Cancer causes & control : CCC最新文献

{"title":"United States comprehensive cancer control plans: a national review.","authors":"Leslie S Given, Karin Hohman, Cynthia Vinson, Nikki Hayes, Beth Slotman, Lisa Stevens, Prajakta Adsul, Kalina Duncan, Margaret Farrell, Aubrey Villalobos","doi":"10.1007/s10552-026-02216-2","DOIUrl":"10.1007/s10552-026-02216-2","url":null,"abstract":"<p><strong>Purpose: </strong>In 2021, the United States (US) Comprehensive Cancer Control National Partnership conducted a review of US cancer control plans. Here we have summarized the methods used and the results of this review to better understand the plans' comprehensiveness, strengths, weaknesses, and inclusion of emerging cancer prevention and control topics.</p><p><strong>Methods: </strong>For this review, the authors adapted a tool used in a global review of national cancer control plans. The review tool was piloted, modified, and programmed into a web survey software for reviewer data entry. We obtained and reviewed plans from all 50 states, the District of Columbia, 6 US Pacific Island Jurisdictions and Puerto Rico, and 8 Tribes and Tribal organizations (N = 66).</p><p><strong>Results: </strong>This review highlighted many strengths (e.g., use of data) of US cancer control plans and some areas where more specific plan strategies and content are needed (e.g., resource needs). 59% of plans covered all six cancer control areas. Most addressed equitable access to services (83%), but few targeted specific groups like people with disabilities (12%). Nearly all used data for objectives (96%), and most defined implementation responsibilities (76%), though only 15% discussed financial resources or strategies.</p><p><strong>Conclusion: </strong>CCC plans are data-informed documents developed with community input outlining jurisdictional priorities that help inform policies and are implemented through multisectoral coalitions. These plans offer adaptable strategies that address both cancer burden and shifting social, economic, and organizational factors. While plans are strong in areas like prevention and use of data, opportunities exist to better address financial planning, the needs of specific populations like older adults and people with disabilities, and emerging topics such as vaping. The review serves as a call to action for enhanced collaboration to address these gaps and accelerate efforts to reduce the burden of cancer.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148552070","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":"Genetically predicted vitamin D levels and risk of head and neck cancer: a mendelian randomization study.","authors":"Gowri Sivaramakrishnan, Kannan Sridharan","doi":"10.1007/s10552-026-02219-z","DOIUrl":"10.1007/s10552-026-02219-z","url":null,"abstract":"<p><strong>Objectives: </strong>Observational studies examining the association between vitamin D and head and neck cancer (HNC) have reported conflicting results. We conducted a two-sample MR study to investigate the causal association between genetically predicted serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of HNC and its major subtypes: oral cavity, laryngeal, hypopharyngeal, and HPV-negative oropharyngeal cancers.</p><p><strong>Design: </strong>Genetic instruments were selected from GWAS of 441,291 individuals (UK Biobank). Cancer outcomes were obtained from the HEADSpAcE consortium. Multiple sclerosis (MS) was analyzed as a positive control. We identified 115 independent genetic instruments for serum 25(OH)D. Causal estimates were primarily derived using inverse variance weighted (IVW) MR, supported by MR-Egger, weighted median, and mode-based methods. Extensive sensitivity analyses assessed heterogeneity, pleiotropy, and directionality.</p><p><strong>Results: </strong>We identified 115 independent genetic instruments for serum 25(OH)D levels, which explained 5.12% of the total phenotypic variance. The mean F-statistic was 198.3 and satisfied MR assumptions. Only 17 of 682 (2.5%) SNP-confounder associations reached nominal significance (p  < 5 × 10⁻⁸), and none remained significant after Bonferroni correction, indicating no systematic confounding. Higher 25(OH)D levels were associated with a reduced risk of MS (IVW OR = 0.84, 95% CI 0.71-0.99, p = 0.038; weighted median OR = 0.82, 95% CI 0.70-0.96, p  = 0.015), while no evidence of a causal association was observed between 25(OH)D and risk of HNC or any subtype (all IVW p  > 0.05; ORs ranging from 0.95 to 1.25). Sensitivity analyses revealed no evidence of horizontal pleiotropy, influential outliers, or reverse causation for any cancer outcome.</p><p><strong>Conclusions: </strong>This study provides robust genetic evidence that circulating 25(OH)D levels are not a major causal determinant of HNC risk and that our instruments are not confounded by major lifestyle or UV-related factors.