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Sexual health outcomes after colorectal cancer diagnosis in females: a population-based cohort study 女性结直肠癌诊断后的性健康结果:一项基于人群的队列研究
Journal of the National Cancer Institute Pub Date : 2025-06-01 DOI: 10.1093/jnci/djaf120
Niki Oveisi, Eric C Sayre, Lori A Brotto, Vicki Cheng, Vienna Cheng, Sharlene Gill, Gillian E Hanley, Helen McTaggart-Cowan, Stuart Peacock, Meera Rayar, Amirrtha Srikanthan, Dani Taylor, Mikaela Barnes, Mary A De Vera
{"title":"Sexual health outcomes after colorectal cancer diagnosis in females: a population-based cohort study","authors":"Niki Oveisi, Eric C Sayre, Lori A Brotto, Vicki Cheng, Vienna Cheng, Sharlene Gill, Gillian E Hanley, Helen McTaggart-Cowan, Stuart Peacock, Meera Rayar, Amirrtha Srikanthan, Dani Taylor, Mikaela Barnes, Mary A De Vera","doi":"10.1093/jnci/djaf120","DOIUrl":"https://doi.org/10.1093/jnci/djaf120","url":null,"abstract":"Background Colorectal cancer (CRC) affects a growing number of females. Our objective was to evaluate the impact of CRC on sexual health outcomes among females, while controlling for age. Methods We conducted a cohort study using administrative health data from the province of British Columbia (BC) including linked health visits and cancer registry from 1985–2017. The cohort included females with CRC (n = 25,402; mean age (SD): 69.0 (13.1)) and matched controls without cancer (n = 254,020; 69.0 (13.1)) in a 1:10 ratio by age, further stratified by age groups (≤39 years and ≥40 years). Multivariable Cox regression models assessed the associations between CRC and five sexual health outcomes (dyspareunia, pelvic inflammatory disease, endometriosis, abnormal bleeding, and premature ovarian failure), adjusting for covariates. Sensitivity analyses focused on females with CRC to explore associations between sociodemographic and cancer-related factors and sexual health outcomes. Tests were 2-sided (statistical significance p-value < 0.05). Results Females with CRC had higher risks of dyspareunia (HR 1.67; 95% CI 1.62–1.73), pelvic inflammatory disease (HR 3.42; 95% CI: 3.07–3.81), and endometriosis (HR 1.95; 95% CI: 1.69 –2.25) compared to controls. In the ≥40-year group, these associations persisted, while in the ≤39-year group, endometriosis was not associated with CRC, but premature ovarian failure was (HR 1.75; 95% CI: 1.40–2.19). In sensitivity analyses, we also observed associations with cancer treatments (surgery, chemotherapy, radiation) and sexual health outcomes. Conclusions This population-based study identified associations between CRC and adverse sexual health outcomes among female patients, highlighting the need for targeted interventions and support.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"182 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188969","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}
引用次数: 0
Risk of atherosclerotic cardiovascular disease after cancer diagnosis: findings from three prospective cohort studies 癌症诊断后动脉粥样硬化性心血管疾病的风险:来自三个前瞻性队列研究的结果
Journal of the National Cancer Institute Pub Date : 2025-05-30 DOI: 10.1093/jnci/djaf122
Qiang Liu, Qiaoli Wang, Kai Wang, Han Han, Molin Wang, Jing Wang, Mingyang Song, Edward Giovannucci
{"title":"Risk of atherosclerotic cardiovascular disease after cancer diagnosis: findings from three prospective cohort studies","authors":"Qiang Liu, Qiaoli Wang, Kai Wang, Han Han, Molin Wang, Jing Wang, Mingyang Song, Edward Giovannucci","doi":"10.1093/jnci/djaf122","DOIUrl":"https://doi.org/10.1093/jnci/djaf122","url":null,"abstract":"Background To determine the association between cancer diagnosis and subsequent risk of ASCVD, and to examine the trajectory of the association over time after cancer diagnosis. Methods We prospectively followed 108,689 women in the Nurses’ Health Study (NHS) (1984-2020), 113,569 women in the NHSII (1991-2019), and 45,328 men in the Health Professionals Follow-up Study (HPFS) (1986-2016) who were free of ASCVD and cancer at baseline. We conducted multivariable-adjusted time-varying Cox proportional hazards regression models to assess ASCVD risk