JNCI Cancer Spectrum最新文献

{"title":"The need for a cancer exposome atlas: a scoping review.","authors":"Anna S Young, Catherine E Mullins, Neha Sehgal, Roel C H Vermeulen, P Martijn Kolijn, Jelle Vlaanderen, Mohammad L Rahman, Brenda M Birmann, Dinesh Barupal, Qing Lan, Nathaniel Rothman, Douglas I Walker","doi":"10.1093/jncics/pkae122","DOIUrl":"10.1093/jncics/pkae122","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in understanding genetic susceptibility to cancer, much of cancer heritability remains unidentified. At the same time, the makeup of industrial chemicals in our environment only grows more complex. This gap in knowledge on cancer risk has prompted calls to expand cancer research to the comprehensive, discovery-based study of nongenetic environmental influences, conceptualized as the \"exposome.\"</p><p><strong>Methods: </strong>Our scoping review aimed to describe the exposome and its application to cancer epidemiology and to study design limitations, challenges in analytical methods, and major unmet opportunities in advanced exposome profiling methods that allow the quantification of complex chemical exposure profiles in biological matrices. To evaluate progress on incorporating measurements of the exposome into cancer research, we performed a review of such \"cancer exposome\" studies published through August 2023.</p><p><strong>Results: </strong>We found that only 1 study leveraged untargeted chemical profiling of the exposome as a method to measure tens of thousands of environmental chemicals and identify prospective associations with future cancer risk. The other 13 studies used hypothesis-driven exposome approaches that targeted a set of preselected lifestyle, occupational, air quality, social determinant, or other external risk factors. Many of the included studies could only leverage sample sizes with less than 400 cancer cases (67% of nonecologic studies) and exposures experienced after diagnosis (29% of studies). Six cancer types were covered, most commonly blood (43%), lung (21%), or breast (14%) cancer.</p><p><strong>Conclusion: </strong>The exposome is underutilized in cancer research, despite its potential to unravel complex relationships between environmental exposures and cancer and to inform primary prevention.</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/PMC11729703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864107","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":"Indices of neighborhood disadvantage and individual cancer control behaviors among African American adults.","authors":"Bernard F Fuemmeler, Joseph Boyle, Carrie A Miller, Debarchana Ghosh, Cheryl L Knott","doi":"10.1093/jncics/pkaf015","DOIUrl":"10.1093/jncics/pkaf015","url":null,"abstract":"<p><strong>Background: </strong>Emerging literature notes the importance of neighborhood-level factors for cancer control behaviors beyond that of individual factors. Markers of neighborhood-level disadvantage have been linked to greater likelihood of nonsalutary cancer control behaviors. There has been less examination of many neighborhood factors simultaneously, which more accurately reflects individuals' daily experiences. We estimated associations of neighborhood deprivation indices with cancer control behaviors, identifying the relative importance of neighborhood-level deprivation index components for these outcomes.</p><p><strong>Methods: </strong>We used data from the Religion and Health in African Americans study, a national probability sample of African American adults. We separately considered 4 screening and 4 prevention behaviors as outcomes. We constructed neighborhood deprivation indices using census tract-level data and estimated their associations with outcomes using bayesian index models, adjusting for individual-level covariates. We reported odds ratios (ORs), credible intervals, and exceedance probabilities.</p><p><strong>Results: </strong>Participants in our sample engaged in relatively high levels of screening behaviors and lower levels of prevention behaviors. Neighborhood deprivation indices were statistically significantly associated with a greater likelihood of binge drinking (OR = 1.13, exceedance probability = 98.5%), smoking (OR = 1.07, exceedance probability = 99.4%), and insufficient colonoscopy (exceedance probability = 99.9%), Papanicolaou (exceedance probability = 99.7%), and prostate-specific antigen (exceedance probability = 99.1%) screening. Within neighborhood deprivation indices, median household income, percentage of individuals without some college education, and percentage of individuals unemployed received large estimated importance weights.