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148552114","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":"Access to cervical screening in Australian general practices: a cross-sectional study using a 'secret shopper' approach.","authors":"Lucy Boyd, Claire Nightingale, Javiera Martinez-Gutierrez, Ana Machado Colling, Angela Kelly-Hanku, Paula Jops, Claire Bavor, Maleeha Ashfaq, Claire Zammit, Kristy Meiselbach, Julia Brotherton","doi":"10.1007/s10552-026-02215-3","DOIUrl":"10.1007/s10552-026-02215-3","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical screening in Australia is currently accessed through a healthcare provider, typically a general practitioner in primary care. We aimed to assess the real-world availability of and access to cervical screening services, including self-collection.</p><p><strong>Methods: </strong>Cross-sectional study was conducted using a secret shopper methodology with a standardized telephone script that emulated real-life calls. A random sample of Australian general practices, from each State/Territory (contacted November 2024-February 2025).</p><p><strong>Results: </strong>Of the 310 general practices, 72 (23%) could not offer a cervical screening appointment for new patients. Among practices able to provide an appointment, 217 (89%) said self-collection was available. By jurisdiction, the proportion of practices reporting availability of cervical screening ranged from 72 to 83% but did not significantly differ. The proportion of clinics that offered the choice of self-collection differed significantly by State/Territory ( <math><msubsup><mi>χ</mi> <mrow><mn>7</mn></mrow> <mn>2</mn></msubsup> </math> =15·774, P = ·013), ranging from 60 to 100%. More regional clinics (94%) offered self-collection compared to metropolitan clinics (85%)(P = ·017). Practices located in the most disadvantaged socioeconomic quintile had a significantly higher proportion offering self-collection (95%) compared to those located in the most advantaged quintile (79%)(P = ·043). Out-of-pocket or gap fees were charged by 183 (75%) clinics (average: $AU50·73, range $AU15-$94·15).</p><p><strong>Conclusion: </strong>Our study highlighted that access to cervical screening may be constrained by limited appointments for new patients, out-of-pocket costs, and other factors. These barriers may disproportionately affect individuals facing structural and financial disadvantage. We found significant variability in availability of self-collection by location. Exploring flexible models, including mail-out, pharmacy supported, or community-led models, may improve accessibility and reduce burden on general practices.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148552092","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 disparities among screening-eligible older Black adults with 20 + years of tobacco use: Quantitative findings from a mixed-methods, quasi case-control study.","authors":"Delvon T Mattingly, Courtney Blair, Meman Diaby, Tia N Weber, Justin X Moore, Jessica L Burris","doi":"10.1007/s10552-026-02214-4","DOIUrl":"10.1007/s10552-026-02214-4","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is the leading cause of cancer death in the United States and disproportionately affects Black adults. Lung cancer screening (LCS) remains narrowly focused on cigarette smoking, often excluding other tobacco use, and low provider referral rates continue to limit screening uptake. Addressing these gaps is critical to advancing screening equity.</p><p><strong>Methods: </strong>We surveyed 100 Black adults (aged 50 + years) with a 20 + year history of tobacco use who either currently used or had quit within the past 15 years. The survey assessed tobacco use characteristics, cessation intentions, tobacco product harm perceptions, LCS-related quit motivations, and LCS knowledge and beliefs. We compared characteristics, beliefs, and experiences by LCS status (56% screened) using a quasi case-control approach.</p><p><strong>Results: </strong>LCS uptake varied by insurance status (p = 0.03), tobacco risk perceptions (p = 0.037), past-year quit attempts (p = 0.005), and lung cancer beliefs, including early detection knowledge (p < 0.001). Screening experiences were associated with health care discrimination and LCS-related risk perceptions. Among adults reporting past-year use of combustible tobacco products other than cigarettes, unscreened adults were more likely than screened adults to report current use (22.7% vs. 5.4%; p = 0.01). Participants most identified social media (48.0%), followed by magazines/newspapers (31.0%) and local news (29.0%), as trusted sources of information on early lung cancer detection.