JNCI Journal of the National Cancer Institute最新文献

{"title":"Prediction of breast cancer risk for adolescents and young adults with Hodgkin lymphoma.","authors":"Sander Roberti, Flora E van Leeuwen, Ibrahima Diallo, Florent de Vathaire, Michael Schaapveld, Wendy M Leisenring, Rebecca M Howell, Gregory T Armstrong, Chaya S Moskowitz, Susan A Smith, Berthe M P Aleman, Inge M Krul, Nicola S Russell, Ruth M Pfeiffer, Michael Hauptmann","doi":"10.1093/jnci/djae274","DOIUrl":"10.1093/jnci/djae274","url":null,"abstract":"<p><strong>Background: </strong>Although female survivors of Hodgkin lymphoma (HL) have an increased risk of breast cancer (BC), no BC risk prediction model is available. We developed such models incorporating mean radiation dose to the breast or breast quadrant-specific radiation doses.</p><p><strong>Methods: </strong>Relative risks and age-specific incidence for BC and competing events (mortality or other subsequent cancer) were estimated from 1194 Dutch 5-year HL survivors, treated at ages 11-40 during 1965-2000. Predictors were doses to 10 breast segments or mean breast radiation dose, BC family history, year of and age at HL diagnosis, and ages at menopause and first live birth. Models were independently validated using US Childhood Cancer Survivor Study cohort participants.</p><p><strong>Results: </strong>Predicted absolute BC risks 25 years after HL diagnosis ranged from 1.0% for survivors diagnosed at ages 20-24 with less than 10 Gy mean breast radiation dose and who were menopausal 5 years after HL diagnosis, to 22.0% for survivors 25-29 years at diagnosis, with at least 25 Gy mean breast dose and no menopause within 5 years. In external validation, the observed/expected BC case ratio was 1.19 (95% confidence interval 0.97 to 1.47) for the breast segment-specific dose model, and 1.29 (1.05 to 1.60) for the mean breast dose model. The areas under the receiver operating characteristic curve were 0.68 (0.63 to 0.74) and 0.68 (0.62 to 0.73), respectively.</p><p><strong>Conclusion: </strong>Breast segment-specific or mean breast radiation dose with personal and clinical characteristics predicted absolute BC risk in HL survivors with moderate discrimination but good calibration, rendering the models useful for clinical decision-making.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"619-628"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562789","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":"Trends in cancer mortality under age 50 in 15 upper-middle and high-income countries.","authors":"Claudia Santucci, Silvia Mignozzi, Gianfranco Alicandro, Margherita Pizzato, Matteo Malvezzi, Eva Negri, Prabhat Jha, Carlo La Vecchia","doi":"10.1093/jnci/djae288","DOIUrl":"10.1093/jnci/djae288","url":null,"abstract":"<p><strong>Background: </strong>Rising cancer incidence, particularly for colorectal cancer, has been reported in young adults. This study examined whether this is related to an increase in mortality.</p><p><strong>Methods: </strong>We analyzed World Health Organization mortality data among young adults aged 25-49 years in 15 most populous upper-middle and high-income countries from 1990 to 2021 with reliable data. Midyear populations were retrieved from the United Nations for the American Countries and from the World Health Organization for the other countries. We compared age-standardized mortality rates in 2019-2021 with those in 2009-2011 and performed joinpoint regression analysis for all cancers and selected most common cancer sites: colorectum, pancreas, lung, and breast.</p><p><strong>Results: </strong>In 2019-2021, the highest age-standardized mortality rates (per 100 000) were in Romanian males (38.6) and Argentinian females (45.9), while the lowest ones were in Japanese males (16.3) and females (22.7). Age-standardized mortality rates for colorectal cancers increased in 2019-2021 compared with 2009-2011 in 9 countries among men and in 7 countries among women. The highest increases were in the United Kingdom (males: +26.1%; females: +33.7%), Canada (males: +25.3%), and Mexico (males: +33.5%; females: +29.7%). Long-term analysis over the last 3 decades showed declining trends in total cancer mortality in the majority of countries, in lung cancer mortality across all countries, and in breast cancer in all countries except in Latin America.</p><p><strong>Conclusions: </strong>Although mortality from common cancers has generally decreased over the past 3 decades, mortality from colorectal cancer has increased in some countries. This highlights the need to control the obesity epidemic and implement targeted surveillance strategies in young populations.