</p><p><strong>Conclusion: </strong>We identified statistically significant associations between neighborhood disadvantage and nonsalutary cancer control behaviors as well as important neighborhood-level deprivation index components for each outcome. These and similar findings from future studies should be used to target specific neighborhood factors for specific cancer control behaviors rather than using a one-size-fits-all approach.</p>","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/PMC11879093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556907","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":"Improving real-world evaluation of patient- and physician-reported tolerability: niraparib for recurrent ovarian cancer (NiQoLe).","authors":"Florence Joly, Fernando Bazan, Delphine Garbay, Yaelle Ouldbey, Philippe Follana, Élise Champeaux-Orange, Eric Legouffe, Pierre-Emmanuel Brachet, Dominique Spaeth, Pierre Combe, Anne-Claire Hardy-Bessard, Frédéric Selle, Julien Grenier, Coriolan Lebreton, Olfa Derbel, Elise Bonnet, Pierre Fournel, Yolanda Fernandez Diez, Valérie Delecroix, Sheik Emambux, Jérôme Alexandre, Thomas Grellety, Dominique Mille, Hubert Orfeuvre, Catherine Favier, Delphine Le Roux, Marie-Ange Mouret-Reynier, Stanislas Quesada, Jean-Emmanuel Kurtz","doi":"10.1093/jncics/pkae114","DOIUrl":"10.1093/jncics/pkae114","url":null,"abstract":"<p><strong>Background: </strong>Maintenance niraparib at an individualized starting dose (ISD) is established in platinum-sensitive recurrent ovarian cancer (PSROC). However, patients' perspectives on the burden of prolonged maintenance therapy have not been reported in prospective trials or routine practice.</p><p><strong>Methods: </strong>In the real-life multicenter NiQoLe study, patients with PSROC received ISD maintenance niraparib. The primary objective was to describe physician-reported adverse events (AEs) leading to treatment modification during the first 3 months. Secondary endpoints included patient-reported outcomes (symptomatic AEs using PRO-CTCAE, self-reported fatigue, and impact on daily activities/function using FACT-F) collected remotely weekly using a specifically designed electronic device.</p><p><strong>Results: </strong>Most (80%) of 139 treated patients (median age = 70 years) began niraparib at 200 mg/day. Median treatment duration was 5.7 (range = 0.2-21.4) months. During the first 3 months, 86 patients (62%) required treatment modification (median = 27 days to modification). Physician-reported grade ≥3 niraparib-related AEs occurred in 34 patients (24%); 68 patients (49%) had treatment modification for AEs, predominantly thrombocytopenia. The most frequent patient-reported AEs (PRO-CTCAE) were fatigue, insomnia, constipation, and dry mouth. Self-reported AEs were severe in 66% of patients. At baseline, 33% of patients reported severe fatigue (FACT-F), which generally persisted during niraparib. Physicians systematically underestimated major patient-reported symptoms.</p><p><strong>Conclusions: </strong>In routine practice, niraparib dose modification was often required during the first 3 months despite individualized dosing. Physicians underestimated the burden of fatigue and symptomatic AEs. Digital self-reporting of AEs is feasible, provides patient-centered information complementing physician-reported AEs, and allows fuller appreciation of toxicity in real-world studies.</p><p><strong>Clinical trial information: </strong>NCT03752216.</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/PMC11878563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824191","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 novel machine learning-based cancer-specific cardiovascular disease risk score among patients with breast, colorectal, or lung cancer.","authors":"Nickolas Stabellini, Omar M Makram, Harikrishnan Hyma Kunhiraman, Hisham Daoud, John Shanahan, Alberto J Montero, Roger S Blumenthal, Charu Aggarwal, Umang Swami, Salim S Virani, Vanita Noronha, Neeraj Agarwal, Susan Dent, Avirup Guha","doi":"10.1093/jncics/pkaf016","DOIUrl":"10.1093/jncics/pkaf016","url":null,"abstract":"<p><strong>Background: </strong>Cancer patients have up to a 3-fold higher risk for cardiovascular disease (CVD) than the general population. Traditional CVD risk scores may be less accurate for them. We aimed to develop cancer-specific CVD risk scores and compare them with conventional scores in predicting 10-year CVD risk for patients with breast cancer (BC), colorectal cancer (CRC), or lung cancer (LC).</p><p><strong>Methods: </strong>We analyzed adults diagnosed with BC, CRC, or LC between 2005 and 2012. An machine learning (ML) Extreme Gradient Boosting algorithm ranked 40-50 covariates for predicting CVD for each cancer type using SHapley Additive exPlanations values. The top 10 ML-predictors were used to create predictive equations using logistic regression and compared with American College of Cardiology (ACC)/American Heart Association (AHA) Pooled Cohort Equations (PCE), Predicting Risk of cardiovascular disease EVENTs (PREVENT), and Systematic COronary Risk Evaluation-2 (SCORE2) using the area under the curve (AUC).