International Journal of Cancer最新文献

{"title":"Improved Prediction of Colon Cancer Recurrence Using the ColoNode mRNA Test: A 5-Year Survival Analysis.","authors":"Basel Sitohy, Gudrun Lindmark, Anne Israelsson, Lina Olsson, Tamer Roshdy, Joel Blomqvist, Sara Kero, Mattias Söderholm, Annamaria Turi, Thorbjörn Sakari, Michiel Dooper, George Dafnis, Pehr Forsberg, Susanne Skovsted, Maria Walldén, Chih-Han Kung, Martin Rutegård, Johanna Nordmyr, Måns Muhrbeck, Sten Hammarström, Marie-Louise Hammarström","doi":"10.1002/ijc.70743","DOIUrl":"https://doi.org/10.1002/ijc.70743","url":null,"abstract":"<p><p>Twenty-five percent of colon cancer patients having curative surgery will recur. Most of them will die from distant metastasis partly due to shortcomings of routine histopathological analysis, that is, undetected tumor cells in the regional lymph node field. We have developed ColoNode, an mRNA test in which five biomarkers are quantified and related to a house-keeping gene. Thereby, four different risk groups are defined from low to very high-risk of recurrence being highly valuable as various indicators of the risk of occult tumor cell dissemination and their aggressiveness. Here we report results of the 5-year survival analysis of a prospective study involving nine Swedish hospitals comparing ColoNode with routine histopathology. The study involves 186 colon cancer patients. The following four conclusions can be drawn: (1) ColoNode surpassed histopathology by identifying all 20 patients who were found by histopathology and an additional seven patients who recurred. Multivariate analysis provided a hazard ratio of 6.7 (p = 0.002) while histopathology lost its significance (HR: 1.3; p = 0.60). Only perineural invasion remained as an independent risk factor apart from ColoNode, with a hazard ratio of 2.7 (p = 0.038). (2) Patients belonging to medium-risk group apparently benefited from adjuvant chemotherapy treatment. (3) A total of 113 patients (≈60%) belonged to the low-risk group and can be considered cured by surgery alone. (4) Four patients were missed by both ColoNode and histopathology. Possible reasons for this are discussed. The results suggest that the ColoNode test should be added to the arsenal of prognostic tools, maybe even replacing histopathological lymph node analysis.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited Assessment of Proportional Hazards Despite More Frequent Violations Identified in Updated Oncology Trial Analyses: Frequency, Patterns, and Statistical Implications.","authors":"Mingye Zhao, Yunlin Jiang, Taihang Shao, Hanqiao Shao, Yunong Jiang, Yuan Li, Hongshu Fang, Wenxi Tang","doi":"10.1002/ijc.70748","DOIUrl":"https://doi.org/10.1002/ijc.70748","url":null,"abstract":"<p><p>Prior studies suggest that proportional-hazards violations (PHVs) occur in oncology randomized controlled trials (RCTs) and may affect conclusions, but evidence has largely focused on initial reports rather than updated analyses. We examined PH testing practices, frequency, patterns, and statistical implications of PHVs in updated oncology RCTs. We focused on oncology RCTs supporting US Food and Drug Administration approvals. Phase II-III oncology RCTs supporting FDA approvals between 2006 and 2025 were identified. Individual patient data were reconstructed from Kaplan-Meier curves. PHVs were assessed using Schoenfeld residuals. Treatment effects were analyzed with Cox proportional-hazards models, log-rank tests, MaxCombo, and restricted mean survival time difference (RMSD). Two hundred seventy endpoint comparisons (150 overall survival [OS], 120 non-OS) from 168 RCTs were included. PH testing dropped from 24.1% in initial reports to 11.5% in updates (McNemar p < 0.001). Although PH testing increased over the past decade in initial publications (Wald p < 0.001), no trend in updates (Wald p = 0.29). PHV frequency was numerically higher