</p><p><strong>Conclusion: </strong>Expanding LCS eligibility to include non-cigarette combustible tobacco use-while addressing structural barriers, provider recommendations, gaps in screening knowledge, risk perception, and culturally responsive communication-are essential for improving the reach, implementation, and equity of LCS in Black communities.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521678","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":"Lifestyle and metabolic determinants of early- and late-onset colorectal cancer: insights from a tertiary medical center in Alabama.","authors":"Pranali G Patel, Howard W Wiener, Robert H Hollis, Carrie G Lenneman, Sadeep Shrestha","doi":"10.1007/s10552-026-02213-5","DOIUrl":"10.1007/s10552-026-02213-5","url":null,"abstract":"<p><strong>Purpose: </strong>Early-onset colorectal cancer (EOCRC, < 50 years) is rising in the United States, whereas late-onset CRC (LOCRC, ≥ 50 years) is declining. Fewer studies have examined association between risk factors and age at colorectal (CRC) diagnosis by race. Hence, we investigated whether associations between lifestyle and clinical risk factors and age at CRC diagnosis differed by race.</p><p><strong>Methods: </strong>Retrospective study conducted between 2010 and 2023 using data from a tertiary medical center in Alabama. Exposure included lifestyle factors-smoking status, and body mass index; clinical factors-type 2 diabetes (T2D), hypertension, and hyperlipidemia. Outcome was age at CRC diagnosis categorized as LOCRC and EOCRC. Multivariable logistic regression was used to examine association between lifestyle and clinical risk factors with age at CRC diagnosis after controlling for race, sex, and marital status. Race-stratified analyses were conducted.</p><p><strong>Results: </strong>Among 3,209 CRC patients, 54.1% were male, 71.4% White, and 55.8% were married. LOCRC was diagnosed in 81.2%. Patients who were former smokers (OR: 1.89; 95% CI: 1.50, 2.39), had T2D (OR: 1.92; 95% CI: 1.44, 2.57), hypertension (OR: 2.46; 95% CI: 1.65, 3.66), and hyperlipidemia (OR: 3.32; 95% CI: 2.35, 4.70) had higher odds of LOCRC, whereas obesity (OR: 0.61; 95% CI: 0.48, 0.77) had lower odds of LOCRC compared to EOCRC. Hypertension showed significant association with LOCRC in White patients. Hyperlipidemia showed stronger association with LOCRC in Black patients.</p><p><strong>Conclusion: </strong>Obesity was more prevalent in EOCRC patients and hence these differences should be considered in development of age-stratified screening and prevention strategies.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475634","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":"Early and late-onset colorectal cancers: a case-case comparison of risk factors.","authors":"Samantha Rees, Rachel Pearlman, Electra D Paskett, Peter G Shields, Heather Hampel, Jo L Freudenheim","doi":"10.1007/s10552-026-02208-2","DOIUrl":"10.1007/s10552-026-02208-2","url":null,"abstract":"<p><strong>Purpose: </strong>Examine which demographic, lifestyle, and clinical risk factors differ between patients with early-onset colorectal cancers (EOCRC) compared to late-onset colorectal cancers (LOCRC).</p><p><strong>Methods: </strong>We conducted a case-case comparison of risk factors and symptoms for EOCRC and LOCRC, utilizing the Ohio Colorectal Cancer Prevention Initiative (OCCPI) data, a statewide study of newly diagnosed CRC among Ohio residents, aged 20-92 years. Unconditional logistic regression (odds ratios (OR) and 95% confidence intervals (CI)) was used to compare risk factors by age-at-diagnoses; those diagnosed < 50 years (EOCRC, N = 288) compared to those diagnosed ≥ 50 years (LOCRC, N = 1,018), adjusting for sex, race/ethnicity, education, smoking status, and family history of CRC.</p><p><strong>Results: </strong>Compared to LOCRC, EOCRC cases had higher odds of ever consuming alcohol (OR = 2.47, CI: 1.55-3.91), consuming more alcohol in their teens/twenties than in other decades (OR = 1.85, CI: 1.36-2.51), and binge drinking (OR = 3.15, CI: 2.31-4.30). EOCRC cases were more likely to have Lynch syndrome (OR = 4.61, CI: 2.72-7.84), and report experiencing pre-diagnostic CRC symptoms (OR = 6.08, CI: 3.77-9.82), including blood in stool (52.3 vs. 30.7%), change in bowel habits (37.2 vs. 19.8%), and bowel obstruction (13.9 vs. 7.7%). Birth weight, inflammatory bowel disease, irritable bowel syndrome, and sex did not differ by age-at-diagnosis. However, when birthweight was compared between the youngest EOCRC to the oldest LOCRC cases (< 40 vs. ≥ 65 years), odds of birthweight of < 6lbs was higher in the youngest cases (OR: 2.15, CI: 0.95-4.87).</p><p><strong>Conclusion: </strong>Alcohol consumption, consuming the most alcohol in one's teens/twenties, binge drinking, having Lynch syndrome, and pre-diagnostic CRC symptoms were more associated with EOCRC than LOCRC.