Journal of the National Cancer Institute最新文献

{"title":"Multi-federal agency actions to integrate patient-reported outcomes into cancer research and care.","authors":"Ashley Wilder Smith,Christine Dymek,Terri S Armstrong,Batsheva Honig,Aaliyah Parker,Shannon Mcdevitt,Vida Passero,Ashley Gruszkowski,Vishal Bhatnagar","doi":"10.1093/jnci/djaf273","DOIUrl":"https://doi.org/10.1093/jnci/djaf273","url":null,"abstract":"Recognizing the need to improve care and outcomes for patients affected by cancer, federal agencies collaborated to identify current efforts and timely actions to support and empower cancer patients and caregivers. One important approach is to capture information directly from patients about their health, such as their symptoms and functioning. Patient-reported outcomes (PROs) can be used to inform clinical trials, in care delivery, and to examine treatment effectiveness and care quality. Across the Department of Health and Human Services and the Department of Veterans Affairs, multiple agencies have recognized the value of PROs for people with cancer and developed initiatives that complement extensive work spearheaded by academic and other non-governmental organizations. Given that there are efforts occurring within and across several federal agencies, there is a need to appraise and synergize federal efforts to support PRO adoption. Such an approach would promote methods to engage patients and caregivers, with specific efforts to address barriers for all cancer populations as well as encourage and support researchers, clinicians, and health systems to collect meaningful health information from all patients. This report describes the value of using PROs in research and healthcare settings to inform cancer care. Demonstrations of how federal agencies support PRO use are described. This manuscript is not exhaustive; and does not describe the extensive PRO work accomplished outside of the United States (US) government. Instead, it is intended to emphasize the independent commitment across federal agencies to support monitoring PROs for people with cancer to improve care and outcomes.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing paradigms in colorectal cancer screening.","authors":"Partha Basu","doi":"10.1093/jnci/djaf267","DOIUrl":"https://doi.org/10.1093/jnci/djaf267","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of visually and computationally-assessed tumor-infiltrating lymphocytes in early-stage triple-negative breast cancer (TBCRC-030).","authors":"Guilherme Nader-Marta,Xiangying Chu,Satabhisa Mukhopadhyay,Vandana G Abramson,Adam Brufsky,Erica Michelle Stringer-Reasor,Susan Faye Dent,Tiffany A Traina,Lisa A Carey,Mothaffar F Rimawi,Jennifer M Specht,Kathy D Miller,Cesar Augusto Santa-Maria,Tathagata Dasgupta,Busem Binboğa Kurt,Michelle DeMeo,Ian E Krop,Nadine M Tung,Stuart J Schnitt,Nabihah Tayob,Erica L Mayer","doi":"10.1093/jnci/djaf289","DOIUrl":"https://doi.org/10.1093/jnci/djaf289","url":null,"abstract":"BACKGROUNDTumor-infiltrating lymphocytes (TILs), assessed by visual examination (VE), are prognostic and predictive in early-stage triple-negative breast cancer (TNBC). Computational assessment (CA) may provide a complementary approach. We evaluated the prognostic value of TILs by VE and CA.METHODSTBCRC 030 was a randomized phase II trial enrolling patients with BRCA1/2-proficient stage I-III TNBC to receive preoperative cisplatin or paclitaxel. The primary endpoint was pathologic response at surgery. TILs were visually scored on digitized pre-treatment biopsies per International TILs Working Group recommendations. CA used the 4D QPOR platform to generate TILs, immune heterogeneity index (IHI), and a combined immune/cell cycle biomarker (CmbI). Predictive performance for residual cancer burden (RCB) 0/1 was assessed using ROC curves and odds ratios (ORs) with 95% CIs; all statistical tests were two-sided.RESULTSOf 139 response-evaluable patients, 121 had matched VE and CA data (59 cisplatin, 62 paclitaxel). Median VE TILs were higher in responders (40.0% vs. 10.0%, p = .002) and predicted response (OR 1.86, 95% CI 1.24-2.87, AUC 0.69, 95% CI 0.57-0.80). CA CmbI differed by response group and predicted RCB 0/1 (OR 3.20, 1.05-11.07; AUC 0.62, 0.51-0.73). CA TILs and IHI were not predictive. VE TILs and CA CmbI predicted response to paclitaxel (OR 2.91, 1.56-6.14; OR 9.17, 2.01-66.39, respectively), but not to cisplatin.CONCLUSIONVE TILs and CA CmbI were each associated with response to NAC in TNBC in the overall cohort and the paclitaxel arm. CA CmbI did not outperform visual assessment. Further validation is needed before clinical implementation of computational approaches.