following individual cancer diagnosis. Results During up to 36 years of follow-up, 4,334 new-onset ASCVD events among 49,603 incident cancer cases were documented. After adjusting for shared risk factors, cervical cancer (HR: 1.56; 95%CI: 1.06-2.29) and Hodgkin lymphoma (HR: 2.80; 95%CI: 1.89-4.15) was associated with increased risk of ASCVD incidence, while prostate cancer was associated with a lower ASCVD incidence (HR: 0.91; 95% CI: 0.85-0.97). Compared to cancer-free individuals, breast cancer survivors experienced lower ASCVD risk during the first 7.5 years but gradually increased afterwards (Pnon-linearity=0.01). The risk of ASCVD increased over time among patients with cancers of the colorectum (P = .003), lung (P = .002), and endometrium (P = .04). No significant association with ASCVD risk was observed for cancers of the oral cavity and pharynx, sarcoma, melanoma, kidney, thyroid, leukemia, or ovary. Conclusions Cervical cancer or Hodgkin lymphoma was associated with an increased risk of new-onset ASCVD, independent of shared risk factors, while no increased risk was found with other cancers. ASCVD risk trajectories varied over time after diagnosis according to cancer types.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183779","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}
引用次数: 0
Risk of aggressive prostate cancer with successive generations in the U.S. among Latino men 侵袭性前列腺癌的风险与连续几代美国拉丁裔男性
Journal of the National Cancer Institute Pub Date : 2025-05-27 DOI: 10.1093/jnci/djaf119
Fei Chen, Adelynn Paik, Xin Sheng, Iona Cheng, Salma Shariff-Marco, Lynne R Wilkens, Loïc Le Marchand, David V Conti, Christopher A Haiman, Veronica Wendy Setiawan
{"title":"Risk of aggressive prostate cancer with successive generations in the U.S. among Latino men","authors":"Fei Chen, Adelynn Paik, Xin Sheng, Iona Cheng, Salma Shariff-Marco, Lynne R Wilkens, Loïc Le Marchand, David V Conti, Christopher A Haiman, Veronica Wendy Setiawan","doi":"10.1093/jnci/djaf119","DOIUrl":"https://doi.org/10.1093/jnci/djaf119","url":null,"abstract":"Background US-born Latino men have a higher incidence of prostate cancer (PCa) than foreign-born Latino men. It was not clear whether these increases were exclusively due to increased detection of PCa in the US, changes in risk factors of PCa, or a combination of both. Methods In the Multiethnic Cohort (MEC) we evaluated the association between generational status and risk of PCa in 19,597 Latino men, adjusting for demographic and lifestyle factors, individual- and neighborhood-level socioeconomic status (SES), as well as history of PSA screening. Additional adjustments on polygenic risk score (PRS) and genetic ancestry were included in the sensitivity analysis in the biorepository cohort with genetic data. Results This analysis included 10,241 1st-generation, 4,610 2nd-generation, and 4,746 3rd-generation Latino men, among whom 2,366 PCa were diagnosed during an average of 19.2 years of follow-up. After adjusting for covariates, we observed no association between generational status and risk of overall, localized, or low-grade PCa. A per generation increase was significantly associated with a 13% to 15% elevated risk of high-grade, advanced, or aggressive PCa. These associations with aggressive forms of PCa remained significant in the biorepository cohort with additional adjustment on PRS and genetic ancestry. Conclusions Successive generations in the US were associated with an increased risk of aggressive forms of PCa among Latino men and the observed increases cannot be explained by differences in genetic susceptibility, ancestry, PSA screening, lifestyle, and SES factors. Further investigations are needed to identify additional factors that contribute to this increased risk.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153320","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}
引用次数: 0
Assisted reproductive technology utilization for cancer survivors: how we can do better. 辅助生殖技术在癌症幸存者中的应用:我们如何能做得更好。
Journal of the National Cancer Institute Pub Date : 2025-05-25 DOI: 10.1093/jnci/djaf101