</p><p><strong>Results: </strong>We included 10 339 patients: 55.5% had BC, 15.6% had CRC, and 29.7% had LC. The actual 10-year CVD rates were: BC 21%, CRC 10%, and LC 28%. The predictors derived from the ML algorithm included cancer-specific and socioeconomic factors. The cancer-specific predictive scores achieved AUCs of 0.84, 0.76, and 0.83 for BC, CRC, and LC, respectively, and outperformed PCE, PREVENT, and SCORE2, increasing the absolute AUC values by up to 0.31 points (with AUC ranging from 0 to 1). Similar results were found when excluding patients with cardiac history or advanced cancer from the analysis.</p><p><strong>Conclusions: </strong>Cancer-specific CVD predictive scores outperform conventional scores and emphasize the importance of integrating cancer-related covariates for precise prediction.</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/PMC11878632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065663","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":"Duration of aromatase inhibitor use and long-term cardiovascular risk in breast cancer survivors.","authors":"Yuhan Huang, Marilyn L Kwan, Susan R Heckbert, Nicholas L Smith, Megan Othus, Cecile A Laurent, Janise M Roh, Eileen Rillamas-Sun, Valerie S Lee, Tatjana Kolevska, Richard K Cheng, Carlos Irribarren, Mai Nguyen-Huynh, Dawn L Hershman, Lawrence H Kushi, Heather Greenlee","doi":"10.1093/jncics/pkaf009","DOIUrl":"10.1093/jncics/pkaf009","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on duration of aromatase inhibitor (AI) and cardiovascular disease (CVD) risk in breast cancer (BC) survivors. We examined the risk of CVD and mortality associated with the duration of AI use in postmenopausal women with early stage hormone receptor-positive BC.</p><p><strong>Methods: </strong>Postmenopausal women diagnosed with hormone receptor-positive BC (n = 5853) who used an AI were included. Cause-specific hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between AI use duration (short term: >0 and <2 years; intermediate term: ≥2 and <5 years; long term: ≥5 years) and CVD and mortality outcomes. The landmark method was used to avoid immortal time bias; the selected landmark was 6 years after BC diagnosis.</p><p><strong>Results: </strong>Anastrozole was the AI predominantly prescribed (95.4%). Over a median follow-up of 3 years for women who survived 6 years after BC diagnosis, a lower risk of stroke was observed in intermediate-term AI users (HR = 0.60, 95% CI = 0.37 to 0.96) and long-term AI users (HR = 0.51, 95% CI = 0.30 to 0.85), than in short-term AI users. The longer duration of AI use was also associated with lower risk of all-cause mortality and non-CVD-related mortality. In addition, long-term AI users were at 37% lower risk of CVD-related mortality than short-term AI users. No statistically significant differences were observed in risks of major adverse cardiovascular events, ischemic heart disease, and heart failure across the 3 groups.</p><p><strong>Conclusion: </strong>Among postmenopausal women with early stage hormone receptor-positive BC who survived 6 years after BC diagnosis, longer duration of AI use was not associated with elevated CVD risk.</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/PMC11879121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052425","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":"Reply to Braillon.","authors":"Kaitlin Chakos, Lisa Tussing-Humphreys, Kelsey Gabel","doi":"10.1093/jncics/pkae126","DOIUrl":"10.1093/jncics/pkae126","url":null,"abstract":"","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/PMC11729702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869329","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":"Assessing impact of a community-based screening campaign to address social determinants of cervical cancer.","authors":"Justine Po, Arthur Bookstein, Woori Lee, Rosa Barahona, Lourdes Baezconde-Garbanati","doi":"10.1093/jncics/pkaf006","DOIUrl":"10.1093/jncics/pkaf006","url":null,"abstract":"<p><strong>Background: </strong>Screening represents a cornerstone of cervical cancer control strategy. However, disparities in social determinants of health have perpetuated gaps in screening among racial and ethnic minorities. Social determinants of health including cultural stigma and lack of insurance have contributed to decreased screening among Hispanic women. To increase cancer screening in this population, community-academic partnerships and culturally tailored media have emerged as promising strategies.