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428399","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":"The role of rurality and area-level disadvantage in lifestyle risk factors and psychological well-being among cancer survivors: findings from the 2021 NCI HINTS-SEER.","authors":"Anita M Kumar, Carrie A Miller, Reyna Han, D Jeremy Barsell, Joseph Boyle, Bernard F Fuemmeler","doi":"10.1007/s10552-026-02212-6","DOIUrl":"10.1007/s10552-026-02212-6","url":null,"abstract":"<p><strong>Background: </strong>Rural cancer survivors consistently experience poorer health outcomes than their urban counterparts, yet the interplay between rurality and area-level disadvantage remains understudied. This study examines how rural versus urban residence and neighborhood disadvantage relate to obesity, smoking, and psychological well-being among cancer survivors.</p><p><strong>Methods: </strong>Data from 1,062 HINTS-SEER participants across three registries were analyzed. Logistic regression models estimated associations between area-level factors (Social Deprivation Index (SDI) and Areas of Persistent Poverty) and health outcomes, adjusting for individual sociodemographic factors. Analyses accounted for complex survey design using Taylor series linearization.</p><p><strong>Results: </strong>Urban residents showed lower odds of obesity compared with their rural counterparts (OR: 0.69; 95% CI: 0.50-0.95). In stratified analyses, area-level social deprivation demonstrated smaller statistically significant associations. Higher deprivation was associated with increased odds of obesity among urban cancer survivors (OR: 1.01; 95% CI: 1.00-1.02) and increased depression/anxiety among rural survivors (OR: 1.02; 95% CI: 1.00-1.04). Across all models, individual-level socioeconomic factors (education, income) showed stronger, more consistent protective associations than area-level indicators.</p><p><strong>Conclusions and implications: </strong>Area-level disadvantage was a contributor to rural cancer survivors' psychological well-being. Individual socioeconomic status remains the dominant determinant of lifestyle and mental health outcomes. Cancer survivors residing in socioeconomically disadvantaged rural areas may benefit from targeted mental health intervention. Future longitudinal research incorporating census tract-level geographic measures and residential histories is needed to clarify the mechanisms linking the geographic and socioeconomic context to survivorship outcomes.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414558","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":"Epidemiological landscape and clinical heterogeneity of primary pancreatic lymphoma: a population-based study.","authors":"Le Guan, Feng Zhou, Conghua Song, Xiaojiang Zhou, Yang Liu","doi":"10.1007/s10552-026-02193-6","DOIUrl":"10.1007/s10552-026-02193-6","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological and clinical characteristics of primary pancreatic lymphoma (PPL) have been rarely reported in the literature. This study aimed to characterize the epidemiological features of PPL and develop robust nomograms for predicting patient survival outcomes.</p><p><strong>Methods: </strong>Patients diagnosed with PPL were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for the period 1983-2015. Incidence rates of PPL were calculated for 1975-2018, and temporal trends were assessed using Joinpoint regression analysis. Cox proportional hazards regression models were applied to identify independent prognostic factors for overall survival (OS) and disease-specific survival (DSS). Nomograms were constructed based on independent clinicopathological factors to predict the probability of survival in PPL patients.</p><p><strong>Results: </strong>A total of 867 PPL patients were identified between 1983 and 2015, with a mean age at diagnosis of 65.7 years and a male-to-female ratio of 1.5:1. The overall age-adjusted incidence of PPL from 1975 to 2018 was 0.44 per 1,000,000 population, exhibiting a statistically significant increasing trend with an annual percentage change (APC) of 2.33 (95% confidence interval [CI]: 0.88-3.80, P < 0.05). Multivariate Cox regression analysis revealed that age, sex, marital status, pathological subtype, Ann Arbor stage, surgical intervention, and chemotherapy were independent prognostic factors for both OS and DSS (all P < 0.05). Nomograms were developed to predict 1-, 5-, and 10-year OS and DSS, and the predictive performance and calibration of these models were validated using the concordance index (C-index) and calibration curves, respectively.</p><p><strong>Conclusion: </strong>PPL is an extremely rare malignancy, yet its incidence has increased steadily over the past four decades. The constructed nomograms can accurately predict 1-, 5-, and 10-year OS and DSS in PPL patients and effectively stratify patients into high-risk and low-risk groups, thus facilitating clinical decision-making.