Cancer Control最新文献

{"title":"Cervical Cancer Screening in Uganda: Determinants of Past Screening and Post-Education Uptake; A Cross-Sectional Survey.","authors":"Ali Ssetaala, Ibrahim Muwonge, Dorcus Namulwa, Nasimu Kyakuwa, Mathias Wambuzi, Gertrude Nanyonjo, Brenda Okech, Elien De Paepe, Heleen Vermandere, Olivier Degomme","doi":"10.1177/10732748261427062","DOIUrl":"10.1177/10732748261427062","url":null,"abstract":"<p><p>IntroductionCervical cancer (CC) is the leading cause of cancer-related deaths among women in Uganda, largely due to late diagnosis. CC screening (CCS) is key to preventing these deaths. Awareness of past CCS, its determinants, and uptake of CCS after receiving information is crucial to informing prevention programming.MethodsA two-phase community based cross-sectional survey was conducted among 600 randomly selected women aged 25-65 years, from two Ugandan districts (Mukono and Wakiso). Participants completed a baseline questionnaire that assessed their knowledge, attitudes, and past practices related to CCS. Information on cervical cancer and screening was provided during and after the survey to encourage uptake, which was assessed three months later. Logistic regression identified factors associated with past CCS and follow-up uptake after information giving.ResultsFew women [5.3%, (32/600)] were aware that Human Papillomavirus (HPV) infection causes CC. Past CCS was low [22.3%, (134/600)], associated with the age group 36-65 years (AOR= 1.9, 95% CI 1.2 - 3.2), owning a mobile telephone (AOR = 2.3, 95% CI 1.4 - 3.9), residing in a household headed by someone with tertiary or higher education (AOR=2.6, 95% CI 1.3 - 5.0), self-reported HIV infection (AOR=10.5, 95% CI 5.2 - 21.3), awareness of the location of CCS services (AOR=3.2, 95% CI 1.3 - 7.8), and awareness that accessing the CCS location was not expensive (AOR=2.3, 95% CI 1.3 - 4.0).The uptake of CCS following information provision was 40.3%, (236/585), associated with employment (AOR=2.7, 95% CI 1.2 - 5.8), moderate-high income (AOR=1.6, 95% CI 1.0 - 2.6), and prior receipt of CCS services (AOR 6.7, 95% CI 4.0 -11.2).ConclusionCCS remains low but is higher among women with better socioeconomic status, awareness of services, and HIV infection. Targeted strategies addressing awareness and motivating women to get screened can boost screening uptake.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261427062"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349640","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":"Risk Stratification for Underlying Cervical Intraepithelial Neoplasia Grade (CIN)3+ in Reproductive-Age Women With Biopsy-Confirmed CIN2: Implications for Fertility-Preserving Management.","authors":"Hangjing Gao, Qiao Gao, Lifang Xue, Hao Lin, Diling Pan, Xiqi Huang, Huifeng Xue, Zhenhong Wang, Xiaoqi Sun","doi":"10.1177/10732748261427836","DOIUrl":"10.1177/10732748261427836","url":null,"abstract":"<p><p>IntroductionManaging biopsy-confirmed cervical intraepithelial neoplasia grade 2 (CIN2) in women of reproductive age poses clinical challenges. Immediate treatment with large-loop excision of the transformation zone (LLETZ) is associated with a substantial risk of adverse obstetric outcomes. This study aimed to identify the risk factors for predicting CIN3+ lesions in reproductive-aged women with biopsy-diagnosed CIN2, to inform personalized management strategies that are particularly relevant to China's evolving fertility policies.MethodsThis retrospective cohort study analyzed the data from a regional cervical lesion screening database. Reproductive-aged women (<45 years) with biopsy-confirmed CIN2 who underwent subsequent LLETZ between 2016-2024 were included in the study (n=516). Pathological upgrade was defined as CIN3+ in the LLETZ specimen. Univariate and multivariate logistic regression analyses identified independent risk factors for pathological upgrade.ResultsFollowing LLETZ, 18.4% (95/516) of the women had CIN3+ lesions, indicating biopsy underestimation. HPV 16 (56.3%) and HPV 52 (27.5%) were the most prevalent genotypes in CIN3+ and CIN2- groups, respectively. Multivariable analysis identified three independent predictors: liquid-based cytology (TCT) ≥HSIL (OR = 6.308; 95% CI: 2.390-16.650; <i>P</i><0.001); specific HR-HPV genotypes: HPV 16 infection (OR = 2.372; 95% CI: 1.165-4.831; <i>P</i>=0.017) and HPV 33 infection (OR = 3.263; 95% CI: 1.035-10.292; <i>P</i>=0.044); endocervical curettage (ECC) ≥CIN2 (OR = 3.067; 95% CI: 1.474-6.384; <i>P</i>=0.003). Age did not increase the risk of developing CIN3+ lesions.ConclusionThis risk-stratification model offers evidence-based guidance for optimizing individualized treatment decisions in clinical settings where fertility preservation is prioritized.