Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology最新文献

{"title":"The Effectiveness of Incentives on Cancer Screening among Indigenous Populations: Systematic Review.","authors":"Nafiseh Khalaj, Idin Panahi, Ella J McLaren, Shafkat Jahan, Jonathan Leitch, Gail Garvey","doi":"10.1158/1055-9965.EPI-25-2071","DOIUrl":"10.1158/1055-9965.EPI-25-2071","url":null,"abstract":"<p><p>Indigenous peoples experience inequitable access to population-based cancer screening programs compared with non-Indigenous populations. Incentives including financial incentives, outreach programs, and educational programs have been used to increase participation; however, their effectiveness among Indigenous populations remains unclear. This systematic review evaluated the effectiveness of incentives on cancer screening participation among Indigenous populations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Web of Science, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for published articles from inception to September 2025. Eligible articles were reviewed and appraised by 2 independent reviewers using the Mixed Methods Appraisal Tool. A total of 35 articles were included, reporting on education programs (63%), outreach programs (23%), and a combination of both (14%). Education-based interventions improved cancer screening participation rates (ranging from 11.7% to 370%) and/or knowledge among Indigenous populations. Outreach programs, particularly those with personalized follow-ups, improved participation by more than 31%. Combining outreach and education was also effective, especially with trained healthcare workers and tailored community approaches. Financial and nonfinancial incentives like transportation and childcare increased engagement. Approaches co-designed with Indigenous communities were more effective in improving knowledge, attitudes, and increasing screening rates. Culturally tailored incentives, co-designed with Indigenous communities, should inform future cancer screening research, policy, and practice.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":"1696-1708"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612196","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":"Associations between Metabolomic Signatures of Persistent Smoking Effects and Lung Cancer Risk among Former Smokers.","authors":"Duc Huy Le, Hui Cai, Danxia Yu, Sang Minh Nguyen, Wei Zheng, Qiuyin Cai, Xiao-Ou Shu","doi":"10.1158/1055-9965.EPI-25-2011","DOIUrl":"10.1158/1055-9965.EPI-25-2011","url":null,"abstract":"<p><strong>Background: </strong>Smoking-related metabolic perturbations may persist long after smoking cessation. We aimed to develop a metabolomic signature for persistent smoking (MSPS) and prospectively assess its association with lung cancer risk among former smokers.</p><p><strong>Methods: </strong>Global untargeted metabolomic data from 1,732 participants of the Shanghai Men's Health Study (SMHS) and Southern Community Cohort Study (SCCS) were used to construct MSPS. Linear regression and elastic net regression were applied to select persistent smoking-related metabolites and develop MSPS. We evaluated the association of MSPS with lung cancer via conditional logistic regression among 229 case-control pairs nested in former smokers of the SCCS and SMHS.</p><p><strong>Results: </strong>We identified 130 metabolites significantly associated with current smoking status (PFDR < 0.05). After excluding tobacco-specific metabolites, we selected 16 metabolites associated with former smoking (6 lipids, 6 xenobiotics, 2 amino acids, and 2 carbohydrates) to derive the MSPS. The MSPS showed a significant association with increased lung cancer risk [odds ratio (OR); 95% confidence interval (CI), 1.44 (1.15-1.81) per standard deviation (SD)], independent of smoking pack-years and quitting duration. The association was consistently seen in Whites (OR = 1.91; 95% CI, 1.19-3.07 per SD), Blacks (OR = 1.66; 95% CI, 1.07-2.56 per SD), and Asians (OR = 1.15; 95% CI, 0.81-1.63 per SD).</p><p><strong>Conclusions: </strong>We developed an MSPS that was robustly associated with lung cancer risk independent of smoking history for former smokers. If validated, the MSPS can be applied to identify former smokers at high risk of developing lung cancer.</p><p><strong>Impact: </strong>The MSPS provides a novel tool to stratify lung cancer risk among former smokers, beyond current guidelines based on smoking history.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":"1723-1732"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521689","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":"Oral Health and Risk of Liver Cancer: Evidence from Pooled and Meta-Analyses.","authors":"Zeni Wu, Haydée W T Jordão, Gieira S Jones, Gerry McKenna, Andrea A Almeida, Dawn Q Chong, Helen G Coleman, A Heather Eliassen, Edward L Giovannucci, Barry I Graubard, Úna C McMenamin, Lorelei A Mucci, Meir J Stampfer, Lesley Tinker, Jean Wactawski-Wende, Xinyuan Zhang, Xuehong Zhang, Peter T Campbell, Andrew T Kunzmann, Katherine A McGlynn, Jessica L Petrick","doi":"10.1158/1055-9965.EPI-26-0461","DOIUrl":"10.1158/1055-9965.EPI-26-0461","url":null,"abstract":"<p><strong>Background: </strong>Poor oral health, including periodontal disease and tooth loss, is linked to systemic inflammation and oral microbial dysbiosis, which may promote liver carcinogenesis through the oral-gut-liver axis. However, epidemiologic evidence on oral health and liver cancer risk remains inconsistent. We examined these associations in three prospective US cohorts and conducted a systematic review and meta-analysis of prospective studies.