</p><p><strong>Methods: </strong>This study assessed the impact of a culturally tailored cervical cancer screening campaign implemented through academic-community-government partnerships. Intercept surveys, conducted from 2015 to 2018 in eastern neighborhoods of Los Angeles, assessed campaign recall, interpretation, and screening intention among Hispanic women aged 21-65 years after exposure to the campaign. Screening intention was evaluated using χ2 and logistic regression by participant characteristics, with thematic analysis for campaign interpretation.</p><p><strong>Results: </strong>Of 673 participants, 26.1% were uninsured, and 85.9% primarily spoke Spanish at home. Campaign recall was 25.1%, with 64.5% interpreting the campaign's message as cervical cancer screening or health checkups. The campaign's most liked aspect was emphasis on family (cited by 37.1% of participants). Postcampaign, 89.5% of participants overall were likely or extremely likely to schedule a Pap test, including 83.5% of women who had not had a Pap test in the past 3 years.</p><p><strong>Conclusions: </strong>Our findings underscore several important strategies to reduce cervical cancer disparities: (1) associating positive cultural values with screening to decrease stigma, (2) combining culturally tailored outreach with interventions that target other known screening barriers, (3) facilitating long-term community relationships, and (4) leveraging academic-community-government partnerships.</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/PMC11878794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070875","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":"Trilaciclib prior to FOLFOXIRI/bevacizumab for patients with untreated metastatic colorectal cancer: phase 3 PRESERVE 1 trial.","authors":"Heinz-Josef Lenz, Tianshu Liu, Emerson Y Chen, Zsolt Horváth, Igor Bondarenko, Iwona Danielewicz, Michele Ghidini, Pilar García-Alfonso, Robert Jones, Matti Aapro, Yanqiao Zhang, Jufeng Wang, Wayne Wang, Jennifer Adeleye, Andrew Beelen, Joleen Hubbard","doi":"10.1093/jncics/pkae116","DOIUrl":"10.1093/jncics/pkae116","url":null,"abstract":"<p><strong>Background: </strong>In metastatic colorectal cancer (mCRC), improvements in survival from combining leucovorin/fluorouracil/oxaliplatin/irinotecan (FOLFOXIRI) with bevacizumab have come at the risk of increased rates of high-grade toxicities. Trilaciclib is indicated to decrease the incidence of chemotherapy-induced myelosuppression in patients receiving standard-of-care chemotherapy for extensive-stage small cell lung cancer.</p><p><strong>Methods: </strong>Patients with untreated mCRC were randomly assigned 1:1 to trilaciclib (n = 164) or placebo (n = 162) prior to FOLFOXIRI/bevacizumab for up to 12 cycles (induction), followed by trilaciclib or placebo prior to fluorouracil/leucovorin/bevacizumab (maintenance). Co-primary endpoints were duration of severe (grade 4) neutropenia (DSN) in cycles 1-4 and occurrence of severe neutropenia (SN) during induction. Secondary endpoints included antitumor efficacy, survival, and safety.</p><p><strong>Results: </strong>The study met its co-primary endpoints. Administering trilaciclib prior to FOLFOXIRI/bevacizumab resulted in significant reductions in DSN in cycles 1-4 vs placebo (mean, 0.1 vs 1.3 days; P < .001) and occurrence of SN during induction (1.3% vs 19.7%; adjusted relative risk [96% CI] = 0.07 [0.0 to 0.3]; P < .001). Grade 3/4 adverse events, including neutropenia, diarrhea, and leukopenia, were less frequent with trilaciclib vs placebo (64.8% vs 73.1%). Trilaciclib was associated with fewer chemotherapy dose reductions and delays and with reduced administration of supportive therapies, compared with placebo. Objective response rate (41.6% vs 57.1%; P = .009) and median progression-free survival (10.3 vs 13.1 months; P < .001) were significantly lower with trilaciclib vs placebo.</p><p><strong>Conclusions: </strong>Administering trilaciclib prior to FOLFOXIRI/bevacizumab protected the neutrophil lineage from the effects of chemotherapy-induced myelosuppression. However, antitumor efficacy endpoints favored placebo.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov: NCT04607668.</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/PMC11708780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695537","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 clinical trial participation: a qualitative study of Black/African American communities' and patient/survivors' recommendations.","authors":"Linda Kaljee, Sylvester Antwi, Doreen Dankerlui, Donna Harris, Barbara Israel, Denise White-Perkins, Valerie Ofori Aboah, Livingstone Aduse-Poku, Harriet Larrious-Lartey, Barbara Brush, Chris Coombe, La'Toshia Patman, Nayomi Cawthorne, Sophia Chue, Zachary Rowe, Cassandra Mills, Kurt Fernando, Gwendolyn Daniels, Eleanor M Walker, Evelyn Jiagge","doi":"10.1093/jncics/pkae119","DOIUrl":"10.1093/jncics/pkae119","url":null,"abstract":"<p><strong>Background: </strong>Black/African Americans experience disproportionate cancer burden and mortality rates. Racial and ethnic variation in cancer burden reflects systemic and health-care inequities, cancer risk factors, and heredity and genomic diversity. Multiple systemic, sociocultural, economic, and individual factors also contribute to disproportionately low Black/African American participation in cancer clinical trials.