Cancer Control最新文献

{"title":"Ga-68-Edotreotide PET/CT SSTR Total Tumor Volume as a Predictor of Outcome in Patients With Metastatic Gastroenteropancreatic Neuroendocrine Tumors.","authors":"Rosj Gallicchio, Mariarita Milella, Alessia Giordano, Mauro Cives, Rebecca Storto, Anna Nardelli, Giovanni Calice, Matteo Landriscina, Giovanni Storto","doi":"10.1177/10732748251413808","DOIUrl":"10.1177/10732748251413808","url":null,"abstract":"<p><p>IntroductionThe somatostatin receptor (SSTR) standardized uptake value (SUVmax_sstr) obtained by [⁶⁸Ga]Ga-edotreotide positron emission tomography-computed tomography ([⁶⁸Ga]Ga-SSTR PET/CT) helps recognize patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) who are at a high risk for adverse outcomes. This observational cohort study was conducted to verify whether the SSTR representative tumor volume (RTV_sstr) can provide incremental prognostic information over conventional PET/CT parameters in patients with metastatic disease.MethodsWe retrospectively evaluated patients (48% female) with metastatic GEP-NETs who underwent [⁶⁸Ga]Ga-SSTR PET/CT between January 2022 and November 2023. The mean SUVmax_sstr, mean RTV_sstr (cm³; 42% threshold), and total RTV_sstr were recorded. Thereafter, patients were followed up for 22.9 (range: 8-42) months. The PET/CT results were compared to the progression free survival (PFS).ResultsSixty patients (59 ± 5 years) were enrolled. Only the mean and total RTV_sstr values were predictive in the multivariate analysis. Kaplan-Meier survival analysis for both the mean and total RTV_sstr demonstrated a significantly better PFS in patients presenting with lower than greater values (<i>P</i> = 0.001 and <i>P</i> = 0.007, respectively; log-rank test). SUVmax_sstr was not appropriate for predicting PFS.ConclusionThe mean or total RTV_sstr represents a valuable volumetric parameter able to predict outcomes in patients with GEP-NETs that are metastatic at onset. The degree of the SSTR representative tumor burden, rather than the maximal SSTR representation at single voxel, has a predominant value for influencing the response to therapy in this cohort.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748251413808"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12833188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Colorectal Cancer Chemoprevention Acceleration and Improvement Platform (CRC-CHAMP) - Cohort Description.","authors":"Darren R Brenner, Xuanhao Feng, Courtney Maxwell, John M Hutchinson, Chantelle Carbonell, Reynaldo Nambayan, Linda Rabeneck, Jill Tinmouth, Nauzer Forbes, Steven J Heitman, Khara M Sauro, Colleen Cuthbert, Dylan E O'Sullivan, Robert J Hilsden","doi":"10.1177/10732748251413334","DOIUrl":"10.1177/10732748251413334","url":null,"abstract":"<p><p>IntroductionTherapeutic intervention with chemopreventive agents (CPA) represents a promising avenue for cancer prevention; however, additional data on patient adherence are needed. We developed the Colorectal Cancer Chemoprevention Acceleration Platform (CRC-CHAMP) and examined the feasibility of real-world CPA intervention in persons with an increased risk for CRC. Herein, we describe the recruitment, uptake, and adherence within this pilot study.MethodsFor this single-arm prospective pilot study (NCT05402124), we recruited individuals from the Forzani and MacPhail Colon Cancer Screening Centre (CCSC) in Calgary, Alberta, Canada. Eligible individuals were between the ages of 50-59 and had a history of high-risk adenomatous polyps diagnosed at the CCSC in the preceding 12 months. After consenting, each participant was provided open-label acetylsalicylic acid (ASA) at 81 mg every day for 90 days. Participants were contacted by telephone every 30 days to collect current adherence (primary outcome) and occurrence of any adverse events (secondary outcome).ResultsThroughout recruitment, 823 potential participants were identified, with 69 (53.1%) being eligible and 67 (51.5%) finally enrolling in the study. The median age of the participants was 56 yr. At the follow-ups, 60 participants (89.6%) were adherent at 30 days, 54 participants (80.6%) were adherent at 60 days, and 55 (82.1%) participants were adherent at 90 days. A total of 9 (13.4%) participants experienced minor adverse events likely unrelated to the ASA.ConclusionParticipants recruited to this pilot study had a high level of adherence throughout the 90-day period with minimal side effects. Challenges to recruitment included low response rate by mail and a high number of those contacted already taking non-steroidal anti-inflammatory drugs. This study suggests that individuals post-polypectomy of large polyp may be interested in CRC chemoprevention. Additionally, this study provides a framework for future evaluation of additional therapeutic interventions.