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Will adaptive radiation therapy be the new state-of-the-ART in head and neck cancer?","authors":"Alisa Rybkin,Melissa R Young,Henry S Park","doi":"10.1093/jnci/djaf283","DOIUrl":"https://doi.org/10.1093/jnci/djaf283","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk in long-term survivors of breast, prostate, colon, and rectal cancer.","authors":"Sarah J Westvold,Jessica B Long,Jane Fan,Madhav Kc,Terry Hyslop,Kerry Conlin,Sofia Jacobson,Andrea Silber,Shi-Yi Wang,Michael S Leapman,Ira Leeds,Lisa Spees,Stephanie B Wheeler,Cary P Gross,Kevin Oeffinger,Michaela A Dinan","doi":"10.1093/jnci/djaf243","DOIUrl":"https://doi.org/10.1093/jnci/djaf243","url":null,"abstract":"BACKGROUNDCardiovascular disease (CVD) is the leading cause of non-cancer mortality in long-term cancer survivors. Population-level assessment of cancer-related exposures is limited with respect to long-term cardiovascular risk in older survivors, who have additional aging-related risks.METHODSThis was a SEER-Medicare retrospective cohort study of long-term (five-year) survivors of breast, prostate, colon, and rectal cancers who were aged 66+, diagnosed from 2003-2012, and received definitive treatment. The primary endpoint was late CVD, defined as MI, stroke, CHF/cardiomyopathy on an inpatient administrative claim or as SEER cause of death occurring 5-15 years post-diagnosis. Restricted mean survival time regression was used to assess predictors of shorter average time without CVD and develop a prediction rule for risk stratification. Survivors were assigned a risk score and stratified into tertiles.RESULTSIncluded were 95,100 survivors with a mean age of 74 (SD = 6) at diagnosis. Late CVD occurred in 23.2% of survivors. Older age, comorbidities, and prior CVD were associated with shorter time without CVD. In contrast, cancer-related factors were not associated, except for stage III breast cancer, and radiation plus ADT for prostate cancer. Across all cohorts, the high-risk strata had a 3- to 4-fold higher risk of CVD compared to the low-risk strata.CONCLUSIONSIn this cohort of older, long-term cancer survivors, cancer-related exposures were not independently associated with onset of CVD 5-15 years after diagnosis but may still contribute to latent cardiovascular risk. Given the limited impact of cancer-specific factors, cancer-agnostic risk prediction may be adequate to predict individual cardiovascular risk.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer care underuse, overuse, and inequalities","authors":"Salvatore Vaccarella, Paolo Vineis","doi":"10.1093/jnci/djaf290","DOIUrl":"https://doi.org/10.1093/jnci/djaf290","url":null,"abstract":"While large socioeconomic inequalities in cancer outcomes exist between- and within-countries, financial and human resources are increasingly allocated to medical interventions that have minimal impact or that cause harm, including overdiagnosis and overtreatment. Underuse and overuse of medical cancer care stem from similar underlying mechanisms, including environmental, social, economic, and cultural factors, as well as healthcare system organization and medical practices, and their coexistence represents two opposing yet interconnected aspects of healthcare inefficiency. Identifying and measuring low-value in cancer prevention and care is challenging. However, emerging evidence shows that the magnitude and consequences of underuse and overuse are vast, shaping the current epidemiological landscape of cancer, causing physical, psychological, and social harm to millions of individuals and posing significant challenges to the sustainability of health systems. In this paper, we propose a novel perspective and a comprehensive roadmap that examines inefficiencies of health systems through the lens of simultaneous underuse of cancer care by underserved populations and overuse by groups with greater access to healthcare system.