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261427836"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349740","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":"New Compass for Precision Oncology: Evidence, Challenges, and Prospects of Circulating Tumor DNA in Colorectal Cancer.","authors":"Keito Suzuki, Akira Ooki, Eiji Shinozaki, Eiichiro Toyokawa, Kaoru Yoshikawa, Manabu Shiozawa, Shin Maeda, Kensei Yamaguchi, Hiroki Osumi","doi":"10.1177/10732748261458456","DOIUrl":"10.1177/10732748261458456","url":null,"abstract":"<p><p>Circulating tumor DNA (ctDNA) has emerged as a clinically actionable biomarker for the management of colorectal cancer (CRC). Improvements in analytical accuracy and sequencing depth have expanded the role of ctDNA from early cancer detection to include molecular profiling of advanced disease, postoperative risk stratification, and real-time evaluation of therapeutic response and resistance. In screening and early detection settings, ctDNA-based assays integrating mutation analysis, methylation profiling, and fragmentomic features have demonstrated high specificity for CRC and multi-cancer early detection (MCED). Prospective studies suggest that ctDNA can identify CRC before clinical diagnosis; however, its sensitivity for advanced premalignant lesions remains limited, supporting its use as a complementary approach for individuals who do not participate in established screening rather than as a replacement for stool-based tests or colonoscopy. Postoperatively, ctDNA-based detection of minimal residual disease (MRD) is a strong independent predictor of recurrence and survival, often preceding radiographic evidence of relapse. Randomized trials have demonstrated that ctDNA-guided adjuvant strategies have the potential to reduce overtreatment and identify candidates for treatment escalation, although the impact on long-term outcomes remains under prospective validation. In metastatic disease, serial ctDNA monitoring enables early treatment-response assessment, detection of resistance mechanisms, and optimization of targeted therapy, including rechallenge strategies. The emerging concept of Neo<i>RAS</i> further illustrates the dynamic nature of tumor genomics and its therapeutic implications. Collectively, these advances have positioned ctDNA as a central tool in precision medicine. This narrative review summarizes recent clinical evidence supporting ctDNA-guided strategies for CRC and discusses their implications for the broader field of precision oncology.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261458456"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13230682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152018","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":"Effectiveness of Visual-Based Interventions on Understanding Cancer Information: A Systematic Review.","authors":"Linda Siachalinga, Hansoo Kim, Karin Brochstedt Dieperink, Elisabeth Coyne","doi":"10.1177/10732748261446035","DOIUrl":"10.1177/10732748261446035","url":null,"abstract":"<p><p>IntroductionThe aim of this study was to assess the effectiveness of visual-based education intervention on understanding cancer information.MethodsWe conducted a systematic review across PubMed, Embase and Scopus electronic databases using Preferred Reporting Items for Systematic Reviews and Meta-analysis, in July 2025. Randomized and non-randomized studies measuring impact of visual-based education interventions on health literacy, knowledge, comprehension, or understanding in cancer were considered for inclusion. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). A descriptive analysis of included studies was performed, and a meta-analysis was performed for Randomised clinical trials (RCTs).ResultsTwenty-one studies were included in the review, 11 RCTs, seven non-RCTs, and three mixed methods design. The studies were conducted in seven countries across five continents. A high proportion of the included studies satisfied the MMAT quality assessment criteria. Visual-based interventions improved knowledge and comprehension compared to non-visual communication such as audio or basic text. In one study, video intervention increased knowledge with mean difference 3.96 ± 1.69 compared to pamphlet (1.76 ± 1.42). Crowd-figure-pictograms with numeric data increased knowledge by 2.42 compared to non-numeric controls (0.20). Furthermore, 3D printed models improved understanding compared to imaging alone (4.60-4.78/5 vs. 4.06-4.49/5), and visual-based treatment timelines improved comprehension compared to audio (0.84 vs 0.68). However, certain visual-based interventions had no impact over well-designed static materials in some contexts. Health literacy was a significant moderator of outcomes, and low health literacy was consistently associated with poor baseline knowledge and comprehension, regardless of visualization format.ConclusionVisual-based education interventions may improve knowledge, comprehension and understanding, overcoming barriers imposed by limited health literacy, hence empowering patients to self-manage their health across various cancer contexts.