Cancer causes & control : CCC最新文献

{"title":"Effect of the SARS-CoV-2 pandemic on the opportunity to treat patients with breast cancer: experience at a reference cancer center in Mexico City.","authors":"Blanca Margarita Cruz-Badillo, Caleb García-Arango, Ixtayul Leopoldo Aldama-Santos, Laura Denisse Cuapantecatl-Hernandez, Nancy Reynoso-Noverón","doi":"10.1007/s10552-026-02235-z","DOIUrl":"10.1007/s10552-026-02235-z","url":null,"abstract":"<p><strong>Background: </strong>Delays from diagnosis to first treatment are a persistent challenge in Mexico.</p><p><strong>Materials and methods: </strong>Retrospective observational cohort at the National Cancer Institute (INCAN), Mexico City (November 2017-December 2021). Women with first-time breast cancer and complete dates for diagnosis and treatment start were included. Primary outcome was diagnosis-to-treatment interval (DTI) in days; timeliness was defined as initiation ≤ 30 days. Bivariate tests and multivariable logistic regression were used (two-sided α = .05).</p><p><strong>Results: </strong>We included 425 women. Median DTI was 18 days (IQR 14-24) among timely cases and 42 days (IQR 35-55) among delayed cases. By care period, median DTI was 28 days pre-pandemic and 23.5 days during the pandemic; the proportion initiating ≤ 30 days was similar (58.7 vs 61.9%; P = .509). In bivariate analysis (Supplementary Table S1), timeliness differed by initial treatment-chemotherapy and hormone therapy showed higher odds than surgery (global P< .001)-and high socioeconomic status had lower odds versus low status (OR, 0.36; 95% CI, 0.14-0.96; P = .042); the care period was not significant (P = .509). In multivariable models, pandemic care was associated with lower odds of timeliness (aOR, 0.54; 95%  CI, 0.33-0.88; P = .014); starting with chemotherapy (aOR, 19.77; 95%  CI, 5.23-74.62; P <.001) or hormone therapy (aOR, 2.79; 95% CI, 1.14-6.85; P = .024) increased the odds; each additional day from first consultation to referral to medical oncology reduced the odds (per-day OR, 0.99; 95% CI, 0.98-0.99; P = .005).</p><p><strong>Conclusion: </strong>A subset of patients experienced clinically relevant delays. Despite similar ≤ 30-day proportions across periods, pandemic care was independently linked to reduced timeliness after adjustment. Streamlined referral and process optimization are priorities to preserve timely access under system stress.</p><p><strong>Implications for practice: </strong>In a tertiary center in Mexico City, the diagnosis-to-treatment interval was substantially shorter for patients initiating chemotherapy or hormone therapy than for those starting with surgery. Each additional day from first consultation to referral to medical oncology reduced the odds of meeting the ≤ 30-day target. Focusing on referral logistics and early treatment decision points can preserve timeliness under system stress and can be implemented without new infrastructure, informing pragmatic pathways in similar middle-income settings.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858069","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":"Racial and ethnic disparities in enrollment for clinical trials of poly (ADP-ribose) polymerase (PARP) inhibitors in breast cancer treatment.","authors":"Parnian Kheirkhah Rahimabad, Simran Sekhon, Elizabeth John","doi":"10.1007/s10552-026-02236-y","DOIUrl":"10.1007/s10552-026-02236-y","url":null,"abstract":"<p><strong>Background: </strong>Poly (ADP-ribose) polymerase (PARP) inhibitors have shown promise in treating breast cancer with BRCA1/2 mutations, particularly triple-negative breast cancer (TNBC). There is limited data on the representation of different racial groups in PARP inhibitor clinical trials.</p><p><strong>Methods: </strong>We conducted a systematic review of phase II/III clinical trials using PARP inhibitors for the treatment of BRCA1/2-mutated breast cancers from 2016 to 2023, using PubMed, Embase, Scopus, CENTRAL, ClinicalTrials.gov, and Cochrane. Nine trials remained for analysis. Enrollment fraction (EF) was calculated by comparing the number of trial enrollees to the number of incident cancer cases. Logistic regression was used to determine the odds ratio (OR) of trial enrollment across racial groups.</p><p><strong>Results: </strong>Overall, the trials included a total of 2845 White, 136 Black, 83 Hispanic, 662 Asian, and 247 Other racial group patients. Other group was excluded from further analysis due to unspecified racial makeup. Among breast cancer patients of any type, EF was the highest for Asian (0.85%), followed by White (0.47%), Black (0.12%), and Hispanic (0.06%) patients. Comparing to White patients, the enrollment ORs were 0.26 for Black, 0.12 for Hispanic, and 1.80 for Asian (p < .001). Analyses were repeated excluding the Asian group, as these patients were recruited from Asian countries rather than the Asian American population. The ORs for Black and Hispanic patients remained the same and significant.