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"747-760"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687122","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: Genetic risk, health-associated lifestyle, and risk of early-onset total cancer and breast cancer.","authors":"Ya Zhang, Pengfei Lyu","doi":"10.1093/jnci/djae322","DOIUrl":"10.1093/jnci/djae322","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"801-802"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864215","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":"High-grade serous carcinoma occurring after risk-reducing salpingo-oophorectomy in BRCA1/2 germline pathogenic variant carriers.","authors":"Iris A S Stroot, Joost Bart, Harry Hollema, Marise M Wagner, Refika Yigit, Helena C van Doorn, Joanne A de Hullu, Katja N Gaarenstroom, Marc van Beurden, Luc R C W van Lonkhuijzen, Brigitte F M Slangen, Ronald P Zweemer, Encarna B Gómez Garcia, Margreet G E M Ausems, Fenne L Komdeur, Christi J van Asperen, Muriel A Adank, Marijke R Wevers, Maartje J Hooning, Marian J E Mourits, Geertruida H de Bock","doi":"10.1093/jnci/djae300","DOIUrl":"10.1093/jnci/djae300","url":null,"abstract":"<p><strong>Background: </strong>Risk-reducing salpingo-oophorectomy (RRSO) effectively prevents high-grade serous carcinoma (HGSC) in BRCA1/2 germline pathogenic variant (GPV) carriers. Still, some women develop HGSC after RRSO without pathological findings. This study assessed long-term incidence and risk factors for developing HGSC after RRSO without pathological findings.</p><p><strong>Methods: </strong>BRCA1/2 GPV carriers were selected from the Hereditary Breast and Ovarian cancer in the Netherlands (HEBON) cohort. Follow-up data for HGSC after RRSO were obtained from the Dutch Nationwide Pathology Databank (PALGA) and confirmed by histopathological review. Cumulative incidence rates of HGSC were calculated using Kaplan-Meier analyses. A Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for factors associated with an increased risk of HGSC after RRSO without pathological findings.</p><p><strong>Results: </strong>A total of 2519 women were included, with a median follow-up of 13.4 years (range: 0.0-27.6 years). The 20-year cumulative incidence rate of HGSC was 1.5% (95% CI = 0.0 to 2.1) for BRCA1 and 0.2% (95% CI = 0.0 to 1.4) for BRCA2 GPV carriers. All women who developed HGSC underwent RRSO after the recommended age. Incomplete embedding of the RRSO specimen (HR = 4.2, 95% CI = 1.4 to 12.6), higher age at RRSO (HR per year = 1.1, 95% CI = 1.0 to 1.1), and carrying a BRCA1 GPV (HR = 12.1, 95% CI = 1.6 to 91.2) were associated with increased risk of HGSC.</p><p><strong>Conclusions: </strong>In BRCA1/2 GPV carriers, long-term incidence of HGSC after RRSO without pathological findings was low. Strict adherence to guidelines regarding timely RRSO followed by complete specimen embedding can further reduce the risk of HGSC in the years after RRSO.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"719-727"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695545","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":"Using GPT-4o to interpret patient-reported outcomes without training.","authors":"Thomas M Atkinson, Aleksandr Petrov, Kathleen A Lynch, Login S George, Jennifer R Cracchiolo, Bobby Daly, Kristen L Fessele, James H Flory, Jun J Mao, Yuelin Li","doi":"10.1093/jnci/djaf016","DOIUrl":"10.1093/jnci/djaf016","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"809-811"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079348","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":"Active surveillance for prostate cancer: How active is too active?","authors":"Jeffrey J Tosoian","doi":"10.1093/jnci/djae342","DOIUrl":"10.1093/jnci/djae342","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"583-585"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046608","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":"Response to Zhang and Lv.","authors":"Yin Zhang, Sara Lindström, Peter Kraft, Yuxi Liu","doi":"10.1093/jnci/djae323","DOIUrl":"10.1093/jnci/djae323","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"803-804"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864219","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":"A randomized study of 2 risk assessment models for individualized breast cancer risk estimation.","authors":"Adrià López-Fernández, Laura Duran-Lozano, Guillermo Villacampa, Mónica Pardo, Eduard Pérez, Esther Darder, Anna Vallmajó, Rosa Alfonso, Mara Cruellas, Ariadna Roqué, Mireia Cartró, Adriana Bareas, Estela Carrasco, Alejandra Rezqallah, Ana Raquel Jimenez-Macedo, Sara Torres-Esquius, Maite Torres, Consol Lopez, Martín Espinosa, Alex Teulé, Elisabet Munté, Noemi Tuset, Orland Diez, Lidia Feliubadaló, Conxi Lázaro, Gemma Llort, Tim Carver, Lorenzo Ficorella, Nasim Mavaddat, Anna Mercadé, Antonis C Antoniou, Joan Brunet, Teresa Ramon Y Cajal, Judith Balmaña","doi":"10.1093/jnci/djaf067","DOIUrl":"https://doi.org/10.1093/jnci/djaf067","url":null,"abstract":"<p><strong>Background: </strong>Estimating breast cancer risk involves quantifying genetic and non-genetic factors. This supports health interventions and risk communication to ensure adherence to screening recommendations. This study evaluated the change in risk estimation when incorporating breast density and polygenic risk score (PRS) into the baseline cancer risk assessment and compared the efficacy of two risk-assessment delivery models.