JNCI Journal of the National Cancer Institute最新文献

{"title":"Response to Zhou, Cui, Sun et al.","authors":"Stephanie Tuminello, Wiley M Turner, Emanuela Taioli","doi":"10.1093/jnci/djaf082","DOIUrl":"10.1093/jnci/djaf082","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1524"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730070","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 and outcomes in adults undergoing systemic anticancer treatment: a systematic review and meta-analysis.","authors":"Jessica Pearce, Sally Martin, Sophie Heritage, Emma G Khoury, Joanna Kucharczak, Thitikorn Nuamek, David A Cairns, Galina Velikova, Suzanne H Richards, Andrew Clegg, Alexandra Gilbert","doi":"10.1093/jnci/djaf017","DOIUrl":"10.1093/jnci/djaf017","url":null,"abstract":"<p><strong>Background: </strong>It is increasingly recognized that frailty should be assessed and considered in treatment decision making in patients with cancer. This review and meta-analysis synthesizes existing evidence evaluating the association between baseline frailty and systemic anticancer treatment outcomes in adults with cancer.</p><p><strong>Methods: </strong>Five databases were systematically searched from database inception to January 2023 to identify prognostic factor studies (cohort or case-control design) reporting the associations between validated frailty assessments (pretreatment) and follow-up outcomes in adults with solid-organ malignancy undergoing systemic anticancer treatment. Risk of bias was assessed via Quality of Prognosis Studies in Systematic Reviews tool. Where appropriate, associations between frailty and outcomes (survival, toxicity, treatment tolerance, functional decline/quality of life, and hospitalization) were synthesized in meta-analysis and presented as forest plots.</p><p><strong>Results: </strong>A total of 58 studies met inclusion criteria. They were undertaken in a range of tumor sites and mainly in older patients and advanced and/or palliative disease settings. Most had low or moderate risk of bias. Nine frailty assessment tools were evaluated. Four outcomes were synthesized in meta-analysis, which demonstrated the prognostic value of 2 tools: Geriatric-8 (survival, treatment tolerance, hospitalization) and Vulnerable Elders Survey-13 (survival, toxicity, treatment tolerance). Overall pooled estimates indicate that frailty conveys an increased risk of mortality (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.41 to 2.00), toxicity (odds ratio [OR] 1.83, 95% CI = 1.24 to 2.68), treatment intolerance (OR = 1.68, 95% CI = 1.32 to 2.12), and hospitalization (OR = 1.94, 95% CI = 1.32 to 2.83).</p><p><strong>Conclusion: </strong>Simple, brief frailty assessments including Geriatric-8 and Vulnerable Elders Survey-13 are prognostic for a range of important outcomes in patients undergoing systemic anticancer treatment. Risk estimates should be used to support shared decision making.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1316-1339"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064601","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":"Changes in time-to-treatment initiation for breast, non-small cell lung, colon, or rectal cancers throughout the COVID-19 pandemic in the United States.","authors":"Qinjin Fan, Weichuan Dong, Elizabeth J Schafer, Nikita Sandeep Wagle, Jingxuan Zhao, Kewei Sylvia Shi, Xuesong Han, K Robin Yabroff, Leticia M Nogueira","doi":"10.1093/jnci/djaf011","DOIUrl":"10.1093/jnci/djaf011","url":null,"abstract":"<p><p>The COVID-19 pandemic disrupted health care and reduced cancer diagnoses in the United States, raising concerns about its impact on time-to-treatment initiation (TTI), a critical factor for survival. This study examined the changes in TTI for 1 213 481 individuals newly diagnosed with female breast, nonsmall cell lung, colon, or rectal cancer between 2019 and 2022, using the National Cancer Database. We compared TTI in 2020-2022 with 2019 by cancer site, diagnosis time of year, stage, and treatment modality. In 2020, TTI statistically significantly decreased for all cancers compared to 2019, especially in the second quarter (2.97-4.29 days). However, TTI increased across sites in 2021 (0.31-2.15 days) and in 2022 (1.43-5.07 days). Reduced diagnoses and efforts to prioritize cancer care during the pandemic may partly explain observed TTI decreases, whereas workforce constraints likely contributed to the later increases. Ongoing evaluation of TTI and associations with patient outcomes is warranted.