</p><p><strong>Conclusion: </strong>Our results show the significant under-representation of Black and Hispanic patients in PARP inhibitor trials in the U.S., raising concerns about equity and the generalizability of trial outcomes for these populations.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820514","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":"\"I never thought to bring them up to the doctor\": examining symptom appraisal, help-seeking behaviors, and diagnostic delays among young adults with cancer.","authors":"Natasha C Allard, Elizabeth G Bouchard, Jennifer S Ford, Thomas Hugh Feeley, Denise Rokitka, Heather Orom","doi":"10.1007/s10552-026-02231-3","DOIUrl":"10.1007/s10552-026-02231-3","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer incidence is rising among young adults (20-39 years), and it is one of the top five causes of death for this age group. Young adults often experience longer delays in diagnosis than children and older adults, which negatively impacts survival and quality of life. Communication interventions might help reduce these delays, but understanding the factors driving delays is crucial for developing effective strategies.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 30 young adults diagnosed with cancer to explore factors contributing to delays across three intervals: symptom appraisal, help-seeking, and diagnostic. Interviews were conducted in January and February 2023 and analyzed using template analysis by three independent coders.</p><p><strong>Results: </strong>Most young adults misattributed symptoms to stress, lifestyle, or minor issues, and thus delayed seeking medical evaluation. Many used online information to inform care-seeking decisions but encountered content that minimized symptom severity or offered unclear guidance. Upon seeking care, several young adults had to self-advocate for diagnostic testing after providers initially dismissed their concerns.</p><p><strong>Conclusion: </strong>These patterns highlight potentially modifiable targets for future communication interventions. Strategies to improve young adults' awareness of potential cancer symptoms, address misconceptions about cancer risk, and promote timely care-seeking are warranted. Efforts should also focus on improving the quality of online symptom information and equipping young adults with tools to communicate more effectively with providers. While systemic changes are also needed, individual-level communication campaigns could help shorten time to diagnosis and improve outcomes for young adults with cancer.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing primary care in breast cancer survivors after completion of cancer therapy.","authors":"Kendall Kay, Yancen Pan, Jessica Li, Lan Zhang, Vanessa N Torres, Yelba Castellon-Lopez, Meng-Han Tsai, Geetanjali D Datta, Jennifer Henry, Cody Ramin","doi":"10.1007/s10552-026-02230-4","DOIUrl":"10.1007/s10552-026-02230-4","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the potential for primary care to optimize comorbidity management among breast cancer survivors, engagement with primary care providers (PCPs) remains low. This study comprehensively examined PCP-led care after breast cancer treatment to identify survivors who may benefit from targeted interventions to improve primary care engagement.</p><p><strong>Methods: </strong>We identified 1,582 posttreatment breast cancer survivors from the U.S. Behavioral Risk Factor Surveillance System survey. Weighted multivariable-adjusted logistic regression models were used to examine associations of sociodemographic, lifestyle, clinical, and survivorship-related factors with PCP-led care after cancer treatment.</p><p><strong>Results: </strong>Overall, 72% of survivors reported receiving PCP-led follow-up (64% among those aged < 65 years; 75% among those aged ≥ 65 years), with survivors aged < 65 years having significantly lower odds of PCP-led care than those aged ≥65  years (OR: 0.63, 95% CI: 0.41-0.98). Racial and ethnic differences were also evident with lower odds of receiving primary care among Non-Hispanic (NH)-Black and NH-Asian survivors compared with NH-White survivors (OR: 0.49, 95% CI: 0.24-0.97; OR: 0.33, 95% CI: 0.11-0.97, respectively), with particularly lower odds among younger Hispanic survivors (OR: 0.13, 95% CI: 0.03-0.49). Geographic variation across regions was also observed (South OR: 0.42, 95% CI: 0.25-0.72; West OR: 0.60, 95% CI: 0.37-0.96, compared with Midwest). Survivors with a history of myocardial infarction further had lower odds of PCP-led care (OR: 0.40, 95% CI: 0.20-0.80).