</p><p><strong>Methods: </strong>This two-step study included 663 healthy women with a family history of breast cancer in which no pathogenic variants were identified. First, breast density and PRS were added to the baseline risk assessment for all participants. A randomized intervention study compared two delivery models (in-person vs pre-recorded video) for risk assessment in women at moderate or average risk. All tests were two sided.</p><p><strong>Results: </strong>Breast density and PRS reclassified the risk group into 33% of the participants, with only 5% reclassified as high-risk. After disclosure of their estimated multifactorial risk, 65% of women aligned their risk perception with their estimated risk, compared to 47% at baseline (p-value < 0.05). No statistically significant differences were found in the primary endpoint cancer worry [mean = 10.2(SD = 3.1) vs 10.1(2.7), between delivery models. In-person delivery had slightly better psychological outcomes (excluding the primary outcome) and higher satisfaction, though few participants in the video group sought in-person clarification.</p><p><strong>Conclusions: </strong>Incorporating breast density and PRS into risk assessments led to substantial reclassification, with 1 in 5 women facing de-escalated surveillance. Personalized assessments improve objective perceptions alignment. A model using a pre-recorded video-based model matches in-person delivery for moderate and average-risk women and is scalable for population-level implementation.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763363","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":"Response to Kratz, Plon, and Lupo.","authors":"Shuai Li, Laura Madanat-Harjuoja, Timothy R Rebbeck, Lisa R Diller","doi":"10.1093/jnci/djaf028","DOIUrl":"10.1093/jnci/djaf028","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"814-815"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389942","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":"Clinical and patient-reported outcomes after oncoplastic vs conventional breast-conserving surgery-a longitudinal, multicenter cohort study.","authors":"Claudia A Bargon, Dieuwke R Mink van der Molen, Danny A Young-Afat, Marilot C T Batenburg, Iris E van Dam, Inge O Baas, Miranda F Ernst, Wiesje Maarse, Maartje F Sier, Ernst J P Schoenmaeckers, Josephina P J Burgmans, Rhodé M Bijlsma, Sabine Siesling, Hinne A Rakhorst, Marc A M Mureau, Femke van der Leij, Annemiek Doeksen, Helena M Verkooijen","doi":"10.1093/jnci/djae310","DOIUrl":"10.1093/jnci/djae310","url":null,"abstract":"<p><strong>Background: </strong>Oncoplastic breast-conserving surgery (OP-BCS) is becoming increasingly popular to avoid mastectomy or optimize cosmetic outcomes of breast-conserving surgery (BCS). Few studies have compared clinical outcomes and patient-reported outcomes (PROs) of OP-BCS to conventional BCS (C-BCS). This study aims to compare clinical outcomes and short- and long-term PROs after OP-BCS and C-BCS in a large prospective breast cancer cohort.</p><p><strong>Methods: </strong>Women in the prospective, multicenter UMBRELLA (Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaLuAtion) breast cancer cohort who underwent OP-BCS or C-BCS were included. Clinical outcomes and PROs (measured by EORTC QLQ-C30/BR23) up to 24 months postoperatively were evaluated. Mixed-model analysis was performed to assess differences in PROs over time between groups.</p><p><strong>Results: </strong>A total of 1628 (84.9%) patients received C-BCS and 290 (15.1%) received OP-BCS. After C-BCS and OP-BCS, free resection margins were obtained in 84.2% (n = 1370) and 86.2% (n = 250), respectively, reoperation for re-excision of margins within 3 months occurred in 5.3% (n = 86) and 4.8% (n = 14), and the median time interval from surgery until adjuvant systemic therapy was 66 and 63 days, and 36 and 41 days until radiotherapy. Shortly postoperative, OP-BCS was associated with statistically significant lower mean scores for physical functioning (83.6 vs 87.2) and body image (82.8 vs 89.4) and more pain (19.8 vs 26.5) and breast symptoms (22.7 vs 30.3) than C-BCS. Body image scores remained statistically significantly less favorable after OP-BSC than C-BCS up to 24 months postoperatively (87.8 vs 92.2).</p><p><strong>Conclusions: </strong>Oncoplastic surgery safely enables BCS but may lead to less favorable long-term body image compared to C-BCS. These findings are important for patient education and shared decision-making.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"781-789"},"PeriodicalIF":9.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769056","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}