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1506-1511"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080199","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":"Association of opioid and benzodiazepine coprescribing with adverse events among older adults with cancer.","authors":"Devon K Check, Samir Soneji, Harvey Jay Cohen, Andrea Des Marais, Katie F Jones, Charles E Gaber, Jessica S Merlin, Amy O'Regan, Nicole Fergestrom, Lauren E Wilson, Aaron N Winn","doi":"10.1093/jnci/djaf072","DOIUrl":"10.1093/jnci/djaf072","url":null,"abstract":"<p><strong>Background: </strong>Many older adults with cancer are coprescribed opioids/benzodiazepines; evidence on harms is lacking.</p><p><strong>Methods: </strong>Using SEER-Medicare (2012-2019), we identified patients with breast, colorectal, or lung cancer. Cox proportional hazards models estimated the adjusted hazard ratios (HRs) of coprescribing (measured from claims, at the day level) with the immediate risk of overdose, fall/fracture, and all-cause hospitalization. In a secondary analysis, models were stratified by ≥90 days of continuous medication supply.</p><p><strong>Results: </strong>In our cohort of 107 288 patients, compared with those prescribed neither medication, those prescribed benzodiazepines had an increase in the immediate risk of falls/fractures (HR = 1.17, 95% CI = 1.02 to 1.34) and all-cause hospitalizations (HR = 1.08, 95% CI = 1.04 to 1.12). Patients prescribed opioids had an increase in the immediate risk of overdose (HR = 5.62, 95% CI = 4.86 to 5.62), falls/fractures (HR = 1.56, 95% CI = 1.41 to 1.73), and all-cause hospitalizations (HR = 1.26, 95% CI = 1.23 to 1.30). HRs were similar for patients coprescribed opioids/benzodiazepines. For patients without continuous exposure to 1 or both medications, effects were larger for coprescribed opioids/benzodiazepines vs opioids for overdose (HR = 15.22, 95% CI = 8.79 to 26.35 vs HR = 6.85, 95% CI = 6.85 to 26.35) and all-cause hospitalization (HR = 3.21, 95% CI = 2.60 to 3.96 vs HR = 1.98, 95% CI = 1.87 to 2.10).</p><p><strong>Conclusions: </strong>Overall, compared with no prescribing, benzodiazepine prescribing and opioid prescribing were each associated with an increase in the immediate risk of adverse events. Effects were similar for those prescribed opioids and those coprescribed opioids/benzodiazepines. For patients with intermittent vs long-term medication exposure, coprescribing additionally increased the risk of overdose and all-cause hospitalization.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1465-1473"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669906","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":"RE: Clinical and patient-reported outcomes after oncoplastic vs conventional breast-conserving surgery-a longitudinal, multicenter cohort study.","authors":"Jilong Yuan, Qu Zheng, Peizhuo Zang","doi":"10.1093/jnci/djaf157","DOIUrl":"https://doi.org/10.1093/jnci/djaf157","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528052","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":"Sex-specific radiation-associated lung cancer mortality risks as impacted by smoking among US radiological technologists.","authors":"Cato M Milder, Elizabeth K Cahoon, Sara J Schonfeld, Dale L Preston, Bruce H Alexander, Martha S Linet, Cari M Kitahara","doi":"10.1093/jnci/djaf064","DOIUrl":"10.1093/jnci/djaf064","url":null,"abstract":"<p><strong>Background: </strong>The Life Span Study of Japanese atomic bomb survivors estimated greater risks of radiation-associated lung cancer among females than males, with direct implications for occupational radiation safety policy. To evaluate replicability of these findings in radiation workers, we assessed sex-specific radiation-associated risks of lung cancer mortality in a large cohort of US radiological technologists.</p><p><strong>Methods: </strong>Using data from 4 questionnaires (1983-2013), we reconstructed lifetime smoking history for 83 715 female and 26 650 male technologists. We estimated individual lung occupational radiation doses using badge dose and questionnaire data. We used Poisson regression to investigate joint radiation-smoking effects on sex-averaged and sex-specific lung cancer mortality risk.</p><p><strong>Results: </strong>For 1243 female and 607 male technologists who died from lung cancer, median cumulative lung dose was 16.2 mGy (non-cases: 7.7 mGy) and 24.5 mGy (non-cases: 10.1 mGy), respectively. Excess risk of lung cancer increased with increasing radiation dose. However, smoking modified this effect: the radiation effect at 100 mGy increased until 16 cigarettes/day, after which it declined. Excess relative risk (ERR) per 100 mGy was greater among males (never smoking additive ERR = 1.98; 95% CI = 0.34 to 6.25) than females (never smoking additive ERR = 0.40; 95% CI = -0.02 to 1.21); sex differences persisted up to ∼40 cigarettes/day.