Erin Hupy,Zaraq Khan,Alessandra J Ainsworth,Chandra C Paff Shenoy
{"title":"Assisted reproductive technology utilization for cancer survivors: how we can do better.","authors":"Erin Hupy,Zaraq Khan,Alessandra J Ainsworth,Chandra C Paff Shenoy","doi":"10.1093/jnci/djaf101","DOIUrl":"https://doi.org/10.1093/jnci/djaf101","url":null,"abstract":"","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136723","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}
引用次数: 0
Analysis of 2023 World Health Organization cancer Essential Medicines List and concordance with resource stratified guidelines 2023年世界卫生组织癌症基本药物目录及其与资源分层指南的一致性分析
Journal of the National Cancer Institute Pub Date : 2025-05-23 DOI: 10.1093/jnci/djaf100
Brooke E Wilson, Kristin Wright, Manju Sengar, Richard Sullivan, Sallie-Anne Pearson, Michael B Barton, Bishal Gyawali, Elisabeth De Vries, Lorenzo Moja, C S Pramesh, Christopher M Booth
{"title":"Analysis of 2023 World Health Organization cancer Essential Medicines List and concordance with resource stratified guidelines","authors":"Brooke E Wilson, Kristin Wright, Manju Sengar, Richard Sullivan, Sallie-Anne Pearson, Michael B Barton, Bishal Gyawali, Elisabeth De Vries, Lorenzo Moja, C S Pramesh, Christopher M Booth","doi":"10.1093/jnci/djaf100","DOIUrl":"https://doi.org/10.1093/jnci/djaf100","url":null,"abstract":"Background The Essential Medicines List (EML) and Resource Stratified Guidelines (RSG) both prioritize high-value medicines. We compare the 2023 EML cancer medicines list to global cancer statistics, examine the proportion of EML therapies recommended by RSGs, and identify gaps that merit evaluation by the EML Committee. Methods We compared the 2023 EML medicines for adult cancers with cancer incidence and mortality data from GLOBOCAN2022. We cross-referenced the EML with two RSGs (National Comprehensive Cancer Network (NCCN) and National Cancer Grid (NCG) of India), and evaluated preferred treatments in RSG that were not recommended by the EML. Findings The 2023 EML included 64 cancer medicines for 219 tumor-specific indications. The greatest number of medicines are listed for leukaemia (n = 37, 17%) and lymphoma (n = 33, 15%). While some common cancers (eg, hepatocellular carcinoma) have no EML listed medicines due to the low clinical benefit, we identified some cancers (eg, esophageal and gastric) with effective therapies that should be evaluated by the EML for inclusion. Cancers with no listed medicines comprise 34% of cancer deaths globally. Among EML indications with a NCCN RSG, 42% (35/84) and 73% (62/84) were recommended by the NCCN Basic and Core Guidelines, respectively. Among EML indications with a NCG RSG, 163/196 (83%) and 175/196 (89%) were recommended by the NCG Essential and Optimal guidelines, respectively. Interpretation We identified some effective medicines which should be evaluated for inclusion in the EML. Prioritisation of cancer medicines was similar between the EML and NCG India, but discordant between with NCCN RSG.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130298","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}
引用次数: 0
Leisure-time physical activity after diagnosis and survival by cancer type: a pooled analysis. 诊断后的休闲时间体育活动和癌症类型的生存:一项汇总分析。
Journal of the National Cancer Institute Pub Date : 2025-05-21 DOI: 10.1093/jnci/djaf112
Erika Rees-Punia,Lauren R Teras,Christina C Newton,Steven C Moore,I-Min Lee,Lauren Bates-Fraser,Den E Bloodworth,A Heather Eliassen,Lorelei Mucci,Brigid M Lynch,Meir Stampfer,Mingyang Song,Kristen D Brantley,Konrad H Stopsack,Charles E Matthews,Alpa V Patel
