JNCI Journal of the National Cancer Institute最新文献

{"title":"Correction to: Restoring Anticancer Immune Response by Targeting Tumor-Derived Exosomes With a HSP70 Peptide Aptamer.","authors":"","doi":"10.1093/jnci/djaf123","DOIUrl":"10.1093/jnci/djaf123","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"1529"},"PeriodicalIF":9.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234151","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":"Correction to: The association of where patients with prostate cancer live and receive care on racial treatment inequities.","authors":"","doi":"10.1093/jnci/djaf148","DOIUrl":"https://doi.org/10.1093/jnci/djaf148","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496725","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":"Benefits of colorectal cancer screening using FIT with varying positivity thresholds by age and sex.","authors":"Matthias Harlass, Amy B Knudsen, Daan Nieboer, Luuk A van Duuren, Karen M Kuntz, Carolyn M Rutter, Pedro Nascimento de Lima, Nicholson Collier, Jonathan Ozik, Anne I Hahn, Fernando Alarid-Escudero, Ann G Zauber, John M Inadomi, Reinier G S Meester, Iris Lansdorp Vogelaar","doi":"10.1093/jnci/djaf149","DOIUrl":"https://doi.org/10.1093/jnci/djaf149","url":null,"abstract":"<p><strong>Background: </strong>Fecal immunochemical test (FIT) performance for colorectal cancer (CRC) screening varies by age and sex, yet most FIT-based screening programs use uniform thresholds. This study assessed the potential benefits of stratifying FIT thresholds based on age and sex.</p><p><strong>Methods: </strong>We conducted a meta-analysis of FIT sensitivity and specificity at various positivity thresholds by age and sex. We then used these estimates in two microsimulation models of CRC and projected lifetime clinical outcomes, incremental costs, and quality-adjusted life-years gained (QALYG) from age- and sex-stratified FIT strategies. FIT thresholds ranged from 10 to 50 µg hemoglobin/g feces (µg/g).</p><p><strong>Results: </strong>For current uniform FIT screening (20 µg/g), models projected 85.67 to 122.15 QALYG at incremental costs of -$982 to $504 per 1,000 individuals compared to no screening. At equivalent costs to current uniform screening, only one model found stratified FIT approaches cost-effective, yielding a marginal increase of 1.04 and 1.10 QALYG/1,000 females and males, respectively. At a willingness-to-pay threshold of $100,000/QALYG, both models found stratified FIT cut-offs to be the best strategy, with cut-offs being equal or higher for men and lowest at older ages. Uniform strategies showed comparable effectiveness, falling within one quality-adjusted life day per person of efficient strategies at up to $112 more per person. Results were sensitive to FIT test performance characteristics and one-time setup costs.</p><p><strong>Conclusion: </strong>Stratifying FIT thresholds by age and sex may be cost-effective compared to current screening. However, the gain in expected health benefits with stratified FIT screening is likely small.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528051","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":"The association between new cancer therapy innovations and financial toxicity.","authors":"Sara Khor, Josh J Carlson, Anirban Basu, Aasthaa Bansal, Kaiyue Yu, Catherine R Fedorenko, Scott Ramsey, Veena Shankaran","doi":"10.1093/jnci/djaf152","DOIUrl":"https://doi.org/10.1093/jnci/djaf152","url":null,"abstract":"<p><strong>Background: </strong>Recent advancements in cancer treatments have improved survival rates, but rising costs associated with these innovations raise concerns about their financial impact on patients. This study investigates the trade-off between improved survival and the financial toxicity over time in advanced non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using linked data from the Western Washington SEER cancer registry and TransUnion credit records, focusing on adults diagnosed with advanced NSCLC, bladder, uterine, head and neck, and liver cancers between 2013 and 2017. Financial toxicity was assessed through major adverse financial events (AFEs), including collections, charge offs, liens, delinquent payments, foreclosures, repossessions, and bankruptcies. Multivariable multinomial logistic regression evaluated trends in a composite outcome of survival and AFEs for NSCLC patients within two years post-diagnosis. A falsification test evaluated a negative control group of advanced cancers lacking new therapies.