JNCI Cancer Spectrum最新文献

{"title":"Revisiting surrogacy of pathological complete response for long-term survival in triple-negative breast cancer.","authors":"Toru Yoshino, Zao Zhang, Ryota Sato, Stanley Lipkowitz, Takeo Fujii","doi":"10.1093/jncics/pkaf022","DOIUrl":"10.1093/jncics/pkaf022","url":null,"abstract":"<p><strong>Background: </strong>Pathological complete response has been used as a primary endpoint in neoadjuvant trials in early stage triple-negative breast cancer, and the Food and Drug Administration accepted pathological complete response as a surrogate endpoint for long-term survival outcomes in high-risk early stage breast cancer for new drug approval. However, there is insufficient trial-level data to robustly support pathological complete response as a surrogate for long-term survival in triple-negative breast cancer.</p><p><strong>Methods: </strong>A systematic literature review was performed to identify randomized clinical trials of neoadjuvant systemic therapy for patients with clinical stage I-III triple-negative breast cancer. Data of odds ratios (ORs) for pathological complete response and hazard ratios (HRs) for event-free survival and overall survival were extracted. Disease-free survival was used as an alternative when event-free survival data were unavailable. A linear regression model on a logarithmic scale, coefficient of difference, and 95% confidential interval (CI) were calculated to assess the trial-level association between odds ratio for pathological complete response and hazard ratio for overall survival and event-free survival.</p><p><strong>Results: </strong>Eight trials with 2342 patients were included. Three trials tested immune checkpoint inhibitors. Coefficient of difference (R2) was 0.2 for hazard ratio of event-free survival (95% CI = 0.17 to 0.22, P = .27), and R2 for hazard ratio of overall survival was 0.19 (95% CI = 0.17 to 0.22, P = .33).</p><p><strong>Conclusions: </strong>There is no strong evidence to support using pathological complete response as a surrogate marker for event-free survival or overall survival in early stage triple-negative breast cancer at the trial level. Because of the necessity of minimizing drug approval delay with reliable long-term outcome, further studies of surrogate markers in early stage triple-negative breast cancer are warranted.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483006","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":"Prostate cancer screening in the Middle East and North Africa: a cross-sectional study on current practices.","authors":"Ozlem Aynaci, Yetkin Tuac, Layth Mula-Hussain, Lubna Hammoudeh, Salameh Obeidat, Enas Abu Abeelh, Ahmed H Ibrahim, Sepideh Mohammadipour, Bader Alali, Ahmed Jdaini, Ali Barki, Nesrine Mejri, Zeinab Alhaddad, Nadeem Pervez, Hussain Al Hussain, Mohamad Kadri, Mohamed A Elfagieh, Adda Bounedjar, Moamin Junaid, Ahmed M Badheeb, Ibrahim Abu Ghida, Shalini Moningi, Jonathan E Leeman, Peter F Orio, Paul L Nguyen, Anthony V D'Amico, Mutlay Sayan","doi":"10.1093/jncics/pkaf019","DOIUrl":"10.1093/jncics/pkaf019","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is a substantial health concern in the Middle East and North Africa region, with many cases diagnosed at advanced stages, a high mortality to incidence ratio, and low prostate cancer awareness. This study aimed to evaluate prostate cancer screening practices in the region to inform effective early detection and management strategies.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from July 1, 2023, to November 8, 2024, among physicians from 19 countries in the Middle East and North Africa region. The study used a validated questionnaire to assess prostate cancer screening practices, barriers, and educational needs.</p><p><strong>Results: </strong>The survey had a response rate of 96.8% and 1163 participants. Of these participants, 34.7% routinely performed prostate cancer screenings, with 61.1% using prostate-specific antigen tests. The primary barrier was lack of patient awareness (51.2%). In addition, 65.3% of participants had no formal training. To improve screening rates, participants suggested better patient education (63.5%), increased training for health-care professionals (41.9%), and improved access to screening equipment (38.9%).