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent associations between obesity, glucose metabolism, and breast cancer risk through unrelated pathways.","authors":"Thi Huyen Trang Nguyen,Somin Jeon,Junghyun Yoon,Boyoung Park","doi":"10.1093/jnci/djaf287","DOIUrl":"https://doi.org/10.1093/jnci/djaf287","url":null,"abstract":"BACKGROUNDWe examined whether fasting blood glucose (FBG) mediates the associations between body mass index (BMI), waist circumference (WC), and breast cancer (BC) risk among postmenopausal women, while considering the temporal order of exposure, mediator, and disease onset.METHODSData from 2,093,578 postmenopausal women in the Korean National Breast Cancer Screening Program (2009-2010) were analyzed. Participants underwent at least one repeat screening (2011-2014) and were followed until 2021. Baseline BMI and WC served as exposures, and FBG levels, measured during 2011-2014, were examined as potential mediators. Associations among BMI, WC, FBG, and BC risk were evaluated using Cox proportional hazards regression and mediation analyses.RESULTSOver a median follow-up of 11.9 years, 17,120 women (0.82%) developed BC. Compared to lower values higher BMI (≥30 kg/m2) and WC (≥88 cm) were significantly associated with increased BC risk, with hazard ratios (HRs) of 1.82 (95% confidence interval [CI]=1.69-1.96) and 1.43 (95% CI = 1.37-1.49), respectively. Two-way decomposition mediation analysis indicated that FBG minimally mediated these associations, with natural indirect effect odds ratios near 1.00 and mediated effects ranged up to 2.23%. A four-way decomposition further confirmed that over 95% of the associations were attributable to the controlled direct effects of BMI and WC, while the pure indirect effect via FBG comprised approximately 5% of the total association.CONCLUSIONAlthough BMI and WC are robustly linked to BC risk, FBG plays a negligible mediating role. These findings suggest that obesity and glucose metabolism independently influence breast cancer risk.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heuriskance: a novel paradigm for systematic earlier detection of sporadic pancreatic cancer.","authors":"Suresh T Chari,Ziding Feng,Bechien Wu,William Fisher,Avinash Kambadakone,Ying-Qi Zhao,Anirban Maitra,Barbara Kenner,Lynn M Matrisian","doi":"10.1093/jnci/djaf291","DOIUrl":"https://doi.org/10.1093/jnci/djaf291","url":null,"abstract":"Early detection is key to improving survival and mortality from pancreatic cancer. Traditional periodic screening for cancer in an asymptomatic population is infeasible and not recommended for this low-incidence disease. We describe a novel approach we call \"heuriskance\" (hyou-ris-kance) wherein a systematic search for and onetime workup of a \"heurisk\" (hyou-risk) leads to earlier detection of cancer. A heurisk is an early warning sign with three defining characteristics: i) indicates higher-than-threshold-probability of having prevalent invasive cancer, ii) is associated with a meaningful lead time to diagnosis, and iii) is identifiable by a systematic and scalable process in the population. Heuriskance aims to systematically detect cancer with clinically meaningful lead time to clinical diagnosis, minimize proportion of patients with advanced disease, and maximize treatment options leading to increases in lead time-adjusted 1-, 3- and eventually 5- year survival. A specific example of a heurisk for pancreatic cancer is glycemically defined new onset diabetes (GNOD) and the Early Detection Initiative (NCT04662879) an example of GNOD-based heuriskance. As heuriskance has no precedent, we provide i) a tiered risk stratification approach (Define-Enrich-Find), ii) metrics for choosing a heurisk, iii) success metrics for strategy and iv) Phases 1-5 for evaluating the strategy in retrospective and prospective studies. Like all current cancer therapies, heuriskance aims to iteratively improve survival from a fatal disease using a pragmatic, evidence-based systematic approach to its earlier detection. The concept of heuriskance is applied to pancreatic cancer but could be extended to other cancer types.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to cheng, palesh, and hong.","authors":"Qinjin Fan,Jingxuan Zhao,Xuesong Han,K Robin Yabroff,Leticia M Nogueira","doi":"10.1093/jnci/djaf167","DOIUrl":"https://doi.org/10.1093/jnci/djaf167","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: Evaluating benefit-to-burden ratios of the established and emerging colorectal cancer screening strategies.","authors":"Derek W Ebner,Chris Estes,Paul J Limburg","doi":"10.1093/jnci/djaf266","DOIUrl":"https://doi.org/10.1093/jnci/djaf266","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}