</p><p><strong>Conclusion: </strong>Gaps in PCP-led care after breast cancer treatment underscore the importance of improving access and support for PCP-led engagement throughout survivorship. Future studies are needed to examine barriers to PCP-led care among younger survivors, NH-Black and NH-Asian survivors, and those with heart disease, and to characterize region-specific differences in PCP-led care across the U.S.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung cancer screening eligibility and completion among adults diagnosed with lung cancer: retrospective analysis of 2024 National Health Interview Survey.","authors":"Izabella Zanazanian, Angela Yin Chieh, Aarushi Madan, Franceskrista Morales, Gelareh Sadigh","doi":"10.1007/s10552-026-02229-x","DOIUrl":"10.1007/s10552-026-02229-x","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer screening using low-dose computed tomography (LDCT) is recommended for high-risk individuals, yet uptake remains low. We evaluated screening eligibility and completion among adults with lung cancer.</p><p><strong>Methods: </strong>In the 2024 National Health Interview Survey, adults aged ≥ 50 years with a lung cancer diagnosis within the past 10 years were included. Eligibility at diagnosis was determined using 2021 United States Preventive Services Task Force criteria based on self-reported smoking history. LDCT completion before diagnosis was assessed. Weighted multivariable logistic regression identified factors associated with outcomes.</p><p><strong>Results: </strong>115 participants were included (weighted n = 638,702). Eligibility could not be determined for 3.5% (4/115). Among those with known eligibility, 52.3% (58/11) met screening criteria at diagnosis. Female sex (OR 0.31; 95% CI 0.12-0.77; p = 0.01) was associated with lower odds of eligibility, while non-white race showed a trend toward lower eligibility (OR 0.35; 95% CI 0.12-1.04; p = 0.06). After excluding participants who never smoked, no variables were significant. Overall, 83.6% (92/110) reported receipt of LDCT, but only 32.7% (36/110) received it before diagnosis. No variables were significantly associated with screening completion.</p><p><strong>Conclusion: </strong>Among US adults with lung cancer, approximately half were screening-eligible, and only one-third underwent screening before diagnosis, highlighting gaps in both eligibility and utilization.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of prostate cancer (1990-2021) from Brazil: trends in disability-adjusted life years, incidence, mortality, and prevalence.","authors":"Gabriela Daiprai, Bruna Cristina Jordon Togni, Maria Noêmia Souza de Alcântara, Joana Ecco, Ágatha Kniphoff da Cruz, Fernanda Majolo, Guilherme Liberato da Silva","doi":"10.1007/s10552-026-02232-2","DOIUrl":"10.1007/s10552-026-02232-2","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer remains a significant public health challenge globally, with marked regional disparities in Brazil linked to demographic, socioeconomic, and healthcare access factors. This study analyzed trends in disability-adjusted life years (DALYs), incidence, mortality, and prevalence of prostate cancer across Brazilian macroregions (1990-2021) using data from the Global Burden of Disease (GBD) database. Joinpoint regression was employed to identify temporal trends and average annual percentage changes (AAPCs), stratified by age and region.</p><p><strong>Methods: </strong>Data were extracted from GBD 2021, encompassing national and regional estimates. Statistical analyses included age-standardized rates, AAPC calculations, and pairwise comparisons to assess parallelism in trends.</p><p><strong>Results: </strong>Results revealed substantial regional disparities: Southern and Southeastern regions exhibited the highest DALYs, incidence, and prevalence, patterns that are consistent with better diagnostic infrastructure and aging populations. In contrast, Northern regions showed lower rates but the steepest AAPC increases (e.g., incidence: + 2.59% annually in age group 70-74), suggestive of improving yet insufficient healthcare access. Mortality declined in the South and Southeast (AAPC up to -0.70% in age group 70-74) due to therapeutic advances but rose in the Northeast (AAPC up to + 0.76% in age group 65-69). Prevalence surged nationwide, peaking in older age groups (e.g., 2,619.50 cases/100,000 men in Southern 70-74 age group), indicating prolonged survival. Joinpoint analyses identified non-linear trends, with incidence stabilizing post-2010 following shifts in screening guidelines.</p><p><strong>Conclusion: </strong>These findings underscore the need for region-specific policies to address inequities in cancer care, enhance early diagnosis, and optimize resource allocation. Strengthening healthcare infrastructure in underserved regions and targeted screening for younger high-risk populations are critical to mitigating Brazil's prostate cancer burden.