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261446035"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786823","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":"Artificial Intelligence Meets Cancer Rehabilitation: Emerging Evidence for Exercise and Physical Activity Interventions.","authors":"Kelcey A Bland, Ignacio Catalá-Vilaplana, John-Jose Nunez, Lauren C Capozzi, Kristin L Campbell","doi":"10.1177/10732748261432280","DOIUrl":"10.1177/10732748261432280","url":null,"abstract":"<p><p>Comprehensive cancer rehabilitation programs that incorporate evidence-based physical activity (PA) and exercise are currently recommended as a standard component of cancer care. However, reach and access to cancer rehabilitation is fragmented due to patient-, healthcare provider-, and organizational-level barriers. Artificial intelligence (AI), including both generative AI (e.g. chatbots that use large language models) and predictive AI techniques (e.g. forecasting future outcomes), holds potential to scale cancer rehabilitation at a relatively low cost, while filling critical gaps in care. The purpose of this narrative review is to introduce the concept of AI-supported cancer rehabilitation and synthesize emerging evidence focused on PA and structured exercise interventions. We found that existing research on the role of AI to support cancer rehabilitation is in its early stages. To-date, AI has been used to support cancer rehabilitation to: 1) screen and identify patients in need of rehabilitation; 2) predict exercise training responses and outcomes; 3) enhance patient engagement and behavior change (e.g., through feedback, coaching, or conversational agents); and 4) support precision exercise prescription. Early AI-supported interventions have demonstrated modest improvements in PA levels, although evidence remains limited. We outline priority research questions and summarize key challenges relating to the ethics, equity, and implementation of AI-tools to support cancer rehabilitation. By leveraging multidisciplinary collaboration and patient-engagement, ethically and effectively designed AI-supported cancer rehabilitation tools have the potential to overcome barriers to cancer rehabilitation access and delivery, while remaining trustworthy and meaningful to end-users.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261432280"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366909","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":"Treatment Outcomes of Methotrexate-Resistant Post-Molar Gestational Trophoblastic Neoplasia: A Retrospective Cohort Study at Tu Du Hospital, Vietnam.","authors":"Tuan M Vo, Khue T T Le, Nam H Nguyen, Cuong V Le","doi":"10.1177/10732748261427057","DOIUrl":"10.1177/10732748261427057","url":null,"abstract":"<p><p>IntroductionThe aim of this study was to determine the success rate of alternative chemotherapy regimens, and related factors, in Gestational Trophoblastic Neoplasia (GTN) patients who failed first-line Methotrexate (MTX) chemotherapy at Tu Du Hospital, Vietnam.MethodsThis was a retrospective cohort study of 124 patients with post-molar GTN resistant to MTX, who were treated between January 2018 and December 2023 at Tu Du Hospital. We used the log-rank test and Cox proportional hazard model to determine factors related to failure of alternative chemotherapy.ResultsThe success rate of alternative chemotherapy was 89.52%. There were 13/124 cases requiring salvage chemotherapy; the salvage chemotherapy rate in the Act-D group was 16.67%, and in the EMA-CO group 3.44%. Based on the multivariate regression analysis model, the prognostic factors for failure of alternative chemotherapy were the number of MTX chemotherapy cycles < 4 (HR = 0.24, 95% CI = 0.07 - 0.83, p=0.024), and the alternative chemotherapy regimen being Act-D (HR = 9.51, 95% CI = 2.27 - 39.82, p=0.002). Regarding safety, EMA-CO was associated with significantly higher hematological toxicity. Grade 3-4 neutropenia and leukopenia occurred in 56.9% and 43.1% of the EMA-CO group, respectively, compared to 13.6% and 9.1% in the Act-D group (p<0.001).ConclusionThe success rate of alternative chemotherapy was 89.52%; factors including the number of MTX chemotherapy cycles and the type of alternative chemotherapy regimen being Act-D were prognostic factors for failure.