</p><p><strong>Conclusion: </strong>This study revealed that prostate cancer screening rates were low, with barriers including a lack of patient awareness and formal training among physicians. Addressing these issues through culturally tailored education programs may improve early detection rates and ultimately reduce the burden of prostate cancer in the Middle East and North Africa region.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373974","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":"Forward momentum: progressive change through diversity equity and inclusion initiatives in academic health care.","authors":"Chaitanya Kalavagunta, Bansi Savla, Jessica White, Dominic Bulkley, Anna Dunlap, Renee Kwok, Kennecia Shaw, Michael MacFarlane, Sara Dudley, David Alicia, Kimberly Marter, Rivka Leichter, Cameron Chason, Søren M Bentzen, William Regine, Melissa Vyfhuis","doi":"10.1093/jncics/pkaf029","DOIUrl":"10.1093/jncics/pkaf029","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the impact of a 2-year Diversity, Equity, and Inclusion (DEI) intervention program within a radiation oncology department. We analyzed employee perceptions of inclusivity, bias, training, and career development, recognizing the challenges of assessing DEI initiatives in an evolving sociopolitical context.</p><p><strong>Methods: </strong>A voluntary survey was distributed in 2021 and 2023. The survey assessed 4 DEI domains: Inclusivity, Department Bias, Training/Education, and Career Development. Responses were analyzed using nonparametric tests. DEI initiatives included implicit bias training, allyship training, book clubs, anonymous feedback platforms, and a DEI website.</p><p><strong>Results: </strong>Survey completion rates were 40% (2021) and 50% (2023). Significant improvements were observed in Inclusivity (3.72 vs 3.91, P = .042), Training/Education (3.57 vs 4.14, P < .001), and Career Development (3.39 vs 3.60, P = .019). Department Bias showed no significant change (P = .130). Anti-DEI sentiment increased in 2023, highlighting challenges in fostering inclusivity. Subgroup analyses revealed improvements for Black employees but persistent disparities for women.</p><p><strong>Conclusions: </strong>This exploratory study suggests that targeted DEI initiatives can improve employee perceptions of workplace culture in academic health-care settings. Notably, the program improved perceptions of inclusivity, training opportunities, and career development. However, persistent gender inequities in training and career development highlight the need for monitoring and focused efforts. These findings can inform future DEI strategies and underscore the importance of continued vigilance in promoting an inclusive work environment. Future research should explore the program's downstream effects on patient care, clinical trial enrollment, and residency enrollment.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11976714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634018","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":"Antibiotic treatment and survival in patients with resected, early-stage pancreatic ductal adenocarcinoma receiving chemotherapy.","authors":"Emma Gong, Daniel J Fulop, Joyce Serebrenik, Arielle J Labiner, Deirdre J Cohen, Keith M Sigel, Aimee L Lucas","doi":"10.1093/jncics/pkaf024","DOIUrl":"10.1093/jncics/pkaf024","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic ductal adenocarcinoma is a clinically challenging malignancy largely because of its chemoresistance. Bacteria within the pancreatic ductal adenocarcinoma microbiome may mediate chemoresistance, suggesting that alteration of the microbiome with antibiotics could improve chemotherapy response.</p><p><strong>Methods: </strong>We utilized the Surveillance, Epidemiology, and End Results Program-Medicare database to select patients with resected, early-stage pancreatic ductal adenocarcinoma diagnosed between 2007 and 2017. The primary outcome of this study was overall survival. Receipt of antibiotic treatment within 1 month after adjuvant chemotherapy initiation was determined from Medicare claims data. Propensity scores were used to match patients who received antibiotics with patients who did not receive antibiotics. The Kaplan-Meier method was used to calculate 5-year overall survival rates, and Cox regression analysis was used to assess the association between receiving antibiotics and overall survival. All hypotheses were 2 sided.