JNCI Journal of the National Cancer Institute最新文献

{"title":"Determinants of late metastases in renal cell carcinoma.","authors":"Payal Kapur, Hua Zhong, Alana Christie, Haitao Xu, Qi Cai, Ellen Araj, David Kim, Jeffrey Miyata, Vanina T Tcheuyap, Colleen T Ball, David D Thiel, Alexander Parker, Samuel O Antwi, Brad C Leibovich, Zora Modrusan, John C Cheville, James Brugarolas","doi":"10.1093/jnci/djaf060","DOIUrl":"https://doi.org/10.1093/jnci/djaf060","url":null,"abstract":"<p><p>The mechanisms underlying metastatic latency in renal cell carcinoma (RCC) remain poorly understood. This study evaluated two large independent cohorts for differences in tumor biology between patients who developed metastases early (≤1 year after nephrectomy) and those with late-onset (>3 years). In the discovery cohort (n = 161), late-metastatic RCC (late-mRCC) was associated with clear cell histology (88.9% vs 78.7%), lower pathological stage (pT1-2; 40.3% vs 18.0%), and favorable histopathological features including low grade (40.0% vs 2.3%), less sarcomatoid (5.6% vs 21.8%), and reduced necrosis (37.7% vs 78.3%; all p < .02). Late-mRCC tumors exhibited increased angiogenesis (63.5% vs 19.4%) and reduced inflammation (78.8% vs 50.0%; all p < .02) profiles. Genomic driver analyses revealed comparable rates of PBRM1 and SETD2 loss in both late- and early-mRCC, while BAP1 loss was significantly less common in late-mRCC (7.5% vs 27.1%; p < .02). In multivariable models, BAP1/PBRM1/SETD2 status and tumor necrosis emerged as key discriminators of late-mRCC. These findings were confirmed in the second cohort (n = 307). Late-mRCC was enriched for fatty acid oxidation and angiogenesis pathways, supporting a less aggressive phenotype. This was further evidenced by a lower engraftment rate in murine models (0% vs 36.5%; p < .001) and significantly longer overall survival from the time of metastasis (median survival doubled, p < .001). Interestingly, late-mRCC shared genomic and phenotypic features with RCC that metastasizes to the pancreas, suggesting a common underlying biology that influences both metastatic latency and pancreatic tropism. Overall, these findings advocate for recognition of late-mRCC, due to its distinct biology and improved prognosis.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596991","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":"Facility exposure to wildfire disasters and hospital length of stay following lung cancer surgery.","authors":"Leticia M Nogueira, K Robin Yabroff, Elizabeth Yates, James M Shultz, R Burciaga Valdez, Amruta Nori-Sarma","doi":"10.1093/jnci/djaf040","DOIUrl":"https://doi.org/10.1093/jnci/djaf040","url":null,"abstract":"<p><strong>Background: </strong>Wildfires pose substantial health and safety threats to patients recovering from lung cancer surgery. Without specific disaster preparedness guidelines, surgical oncologists might resort to improvisational strategies, such as extending post-operative length of stay (LOS) to support surgical recovery and better protect the health and safety of patients.</p><p><strong>Methods: </strong>Individuals aged ≥18 years who received curative-intent lobectomy or pneumonectomy for stage I-III non-small cell lung cancer between 2004 and 2021 were selected from the National Cancer Database. Exposure was defined as a Federal Emergency Management Agency wildfire Presidential Disaster Declaration in the county of the treating facility between date of surgery and date of discharge from the hospital. Differences in the cumulative distribution function of LOS were evaluated between exposed and propensity score-matched unexposed patients treated at the same facility.</p><p><strong>Results: </strong>Patients exposed to a wildfire disaster declaration in the county of the treating facility had longer LOS than unexposed patients (9.4 days compared to 7.5 days, respectively; p < .001) overall and for each stage (I-III) for which surgery is the recommended treatment modality.</p><p><strong>Conclusions: </strong>Patients whose facility was impacted by a wildfire disaster during recovery from lung cancer surgery had longer LOS than similar patients treated at the same facility but at times when no disaster occurred. Such findings complicate the use of LOS as a post-operative quality metric. Future studies should evaluate whether extended hospital stay improves surgical care outcomes during disasters. Moreover, these findings should be considered for disaster preparedness guidelines tailored to vulnerable patient populations.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596993","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":"https://doi.org/10.1093/jnci/djaf055","url":null,"abstract":"<p><strong>Background: </strong>Following 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 state-wide 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 three 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, 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 significantly for vaccine types HPV16/18 and for HPV31 and HPV33. While 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":""},"PeriodicalIF":9.