Cancer causes & control : CCC最新文献

{"title":"Post-diagnosis physical activity in relation to mortality among gynecological cancer survivors.","authors":"Alina Hamann, Pauline Benker, Michael F Leitzmann, Michael J Stein","doi":"10.1007/s10552-026-02211-7","DOIUrl":"10.1007/s10552-026-02211-7","url":null,"abstract":"<p><strong>Purpose: </strong>Physical activity may play a supportive role in cancer survivorship. However, evidence on the association between post-diagnosis physical activity and mortality among women with gynecological cancer remains limited and inconsistent.</p><p><strong>Methods: </strong>We conducted a systematic review of the literature published between 1949 and January 2026. Eligible observational studies were identified, and random-effects meta-analyses were performed to estimate pooled hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between post-diagnosis physical activity and all-cause mortality among women diagnosed with gynecological cancer.</p><p><strong>Results: </strong>A total of ten eligible studies on endometrial, ovarian, and cervical cancer were included, collectively reporting 3,867 deaths. High levels of post-diagnosis physical activity, compared with low levels, were associated with lower mortality (HR: 0.65; 95% CI 0.54-0.78). This inverse relationship was evident in both endometrial and ovarian cancer survivors (endometrial cancer: HR: 0.60; 95% CI 0.43-0.83; ovarian cancer: HR: 0.71; 95% CI 0.58-0.86). Medium levels of physical activity tended to be inversely associated with mortality (HR: 0.88; 95% CI 0.76-1.02).</p><p><strong>Conclusion: </strong>Higher levels of physical activity after a gynecological cancer diagnosis were associated with improved survival. The results suggest that physical activity may represent a modifiable lifestyle factor with the potential to improve long-term outcomes among gynecological cancer survivors.</p><p><strong>Implications for cancer survivors: </strong>This supports the potential value of integrating physical activity into survivorship care, although further high-quality prospective studies are needed to strengthen causal inference.</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/PMC13332953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388494","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":"Construction and validation of a folate metabolism-related gene signature for prognosis prediction, immune landscape characterization, and molecular subtyping in glioma.","authors":"Chen Huang, Liping Zhao","doi":"10.1007/s10552-026-02210-8","DOIUrl":"10.1007/s10552-026-02210-8","url":null,"abstract":"<p><strong>Background: </strong>Folate metabolism plays essential roles in nucleotide synthesis, redox homeostasis, and cellular proliferation, yet its contribution to glioma progression and the tumor immune microenvironment remains incompletely understood.</p><p><strong>Methods: </strong>We collected transcriptome, genomic, and clinical information of glioma patients from both The Cancer Genome Atlas and the Chinese Glioma Genome Atlas public databases. Key prognostic genes were identified by integrating differential gene expression profiles, weighted gene co-expression network analysis results, and genes linked to folate metabolism (FMRGs). The prognostic model was established through least absolute shrinkage and selection operator regression followed by multivariate Cox regression to select robust gene markers, and validated in two external CGGA cohorts. Subsequent analyses included pathway enrichment, immune landscape assessment (via single-sample gene set enrichment analysis, ESTIMATE, and CIBERSORT), mutation characteristics, drug response prediction, and Tumor Immune Dysfunction and Exclusion-based immunotherapy responsiveness evaluation. Consensus clustering was also employed to explore how the gene signature relates to tumor biology and patient prognosis.</p><p><strong>Results: </strong>A total of 18 FMRGs showing significant expression variation were identified, of which eight formed a robust prognostic model with excellent predictive performance. High-risk patients exhibited markedly worse survival, enhanced apoptotic and p53-mediated stress pathways, extensive immune activation, elevated stromal and immune scores, and higher expression of immune checkpoints. Low-risk patients demonstrated lower TIDE scores and, in an exploratory external anti-PD-L1-treated cohort, showed higher response rates, suggesting potential immunotherapy-related relevance that requires glioma-specific validation. Using consensus clustering, we stratified the samples into two molecular subgroups characterized by unique transcriptomic landscapes, immune features, and prognostic behaviors.