</p><p><strong>Results: </strong>Our study included 6548 patients (mean age 69; 42% female; 86% non-Hispanic White). Two-year survival for NSCLC patients increased from 15.2% to 19.2% between 2013 and 2017 (mean change 4.0%pt, 95%CI 0.7, 7.3). The proportion of survivors without AFEs increased by 2.2%pt (95%CI -0.6, 5.1), while those alive with major AFEs increased by 1.9%pt (95%CI 0.02, 3.6). This trend was absent in the negative control group.</p><p><strong>Conclusions and relevance: </strong>The trade-off between survival gains and increased economic hardships linked to treatment innovations underscores the need to expand our focus beyond clinical outcomes and implement protective measures that ensure healthcare advancements promote population health without inducing financial distress.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528053","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":"Accelerometer-derived concentrated physical activity pattern and mortality in cancer survivors: the UK Biobank accelerometry study.","authors":"Haoting Shi, Zheshen Han, Qing Qu, Jingxuan Huang, Ruixin Pan, Jing Yu, Chao Hu, Qiaoge Chi, Shi Zhao, Jinliang Wang, Xiaosong Chen, Kunwei Shen, Rong Cai","doi":"10.1093/jnci/djaf146","DOIUrl":"https://doi.org/10.1093/jnci/djaf146","url":null,"abstract":"<p><p>Although reduced mortality associated with moderate-to-vigorous physical activity (MVPA) has been reported among cancer survivors, the benefits of a concentrated PA pattern remain unclear. This prospective cohort study included 6,075 cancer survivors from the UK Biobank accelerometry dataset: 2,390 (39.3%) were inactive (< 150 minutes/week), 1,295 (21.3%) were active concentrated (≥ 150 minutes/week and achieved ≥ 50% total MVPA within 1-2 days), and 2,390 (39.3%) were active regular (≥ 150 minutes/week, but other than concentrated). After a median follow-up of 8 years (interquartile range, 7.5-8.5), 634 deaths occurred. Both active concentrated and regular patterns were associated with reduced all-cause mortality (HR 0.72 [95% CI, 0.60-0.86]; HR 0.71 [95% CI, 0.56-0.89]) and non-cancer mortality (HR 0.66 [95% CI, 0.47-0.92]; HR 0.56 [95% CI, 0.35-0.89]). These findings highlight the concentrated PA pattern as a lifestyle intervention for cancer survivors.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511958","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: Association of radiation-induced normal tissue toxicity with a high genetic risk for rheumatoid arthritis.","authors":"Qu Zheng, Bao-Qiang Dong, Yiyan Han","doi":"10.1093/jnci/djaf144","DOIUrl":"https://doi.org/10.1093/jnci/djaf144","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293685","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 non-steroidal anti-inflammatory medications and aspirin with colorectal cancer incidence in older adults.","authors":"Farzana Y Zaman, Suzanne G Orchard, Galina Polekhina, Peter Gibbs, Wendy B Bernstein, Finlay Macrae, Jeanne Tie, Jeremy Millar, Lucy Gately, Luz María Rodríguez, Gj Van Londen, Victoria Mar, Emma Hiscutt, Nikki Adler, Aaron Kent, Wee Loon Ong, Andrew Haydon, Erica Warner, Andrew T Chan, John Zalcberg","doi":"10.1093/jnci/djaf145","DOIUrl":"https://doi.org/10.1093/jnci/djaf145","url":null,"abstract":"<p><strong>Background: </strong>The relationship between aspirin, and/or other non-steroidal anti-inflammatories (NSAIDs), and colorectal cancer (CRC) risk in older adults is uncertain. This study investigated the association between non-aspirin NSAIDs (NA-NSAIDs) use, alone or combined with aspirin, on CRC incidence in older adults.</p><p><strong>Methods: </strong>This is a post-hoc analysis of ASPREE randomized controlled trial data and its observational continuation, ASPREE-XT (median follow-up, 8.4 years (IQR: 7.2-9.6)). NA-NSAID exposure was ascertained by self-report and medical record review at baseline, for all ASPREE participants, and for Australian participants, via linkage to the Pharmaceutical Benefits Scheme (PBS). CRC was an adjudicated secondary endpoint of ASPREE. We investigated the association between NA-NSAID use alone, and in combination with randomised aspirin use, on the incidence of CRC in time-to-event analyses.</p><p><strong>Results: </strong>Of 19,114 ASPREE participants, 2713 (14%) reported NA-NSAID use at baseline. NA-NSAID use was associated with a reduced incidence of CRC (HR NA-SAID use:Yes vs No = 0.74; 95%CI: 0.56-0.98). This association between NA-NSAIDs and CRC was not modified by aspirin (P-value for interaction term of 0.81). When assessing NA-NSAID use over 2 years post-randomization in Australian participants who consented to the use of PBS data (N = 13,725), a similar reduction in CRC risk was observed (HR High NA-NSAID use vs None = 0.52, 95%CI 0.32-0.83).