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy results in decreased time to second cancer in children with Li Fraumeni syndrome.","authors":"Emma R Woodward, John-Paul Kilday, Stephanie Ng, Anna Kelsey, D Gareth R Evans","doi":"10.1093/jnci/djaf057","DOIUrl":"https://doi.org/10.1093/jnci/djaf057","url":null,"abstract":"<p><p>Li Fraumeni Syndrome (LFS) arising from germline TP53 mutation results in defective DNA repair and increased risk of multiple primary cancers beginning in childhood. Curative intent radiotherapy is often used to treat childhood cancer but its impact in children in LFS has not been reviewed. We undertook a retrospective case-series review of 4 children with a solid cancer diagnosed ≤16years to assess time and survival following second cancer diagnosis. Following radiotherapy for the first cancer diagnosis, median time to second primary cancer diagnosis was 13.3 years and median survival 9.7 years. Where no radiotherapy was received median time to second primary cancer diagnosis was 25.1 years [Chi2=14.8, P < .0001; HR = 7.9 (95% CI:2.8-22.6)], and median survival of 29.2 years [Chi2=12.5, P = .004, HR = 3.2 (95% CI : 1.5-6.6)]. Radiotherapy for first cancer in children with LFS is associated with adverse outcomes and ought be considered only in the absence of other potentially curative options. Where unavoidable, second cancer risks must be minimised.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585800","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":"Mortality in children with congenital heart disease and cancer: new insights, ongoing challenges.","authors":"Jeremy M Schraw, Amanda E Janitz","doi":"10.1093/jnci/djaf035","DOIUrl":"https://doi.org/10.1093/jnci/djaf035","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556858","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 Young-Onset Cancer Incidence: A Modeling Perspective.","authors":"Lukas Owens, Allison Fung, Jonathan Shuhendler, Joseph Glick, Marc D Ryser, Roman Gulati, Ruth Etzioni","doi":"10.1093/jnci/djaf050","DOIUrl":"https://doi.org/10.1093/jnci/djaf050","url":null,"abstract":"<p><strong>Background: </strong>Recent increases in the diagnosis of certain cancers among younger individuals are generating intense concern. Many studies attribute the increase in so-called \"young-onset\" cancer to an etiologic cause but questions have also arisen about the role of earlier diagnosis.</p><p><strong>Methods: </strong>We simulate incidence trends from a natural history model that includes healthy, preclinical, and clinical disease states, where transitions from a healthy to a preclinical state represent disease onset and transitions from the preclinical to the clinical state represent diagnosis. We superimpose birth cohort effects on the rate of disease onset and period effects on the rate of disease diagnosis to identify those that match patterns of relative incidence by age group and five-year calendar interval from 2000-2019 for six \"young-onset\" cancers (colon, rectum, female breast, gastric, pancreas, kidney).</p><p><strong>Results: </strong>Two types of effects are broadly consistent with the observed increasing incidence trends in younger individuals: (1) A birth-cohort effect on disease onset that begins around 1970 and becomes more pronounced in later birth years, or (2) A period effect consistent with progressive reduction over time in the duration of preclinical disease. An earlier, protective birth cohort effect is consistent with recent declining trends in incidence in older individuals for colon, rectal, and gastric cancers.</p><p><strong>Discussion: </strong>A disease model provides clues about the possible drivers of cancer incidence trends, suggests constraints on the patterns of exposures that might be implicated etiologically, and indicates that the role of diagnostic changes warrants consideration alongside potential etiologic explanations.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":""},"PeriodicalIF":9.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556869","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":"Testing stored control-arm specimens could dramatically increase statistical power yet reduce costs in cancer screening trials.","authors":"Hormuzd A Katki","doi":"10.1093/jnci/djae293","DOIUrl":"10.1093/jnci/djae293","url":null,"abstract":"","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"393-395"},"PeriodicalIF":9.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853951","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":"Prevalence of cancer survivors diagnosed during adolescence and young adulthood in the United States.","authors":"Lindsey L Page, Theresa P Devasia, Angela Mariotto, Lisa Gallicchio, Michelle A Mollica, Emily Tonorezos","doi":"10.1093/jnci/djae250","DOIUrl":"10.1093/jnci/djae250","url":null,"abstract":"<p><strong>Background: </strong>Adolescent and young adult (AYA) cancer incidence rates are rising, and survivors are at risk for numerous cancer- and treatment-related consequences. Despite growing attention to this population, prevalence estimates are lacking.</p><p><strong>Objective: </strong>To estimate the number of individuals living in the United States with a history of cancer diagnosed during the AYA period.