</p><p><strong>Onclusion: </strong>This study establishes a novel folate metabolism-related signature that reliably predicts prognosis, delineates immune landscape heterogeneity, and identifies potential therapeutic susceptibilities in glioma. The findings provide important insights into folate-associated tumor biology and offer a framework for risk stratification and personalized therapy.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379139","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":"Testing behavioral economics principles in mailed FIT outreach: a randomized trial.","authors":"Oyinkansola Adedipe, Nina Bartmann, Lawrence Greenblatt, Holly Bradicich, Melissa Sullivan Jones, Diana Marcella Cardona, Amanda Brucker, Kendell Hill, John Yeatts, Michael Pignone, Elizabeth Malcolm","doi":"10.1007/s10552-026-02204-6","DOIUrl":"10.1007/s10552-026-02204-6","url":null,"abstract":"<p><strong>Purpose: </strong>Mailed stool-based fecal immunochemical testing (FIT) can improve colorectal cancer (CRC) screening rates. We aim to determine whether enhancing communications with evidence-based behavioral economics principles in mailed FIT kits further improves screening rates.</p><p><strong>Methods: </strong>This study focused predominantly on Medicare patients at average-risk for colon cancer who were not up-to-date on CRC screening. Patients were randomly assigned to one of two interventions: original communication (a series of standard communications, including a pre-mailing letter, FIT kit and letter, and reminders via text or robo-call); or enhanced communication (the same sequence, but incorporating behavioral economics principles to encourage FIT completion). We compared the rate of FIT tests completed at 90 days and factors associated with completion.</p><p><strong>Results: </strong>4,070 patients were included. Within 90 days, 27% of all patients successfully completed the FIT test: 28.1% of patients receiving the enhanced communication had FIT test completed compared to 25.5% of patients receiving the original communication. The adjusted risk difference for obtaining patients' FIT tests within 90 days was 2.2% (95% CI = -0.4%, 4.9%) for the enhanced communication outreach compared to the original communication (p = 0.094). Younger participants and patients experiencing greater area-level deprivation were less likely to complete the screening.</p><p><strong>Conclusion: </strong>The FIT test screening rate in the enhanced communication group was not statistically different from the original communication group. Using evidence-based behavioral economics principles in mailed FIT communications did not markedly improve the rate of CRC screening, but mailed FIT remains a key, cost-effective tool for reaching unscreened individuals.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371683","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 receipt of guideline-concordant treatment for early-stage non-small cell lung cancer.","authors":"Miriam L Gorbatov, Angel Arizpe, Elizabeth A David, Lihua Liu, Myles Cockburn, Albert J Farias","doi":"10.1007/s10552-026-02206-4","DOIUrl":"10.1007/s10552-026-02206-4","url":null,"abstract":"<p><strong>Purpose: </strong>Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality in California, with Non-Hispanic Black (NHB) patients experiencing the highest mortality rates. Disparities in receipt of guideline-concordant treatment (GCT) contribute to these outcomes. This population-based study analyzed racial and ethnic differences in GCT receipt among early-stage NSCLC patients.</p><p><strong>Methods: </strong>Patients diagnosed with early-stage NSCLC (tumors ≤ 4 cm, no lymph node involvement, and no distant metastases) between 2012 and 2022 were identified from the Los Angeles County Cancer Surveillance Program. Logistic regression evaluated associations between race/ethnicity and receipt of GCT (surgery or radiation only vs. no treatment or multiple treatments), adjusting for potential confounders.</p><p><strong>Results: </strong>In our sample (n = 2,857), the average age was 69.6 years, 63.2% were female, mean tumor size was 1.9 cm, and the cohort was 57.3% Non-Hispanic White (NHW), 8.9% NHB, 14.2% Hispanic, and 18.8% Asian/Pacific Islander (API). While most patients (87.4%) received GCT, NHB and Hispanic patients had higher rates of non-GCT treatment (18.0% and 15.8%, respectively; p < 0.001). NHB patients had significantly higher odds of not receiving GCT compared with NHW patients (OR: 1.55, 95% CI: 1.07-2.26; p < 0.05). No significant differences were observed for API or Hispanic patients.