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social disruption after cancer: longitudinal changes in marital status, residence, and income among over 450,000 cancer patients.","authors":"Larry M Zhao, Juan Yang, Wendy Yi Xu","doi":"10.1007/s10552-026-02228-y","DOIUrl":"10.1007/s10552-026-02228-y","url":null,"abstract":"<p><strong>Background: </strong>The impact of cancer extends beyond clinical outcomes, often disrupting interpersonal relationships and living situations. Although these social factors are important for survivorship, little is known about how marital status, residential urbanicity, and income change over time for cancer patients.</p><p><strong>Methods: </strong>Using SEER 17, we obtained data from 457,058 adults diagnosed with multiple primary cancers from 2000 to 2021 and evaluated changes in marital status, urbanicity, and household income between the first and last recorded diagnoses. Analyses were stratified by follow-up interval (short: 2-5, long: > 5 years). Marital status change was evaluated among patients who were married at the first cancer diagnosis (n = 255,939), and changes in urbanicity and household income were evaluated as secondary analyses among patients who remained married from first to last diagnosis (n = 214,956). Logistic regressions adjusted for demographic and clinical factors were used to estimate odds ratios and 95% confidence intervals.</p><p><strong>Results: </strong>Among patients married at the first diagnosis, 5% became not married (divorced/separated/single) and 11% were widowed; rates were higher in women (6% not married; 16% widowed) than men (4; 7%). Among patients who remained married from the first to the last diagnosis, 5% changed urbanicity (1.5% more rural; 3.4% more urban) and 26% changed income (15% increase; 10% decrease). NHB patients had > twofold higher odds of being unmarried (not married or widowed) and income decrease compared to non-Hispanic Whites. Hispanic patients also had elevated odds of unmarried, while Non-Hispanic Asian/Pacific Islander patients had lower odds of income decrease.</p><p><strong>Conclusions: </strong>Cancer diagnoses are associated with notable social and economic disruptions, disproportionately affecting women and vulnerable racial/ethnic populations. This study provides the first large-scale analysis of how marital status, residence, and income evolve, highlighting the need to address social determinants of health in survivorship care.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709450","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 information seeking and awareness of multi-cancer detection tests among U.S. adults: a cross-sectional study.","authors":"Dukanwojo Beulah Suleman","doi":"10.1007/s10552-026-02226-0","DOIUrl":"10.1007/s10552-026-02226-0","url":null,"abstract":"<p><strong>Background: </strong>Multi-cancer detection (MCD) tests represent a promising innovation in early cancer detection, yet public awareness of these technologies remains limited. Engagement with cancer-related information may play a key role in shaping awareness of emerging screening tools.</p><p><strong>Methods: </strong>This study used data from the 2024 Health Information National Trends Survey (HINTS 7) (n = 6,145) to examine the association between self-reported cancer information seeking (ever sought cancer information vs. never sought cancer information) and awareness of multi-cancer detection (MCD) tests (heard of MCD tests vs. not heard of MCD tests) among U.S. adults. Survey-weighted logistic regression models were estimated to assess this association, adjusting for age, sex, race/ethnicity, educational attainment, family history of cancer, and health insurance coverage. Average marginal effects (AMEs) and predicted probabilities were estimated to facilitate interpretation. Sensitivity analyses excluded respondents with a personal history of cancer.</p><p><strong>Results: </strong>Overall, 16.7% of respondents reported being aware of MCD tests, while 52.3% had sought cancer-related information. In unadjusted analyses, individuals who sought cancer information had 49% higher odds of MCD test awareness than those who did not (OR = 1.49, 95% CI: 1.16-1.91). After adjustment for sociodemographic characteristics, cancer information seeking remained significantly associated with greater awareness (OR = 1.44, 95% CI: 1.11-1.88). On average, cancer information seeking increased the predicted probability of MCD test awareness by approximately 5 percentage points (AME = 0.050, 95% CI: 0.015-0.084), corresponding to adjusted predicted probabilities of 14.1% among non-seekers and 19.0% among information seekers. No significant interaction by race/ethnicity was observed. Sensitivity analyses restricted to respondents without a personal history of cancer yielded substantively similar findings.