</p><p><strong>Conclusions: </strong>Our results indicated radiation-associated risks of lung cancer mortality were stronger in males than females, in contrast to the Life Span Study. However, both studies found radiation-associated risks were highest in workers with light-to-moderate smoking intensity. Altogether, these findings reinforce the importance of rigorous radiation protection measures for all radiation workers, regardless of sex, alongside interventions to support smoking cessation.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1429-1437"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669909","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":"RE: Racial and socioeconomic disparities in non-small cell lung cancer molecular diagnostics uptake.","authors":"Pengxiang Zhou, Jiaojiao Cui, Rujing Sun, Xiao Liu, Guangping Li","doi":"10.1093/jnci/djaf081","DOIUrl":"10.1093/jnci/djaf081","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1522-1523"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730049","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":"HPV vaccine impact: genotype-specific changes in cervical pre-cancer share similarities with changes in cervical screening cytology.","authors":"Rachael Adcock, Cosette M Wheeler, William C Hunt, Norah E Torrez-Martinez, Michael Robertson, Ruth McDonald, Nancy E Joste, Mark H Stoler, Maurits N C de Koning, Wim G V Quint","doi":"10.1093/jnci/djaf055","DOIUrl":"10.1093/jnci/djaf055","url":null,"abstract":"<p><strong>Background: </strong>After human papillomavirus (HPV) vaccine introduction, declines in the prevalence of HPV vaccine types have been observed in screening cytology, but data from the United States describing HPV type-specific changes in cervical intraepithelial neoplasia (CIN) grades 2-3 and adenocarcinoma in situ (CIN2/CIN3/AIS) are limited.</p><p><strong>Methods: </strong>A statewide sample of individuals with cervical biopsies was selected for broad-spectrum HPV genotyping. CIN2/CIN3/AIS incidence and prevalence were calculated for type-specific high-risk HPV (hrHPV) among individuals aged 15-29 years. Weighted incidence rate ratios (IRR) and relative differences in prevalence (RDP) were computed to compare 3 time periods: 2006-2009 (Cohort 1 [C1], n = 4121), 2012-2015 (C2, n = 2194), and 2015-2018 (C3, n = 1481).</p><p><strong>Results: </strong>When comparing C1 vs C3 among those aged 21-25 years, statistically significant reductions in hrHPV type-specific CIN2/CIN3/AIS incidence were observed for HPV16, HPV18, HPV31, and HPV33, with corresponding IRRs of 0.4 (95% confidence interval [95% CI] = 0.3 to 0.4), 0.3 (95% CI = 0.1 to 0.7), 0.6 (95% CI = 0.5 to 0.9), and 0.4 (95% CI = 0.1 to 0.8), respectively. The RDP comparing C1 vs C3 for HPV16/18-positive CIN2/CIN3/AIS was -43.8% (P < .001). When excluding HPV16/18 or HPV16/18/31/33 from all hrHPV types, the RDP was +56.6% and +92.5% (P < .001), respectively.</p><p><strong>Conclusions: </strong>hrHPV type-specific CIN2/CIN3/AIS incidence decreased with statistical significance for vaccine types HPV16/18 and for HPV31 and HPV33. Although the HPV vaccine is highly beneficial and a top priority for preventing HPV-related cancer, the long-term vaccine impact in cohorts receiving the 4-valent HPV vaccine requires continued follow-up to assess genotype-specific distributions in the remaining CIN2+ lesions and cancers.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1377-1386"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604917","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":"RE: Frailty and outcomes in adults undergoing systemic anticancer treatment: a systematic review and meta-analysis.","authors":"Arif Hakan Önder, Mehmet Mutlu Çatlı","doi":"10.1093/jnci/djaf077","DOIUrl":"10.1093/jnci/djaf077","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1512-1513"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967757","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":"RE: Colon, colorectal, and all cancer incidence increase in the young due to appendix reclassification.","authors":"Rebecca L Siegel, Tyler B Kratzer, Robert A Smith, Ahmedin Jemal","doi":"10.1093/jnci/djaf095","DOIUrl":"10.1093/jnci/djaf095","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1516-1517"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173578","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}