</p><p><strong>Conclusion: </strong>Addressing disparities in GCT for patients diagnosed with early-stage NSCLC is critical to improving survival outcomes. Future studies identifying factors influencing a patient's and physician's decision to receive, recommend, and adhere to GCT guidelines are needed to understand the complexity of treatment decision-making.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364808","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 determinants as pathways in disparities in oral cavity cancer stage at diagnosis: a registry-based analysis from 2010-2020.","authors":"Guillermo A Tortolero, Erich M Sturgis, Itunu O Sokale, Abiodun Oluyomi, Kristina R Dahlstrom, Aaron P Thrift","doi":"10.1007/s10552-026-02209-1","DOIUrl":"10.1007/s10552-026-02209-1","url":null,"abstract":"<p><strong>Purpose: </strong>Racial and ethnic differences in oral cavity cancer (OCC) stage at diagnosis are substantial, but the reasons remain unclear. We assessed insurance status and social neighborhood factors as potential pathways.</p><p><strong>Methods: </strong>Using the Texas Cancer Registry, we identified adults diagnosed with OCC between 2010 and 2020. We examined the crude and multivariable associations of race and ethnicity, insurance status, and social neighborhood factors with stage at diagnosis. We investigated the mediating effects of insurance status and neighborhood-level social factors on racial and ethnic differences in stage at diagnosis using four-way decomposition with modified Poisson regression and robust standard errors.</p><p><strong>Results: </strong>Among the 6,488 patients, 49.6% were diagnosed at a late stage. Compared to non-Hispanic White patients, non-Hispanic Black, Hispanic, and non-Hispanic Asian Americans, Native Hawaiians, and Pacific Islanders had 51% (Prevalence Ratio [PR]: 1.51; 95% confidence interval [95% CI]: 1.40, 1.63), 29% (PR: 1.29; 95% CI 1.22-1.37), and 17% (PR: 1.17; 95% CI 1.05-1.32) higher risks of being diagnosed at a late stage, respectively. For non-Hispanic Black patients, being uninsured, living in a vulnerable neighborhood, and living in a deprived neighborhood explained roughly 20%, 31%, and 15% of the disparity in late stage diagnosis, respectively. These pathways accounted for similar proportions of the disparity in stage at diagnosis among Hispanic patients.</p><p><strong>Conclusions: </strong>Insurance status and neighborhood-level social factors may partially account for the differences in OCC stage at diagnosis between racial and ethnic groups. Identifying these pathways may help clarify and reduce these disparities.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364824","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":"Racial and ethnic disparities in esophageal cancer survival are greatest at curable stages: a population-based study.","authors":"Saurabh Kalra, Cindy Medina Pabón, Deepak Kalra, WayWay M Hlaing, Paulo S Pinheiro","doi":"10.1007/s10552-026-02194-5","DOIUrl":"10.1007/s10552-026-02194-5","url":null,"abstract":"<p><strong>Background: </strong>Racial and ethnic disparities in esophageal cancer outcomes are documented, but whether they differ by stage at diagnosis is unclear. Using population-based data from Florida, a diverse, Medicaid non-expansion state, we conducted a stage-stratified analysis of racial/ethnic differences in survival and treatment receipt.</p><p><strong>Methods: </strong>We analyzed 21,814 esophageal cancer cases from the Florida Cancer Data System (2005-2021). Using cause-specific Cox models, we estimated adjusted hazard ratios (aHRs) for cancer-specific mortality overall and by stage, adjusting for demographics, tumor characteristics, treatment, smoking, and socioeconomic factors. Multivariable logistic regression assessed racial/ethnic differences in receipt of surgery, chemotherapy, and radiation.</p><p><strong>Results: </strong>Patients were 81.0% non-Hispanic (NH) White, 8.0% NH Black, and 10.0% Hispanic. NH Black patients had higher overall mortality than NH White patients (aHR: 1.08; 95% CI 1.02-1.15). Stage-stratified models showed elevated mortality among NH Black patients at localized (aHR: 1.24; 95% CI 1.05-1.45) and regional stages (aHR: 1.19; 95% CI 1.07-1.35) compared with NH White patients, but lower mortality at distant stage (aHR: 0.88; 95% CI 0.80-0.98). NH Black patients had lower odds of surgery (aOR: 0.51; 95% CI 0.43-0.61) and chemotherapy (aOR: 0.79; 95% CI 0.70-0.90) compared with NH White patients; radiation receipt did not differ.