</p><p><strong>Results: </strong>Of the 712 patients with resected, early-stage pancreatic ductal adenocarcinoma, 629 (88.3%) were treated with adjuvant gemcitabine and 177 (24.9%) received antibiotics in the 1 month following chemotherapy initiation. The mean (SD) age at diagnosis was 73.7 (5.1) years, and patients were mostly women, White, and from metropolitan areas in the northeastern or western United States. A total of 143 propensity score-matched pairs were evaluated. Among patients treated with gemcitabine, antibiotic treatment was associated with a 37% improvement in overall survival and a 30% improvement in cancer-specific survival.</p><p><strong>Conclusions: </strong>Antibiotic treatment in the 1 month following adjuvant gemcitabine initiation was associated with improved survival. These findings provide additional support for the hypothesis that antibiotic treatment may alter the pancreatic microbiome in a manner that reduces chemoresistance, potentially improving pancreatic ductal adenocarcinoma outcomes.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468036","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":"Alcohol consumption, polygenic risk score, and the risk of colorectal neoplasia.","authors":"Ruojin Fu, Xuechen Chen, Teresa Seum, Michael Hoffmeister, Hermann Brenner","doi":"10.1093/jncics/pkaf017","DOIUrl":"10.1093/jncics/pkaf017","url":null,"abstract":"<p><strong>Background: </strong>Excess alcohol consumption is associated with increased risk of colorectal cancer, but the evidence on the individual and joint effects of alcohol consumption and genetic risk on the occurrence of various stages of colorectal carcinogenesis is limited.</p><p><strong>Methods: </strong>We evaluated the associations of alcohol consumption and a polygenic risk score based on 140 colorectal cancer related loci with findings of colorectal neoplasia among 4662 participants in the German screening colonoscopy program. Analyses were conducted by multiple logistic regression. We determined genetic risk equivalents to quantify the effect of alcohol consumption in terms of the difference in polygenic risk score conveying equivalent risk.</p><p><strong>Results: </strong>Moderate and high (12 to <25 g/d and ≥25 g/d) alcohol consumption was associated with increased risk of advanced colorectal neoplasia (adjusted odds ratio = 1.28, 95% CI = 1.03 to 1.58, and adjusted odds ratio = 1.44, 95% CI = 1.14 to 1.81, respectively), while associations with any colorectal neoplasia were weaker. No significant interactions between alcohol consumption and polygenic risk score were observed. Participants with high alcohol consumption in the highest polygenic risk score tertile had a 3.4-fold increased risk of advanced neoplasia compared with individuals with low or no alcohol consumption in the lowest polygenic risk score tertile. The estimated impact of high alcohol consumption on the risk of advanced neoplasia was equivalent to the risk increase by a 26-percentile-higher polygenic risk score (genetic risk equivalent = 26, 95% CI = 9 to 44).</p><p><strong>Conclusion: </strong>High alcohol consumption and polygenic risk score have a major impact on the risk of advanced colorectal neoplasia. The estimated preventive impact of avoiding high alcohol consumption is as strong as the impact of having a substantially lower polygenic risk.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080070","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":"Functional outcomes after primary vs delayed robot-assisted radical prostatectomy following active surveillance.","authors":"Christian Corsini, Pietro Scilipoti, Andri Wilberg Orrason, Rolf Gedeborg, Marcus Westerberg, Pär Stattin","doi":"10.1093/jncics/pkaf020","DOIUrl":"10.1093/jncics/pkaf020","url":null,"abstract":"<p><strong>Background: </strong>It is unknown if a period of active surveillance before prostatectomy for prostate cancer (PCa) worsens functional outcomes. The aim of this study was to compare functional outcomes after primary vs delayed robot-assisted radical prostatectomy.