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748251413334"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12789377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity Level and Risk of 90-day and 18-month Complications Among Patients Undergoing Radical Prostatectomy for Prostate Cancer in the Military Health System.","authors":"Yvonne L Eaglehouse, Christian Dide-Agossou, Sarah Darmon, Sean Q Kern, Molly R Oroho, Andrea A Almeida, Craig D Shriver, Kangmin Zhu","doi":"10.1177/10732748261420506","DOIUrl":"10.1177/10732748261420506","url":null,"abstract":"<p><p>IntroductionProstate cancer is frequently diagnosed at ages when men may also have comorbidity. Access to care may influence both comorbidity management and cancer treatment and recovery. We examined the association between comorbidity and postoperative outcomes among men with prostate cancer in the universal access Military Health System (MHS).MethodsWe identified a cohort of men diagnosed with non-metastatic prostate adenocarcinoma from 2001-2014 who received radical prostatectomy (RP) within 1 year of diagnosis in the MilCanEpi database, which links the Department of War Cancer Registry and MHS Data Repository. We used ICD-9 diagnosis codes to capture 90-day postoperative general and genitourinary (GU) complications and hospital readmissions; and 18-month postoperative GU complications. Poisson regression estimated the adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) for the outcomes associated with comorbidity (0, 1-2, or ≥3) measured using the Elixhauser Index.ResultsThe study included 5645 men with non-metastatic prostate cancer (mean age 57.9 ± 7.7 years) who received RP; 39.9% of patients had no comorbidity, 43.9% had 1-2 conditions, and 16.2% had ≥3 conditions. Patients with ≥3 comorbidities had statistically significant higher risks of 90-day general (ARR = 1.88, 95% CI = 1.34, 2.64) and GU (ARR = 1.20, 95% CI = 1.06, 1.36) complications and hospital readmission (ARR = 1.59, 95% CI = 1.12, 2.26) relative to men with no comorbidity. At 18-month post-RP, men with 1-2 comorbidities (ARR = 1.19, 95% CI = 1.05, 1.35) and ≥3 comorbidities (ARR = 1.32, 95% CI = 1.13, 1.55) had statistically significant higher risk of measured GU complications relative to men with no comorbidity.ConclusionsIn the MHS, higher comorbidity was associated with an increased risk of 30-day and 18-month complications and 90-day readmissions following RP for prostate cancer. This study identifies a need for risk management strategies to reduce complication rates among men with higher comorbidity levels diagnosed with prostate cancer and treated by RP.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261420506"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12833137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age at Breast Cancer Diagnosis and Short-Term Postoperative Outcomes for Women Treated in a Universal Health System.","authors":"Gabrielle Falco, Sarah Darmon, Matthew Nealeigh, Robert W Krell, Craig D Shriver, Kangmin Zhu, Yvonne L Eaglehouse","doi":"10.1177/10732748261423266","DOIUrl":"10.1177/10732748261423266","url":null,"abstract":"<p><p>IntroductionSurgery is an essential component of breast cancer treatment. Surgical complications may impact receipt of adjuvant therapy and long-term outcomes. Differences in insurance coverage and access to care by patient age in the general U.S. population may affect breast cancer diagnosis and surgery and thus age comparisons in research. We compared postoperative outcomes following breast cancer surgery between age groups in the U.S. Military Health System, which provides beneficiaries access to comprehensive care across the lifespan.MethodsWe identified women aged ≥18 years with stage I-III breast cancer diagnosed from 2001 to 2014 undergoing surgery without reconstruction in the MilCanEpi database. Multivariable Poisson regression estimated the adjusted risk ratios (ARRs) with 95% confidence intervals (CIs) in association with age at diagnosis (18-39, 40-49, 50-64, and ≥65) for 30-day general and breast complications (surgical site infection, seroma, hematoma, or lymphedema), reoperation, and hospital readmission while controlling for potential confounders.ResultsThe study included 7835 women who were 18-39 (9.2%), 40-49 (23.6%), 50-64 (42.7%), and ≥65 (24.5%). The overall risk of general or breast complications did not differ significantly by age when controlled for demographic, tumor, and treatment variables. However, women aged 40-49 had a statistically increased adjusted risk of seroma (ARR = 1.50; 95% CI = 1.03-2.18) compared to women aged 50-64. No significant age-related differences were observed for reoperation or hospital readmission after adjustment.ConclusionIn the Military Health System, the overall risk of 30-day postoperative complications and hospital readmissions were not statistically different by age after adjustment for clinical and demographic factors. The findings support that surgical decision-making continue to prioritize tumor characteristics, comorbidity burden, and other clinical factors rather than age alone when assessing perioperative risk.