</p><p><strong>Conclusion: </strong>Survival disparities were most pronounced at curable stages, indicating inequities in post-diagnosis management. Lower treatment receipt and  persistent survival differences after clinical adjustment suggest that structural and systemic factors contribute. These findings highlight a critical target for cancer control and underscore the need for system-level reforms to ensure equitable, stage-appropriate care.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364820","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":"Knowledge of cancer genetics and attitudes about genetic counseling and testing: a randomized trial of the Know Your Risk intervention compared to conventional genetic counseling.","authors":"Mira L Katz, Patrick M Schnell, Paul L Reiter, Leigha Senter, Amber Aeilts, Christina Spears, Julia Cooper, Jordan Brown, Kate P Shane-Carson, Doreen M Agnese, Amanda E Toland, Kevin Sweet","doi":"10.1007/s10552-026-02207-3","DOIUrl":"10.1007/s10552-026-02207-3","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if the developed Know Your Risk (KYR) intervention is similar to conventional genetic counseling; we evaluated participants' knowledge of cancer genetics, breast cancer risk perception, attitudes about genetic counseling and testing, and satisfaction with genetic counseling.</p><p><strong>Methods: </strong>Women (n = 866) who screened at elevated risk for breast cancer were randomized to the KYR intervention or conventional genetic counseling (2022-2024). The KYR intervention included a series of online pre-test educational videos, direct access to genetic testing, and patient preference for receiving post-test genetic counseling. Participants completed surveys at baseline and after genetic counseling and testing. Non-inferiority hypothesis testing compared the two participant groups.</p><p><strong>Results: </strong>The mean knowledge score (range 0-12) increased in both study groups from a baseline mean of 6.87 (standard deviation (SD) = 2.46) to 8.66 (SD = 2.16) for the KYR intervention and 8.56 (SD = 2.14) for conventional counseling. Additionally, statistical analyses suggest the non-inferiority of the KYR intervention for participants' accuracy of their breast cancer risk, attitudes about genetic counseling and genetic testing, and satisfaction with genetic counseling compared to participants randomized to conventional genetic counseling.</p><p><strong>Conclusion: </strong>Findings support that the components included in the KYR intervention are non-inferior for cancer genetic knowledge, risk perception, genetic counseling and testing attitudes, and genetic counseling satisfaction among women who screen at elevated risk for breast cancer. By using the combination of components included in the KYR intervention, genetic counseling and genetic testing are more accessible, convenient, and patient-driven.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05325151.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355508","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":"Advances and challenges in CAR-T cell therapy for breast cancer: from molecular design to clinical application.","authors":"Honghao Yu, Wenzhi Feng, Di Lan, Qianyi Liu, Xia He, Siyu Zhang, Chunyu Tong, Bocui Song","doi":"10.1007/s10552-026-02200-w","DOIUrl":"10.1007/s10552-026-02200-w","url":null,"abstract":"<p><p>Globally, breast cancer remains a leading cause of morbidity in women. Conventional therapies, including surgical intervention, radiation, and chemical treatments, though effective, frequently result in significant adverse effects and toxicity. CAR-T cell therapy represents a novel immunotherapeutic strategy, wherein T cells are genetically modified to precisely target and eradicate malignant cells. The article provides a detailed introduction to the structure and function of CAR-T cells, particularly the improvements in anti-tumor efficacy across different generations of CAR-T cells. Furthermore, the article explores the primary targets of CAR-T cell therapy in the clinical treatment of breast cancer, such as HER2, EGFR, and MUC1, and analyzes the potential and limitations of these targets in therapy. In conclusion, the review outlines significant hurdles in CAR-T cell therapy for breast cancer, such as tumor diversity, the inhibitory tumor milieu, unintended targeting, and cytokine storm, offering strategic solutions to mitigate these obstacles.