in updated than initial analyses (38.9% vs. 33.0%). Non-OS endpoints, metastatic settings, and immunotherapy or targeted-therapy regimens were associated with PHVs. Among updated analyses, nominal significance differences between PH-dependent and alternative methods were more frequent with PHVs (MaxCombo: 11.4% vs. 3.6%, chi-square p = 0.012; RMSD: 8.6% vs. 2.4%, chi-square p = 0.021). PHV patterns were diminishing effects (35.2%), delayed separation (27.6%), and crossing hazards (27.6%). PH testing declined in updated analyses despite numerically more frequent PHVs. Although updates are descriptive and do not invalidate original conclusions, unrecognized non-proportionality may affect long-term benefit interpretation, supporting PH diagnostics and prespecified complementary analyses.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Prospective Comparison Between Neoadjuvant Mitomycin C Plus Cisplatin and Paclitaxel Plus Carboplatin in Patients With BRCA1-Associated Ovarian Cancer.","authors":"Tatiana V Gorodnova, Anna P Sokolenko, Khristina B Kotiv, Roman V Donskih, Maria G Yakovleva, Yuri N Trifanov, Svetlana N Aleksakhina, Natalia S Morozova, Ekaterina A Kolesnikova, Victoria O Smirnova, Alexey M Belyaev, Igor V Berlev, Evgeny N Imyanitov","doi":"10.1002/ijc.70750","DOIUrl":"https://doi.org/10.1002/ijc.70750","url":null,"abstract":"<p><p>Neoadjuvant mitomycin C plus cisplatin (MP) previously demonstrated promising activity in high-grade serous ovarian cancer in a single-arm study of BRCA1 pathogenic variant (PV) carriers. This prospective, open-label, randomized Phase II trial (NCT04747717) compared MP with standard paclitaxel-carboplatin (TCbP) in women with germline BRCA1/2 PVs. Here, we report a per-protocol analysis of the BRCA1 subgroup involving 29 MP and 31 TCbP patients. Grade III-IV anemia and thrombocytopenia were more frequent with MP, while other adverse events showed similar distribution. RECIST v1.1 response rates did not differ between treatment arms. Surgery was undertaken for 25 MP and 28 TCbP patients. Complete cytoreduction was achieved in 20/25 (80%) MP and 19/28 (68%) TCbP cases. All MP patients underwent complete debulking after 3-4 neoadjuvant cycles, while six out of 19 women from the TCbP arm required more than 4 cycles to achieve surgical clearance of tumor lumps (p = 0.008). MP outperformed TCbP in the improvement of the peritoneal cancer index (p = 0.001). Complete absence of tumor cells in the omentum was documented in 4/25 (16%) MP patients and 6/28 (21%) TCbP patients (p = 0.73). Maintenance olaparib, complete cytoreduction, resolution of carcinomatosis, and TP53 mutation type (loss-of-function (LOF) versus non-LOF) were associated with improved disease-free interval (DFI). At a median follow-up of 44.8 months, multivariate analysis revealed no differences in progression-free survival or DFI between treatment arms. In conclusion, MP showed no significant efficacy advantage over TCbP but produced a rapid and profound reduction of tumor burden, thus warranting further evaluation. Trial Registration: ClinicalTrials.gov (identifier: NCT04747717).</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene Expression Biomarkers for Breast Ductal Carcinoma in Situ Recurrence Prediction.","authors":"Alexandria Un, Sakshi Mahale, David Byrne, Dorothea Lesche, Carlos Martinez-Perez, Jia-Min Pang, Maree Pechlivanis, Hugo Saunders, Madawa W Jayawardana, Tongtong Luo, Sureshni I Jayasinghe, Tanjina Kader, Lisa Devereux, Puay Hoon Tan, Andrew R Green, Emad A Rakha, Arran K Turnbull, Stephen B Fox, G Bruce Mann, Kylie L Gorringe","doi":"10.1002/ijc.70746","DOIUrl":"https://doi.org/10.1002/ijc.70746","url":null,"abstract":"<p><p>Breast ductal carcinoma in situ (DCIS) is often overtreated due to a lack of robust prognostic and predictive tools. This study aimed to evaluate gene expression in a well-characterised DCIS