</p><p><strong>Methods: </strong>We pooled data from the Health Professionals Follow-Up Study, Nurses' Health Study, and Women's Health Initiative (230,915 participants, 198 liver cancer cases). Oral health, including periodontal disease and tooth loss, was self-reported. Multivariable-adjusted Cox models estimated hazard ratios (HR) and 95% confidence intervals (CI). A systematic review through September 2025 identified four additional prospective studies, which were combined with pooled results in meta-analyses.</p><p><strong>Results: </strong>In the pooled analyses, periodontal disease (HR = 0.99; 95% CI, 0.67-1.47) and complete tooth loss (HR = 1.29; 95% CI, 0.71-2.35) were not associated with liver cancer risk. In the meta-analysis, dominated by one large study, periodontal disease was associated with an increased liver cancer risk (HR = 1.08; 95% CI, 1.03-1.13; n = 4 studies; I2 = 0%). In a linear dose-response meta-analysis, complete tooth loss was associated with an increased risk (HR = 1.32; 95% CI, 1.06-1.66; n = 6; I2 = 0%).</p><p><strong>Conclusions: </strong>The findings of the current investigation suggest that although an association between oral health and liver cancer is possible, the results remain inconclusive.</p><p><strong>Impact: </strong>These findings underscore the need for more studies using harmonized oral health assessments integrating clinical, microbial, and behavioral data to better capture the oral health burden.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":"1770-1780"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633552","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":"Vitamin D status and colorectal neoplasm risk in Lynch syndrome.","authors":"Marjolein T Bulbaai, Evertine Wesselink, Monique E van Leerdam, Tanya M Bisseling, Jan Jacob Koornstra, Femke Fleur Verstraete, Polly A Newcomb, Stephanie L Schmit, N Jewel Samadder, Michelle Cotterchio, Laura Anderson, Loïc Le Marchand, Jody M W van den Ouweland, Ellen Kampman, Fränzel J B van Duijnhoven","doi":"10.1158/1055-9965.EPI-26-0722","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0722","url":null,"abstract":"<p><strong>Background: </strong>Higher circulating vitamin D concentrations have been associated with a decreased colorectal neoplasm (CRN) risk in the general population. However, this association has not yet been investigated in individuals with Lynch syndrome (LS), an inherited predisposition to colorectal cancer.</p><p><strong>Methods: </strong>The study population included 2,351 LS carriers from the GEOLynch and the Colon Cancer Family Registry cohorts. Total plasma 25-hydroxyvitamin D (25(OH)D2 and 25(OH)D3) concentrations were measured using isotope-dilution Liquid Chromatography-tandem Mass Spectrometry. CRNs included adenoma, serrated lesions, and colorectal cancer. Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between 25-hydroxyvitamin D concentrations and CRN risk, overall and by pathogenic variant type, age, sex, CRN history and geographic region.</p><p><strong>Results: </strong>During a median follow-up of 7.2 years [IQR: 3.3-12.6], 647 (27.5%) LS carriers developed a CRN. No association was observed for deficient (<50 nmol/L or <20 ng/mL; HR: 1.12; 95% CI: 0.91, 1.39) or optimal (≥75 nmol/L or ≥30 ng/mL; HR: 0.94; 95% CI: 0.77, 1.15) compared with sufficient (50-<75 nmol/L or 20-<30 ng/mL) vitamin D concentrations. No association was observed for each 10 nmol/L or 4 ng/mL increment in vitamin D concentration. Among PMS2 carriers, a 10 nmol/L increment was associated with a 27% lower CRN risk (HR: 0.73; 95% CI: 0.58-0.91).</p><p><strong>Conclusions: </strong>Vitamin D concentrations were not associated with CRN risk among LS carriers, whereas the association observed among PMS2 carriers warrants further investigation.</p><p><strong>Impact: </strong>If confirmed, these findings could inform personalized risk reduction strategies for PMS2 carriers.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122402","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":"Uncovering hypothesis-generating associations between prescription drugs and digestive cancer risk: a case-control drug-wide association study (DWAS).","authors":"Peng Wang, Katsiaryna Bykov, Peter S Liang, Kelli O'Connell, Edward L Giovannucci, Robin B Mendelsohn, Lisa C Diamond, Elizabeth D Kantor, Mengmeng Du","doi":"10.1158/1055-9965.EPI-26-0907","DOIUrl":"10.1158/1055-9965.EPI-26-0907","url":null,"abstract":"<p><strong>Background: </strong>Prescription drug use among older adults is more common than ever, yet traditional trials are not designed to assess long-term outcomes. Thus, the potential impact of widely used medications on cancer risk remains unclear. This is particularly a concern for digestive cancers for several reasons, most notably their key role in drug absorption and metabolism. We therefore leverage large-scale data to conduct a multi-stage study, aimed at identifying potential associations between oral prescription drugs and digestive cancer risk.</p><p><strong>Methods: </strong>We used the Surveillance, Epidemiology and End Results (SEER)-Medicare data for a case-control drug-wide association study (DWAS), followed by targeted analyses to further address confounding. Subsequent analyses conducted include incorporation of additional adjustment for comorbidities, use of active comparators as well as propensity scores. Associations between prescription drugs and digestive cancer were assessed using adjusted odds ratios (OR), with significance assessed using Benjamini-Yekutieli (BY)-adjusted p-values.