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364838","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":"Community-level contextual factors associated with lung cancer: a hot spot analysis.","authors":"Taylor Jansen, Qian Song, Kristie Long Foley, Elizabeth Dugan","doi":"10.1007/s10552-026-02202-8","DOIUrl":"10.1007/s10552-026-02202-8","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer is the leading cause of death globally. Geographic disparities in rates of lung cancer may be explained by the variation and intensity of risk factors within a given area. This study aims to advance the literature on how community-level contextual factors (i.e., environmental exposures, lung disease prevalence, and socioeconomic status) contribute to the development of lung cancer. If contextual risk factors for lung cancer can be identified, interventions can be implemented early to reduce geographic disparities of lung cancer.</p><p><strong>Methods: </strong>This study utilizes town-level lung cancer prevalence data representing 100% of traditional Medicare beneficiaries in Connecticut, Massachusetts, New Hampshire, and Rhode Island to 1) analyze geospatial trends of lung cancer and 2) identify associated community-level risk factors. Following a series of spatial-based analyses (e.g., Moran's I, Getis-Ord Gi*), a series of spatial regression models estimated the association of selected risk factors with lung cancer prevalence. All analyses were conducted in STATA 18 and ArcMap 10.8.</p><p><strong>Results: </strong>A total of n = 49 towns were identified as lung cancer hot spots at the 95th and 99th percentiles (p < 0.001). In regression modeling, historic releases of chromium from TRI facilities and ozone emissions, prevalence of asthma and chronic obstructive pulmonary disease (COPD), and median house values significantly predicted increased lung cancer prevalence in our sample.</p><p><strong>Conclusion: </strong>This study found that the prevalence of lung cancer across communities can be explained, in part, by levels of environmental emissions, selected health, demographics and socioeconomic indicators.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364823","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":"Factors associated with cervical cancer screening in the South African demographic and health survey.","authors":"M G Singini, F Sitas, P Basu, A P Kengne, N Peer","doi":"10.1007/s10552-026-02205-5","DOIUrl":"10.1007/s10552-026-02205-5","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer is South Africa's second most common cancer among women, yet for complex reasons, Papanicolaou screening uptake remains suboptimal. Only a few studies have explored the interplay between sociodemographic characteristics, women's empowerment, healthcare access, and lifestyle behaviors in influencing screening participation. We examined the associations between cervical cancer screening uptake and sociodemographic, women's empowerment, healthcare access, and risky lifestyle behaviors factors.</p><p><strong>Methods: </strong>Cross-sectional analyses of a nationally representative dataset of women (n = 2789) aged 25-49 years were conducted from the 2016 South African Demographic and Health Survey. We used multivariable generalized linear regression models with Poisson distribution to estimate screening uptake (adjusted prevalence) ratios (aPRs, and 95% confidence intervals (95% CI)). We ordered the factors by their attributable fractions (AF), which takes the proportion of uptake per category into account.</p><p><strong>Results: </strong>Being tested for HIV (aPR = 1.79; 95% CI:1.40-2.30; AF = 41.7%), population group (being Black) (aPR = 0.75; 95% CI:0.66-0.84; AF = 19.7%), rich (aPR = 1.34, 95% CI:1.08-1.67; AF = 15.9%), and education (aPR = 1.18, 95% CI:1.03-1.36; AF = 8.9%), were the most important determinants of cervical screening uptake in South Africa. Alcohol misuse (aPR = 1.23; 95% CI:1.10-1.38; AF = 6.1%), having health insurance (aPR:1.27; 95% CI:1.12-1.45; AF = 5.5%) and disempowerment (aPR = 1.10; 95% CI:1.00-1.22; AF = 5.5%) were less important drivers of screening uptake.</p><p><strong>Conclusions: </strong>Pap smear uptake remains suboptimal, particularly among Black women. There is a need for enhanced awareness and education initiatives as well as novel strategies involving community-based screening programs to encourage the uptake of cervical screening.</p>","PeriodicalId":520579,"journal":{"name":"Cancer causes & control : CCC","volume":"37 7","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364806","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}