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414597","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":"Survivability in patients with rare sigmoid colon adenocarcinoma variants: exploring the influence of rural-urban continuum codes and social determinants of health in the USA.","authors":"Md Roungu Ahmmad, Fazlay Faruque, Rodney Rocconi, Emran Hossain, Salwa Mohamed Musarikandy","doi":"10.1007/s10552-026-02203-7","DOIUrl":"10.1007/s10552-026-02203-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined survival outcomes in patients with rare sigmoid colon adenocarcinoma, excluding rectal cancer, with a focus on the combined effects of rural-urban continuum code (RUCC) and median household income (MHI).</p><p><strong>Methods: </strong>We analyzed the SEER dataset, which includes 93,020 patients diagnosed with this condition. Survival differences were assessed using Kaplan-Meier estimates and multivariable Cox models. Interaction effects between RUCC and MHI were evaluated, and a nomogram was developed to predict five- and 10-year survival probabilities after adjusting for covariates, with sensitivity analyses conducted to assess robustness.</p><p><strong>Results: </strong>A higher degree of rurality was significantly associated with an increased risk of mortality. Patients in RUCC 4 (HR: 1.13; 95% CI: 1.05-1.22) and RUCC 5 (HR: 1.14; 95% CI: 1.06-1.23) had elevated risks compared with RUCC 1. Income modified these associations. Patients in RUCC 2 with MHI above $100,000 had an 8% lower mortality risk (HR: 0.92; 95% CI: 0.83-0.98) than those in RUCC 1 with MHI below $70,000. Similarly, RUCC 4 patients with MHI $90,000-$100,000 experienced a 15% reduction (HR: 0.85; 95% CI: 0.75-0.98). Nomogram predictions indicated the most favorable survival in RUCC 2 with MHI > $100,000 (5 years > 60%; 1 -years ~ 55%), slightly lower survival in RUCC 1 with the same income (5 years 58%; 10 years 52%), and poorest survival in RUCC 4 with MHI < $70,000 (5 years 54%; 10 years 47%), with sensitivity analyses confirming consistent findings.</p><p><strong>Conclusion: </strong>Survival outcomes were significantly influenced by both place of residence and socioeconomic status, with the highest survival observed among patients with higher MHI in RUCC 2 and the poorest outcomes among low-income patients in RUCC 4. These results highlight the compounded impact of rurality and socioeconomic disadvantage, underscoring the need for targeted interventions-including strengthened oncology infrastructure, and reduced structural barriers.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393115","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":"Exercise trajectories and current exercise and risk of breast cancer: a cohort study of 325,953 women who participated in BreastScreen Norway.","authors":"Trude E Robsahm, Nathalie C Støer, Kari Bø, Solveig Hofvind","doi":"10.1007/s10552-026-02184-7","DOIUrl":"10.1007/s10552-026-02184-7","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to elucidate life-course and current exercise levels among women aged 50-69 who participated in BreastScreen Norway during the period from 2006 to 2015, and to estimate the risk of breast cancer based on exercise trajectory classes and current exercise level.</p><p><strong>Methods: </strong>Self-reported data from 325,953 women were utilized for descriptive and exploratory analyses. Retrospective information about exercise levels at ages 15-19, 20-29, 30-39, and 40-49 was used to establish exercise trajectory classes, while reported exercise at ages 50-69 was considered as current activity. Hazard Ratios (HR) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models adjusting for age, educational level and body mass index (BMI).</p><p><strong>Results: </strong>Adjusted HR of breast cancer was 0.92 (95% CI: 0.87-0.98) for women in the stable high class and 0.94 (95% CI: 0.89-0.99) for those in the increasing trajectory class compared to the stable low class. The HRs was 0.89 (95% CI: 0.82-0.97) for 4.5 h current exercise per week and 0.72 (95% CI: 0.62-0.84) for ≥ 6 h, compared to those reporting no current exercise. Statistically significant results were observed for asymptomatic (screen-detected) and symptomatic cancers. Stratification by BMI and smoking status did not reveal substantial differences in the risk estimates.</p><p><strong>Conclusion: </strong>Engaging in high-level exercise throughout one's lifetime significantly reduces the risk of breast cancer. This study highlights the importance of maintaining or increasing physical activity levels throughout life to mitigate breast cancer risk.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 8","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388463","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}