</p><p><strong>Methods: </strong>The Participatory Action for Access to Clinical Trials project used a community-based participatory research approach inclusive of Black/African American community-based organizations, Henry Ford Health, and the University of Michigan Urban Research Center. The project aims were to understand Black/African Americans' behavioral intentions to participate in cancer clinical trials and to obtain recommendations for improving participation. Audio-recorded focus group data were transcribed and coded, and searches were conducted to identify themes and subthemes. Representative text was extracted from the transcripts.</p><p><strong>Results: </strong>Six community focus group discussions (70 participants) and 6 Henry Ford Health patient/survivor focus group discussions (29 participants) were completed. General themes related to trial participation were identified, including (1) systemic issues related to racism, health disparities, and trust in government, health systems, and clinical research; (2) firsthand experiences with health care and health systems; (3) perceived and experienced advantages and disadvantages of clinical trial participation; and (4) recruitment procedures and personal decision-making processes. Specific recommendations on how to address barriers were obtained.</p><p><strong>Conclusions: </strong>Community-based participatory research is effective in bringing communities equitably to the table. To build trust, health systems must provide opportunities for patients and communities to jointly identify factors affecting cancer clinical trial participation, implement recommendations, and address health disparities.</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/PMC11781321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709556","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":"Physical activity and incident cardiovascular disease in breast cancer survivors: the Pathways Study.","authors":"Jacob K Kresovich, Alicia R Richards, Isaac J Ergas, Rikki Cannioto, Catherine Thomsen, Cecile A Laurent, Salma Shariff-Marco, Eileen Rillamas-Sun, Tatjana Kolevska, Song Yao, Christine Ambrosone, Lawrence Kushi, Heather Greenlee, Marilyn L Kwan","doi":"10.1093/jncics/pkae123","DOIUrl":"10.1093/jncics/pkae123","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivors experience higher rates of cardiovascular disease (CVD) than women without breast cancer, due in part to cardiotoxic cancer treatments and shared lifestyle risk factors. Physical activity is associated with lower mortality risk in breast cancer survivors, but associations with CVD have not been examined in detail.</p><p><strong>Methods: </strong>The Pathways Study is a prospective cohort study of 4504 women diagnosed with invasive breast cancer between 2005 and 2013. At enrollment, women self-reported their physical activities during the previous 6 months, which were dichotomized as meeting the Centers for Disease Control and Prevention's Physical Activity Guidelines for Americans (≥150 minutes of moderate-intensity or ≥75 minutes of vigorous-intensity activity per week) vs not. Incident CVD events (heart failure, cardiomyopathy, cardiac arrest, ischemic heart disease, stroke) occurring between enrollment and December 2021 were identified from electronic health records. Covariate-adjusted, competing-risks Cox regression models estimated associations between meeting physical activity guidelines and CVD risk.</p><p><strong>Results: </strong>Compared with women who did not meet physical activity guidelines at their diagnosis, those who did had a 25% lower risk of CVD (HR = 0.75, 95% CI = 0.60 to 0.94). Among the individual CVD outcomes, meeting physical activity guidelines was protective against incident cardiomyopathy (hazard ratio [HR] = 0.54, 95% CI = 0.31 to 0.95), heart failure (HR = 0.66, 95% CI = 0.50 to 0.87), and cardiac arrest (HR = 0.68, 95% CI = 0.49 to 0.99).</p><p><strong>Conclusions: </strong>Meeting physical activity guidelines at breast cancer diagnosis was associated with lower risk of CVD after diagnosis. Studies investigating changes in physical activity after a breast cancer diagnosis and CVD risk are warranted.</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/PMC11737308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846599","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}