{"title":"Leisure-time physical activity after diagnosis and survival by cancer type: a pooled analysis.","authors":"Erika Rees-Punia,Lauren R Teras,Christina C Newton,Steven C Moore,I-Min Lee,Lauren Bates-Fraser,Den E Bloodworth,A Heather Eliassen,Lorelei Mucci,Brigid M Lynch,Meir Stampfer,Mingyang Song,Kristen D Brantley,Konrad H Stopsack,Charles E Matthews,Alpa V Patel","doi":"10.1093/jnci/djaf112","DOIUrl":"https://doi.org/10.1093/jnci/djaf112","url":null,"abstract":"PURPOSEEvidence for potential mortality benefits of leisure-time moderate-to-vigorous intensity physical activity (MVPA) for survivors of cancer types beyond breast and colorectal is limited. The aim of this study was to evaluate relationships between postdiagnosis MVPA and all-cause mortality in participants with a history of eleven cancer types.METHODSData were pooled from six United States-based cohort studies. Cohort-specific hazard ratios and 95% confidence intervals (HR, CI) for associations of MVPA assessed ≥1-year after a cancer diagnosis and all-cause mortality were calculated using multivariable Cox proportional hazards models and then pooled using random effects meta-analysis. Models were adjusted for age, sex, race/ethnicity, smoking status, alcohol use, cancer treatment and stage. The sample included 90,844 cancer survivors (mean [standard deviation] age at diagnosis = 67 [10] years, 55% women), among whom 45,477 died during 10.9 [7.0] years of follow-up.RESULTSCompared to no MVPA, engaging in recommended amounts of MVPA (7.5-<15 MET-hr./wk.) was related to better overall survival in participants with a history of one of ten cancer types: oral (HR = 0.44, 0.27-0.73), endometrial (0.50, 0.34-0.76), lung (0.51, 0.38-0.68), rectal (0.51, 0.36-0.71), respiratory (0.51, 0.29-0.72), bladder (0.53, 0.40-0.72), kidney (0.53, 0.37-0.77), prostate (0.60, 0.49-0.74), colon (0.61, 0.50-0.76), and breast (0.67, 0.55-0.81). Eight of the ten observed inverse associations remained similar when excluding participants who died within two years of follow-up.CONCLUSIONEngaging in leisure-time MVPA after a cancer diagnosis appears to improve survival for people with a history of several cancer types, including bladder, breast, colon, endometrial, kidney, lung, oral, prostate, rectal, and respiratory cancer.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103678","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}
引用次数: 0
The impacts of the Dobbs ruling on US cancer care delivery 多布斯案对美国癌症医疗服务的影响
Journal of the National Cancer Institute Pub Date : 2025-05-20 DOI: 10.1093/jnci/djaf058
Margaret Katana Ogongo, Nicole Huberfeld, Karen Basen Engquist, Julie R Gralow, Farhad Islami, Beth Y Karlan, K Robin Yabroff
{"title":"The impacts of the Dobbs ruling on US cancer care delivery","authors":"Margaret Katana Ogongo, Nicole Huberfeld, Karen Basen Engquist, Julie R Gralow, Farhad Islami, Beth Y Karlan, K Robin Yabroff","doi":"10.1093/jnci/djaf058","DOIUrl":"https://doi.org/10.1093/jnci/djaf058","url":null,"abstract":"The US Supreme Court’s ruling on Dobbs v Jackson Women’s Health Organization (Dobbs) in 2022 eliminated federal constitutional protection for abortion access. Dobbs has clinical and practical implications throughout the cancer control continuum. In abortion access-restrictive states, providers and patients with cancer who are pregnant will need to consider less efficacious cancer treatments, criminal or civil penalties for providers, and/or travel to abortion access-protective states. Provider shortages as well as closures of clinics that offer abortion services and cancer screening will likely contribute to screening declines. Limited access to and delays in reproductive health-care services, including fertility preservation, will likely widen existing gaps in cancer care and outcomes, disproportionately affecting marginalized populations and further perpetuating health inequities. In 2023, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine conducted a webinar series to examine the implications of Dobbs on cancer care delivery. This commentary summarizes presentations and discussions related to (1) cancer treatment in pregnant persons and all people of reproductive age, (2) the cancer care workforce and care delivery, and (3) access to fertility preservation. Where relevant, we discuss how abortion restrictions affect patients with cancer and cancer care delivery; describe how Dobbs affects the health system and workforce; and discuss the ethical, legal, and social implications of overturning Roe v Wade. We also make recommendations for patients, health-care workforce, cancer centers, payers, professional societies, and data and for mitigating the impact of the evolving patchwork of state laws and restrictions for cancer care and outcomes.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144104541","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}