</p><p><strong>Methods: </strong>We included men registered in the National Prostate Cancer Register of Sweden with low and favorable intermediate-risk PCa who underwent robot-assisted prostatectomy in 2018-2020 and had filled a questionnaire on patient-reported outcome measures. Multivariable logistic regression analysis was used to compare the functional outcomes of primary and delayed prostatectomy.</p><p><strong>Results: </strong>2571 men underwent primary, and 921 men underwent delayed prostatectomy. Delayed prostatectomy was not associated with reduced overall quality of life (adjusted Odds Ratio [OR] 1.04; 95% confidence interval [CI] 0.71-1.55) or erectile dysfunction (adjusted OR 0.90, 95% CI 0.69-1.22). Urinary incontinence was slightly more common after delayed prostatectomy (15% vs 11%; adjusted OR 1.38, 95% CI 0.91-2.01). There were weak associations between time to prostatectomy and urinary symptoms and bother, with a 3% annual increase in the risk for urinary incontinence (adjusted OR 1.03; 95% CI 0.94-1.13).</p><p><strong>Conclusion: </strong>These results suggest that a period on active surveillance before robot-assisted radical prostatectomy has little detrimental effect on functional outcomes. Since only around half of men on active surveillance will transit to prostatectomy, these outcomes represent a worst-case scenario for men who start active surveillance. These results support the use of active surveillance for men with low-risk and favorable intermediate-risk PCa.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364876","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":"Utilizing proton therapy to reduce health-care disparities among patients with breast cancers.","authors":"Kristin Hsieh, Jehee Isabelle Choi, Anthony Nehlsen, Jana Fox, Richard Bakst, Julie Bloom, Irini Yacoub, Arpit M Chhabra, Audrey Saitta, Manjeet Chadha, Sheryl Green, Deborah Marshall, Charles B Simone","doi":"10.1093/jncics/pkaf003","DOIUrl":"10.1093/jncics/pkaf003","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":"9 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491894","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":"Cancer outcomes and cardiopulmonary toxicities for Black patients with breast cancer treated with proton therapy.","authors":"Gurbani Singh, Sravya Koduri, Manaahil Rao, Meira Kidorf, Sarah Ruff, Akshar Patel, Søren M Bentzen, Elizabeth Nichols, Sarah McAvoy, Melissa A L Vyfhuis","doi":"10.1093/jncics/pkae129","DOIUrl":"10.1093/jncics/pkae129","url":null,"abstract":"<p><strong>Background: </strong>Black women have a 40% higher breast cancer mortality rate than White women and are at a higher risk of acquiring cardiovascular disease. Proton therapy can be used to mitigate cardiac radiation exposure; however, proton therapy remains a scarce resource in the United States. We report on the cardiovascular profiles of patients undergoing proton therapy to determine the potential benefit of the therapy for Black women compared with patients of other races.</p><p><strong>Methods: </strong>We retrospectively analyzed 599 patients with breast cancer who received proton therapy from June 2016 to December 2021 at the Maryland Proton Treatment Center. A variety of sociodemographic, disease, and treatment variables were analyzed using descriptive statistics.</p><p><strong>Results: </strong>With a median follow-up of 26 months (range = 0.47-90 months), Black patients made up 31.6% of the population and presented with higher rates of hypertension (P < .001), cardiopulmonary conditions (P < .001), and a higher median body mass index (P = .015) compared with the other cohort, a trend that persisted at the time of post-proton therapy follow-up. Black women had higher rates of triple-negative disease (P < .001), with subsequent greater receipt of neoadjuvant chemotherapy (P = .039). Pulmonary events were 2.6 times more likely to occur in Black patients than in the non-Black cohort after proton therapy (odds ratio = 2.60, 95% CI = 1.39 to 4.88; P = .003).</p><p><strong>Conclusions: </strong>Black women presenting for proton therapy had higher baseline risks of cardiovascular co-morbidities combined with more aggressive breast cancer biology and a subsequent 2.6-fold increased risk of pulmonary events after proton therapy. Our findings support the use of advanced radiation techniques as a means of sparing important organs at risk, especially in historically marginalized populations.