cohort to determine their clinical utility as biomarkers for ipsilateral recurrence. RNA was extracted from microdissected tissues from primary DCIS. A 129-gene panel was analysed using NanoString in 174 DCIS cases (131 with no recurrence and 43 with recurrence). Association with recurrence was determined by Cox regression analyses. Validation was performed by immunohistochemistry. A new 7-gene panel (PBK, COL1A2, GSTM5, MMP2, MX1, SLC22A3 and ZEB1) was derived from the NanoString data but could not be validated in external datasets, including when stratified by radiotherapy treatment. Increased expression of ZEB1 alone was consistently significantly associated with longer recurrence-free survival in discovery and validation cohorts (hazard ratios 0.56-0.71). Correlation between mRNA and protein expression showed the strongest association with peri-ductal fibroblast expression. However, there was no association of ZEB1 protein expression in these cells with recurrence in an independent cohort. Existing multigene panels showed inconsistent associations with recurrence in the current cohort. Gene expression panels show limited reproducibility across cohorts, highlighting the need for prospective trials and context-specific validation. ZEB1 mRNA emerges as a potential biomarker warranting further investigation for its clinical utility in guiding management decisions in DCIS.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle Factors Associated With Colorectal Adenomas: Results From a Vietnamese Case-Control Study.","authors":"Chi Thi-Du Tran, Tuan Thanh Nguyen, Mo Thi Tran, Huong Thi-Thu Pham, Hung Nguyen Luu, Xiao-Ou Shu, Linh Cu Le","doi":"10.1002/ijc.70751","DOIUrl":"https://doi.org/10.1002/ijc.70751","url":null,"abstract":"<p><p>Although colorectal cancer (CRC) is the fourth most common cancer in Vietnam, evidence on lifestyle factors associated with colorectal adenomas (CRA) remains limited. We conducted a case-control study to examine lifestyle factors associated with CRA. Conditional logistic regression (CLR) was performed using 845 matched case-control pairs. Structural equation modeling (SEM) and propensity score matching (PSM) analyses were conducted using the full sample of 847 cases and 1201 controls. CLR identified heavy alcohol consumption (OR 1.59, 95% CI: 1.13-2.23), current smoking (OR 1.88, 95% CI: 1.28-2.76), a personal history of colorectal polyps (OR 7.02, 95% CI: 4.02-12.27), and a sibling history of CRC (OR 3.33, 95% CI: 1.23-9.03) as risk factors for overall adenomas. A personal history of colorectal polyps was associated with both advanced and non-advanced adenomas, whereas current smoking and heavy alcohol consumption were associated with advanced but not non-advanced adenomas. SEM and PSM generally corroborated the CLR findings, with heavy alcohol consumption, current smoking, and a personal history of colorectal polyps associated with advanced adenomas. PSM additionally suggested a possible positive association between high meat consumption and advanced adenomas. CLR identified an inverse association between a beverage pattern characterized by coffee, black tea, and fruit juice consumption and adenoma prevalence; however, this finding was not confirmed in PSM. In conclusion, current smoking, heavy alcohol consumption, and a personal history of colorectal polyps were consistently associated with an increased risk of CRA, particularly advanced adenomas. These findings support lifestyle-focused prevention strategies and risk-stratified CRC surveillance in Vietnam.