引用次数: 0
Lineages and sublineages of high-risk HPV types associated with cervical cancer and precancer: a systematic review and meta-analysis 与宫颈癌和癌前病变相关的高危型HPV的谱系和亚谱系:一项系统回顾和荟萃分析
Journal of the National Cancer Institute Pub Date : 2025-05-16 DOI: 10.1093/jnci/djaf118
Eef Van Den Borst, Margo Bell, Ken Op De Beeck, Guy Van Camp, Severien Van Keer, Alex Vorsters
{"title":"Lineages and sublineages of high-risk HPV types associated with cervical cancer and precancer: a systematic review and meta-analysis","authors":"Eef Van Den Borst, Margo Bell, Ken Op De Beeck, Guy Van Camp, Severien Van Keer, Alex Vorsters","doi":"10.1093/jnci/djaf118","DOIUrl":"https://doi.org/10.1093/jnci/djaf118","url":null,"abstract":"BACKGROUND Infection with high-risk types of the human papillomavirus (hrHPV) is known to cause cervical cancer. Cervical cancer risk varies greatly by genotype, which is therefore used in screening algorithms. A significant amount of research has also focused on the differential pathogenicity of hrHPV subtypes called lineages and sublineages (resp. 1.0-10% and 0.5-1.0% genetic difference), albeit with inconclusive and contradictory results. Therefore, the topic is systematically reviewed for the first time to determine whether the clinical use of (sub)lineage detection is supported. METHODS Three databases for health sciences (PubMed, Web of Science, and Scopus) were searched for relevant papers. Meta-analysis was performed for HPV16 positive cancers and controls using random effects models. RESULTS The search yielded 1,535 records and 93 papers were included after the selection process. Although some trends in disease association were detected, 46 studies did not find significant differences between (sub)lineages in cases and controls. Additionally, the reports are heterogeneous in terms of study design and often characterized by a small sample size. The meta-analysis found odds ratios of 2.2 [95% CI: 1.49-3.15] for HPV16 A4, 2.1 [95% CI: 1.25-3.40] for HPV16 D and 0.48 [95% CI: 0.33-0.68] for HPV16 A1-3 with significant heterogeneity (38-77%). CONCLUSION This systematic review and meta-analysis provides an overview of the hrHPV (sub)lineages and association with cervical disease. Although some (sub)lineages marginally correlate with cervical malignancy, there is great variability. Unlike genotyping, this study demonstrates insufficient association between hrHPV (sub)lineages and cervical malignancy for clinical use to date.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066788","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}
引用次数: 0
Unraveling the role of stromal disruption in aggressive breast cancer etiology and outcomes. 揭示基质破坏在侵袭性乳腺癌病因和预后中的作用。
Journal of the National Cancer Institute Pub Date : 2025-05-14 DOI: 10.1093/jnci/djaf070
Mustapha Abubakar,Máire A Duggan,Shaoqi Fan,Ruth M Pfeiffer,Scott Lawrence,Karun Mutreja,Alyssa Klein,Hela Koka,Thomas U Ahearn,Jill E Henry,Brian L Sprague,Pamela M Vacek,Donald L Weaver,Kathryn Richert-Boe,Teresa M Kimes,Nicolas Titiloye,Lawrence Edusei,Jonine D Figueroa,Xiaohong R Yang,Montserrat Garcia-Closas,Thomas E Rohan,Gretchen L Gierach
{"title":"Unraveling the role of stromal disruption in aggressive breast cancer etiology and outcomes.","authors":"Mustapha Abubakar,Máire A Duggan,Shaoqi Fan,Ruth M Pfeiffer,Scott Lawrence,Karun Mutreja,Alyssa Klein,Hela Koka,Thomas U Ahearn,Jill E Henry,Brian L Sprague,Pamela M Vacek,Donald L Weaver,Kathryn Richert-Boe,Teresa M Kimes,Nicolas Titiloye,Lawrence Edusei,Jonine D Figueroa,Xiaohong R Yang,Montserrat Garcia-Closas,Thomas E Rohan,Gretchen L Gierach","doi":"10.1093/jnci/djaf070","DOIUrl":"https://doi.org/10.1093/jnci/djaf070","url":null,"abstract":"BACKGROUNDAggressive (typically high-grade) breast cancers (BCs) remain major contributors to BC-related mortality globally. The tissue changes underpinning their etiology and