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894354","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":"Sex differences in melanoma survival-a GEM study.","authors":"Tharani Murali, Matthew Schwartz, Adam Z Reynolds, Li Luo, Grace Ridgeway, Klaus J Busam, Anne E Cust, Hoda Anton-Culver, Richard P Gallagher, Roberto Zanetti, Stefano Rosso, Lidia Sacchetto, Colin B Begg, Irene Orlow, Nancy E Thomas, Marianne Berwick","doi":"10.1093/jncics/pkaf005","DOIUrl":"10.1093/jncics/pkaf005","url":null,"abstract":"<p><p>Sex differences in melanoma are prominent, with female having a significant survival advantage. However, it is unclear why we see this survival advantage. Here, we investigate the relationship between sex, clinicopathologic variables, and melanoma specific survival in 1753 single primary melanomas from patients in the GEM (Genes, Environment, and Melanoma) study. Using Cox proportional hazard models and formal mediation analysis, the effect of sex on survival is explained largely by differences in the clinicopathologic features of tumors at diagnosis. Specifically, we find evidence that 86.5% of the effect of sex on melanoma survival is mediated by differences in age at diagnosis, Breslow thickness, ulceration, mitoses, and site (hazard ratio [HR] = 1.85, P < .001). This analysis indicates that the female survival advantage in melanoma is not primarily due to a direct effect of sex (HR = 1.19, P = .42) but is largely a result of an indirect effect of sex mediated by clinicopathologic features.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970890","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":"Abdominal visceral and subcutaneous adipose tissue associations with postmenopausal breast cancer incidence.","authors":"Jennifer W Bea, Heather M Ochs-Balcom, Celina I Valencia, Zhao Chen, Robert M Blew, Kimberly E Lind, Bette J Caan, Denise J Roe, Thomas E Rohan, Katherine W Reeves, JoAnn E Manson, Tarah Ballinger, Kerryn W Reding, Shawna Follis, Shelby G Ziller, Andrew O Odegaard","doi":"10.1093/jncics/pkaf007","DOIUrl":"10.1093/jncics/pkaf007","url":null,"abstract":"<p><strong>Background: </strong>Obesity, classified by body mass index (BMI), is associated with higher postmenopausal breast cancer (BCa) risk. Yet, the associations between abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) with BCa are unclear.</p><p><strong>Methods: </strong>We assessed BCa associations with abdominal VAT and SAT in a prospective cohort of postmenopausal women without a history of cancer and with 27 years follow-up (N = 9950), during which all new cancers were adjudicated. Dual-energy x-ray absorptiometry scans assessed adiposity at baseline, year 3, and year 6. Competing-risks multivariable sub-hazard ratios (SHR), with adjustments for sociodemographic, behavioral, reproductive, and anthropometric characteristics, were estimated for baseline and time-dependent associations between VAT, SAT, and incident BCa.</p><p><strong>Results: </strong>Participants averaged 63.3 ± 7.4 years of age and a BMI of 28.20 ± 5.72 kg/m2 at baseline. The models included 738 incident BCa case patients (N = 593 invasive; N = 145 in situ). Baseline VAT and SAT area were associated with statistically significantly increased BCa risk, by 36% and 19%, respectively. Increasing VAT/SAT ratio was associated with an 8% increase in incident BCa. Time-dependent models produced similar results. VAT and VAT/SAT associated BCa risk was highest for African American/Black women, although not statistically significantly different from other groups. Quartiles (Q) of VAT/SAT were also explored; the SHR for Q4 compared with Q1 was 1.49 (95% CI = 1.18 to 1.87).</p><p><strong>Conclusion: </strong>Higher abdominal VAT and SAT are associated with an increased risk of postmenopausal BCa, and VAT/SAT may provide a distinctive risk estimate. Potential racial and ethnic differences require replication in a larger sample (Women's Health Initiative; NCT00000611; https://clinicaltrials.gov/study/NCT00000611).</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028923","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}