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic Markers of Cell Division and Ageing in Relation to Breast Cancer Survival","authors":"Luca Li,&nbsp;Elaheh Zarean,&nbsp;Danmeng Lily Li,&nbsp;Yiyue Zhu,&nbsp;Shuai Li,&nbsp;Enes Makalic,&nbsp;Catriona McLean,&nbsp;Graham G. Giles,&nbsp;Roger L. Milne,&nbsp;Melissa C. Southey,&nbsp;Pierre-Antoine Dugué","doi":"10.1002/ijc.70618","DOIUrl":"10.1002/ijc.70618","url":null,"abstract":"<p>Breast cancer remains a major challenge to public health. Biomarkers may be useful to improve prediction of breast cancer survival. Several epigenetic markers of cell division and ageing based on DNA methylation have been proposed. In this study, we measured these epigenetic markers in breast tumours and assessed their prognostic value. We used genome-wide DNA methylation data measured in 1992 breast cancer tumours from the Melbourne Collaborative Cohort Study and publicly available datasets. We calculated four markers of cell division (<i>epiTOC2</i>, <i>stemTOC</i>, <i>MiAge</i> and <i>CellDRIFT</i>), two markers of chronological age (<i>Horvath age</i> and <i>BTEC</i>), and four markers of biological age (<i>PhenoAge</i>, <i>GrimAge</i>, <i>MRscore</i> and <i>DunedinPACE</i>). Cox regression models were used to assess the associations of age-adjusted epigenetic markers with 5-year overall survival, with adjustment for clinical variables. Effect modification by estrogen receptor (ER) status and molecular subtype was also investigated. After adjustment for age and stratification by study, higher levels of cell division markers were associated with poorer survival (e.g., <i>epiTOC2</i>: per one-standard-deviation increase, hazard ratio [HR] = 1.14, 95% CI: 1.03–1.27), whereas higher chronological age markers were linked to better prognosis (e.g., <i>Horvath age</i>: HR = 0.70, 95% CI: 0.61–0.82). Epigenetic markers of biological age showed variable associations. These associations were partly explained by the main clinicopathological variables at diagnosis and varied across subtypes. Our study revealed associations of several epigenetic markers with breast cancer survival. The associations were quite weak, suggesting these markers may have limited prognostic value. The varying associations observed among subtypes may reflect underlying biological differences that should be further investigated.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":"159 10","pages":"2452-2462"},"PeriodicalIF":4.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ijc.70618","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148337066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Evidence on the Efficacy of Icaritin for Unresectable Advanced Hepatocellular Carcinoma: A Multicenter Retrospective Study","authors":"Dinghu Zhang,&nbsp;Qinfen Xie,&nbsp;Zhewei Zhang,&nbsp;Song Wang,&nbsp;Jibing Liu,&nbsp;Xiang An,&nbsp;Kangshou Liu,&nbsp;Zhengping Yu,&nbsp;Huiling Xiang,&nbsp;Qiang He,&nbsp;Xin Zheng,&nbsp;Zukuan Chang,&nbsp;Ruijie Du,&nbsp;Li Zhang,&nbsp;Gong Li,&nbsp;Qingyu Xu,&nbsp;Wenjie Song,&nbsp;Bin Jin,&nbsp;Chongzhong Liu,&nbsp;Jianjun Li,&nbsp;Xu Zhou,&nbsp;Wenbin Li,&nbsp;Xiaojun Yang,&nbsp;Chuanlei Zhang,&nbsp;Hui Zeng","doi":"10.1002/ijc.70590","DOIUrl":"10.1002/ijc.70590","url":null,"abstract":"<div>\u0000 \u0000 <p>Icaritin's efficacy was evaluated for unresectable advanced hepatocellular carcinoma (HCC), a major global burden with limited advanced-stage treatment options. A multicenter retrospective real-world study (May 2022–May 2024) included 163 patients with unresectable advanced HCC. Treatments were Icaritin monotherapy, Icaritin + anti-VEGF, or Icaritin + PD-1 inhibitors + anti-VEGF. Primary endpoints were progression-free survival (PFS) and overall survival (OS); secondary endpoints were objective response rate (ORR) and disease control rate (DCR). Subgroup analyses assessed alpha-fetoprotein (AFP) impact. In first-line treatment, Icaritin monotherapy achieved an ORR of 26.32%. Combining Icaritin with PD-1 inhibitors and anti-VEGF agents increased ORR to 38.30%. Median PFS was 4.27 months for monotherapy; second-line median OS for Icaritin monotherapy reached 19.91 months. Patients with AFP &lt; 400 ng/mL generally showed numerically better PFS in first-line regimens compared to those with AFP ≥ 400 ng/mL. Patients with high AFP treated with Icaritin + PD-1 inhibitors demonstrated a promising response. Icaritin shows promising efficacy in unresectable HCC, particularly in patients with lower AFP levels. The findings support personalized treatment strategies and warrant further research to optimize outcomes and elucidate Icaritin's mechanisms.