</p><p><strong>Conclusions: </strong>NA-NSAID use in Australian and American adults over the age of 70 years was associated with a reduced CRC incidence, which increased with increasing exposure. Aspirin did not modify the effect of NA-NSAIDs on CRC incidence.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293684","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":"Identifying and mitigating the biological effectors of the social determinants of health in cancer.","authors":"Monica Wagner, Christopher L Benson, Samilia Obeng-Gyasi, Suzanne Conzen, Lauren E Mccullough, Chanita Hughes Halbert, Stanton L Gerson","doi":"10.1093/jnci/djaf141","DOIUrl":"https://doi.org/10.1093/jnci/djaf141","url":null,"abstract":"<p><p>Recognizing the interconnectedness between social determinants of health (SDOH) and biological factors associated with cancer, the research community is working to identify and refine biological markers of SDOH that can help us better understand this complex interaction. The National Academies of Science, Engineering, and Medicine convened a workshop with the intent of exploring this interaction and how these factors affect cancer onset and cancer-related health outcomes1. Workshop presentations and discussions provided an overview of biological effectors and SDOH; emerging research in these areas, including the development and validation of biomarkers and strategies to improve the evidence base for monitoring, diagnosing, policy, research, and clinical practice opportunities to improve health and address the impact of SDOH on cancer risk, diagnosis and outcomes.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284378","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":"Trends in uterine cancer incidence and mortality: insights from a natural history model.","authors":"William D Hazelton, Matthew Prest, Ling Chen, Kevin Rouse, Elena B Elkin, Jennifer S Ferris, Xiao Xu, Nina B Bickell, Chung Yin Kong, Stephanie Blank, Eric J Feuer, Goli Samimi, Brandy M Heckman-Stoddard, Tracy M Layne, Jason D Wright, Evan R Myers, Laura J Havrilesky","doi":"10.1093/jnci/djaf135","DOIUrl":"https://doi.org/10.1093/jnci/djaf135","url":null,"abstract":"<p><strong>Background: </strong>Uterine cancer incidence and mortality are increasing, with concomitant disparities in outcomes between racial groups. Natural history modeling can evaluate risk factors, predict future trends, and simulate approaches to reducing mortality and disparities.</p><p><strong>Methods: </strong>We designed a natural history model of uterine cancer using a multistage clonal expansion design. The model is informed by National Health and Nutrition Examination Surveys (NHANES), National Health Examination Surveys (NHES), age, period, birth cohort, and birth certificate data on reproductive histories (RH) and body mass index (BMI), and is fit and calibrated to Surveillance, Epidemiology, and End Results (SEER) data by race/ethnicity and histologic subgroup. We projected future incidence and estimated the degree of contribution of BMI, RH, and competing hysterectomy to excess uterine cancer incidence.</p><p><strong>Results: </strong>The model accurately replicated SEER incidence for endometrioid (EM), non-endometrioid (non-EM), and sarcoma subgroups for non-Hispanic Black (NHB) and non-Hispanic White (NHW) patients. For EM, non-EM, and Sarcomas, BMI-attributable risks are greater for NHW than NHB; RH-attributable risks are greater for NHB. Between 2018 and 2050, EM incidence is projected to rise by 64.9% in NHB and17.5% in NHW; non-EM projected rise is 41.4% in NHB and 22.5% in NHW; sarcoma incidence projected increase is 36% in NHB and 29.2% in NHW.</p><p><strong>Conclusions: </strong>Uterine cancer risk is substantially explained by RH and BMI, with differences observed between NHB and NHW and future projections indicating perpetuation of disparities. Lower rates of hysterectomy and rising obesity rates will likely contribute to continued increases in uterine cancer incidence.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284383","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 Yin and Dong.","authors":"Tanja Stocks, Josef Fritz","doi":"10.1093/jnci/djaf111","DOIUrl":"https://doi.org/10.1093/jnci/djaf111","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284381","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}