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261423266"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of the Cancer Inflammation Prognostic Index (CIPI) in De Novo Metastatic Colon Cancer: A Multicenter Retrospective Cohort Study.","authors":"Akif Doğan, Sedat Yıldırım, Hande Nur Erölmez, Goncagül Akdağ, Hacer Şahika Yıldız, Zeynep Yüksel Yaşar, Heves Sürmeli, Nurullah İlhan, Özlem Nuray Sever, Hatice Odabaş, Mahmut Emre Yıldırım, Nedim Turan, Mahmut Gümüş","doi":"10.1177/10732748261432273","DOIUrl":"10.1177/10732748261432273","url":null,"abstract":"<p><p>IntroductionThe Cancer Inflammation Prognostic Index (CIPI) is a composite biomarker that integrates carcinoembryonic antigen (CEA), neutrophil, and lymphocyte counts to reflect both tumor burden and systemic inflammation. Although CIPI has demonstrated prognostic value in early-stage and previously treated metastatic colorectal cancer, its role in untreated, de novo metastatic colon cancer remains unclear.MethodsThis multicenter, retrospective cohort study included 287 patients diagnosed with de novo metastatic colon cancer between 2010 and 2023. CIPI was calculated by multiplying serum CEA by the neutrophil-to-lymphocyte ratio, and the optimal cutoff value for overall survival (OS) was determined using receiver operating characteristic (ROC) curve analysis. Patients were stratified into low- and high-CIPI groups based on this threshold.ResultsThe median follow-up period was 4.0 years, during which 202 patients (70.4%) died. The optimal CIPI cutoff value for OS was 86.09. Median OS was significantly shorter in the high-CIPI group compared with the low-CIPI group (36.0 vs 14.5 months, p < 0.001). In multivariable Cox regression analysis, a high CIPI remained an independent prognostic factor for OS (hazard ratio, 2.29; 95% confidence interval, 1.65-3.17; p < 0.001). In a separate multivariable model, elevated CEA was also independently associated with poorer overall survival.ConclusionCIPI independently predicts overall survival in patients with de novo metastatic colon cancer. Its simplicity, cost-effectiveness, and derivation from routine laboratory data make it a practical and promising tool for baseline risk stratification and individualized follow-up planning.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261432273"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Chemoimmunotherapy: Emerging Cellular and Targeted Therapies in Transformed Follicular Lymphoma: A Scoping Review.","authors":"Abdulrahman F Al-Mashdali, Rola Ghasoub, Shrouq Hwafdeh, Mohamed A Yassin","doi":"10.1177/10732748261454479","DOIUrl":"10.1177/10732748261454479","url":null,"abstract":"<p><p>IntroductionTransformed follicular lymphoma (t-FL) is an aggressive lymphoma with limited prospective evidence to guide treatment, particularly in the relapsed setting. We summarized the current evidence on emerging cellular and targeted therapies that extend beyond conventional chemoimmunotherapy.MethodsThis scoping review was conducted in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR) and structured using the Population-Concept-Context (PCC) framework. Adults with histologically confirmed or strongly suspected t-FL were the population of interest. Findings were synthesized narratively.ResultsSeventeen studies met inclusion criteria across three therapeutic categories: CAR-T therapy (7 interventional trials, n = 130 t-FL patients in reported subsets), CD20×CD3 bispecific antibodies (BsAbs; n = 61 t-FL patients with extractable outcomes), and selinexor (n = 31 t-FL patients); together encompassing approximately 222 t-FL patients across primary interventional cohorts with extractable outcomes. CAR-T products achieved overall response rates (ORR) of 52-83% and complete response (CR) rates of 40-58%; randomized second-line trials favored axicabtagene ciloleucel and lisocabtagene maraleucel over standard care. In real-world CAR-T series, ORR ranged from 82-92% and CR rates from 64-67% across registry cohorts. BsAbs were active in heavily pretreated disease (epcoritamab ORR 50%/CR 44%; glofitamab ORR 55%/CR 35%), with predominantly low-grade cytokine release syndrome. Selinexor showed more modest efficacy (ORR 39%/CR 16%) but durable benefit in complete responders.ConclusionsCurrent evidence supports a stepwise treatment framework: DLBCL-like induction at transformation, autologous stem-cell transplant in fit, chemosensitive responders, CAR-T as the preferred option at first relapse, BsAbs after CAR-T or when cellular therapy is not feasible, and selinexor in later-lines of therapy. Additional prospective t-FL-inclusive trials are needed to refine treatment selection and biomarker-guided sequencing.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261454479"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Increase of Early-Onset Colorectal Cancer: New Insights and Emerging Hypotheses.","authors":"Isaac Lee, Ezra Bernstein, Benjamin Lebwohl, Alfred I Neugut","doi":"10.1177/10732748261432271","DOIUrl":"10.1177/10732748261432271","url":null,"abstract":"<p><p>Rising rates of early-onset colorectal cancer have been noted worldwide. This commentary addresses possible causes of this trend and opportunities for intervention.