</p>\u0000 </div>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":"159 10","pages":"2525-2539"},"PeriodicalIF":4.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148215911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Associations Between Inflammation and Multi-Dimensional Fatigue up to 2 Years After Colorectal Cancer Diagnosis","authors":"Anouk E. C. Bruijnzeels,&nbsp;Floortje Mols,&nbsp;Katrijn Van Deun,&nbsp;Dounya Schoormans","doi":"10.1002/ijc.70613","DOIUrl":"10.1002/ijc.70613","url":null,"abstract":"<p>Cancer-related fatigue (CRF) is a prevalent symptom among colorectal cancer (CRC) survivors. While inflammation is a proposed underlying mechanism, longitudinal evidence including pre-treatment assessments remains scarce. Within the population-based PROCORE study, newly diagnosed CRC patients provided blood samples and completed questionnaires at diagnosis (<i>n</i> = 411; 60.6% male; age = 67.0 years), 12- (<i>n</i> = 304), and 24-month follow-up (<i>n</i> = 252). Eleven inflammatory biomarkers (CRP, IFN-γ, IL-1α, IL-1β, IL-6, IL-8, IL-10, IL-17A, IL-22, sTNFRI, and sTNFRII) were assayed; CRF was measured with the Multidimensional Fatigue Inventory. Hybrid linear mixed models disentangled between- and within-subject associations, controlling for sociodemographic (e.g., age), clinical (e.g., cancer treatment), and lifestyle covariates (e.g., BMI), sleep quality, and pain. A normative age- and sex matched sample (<i>n</i> = 204; 52.5% male; age = 64.3 years) was included for comparison. Soluble TNF receptors (sTNFRI/II) were most robustly and positively associated with nearly all fatigue dimensions. CRP was positively associated with mental and physical fatigue; IL-8 positively associated with multiple domains including reduced motivation; and IFN-γ positively associated with general fatigue and reduced activity. Lower IL-1α was associated with more mental fatigue. Between-subject effects mirrored overall results; within-subject effects were more selective. Associations were most consistently observed for mental fatigue. In controls, less associations were significant; CRP was the most robust marker and positively associated with general fatigue, reduced activity, and reduced motivation. CRC survivors exhibited a broader, mostly TNF-α driven inflammatory signature of fatigue than controls. Findings highlight inflammation as a potential target underlying CRF, informing survivorship care strategies.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":"159 10","pages":"2437-2451"},"PeriodicalIF":4.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ijc.70613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can the Parallel or Tandem Combination of Questionnaire-Based Risk Assessment and Fecal Immunochemical Test Improve the Efficiency of Colorectal Cancer Screening?","authors":"Ruyue Liu,&nbsp;Junyi Ji,&nbsp;Xiaolin Wei,&nbsp;Chao Zheng,&nbsp;Nan Zhang,&nbsp;Qiang Sun","doi":"10.1002/ijc.70610","DOIUrl":"10.1002/ijc.70610","url":null,"abstract":"<p>Colorectal cancer (CRC) screening reduces disease burden, but the comparative performance of various screening strategies remains unclear. We evaluated the performance of four screening strategies based on questionnaire-based risk assessment (QRA) and fecal immunochemical test (FIT), followed by colonoscopy. In this population-based study, 14,327 residents aged 40–74 years from 13 regions in Shandong Province, China, were invited to undergo QRA, FIT, and colonoscopy between January 