outcomes, however, remain poorly characterized.METHODSSpatially resolved machine-learning algorithms were used to characterize \"stromal disruption\" as a morphological metric of reduced/altered extracellular matrix and increased immune, inflammatory, and/or wound response-related processes in normal, benign breast disease (BBD), and invasive hematoxylin and eosin (H&E)-stained breast tissues. Associations of stromal disruption with BC etiologic factors were assessed among 4023 healthy breast tissue donors, its impact on BC incidence was assessed among 974 BBD patients in a nested case-control study, while its prognostic associations were assessed in 4 BC patient cohorts (n = 4223).RESULTSEpidemiologic risk factors for aggressive BC, including younger age, multiparity, Black race, obesity, and family history, demonstrated strong associations with increasing stromal disruption in H&E sections prior to tumor development. Substantial stromal disruption in BBD H&E was associated with ∼4-fold increased risk of aggressive (high-grade) BC and ∼3 years shorter latency from BBD to BC diagnosis, independently of BBD histology. Across BC cohorts, stromal disruption in H&E was associated with aggressive (mostly high-grade) tumor phenotypes and with markedly poor prognosis among ER-positive patients, irrespective of histology. The immunobiology of stromal disruption reflected heightened innate (CD68+), adaptive (CD3+CD4+, CD3+CD8+), immunoregulatory (CD3+CD4+FOXP3+), immune escape (PD1+PDL1+), endothelial (CD31+), and myofibroblast (α-SMA+) marker expression.CONCLUSIONOur findings highlight the active stromal role in aggressive BC etiology and outcomes, opening possibilities for readily identifying high-risk women across the BC continuum that may benefit from stroma-centric preventative or therapeutic strategies.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945536","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}
引用次数: 0
Reduced adipose tissue with limited loss of lean mass after weight loss: results from the Prostate Active Lifestyle Study 减肥后脂肪组织减少,瘦质量减少有限:前列腺积极生活方式研究的结果
Journal of the National Cancer Institute Pub Date : 2025-05-10 DOI: 10.1093/jnci/djaf113
Jeannette M Schenk, Roman Gulati, Sarah J Beatty, Steven Plymate, Daniel W Lin, Atreya Dash, Michael P Porter, Matt Vandoren, Jonathan L Wright, Marian L Neuhouser
{"title":"Reduced adipose tissue with limited loss of lean mass after weight loss: results from the Prostate Active Lifestyle Study","authors":"Jeannette M Schenk, Roman Gulati, Sarah J Beatty, Steven Plymate, Daniel W Lin, Atreya Dash, Michael P Porter, Matt Vandoren, Jonathan L Wright, Marian L Neuhouser","doi":"10.1093/jnci/djaf113","DOIUrl":"https://doi.org/10.1093/jnci/djaf113","url":null,"abstract":"Adiposity reduction has both cancer-specific and overall health benefits for patients with overweight or obesity. However, the indiscriminate loss of lean mass accompanying weight loss remains a concern for older cancer patients. Body composition was evaluated in the Prostate Active Lifestyle Study, a randomized controlled weight loss trial targeting caloric restriction and increased physical activity among patients with prostate cancer (PCa) and overweight or obesity on active surveillance. Compared to control, the intervention statistically significantly decreased total fat (-3.4%; 95%CI: -5.3%, -1.5%), android fat (-2.0%; 95%CI: -3.6%, -0.4%), and visceral adipose tissue mass (-613 g; 95%CI: -894 g, -331 g) (all 2-sided p &amp;lt; .001) with no difference in lean mass (p = .70) and a statistically significant increase in lean-to-fat ratio (0.40; 95%CI: 0.06, 0.73; 2-sided p = .02). Weight loss interventions incorporating diet and physical activity among patients with PCa and overweight or obesity can yield statistically significant reductions in adiposity while limiting lean mass loss.","PeriodicalId":501635,"journal":{"name":"Journal of the National Cancer Institute","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932430","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}
引用次数: 0
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