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261427057"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345535","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":"Exploratory Analysis of Health Literacy and Genetic Testing Awareness, Uptake, and Desire for Genetic Risk Information: Findings From a Cross-Sectional Community Survey.","authors":"Mariana Arevalo, Nathanael B Stanley, Kristina A Inman, Kenisha Avery, Vani N Simmons, Susan T Vadaparampil","doi":"10.1177/10732748261477325","DOIUrl":"10.1177/10732748261477325","url":null,"abstract":"<p><p>IntroductionLimited research has examined whether genetic testing awareness and uptake differ for individuals with varying levels of health literacy. We examined the association between health literacy and genetic testing and 1) awareness, 2) uptake, and 3) desire for genetic risk information, while controlling for socio-demographic factors.MethodsWe conducted secondary analyses using cross-sectional data from a Community Health Needs Assessment (CHNA) survey conducted between January and March 2022. Multivariable binary logistic regression models were used to examine the relationship between health literacy and genetic testing awareness and uptake, and an ordinal logistic regression model examined the association between health literacy and desire for genetic risk information. All models were adjusted for demographic characteristics.ResultsThe sample was predominantly female (67.8%), White (75.7%), non-Hispanic (77.1%), employed (52%), had a high school education or vocational training (44.8%), had health insurance coverage (85.6%), and preferred to speak English at home (79.4%). After controlling for socio-demographic characteristics, higher health literacy was associated with greater odds of genetic testing awareness (aOR = 1.27, 95% CI: 1.10 - 1.47), and inversely associated with genetic testing uptake (aOR = 0.78, 95% CI: 0.69 - 0.88). The association between health literacy and desire for genetic risk information was not statistically significant after controlling for demographics.ConclusionsOur findings suggest that health literacy is associated with genetic testing awareness, but more research is needed to fully understand the relationship between health literacy and genetic testing engagement. Our findings could help inform future community-based, health literacy-sensitive interventions.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261477325"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708229","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":"Explainable 1-mm Peritumoral CT Radiomics for <i>EGFR</i> Mutation Prediction in Non-small Cell Lung Cancer: A Vietnamese Real-World Cohort Study.","authors":"Minh Ngoc Le, Tuan Minh Nguyen, Le Lam Ngo, Trong Dung Le, Duy Anh Nguyen, Ngoc Quang Nguyen, Hoang Viet Dinh, Nguyen Quoc Khanh Le, Thi Thu Ha Bui, Thi Oanh Bui","doi":"10.1177/10732748261455532","DOIUrl":"10.1177/10732748261455532","url":null,"abstract":"<p><p>Introduction<i>EGFR</i> genotyping guides therapy selection in non-small cell lung cancer (NSCLC) but may be delayed by limited tissue and testing logistics. We developed and internally validated an explainable CT radiomics model using peritumoral features to predict <i>EGFR</i> mutation in Vietnamese patients with NSCLC.MethodsWe retrospectively analyzed 200 treatment-naïve NSCLC patients who underwent thin-section CT and <i>EGFR</i> testing. Tumor and 1/3/5 mm peritumoral rings were segmented, yielding 1,316 standardized radiomic features per region. After comparing eight selection methods, mRMR was chosen to build logistic regression, random forest, and XGBoost models using nested 5×3-fold cross-validation. Model discrimination, calibration, and decision-curve performance were assessed. SHAP analysis clarified the contribution of key features, and a clinical-radiomics nomogram combined the optimal ring model with age, sex, smoking, and stage. In a 64-patient NGS subset, radiomic signatures were explored in relation to major signaling pathways.Results<i>EGFR</i> mutations were detected in 44% of cases. The 1-mm peritumoral XGBoost model achieved the best performance with an AUC of 0.87, outperforming intratumoral and wider-ring models, p<0.05. SHAP highlighted LoG-filtered texture features capturing heterogeneity at the tumor-stroma interface. The clinical-radiomics nomogram showed strong discrimination (AUC=0.86) and stable calibration. Radiogenomic analysis revealed that peritumoral heterogeneity features were more pronounced in tumors carrying <i>TP53</i> mutations. In addition, <i>EGFR</i> and <i>KRAS</i> alterations did not co-occur in the NGS subset.ConclusionA compact 1-mm peritumoral radiomics model provides explainable, biologically grounded prediction of <i>EGFR</i> mutation and provides a feasible adjunct for precision oncology in resource-limited settings.