</p><p><strong>Conclusion: </strong>Cancer information seeking is independently associated with greater awareness of MCD tests among U.S. adults. Public health communication strategies that encourage engagement with cancer information may help improve population awareness of emerging cancer screening technologies as they become more widely available.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698551","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":"Barriers and facilitators to implementing the European code of cancer practice in a rural and coastal setting: a qualitative study.","authors":"Shanice Thomas, Hannah Cumberland Keeble, Erica Brown, Sarah R Baker, Samuel Cooke, Mark Lawler, Kathie McPeake, Kathy Oliver, Peter Selby, David Nelson","doi":"10.1007/s10552-026-02225-1","DOIUrl":"10.1007/s10552-026-02225-1","url":null,"abstract":"<p><strong>Purpose: </strong>The European Code of Cancer Practice (ECCP) is a patient-centred framework for good clinical cancer practice, to improve outcomes for all of Europe's patients [1]. Given challenges with applications to rural regions, the study aimed to explore the barriers and facilitators to implementing the ECCP in a rural, coastal, and urban context.</p><p><strong>Methods: </strong>We conducted semi-structured individual and group interviews with nine acute cancer professionals; nine non-clinical professionals; and four people with lived experience of cancer. Interviews were analysed using reflexive thematic analysis, underpinned by a constructivist approach.</p><p><strong>Results: </strong>Three themes were developed across all groups. 1) 'Fragmented communication pathways limits access' to information-sharing between services, and about support and research, linked to workforce challenges. 2) 'Geographic and infrastructural disparities between urban, rural, and coastal areas' highlight barriers to accessing and delivering care, including transport issues, alongside place-specific facilitators to wellbeing. 3) 'Unmet needs for living well during and after treatment' denotes financial, work-related, and psychological challenges through treatment and survivorship. These barriers transcended across all ECCP domains.</p><p><strong>Conclusion: </strong>Workforce challenges that limit information-sharing about support and research, and gaps in post-treatment support, must be addressed to meet the ECCP aim to ensure equitable cancer care across geographical locations.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term poverty, rurality, and geographic disparities in colorectal cancer: a spatial analysis in Texas.","authors":"Ryan Ramphul, Tracey Farrigan, Yixiao Chen, Yanchen Liu, Jooyeon Lee, Ruth Rechis, Karen Basen-Engquist, Lorna McNeill","doi":"10.1007/s10552-026-02223-3","DOIUrl":"10.1007/s10552-026-02223-3","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal cancer (CRC) remains a leading cause of cancer morbidity and mortality in the United States and shows substantial geographic variation. Socioeconomically disadvantaged communities experience elevated CRC incidence, yet few studies have analyzed multi-decade poverty measures for long-term structural disadvantage.</p><p><strong>Methods: </strong>We analyzed CRC incidence from 2017 to 2021 across Texas using Texas Cancer Registry data. Age-sex-race/ethnicity standardized cases were incorporated as offsets in Bayesian spatial models to generate tract-level posterior mean relative risks. We evaluated four tract-level poverty measures (high poverty in 2021; persistent poverty since 1990; enduring poverty since 1980 and 1970), Rural-Urban Commuting Area (RUCA) classifications, and CRC screening rates among adults aged 50-75 years.</p><p><strong>Results: </strong>Long-term poverty and rurality were independently associated with elevated CRC risk. Compared with urban tracts, micropolitan and rural tracts had 7-8% higher risks. Poverty measures defined over longer durations showed stronger associations with CRC incidence: high poverty in 2017-2021 (RR = 1.04, 95% CrI: 1.01-1.07), persistent poverty since 1990 (RR = 1.04, 1.00-1.08), enduring poverty since 1980 (RR = 1.06, 1.01-1.11), and enduring poverty since 1970 (RR = 1.09, 1.04-1.15). Higher tract-level CRC screening prevalence was inversely associated with CRC incidence (RR per 1% increase = 0.99).</p><p><strong>Conclusion: </strong>Long-term poverty and rural residence were associated with elevated CRC risk in Texas, even after adjusting for screening prevalence. Multi-decade poverty measures and updated RUCA classifications identified geographic disparities not captured by single-year poverty indicators and supported geographically targeted screening, prevention, and resource allocation efforts. These results can inform geographically targeted, efficiency-focused screening and prevention strategies, particularly in communities experiencing decades of structural disadvantage.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 9","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}