Conclusions: </strong>Among survivors, sleep problems were more closely related to CHC than diagnosis or treatment history, although longitudinal research is needed to determine the direction of this association. Frequent sleep-promoting medication use suggests interest in managing sleep problems; behavioral sleep intervention is advised for long-term management.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10932943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139746628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet quality and cardiovascular disease risk among breast cancer survivors in the Pathways Study.","authors":"Isaac J Ergas, Richard K Cheng, Janise M Roh, Lawrence H Kushi, Jacob K Kresovich, Carlos Iribarren, Mai Nguyen-Huynh, Jamal S Rana, Eileen Rillamas-Sun, Cecile A Laurent, Valerie S Lee, Charles P Quesenberry, Heather Greenlee, Marilyn L Kwan","doi":"10.1093/jncics/pkae013","DOIUrl":"https://doi.org/10.1093/jncics/pkae013","url":null,"abstract":"<p><strong>Background: </strong>Women with breast cancer are at higher risk of cardiovascular disease (CVD) compared with women without breast cancer. Whether higher diet quality at breast cancer diagnosis lowers this risk remains unknown. We set out to determine if higher diet quality at breast cancer diagnosis was related to lower risk of CVD and CVD-related death.</p><p><strong>Methods: </strong>This analysis included 3415 participants from the Pathway Study, a prospective cohort of women diagnosed with invasive breast cancer at Kaiser Permanente Northern California between 2005 and 2013 and followed through December 31, 2021. Scores from 5 diet quality indices consistent with healthy eating were obtained at the time of breast cancer diagnosis. Scores were categorized into ascending quartiles of concordance for each diet quality index, and multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. P values were 2-sided.</p><p><strong>Results: </strong>The Dietary Approaches to Stop Hypertension diet quality index was associated with lower risk of heart failure (HR = 0.53, 95% CI = 0.33 to 0.87; Ptrend = .03), arrhythmia (HR = 0.77, 95% CI = 0.62 to 0.94; Ptrend = .008), cardiac arrest (HR = 0.77, 95% CI = 0.61 to 0.96; Ptrend = .02), valvular heart disease (HR = 0.79, 95% CI = 0.64 to 0.98; Ptrend = .046), venous thromboembolic disease (HR = 0.75, 95% CI = 0.60 to 0.93; Ptrend = .01), and CVD-related death (HR = 0.70, 95% CI = 0.50 to 0.99; Ptrend = .04), when comparing the highest with lowest quartiles. Inverse associations were also found between the healthy plant-based dietary index and heart failure (HR = 0.60, 95% CI = 0.39 to 0.94; Ptrend = .02), as well as the alternate Mediterranean dietary index and arrhythmia (HR = 0.74, 95% CI = 0.60 to 0.93; Ptrend = .02).</p><p><strong>Conclusion: </strong>Among newly diagnosed breast cancer patients, higher diet quality at diagnosis was associated with lower risk of CVD events and death.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11021810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}