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261455532"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036983","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":"Factors Influencing Advance Care Planning in Oncology: A Qualitative Study of Clinician Perspectives Using the Theoretical Domains Framework.","authors":"Candice Donnelly, Kavisha Shah, Sally Greenaway, Paul Harnett, Tim Shaw, Anna Janssen","doi":"10.1177/10732748261441920","DOIUrl":"10.1177/10732748261441920","url":null,"abstract":"<p><p>IntroductionAdvance Care Planning (ACP) is a patient-centered process that enables individuals to consider their goals and priorities and make plans with their healthcare team for future care. Oncology clinicians care for critically ill patients and are central to facilitating and documenting ACP. While Australian and international guidelines strongly support ACP in oncology, clinician engagement and documentation of ACP remain suboptimal. This study aimed to explore oncology clinicians' ACP knowledge, decision-making, and practice, including factors influencing engagement in ACP.MethodsA qualitative study was conducted using semi-structured interviews with oncology clinicians from three metropolitan hospitals in New South Wales, Australia. Participants were purposefully sampled and interviewed between November 2021 and March 2022. Interviews were audio-recorded, transcribed, and analyzed using deductive thematic analysis guided by the Theoretical Domains Framework (TDF). An inductive approach was subsequently applied to develop explanatory subthemes within identified domains.ResultsEleven clinicians participated, including Medical/Radiation Oncology Consultants (54.5%) and Advanced Trainees (45.5%). Interview length ranged from 17.5 to 35.5 minutes. A total of 380 quotes were coded across all 14 TDF domains, generating 33 explanatory subthemes. Four domains were most influential: Knowledge and Skills, Social/Professional Role and Identity, Environmental Context and Resources, and Social Influences. Although all participants recognized ACP as best-practice care, engagement was influenced by limited formal training and legal literacy, uncertainty regarding responsibility for initiating and documenting ACP, variable inconsistent interdisciplinary communication, workload and time constraints, electronic medical record functionality, and patient characteristics (i.e.,psychological state, health literacy, cultural complexity).ConclusionACP in oncology is shaped by complex, interdependent socio-cultural and organizational factors. Applying the TDF identified key behavioral and contextual determinants. Improving ACP requires multilevel strategies targeting clinician capability, role clarity, and system-level supports, including structured education, clearer documentation processes, improved electronic medical record functionality, and integration of ACP into routine multidisciplinary care.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261441920"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399759","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":"Incidence, Trends, and Racial/Ethnic Disparities in Female Breast Cancer in the United States, 2000-2023: A SEER Based Study.","authors":"Nompumelelo O Mzizi, Sandile S Ndabezitha, Julie A Atta, Mohammad A Al Zoubi, Sreelatha Akkala","doi":"10.1177/10732748261470901","DOIUrl":"10.1177/10732748261470901","url":null,"abstract":"<p><p>IntroductionIn 2026, an estimated 321,910 new cases of invasive breast cancer will be diagnosed.However, there is a lack of comprehensive data on breast cancer incidence trends and how they vary across different age groups and racial and ethnic populations. Existing studies have evaluated breast cancer incidence trends over short periods, resulting in a lack of clear information on specific population variations over extended periods to ascertain disease-specific trends.MethodsWe used the 2000-2023 Surveillance, Epidemiology, and End Results program dataset to analyze routine data and published cancer cases to identify incidence trends and disease burden by age and race/ethnicity using Joinpoint regression. We included new cases of breast cancer identified using International Classification of Diseases (ICD) codes. Patient's demographic information was obtained from the medical records.ResultsThe overall breast cancer incidence among women was 190.8 per 100,000, showing an increasing trend from 2000 to 2023. There was also a significant increase in age-adjusted incidence rates in breast cancer trends from 2000 to 2023 (AAPC = 0.76%), with the highest incidence being reported in women aged 75-⁠79 years (456.3 per 100,000). Non-Hispanic white women recorded the highest incidence over the period (228.9 per 100,000). Non-Hispanic White women experienced increasing incidence trends between 2000 and 2023 (AAPC = 0.76%).ConclusionFrom 2000 to 2023, there was a significant increase in breast cancer incidence trends in all groups, with notable rates among women in their 40s and above. These trends underscore the need for adaptive screening strategies and policy recommendations to initiate mammography at age 40. Progress could also be accelerated by understanding the associations among ethnic, racial, and other existing social disparities to ensure early diagnosis and treatment.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"33 ","pages":"10732748261470901"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473779","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}