</p><p><strong>Methods: </strong>Prevalence of cancer survivors diagnosed between the ages of 15 and 39 years was estimated using data from the Surveillance, Epidemiology, and End Results (SEER) program as of January 1, 2020. Limited duration prevalence data were also used to generate complete prevalence by sex, years since diagnosis (0-<1, 1-<5, 5-<10, 10-<15, 15-<20, 20+), and attained age (15-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70+) for the 15 most common AYA cancer sites.</p><p><strong>Results: </strong>There were an estimated 2 111 838 survivors of AYA cancers in the United States as of January 1, 2020. More survivors were female (66%) and long-term (>5 years from diagnosis, 83%) or very long-term survivors (>10 years from diagnosis, 68.8%). A large percentage (44%) were more than 20 years from diagnosis. The most common cancer sites among female survivors were breast (24%) and thyroid cancers (23%) and, among male survivors, testicular cancer (31%). Across the population, the highest percentage of survivors of AYA cancers were 40 to 49 years of age (25.3%).</p><p><strong>Conclusion: </strong>There are more than 2.1 million cancer survivors diagnosed in the AYA period who are living in the United States; most are more than 10 years from diagnosis.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"529-536"},"PeriodicalIF":9.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390690","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":"Impact of COVID-19 on 2021 cancer incidence rates and potential rebound from 2020 decline.","authors":"Nadia Howlader, Huann-Sheng Chen, Anne-Michelle Noone, Daniel Miller, Jeffry Byrne, Serban Negoita, Kathleen A Cronin, Angela B Mariotto","doi":"10.1093/jnci/djae180","DOIUrl":"10.1093/jnci/djae180","url":null,"abstract":"<p><p>The COVID-19 pandemic led to substantial declines in cancer incidence rates in 2020, likely because of disruptions in screening and diagnostic services. This study aimed to assess the impact of the pandemic on cancer incidence rates in the United States using 2021 incidence data from the Surveillance, Epidemiology, and End Results program. The analysis compared observed 2021 cancer incidence rates with expected prepandemic trends, evaluating changes by individual cancer site and stage. Although incidence overall and in many cancer sites the rates were close to prepandemic levels, they did not exhibit a recovery that incorporated the delayed diagnoses from 2020. There were exceptions, however, such as metastatic breast cancer, which showed significantly higher observed rates than expected (rate ratio = 1.09, 95% confidence interval = 1.04 to 1.13). Ongoing monitoring and targeted interventions are needed to address the long-term consequences of the COVID-19 pandemic on cancer care and outcomes.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"507-510"},"PeriodicalIF":9.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307794","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":"Cancer chemotherapy in pregnancy and adverse pediatric outcomes: a population-based cohort study.","authors":"Amy Metcalfe, Zoe F Cairncross, Carly A McMorris, Christine M Friedenreich, Gregg Nelson, Parveen Bhatti, Deshayne B Fell, Sarka Lisonkova, Khokan C Sikdar, Lorraine Shack, Joel G Ray","doi":"10.1093/jnci/djae273","DOIUrl":"10.1093/jnci/djae273","url":null,"abstract":"<p><strong>Background: </strong>Administration of chemotherapy during pregnancy is often delayed, while preterm delivery is common. If in utero exposure to chemotherapy is associated with adverse pediatric outcomes, it is unknown whether that relationship is directly attributable to the chemotherapy or is mediated by preterm birth.</p><p><strong>Methods: </strong>Patients were identified from Canadian cancer registries and administrative data in Alberta, British Columbia, and Ontario, 2003-2017, with follow-up until 2018. The primary exposure was receipt of chemotherapy during pregnancy. Severe neonatal morbidity and mortality (SNM-M), neurodevelopmental disorders and disabilities (NDDs), and pediatric complex chronic conditions (PCCC) reflected short- and long-term pediatric outcomes. Modified Poisson and Cox proportional hazard regression models generated adjusted risk ratios (RR) and hazard ratios (HR), respectively. The influence of preterm birth on the association between exposure to chemotherapy in pregnancy and each study outcome was explored using mediation analysis.</p><p><strong>Results: </strong>Of the 1150 incident cases of cancer during pregnancy, 142 (12.3%) received chemotherapy during pregnancy. Exposure to chemotherapy in pregnancy was associated with a higher risk of SNM-M (RR = 1.67, 95% confidence interval [CI] = 1.13 to 2.46), but not NDD (HR = 0.93, 95% CI = 0.71 to 1.22) or PCCC (HR = 0.96, 95% CI = 0.80 to 1.16). Preterm birth less than 34 and less than 37 weeks mediated 75.8% and 100% of the observed association between chemotherapy and SNM-M, respectively.</p><p><strong>Conclusions: </strong>Most children born to people with cancer during pregnancy appear to have favorable long-term outcomes, even after exposure to chemotherapy in pregnancy. However, preterm birth is quite common and may contribute to increased rates of adverse neonatal outcomes.</p>","PeriodicalId":14809,"journal":{"name":"JNCI Journal of the National Cancer Institute","volume":" ","pages":"554-561"},"PeriodicalIF":9.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545628","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}