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261432271"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the Cascade of Care Framework to Guide Evidence-Informed Implementation of Anal Cancer Screening Guidelines.","authors":"Ann N Burchell, Troy Grennan, Christine Fahim, Dina Gaid, Apondi J Odhiambo, Shuk On Annie Leung","doi":"10.1177/10732748261466365","DOIUrl":"10.1177/10732748261466365","url":null,"abstract":"<p><p>Most squamous cell carcinomas of the anus, or anal cancers, are attributable to persistent infection with the human papillomavirus (HPV), analogous to cervical cancer. Although rare in the general population, rates of anal cancer are high among people with immune-compromising conditions or a history of HPV-related cancers. Recent evidence demonstrates that treatment of high-grade squamous intraepithelial lesions (HSIL), a precursor of anal cancer, prevents progression to anal cancer. This has motivated the international release of several guideline statements now recommending anal cancer screening. For a new practice of cancer screening to be integrated into routine care for at-risk populations, implementation strategies will need adaptation for local settings. Our aim is to illustrate the potential value of combining the methods of implementation science with the anal screening cascade framework to support evidence-informed adoption of the guidelines across the different clinical services points where patients might undergo anal cancer screening. We point out means by which research activity could be directed, with particular attention to identifying and addressing care gaps to inform the adoption and scale-up of anal cancer screening. These approaches may help to guide local decisions regarding first steps for anal cancer screening implementation, including determining which populations may need enhanced effort, and to identify where more preparation may be needed.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261466365"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Tools and Strategies for Engaging Patients in Cancer Clinical Trials.","authors":"Aurora Occa, Jerod L Stapleton","doi":"10.1177/10732748261474016","DOIUrl":"10.1177/10732748261474016","url":null,"abstract":"<p><p>Digital tools are increasingly used to support patient engagement in cancer clinical trials, particularly for recruitment, education, and electronic consent. As these tools become more integrated into clinical research workflows, there is growing recognition that they shape how patients perceive, interpret, and act on trial-related information as they navigate complex decisions under emotional and cognitive strain. Drawing on research in health communication, behavioral science, and patient-centered design, we provide a narrative mini review of current digital approaches such as websites, mobile applications, social media, patient portals, e-consent platforms, and emerging AI-driven tools to identify key challenges related to patients' access and experience. We offer a synthesis of evidence-based design strategies shown to support decision-making, reduce cognitive and emotional burdens, foster trust, and complement, rather than replace, human interaction. We also discuss considerations for implementation and evaluation studies, emphasizing the importance of assessing patient understanding, decisional confidence, retention, and equity alongside traditional enrollment metrics. We conclude by outlining future directions for theory-informed, co-designed digital communication strategies that support meaningful participation in cancer clinical research.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261474016"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Passing the Baton: Succession Planning and Mentorship for Cancer Control in Low- and Middle-Income Countries.","authors":"Nirmala Bhoo-Pathy, Yupei Zhang, Nazik Hammad","doi":"10.1177/10732748261465141","DOIUrl":"10.1177/10732748261465141","url":null,"abstract":"<p><p>In low- and middle-income countries (LMICs), leadership in cancer prevention and control is often concentrated among a small number of key individuals across the cancer continuum. While these leaders are crucial to system development, insufficient succession planning and mentorship mean that over-reliance on individuals places cancer prevention and control at risk of disruption during leadership transitions. Grounded in a critical synthesis of the field, this Perspective examines succession planning and mentorship in cancer prevention and control, highlighting how fragile leadership pipelines, the \"missing middle\" of mid-career professionals, and informal mentorship cultures and structural inequities, weaken system continuity and resilience. The article further examines barriers to effective mentorship in LMICs and proposes strategies centered on institutionalized mentorship, inclusive approaches, and distributed leadership to strengthen continuity and sustainable development of cancer prevention and control systems. A stable leadership structure requires collaboration across career stages, with senior leaders contributing institutional memory and strategic judgement, mid-career professionals anchoring operational delivery and governance, and early-career professionals contributing innovation and fresh perspectives. Importantly, we advocate for succession planning and mentorship to be institutionalized as core functions of cancer systems, rather than left to individual goodwill, to enable this collaborative structure to sustain leadership continuity and resilience.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261465141"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}