2024 and December 2025. Based on test results, we constructed four strategies: QRA-only, FIT-only, parallel (QRA or FIT positive), and tandem (QRA and FIT positive) combinations. The detection rate of CRC and advanced adenoma (AA), number needed to scope (NNS), and cost per case detected were compared. In total, 4982, 1806, 5970, and 764 individuals were identified as high-risk for each strategy. The tandem strategy detected 33 CRCs (4.32%) and 199 AAs (26.03%), compared with 35 (0.71%) and 553 (11.22%) in the QRA-only strategy, 68 (3.77%) and 340 (18.86%) in the FIT-only strategy, and 70 (1.17%) and 694 (11.62%) in the parallel strategy. Across subgroups defined by older age, male, and early-stage disease, the tandem strategy consistently yielded higher detection rates. The NNS to detect one CRC was 141, 27, 86, and 24, and the corresponding costs per CRC detected were $9874.31, $2097.88, $7084.68, and $1700.71 for each strategy. The tandem strategy combining QRA and FIT demonstrated superior performance in CRC screening. In resource-constrained settings, tandem strategies that jointly integrate risk assessment and FIT may improve the allocation and utilization of screening resources.</p>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":"159 10","pages":"2421-2430"},"PeriodicalIF":4.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ijc.70610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival Following Neoplastic Disease in Individuals With Neurofibromatosis 1—A National Danish Population-Based Cohort Study","authors":"Mia Aagaard Doherty,&nbsp;Kathrine Grell,&nbsp;Hanne Hove,&nbsp;Mette M. Handrup,&nbsp;John R. Østergaard,&nbsp;Anja Krøyer,&nbsp;Thomas T. Nielsen,&nbsp;Henrik Hjalgrim,&nbsp;John J. Mulvihill,&nbsp;Jan Wohlfahrt,&nbsp;Henrik Hasle,&nbsp;Cecilie Ejerskov,&nbsp;Line Kenborg","doi":"10.1002/ijc.70608","DOIUrl":"10.1002/ijc.70608","url":null,"abstract":"<div>\u0000 \u0000 <p>Population-based evidence on cancer survival in individuals with neurofibromatosis 1 (NF1) remains limited. We compared survival following a first neoplasm in individuals with NF1 to that of the general Danish population and stratified on age, sex, and potential survival-related factors, including cancer stage and comorbidity. Using the Danish Cancer Registry, we identified 428 individuals with NF1 and 392,885 without NF1, all diagnosed with a first neoplasm (1977–2022). We estimated survival using Kaplan–Meier methods, assessed neoplastic and nonneoplastic mortality, and evaluated prior inpatient disease burden in adults (aged 20–69 years) based on hospital diagnoses 10 years to 6 months before neoplasm diagnosis. Among children (aged 1–19 years), NF1 was overall associated with better 5-year survival (NF1: 87.3% [81.1%–93.5%], non-NF1: 78.7% [77.9%–79.6%]), due to better survival following central nervous system (CNS) neoplasms. In adults, 5-year survival was lower in NF1 compared to the general population (57.0% [51.3%–62.6%] vs. 69.2% [69.0%–69.3%]). NF1 adults more often presented with stage IV breast (17.2% vs. 6.3%) and gastrointestinal cancers (52.5% vs. 37.7%). Among adults with no prior inpatient diagnoses, 5-year survival was poorer in NF1 (60.1% [51.3%–68.9%] vs. 72.1% [71.9%–72.3%]). Five-year neoplastic mortality was higher in NF1 adults (39.4% [33.8%–45.0%] vs. 27.7% [27.6%–27.9%]). In conclusion, individuals with NF1, particularly adults, have poorer cancer survival than the general population. Differences in cancer type and stage at diagnosis contribute but do not fully explain the excess mortality, indicating that factors beyond general health status may play a role.</p>\u0000 </div>","PeriodicalId":180,"journal":{"name":"International Journal of Cancer","volume":"159 10","pages":"2408-2420"},"PeriodicalIF":4.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148292860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}