</p><p><strong>Results: </strong>In initial scan, 218 of 442 oral prescription drugs were associated with digestive cancer (BY-adjusted p<0.05). After our multi-stage targeted analyses, 38 drugs of interest (vs. their active comparators) remained associated with digestive cancer. Specifically, 10 drugs were positively associated (OR>1) and 28 were inversely associated (OR<1).</p><p><strong>Conclusions: </strong>Our study confirms some previously reported associations and identifies additional potential, novel associations between individual oral prescription drugs and digestive cancer that merit additional follow-up.</p><p><strong>Impact: </strong>These findings support the utility of our approach for hypothesis generation and warrant targeted confirmation in prospective studies as well as investigation of specific cancer types driving these associations.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077488","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":"Disparities in Quality of Life between Asian American and Non-Hispanic White American Breast Cancer Survivors.","authors":"Qian Lu, Celia Ching Yee Wong-Meli, Annalyn Valdez-Dadia, Lilian J Shin-Cho, Minxing Chen, Marjorie Kagawa-Singer","doi":"10.1158/1055-9965.EPI-26-0301","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0301","url":null,"abstract":"<p><strong>Background: </strong>Quality of life comparisons with non-Hispanic White (NHW) breast cancer survivors remain limited for Asian Americans, particularly across diverse subgroups, potentially obscuring important disparities. This study investigated ethnic disparities in quality of life among breast cancer survivors, focusing on Chinese, Vietnamese, and Japanese Americans compared with NHW survivors.</p><p><strong>Methods: </strong>Participants (N = 403) completed the Functional Assessment of Cancer Therapy-General (FACT-G) and the SF-36 Health Survey. The FACT-G total score assessed cancer-specific quality of life while the SF-36 component scores included the Physical Component Summary (PCS) and Mental Component Summary (MCS), representing physical and mental health-related quality of life.</p><p><strong>Results: </strong>After controlling for clinical covariates (Ps < .05), Asian Americans scored lower on all three outcomes (FACT-G, and PCS, MCS) than NHWs (ps < .05); Chinese and Vietnamese Americans also scored lower on all three outcomes than NHWs (all Ps < .05). Financial hardship, lower education, and not being employed full-time were associated with lower FACT-G, PCS, and MCS. Adjustment for these social determinant factors attenuated or eliminated group differences.</p><p><strong>Conclusions: </strong>Findings highlight disparities in quality of life among Asian American cancer survivors, challenging the model minority stereotype. The attenuation of group differences after adjustment for social determinants suggests that socioeconomic factors play an important role in observed disparities, underscoring the need for targeted interventions.</p><p><strong>Impact: </strong>Under-representation in research may mask disparities in quality of life and social determinants among Asian American survivors, underscoring the need for more inclusive study designs.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043255","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":"Projected Cancer Burden among Sexual and Gender Minorities by Generation in the United States.","authors":"Crystal W Xu, Kyle Mani, Daniel R Dickstein, Rohan K Patel, Ming Wang, Yifei Xu, Nicholas G Zaorsky","doi":"10.1158/1055-9965.EPI-26-0504","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0504","url":null,"abstract":"<p><strong>Background: </strong>Sexual and gender minority (SGM) representation is growing in the United States. This study estimated future SGM cancer burden amidst shifting cancer patterns.</p><p><strong>Methods: </strong>Age-specific incidence data for breast, prostate, colorectal, lung, and melanoma were obtained from the Surveillance, Epidemiology, and End Results Program's 12-registry database. Nordpred age-period-cohort models projected incidence through 2040-2044. Rates were applied to U.S. Census population estimates and generation- and sex-specific SGM identification proportions from Gallup's 2023-2024 surveys. Prophet was used for sensitivity analysis.</p><p><strong>Results: </strong>At ages 55-59, breast cancer cases among Millennial SGMs were 3,672% higher than among Silent Generation SGMs (34,850 vs 924 cases), melanoma cases were 1,061% higher (5,526 vs 476 cases), and colorectal cancer cases were 2,206% higher (23,594 vs 1,023 cases). Compared with Generation X, Millennial prostate cancer cases were 142% higher (8,100 vs 3,344 cases), and lung cancer cases were 169% higher (5,451 vs 2,029 cases). By 2040-2044, Millennials were projected to account for 68.4% of breast cancer cases and 59.7% of colorectal cancer cases among SGMs.</p><p><strong>Conclusions: </strong>At ages 55-59, five-year cancer burden was projected to be 15 times higher among Millennial than Silent Generation SGMs (77,521 vs 5,134 cases), driven primarily by the larger SGM population in younger generations. Oncology systems will need to prepare for the increase in cancer-care demand.</p><p><strong>Impact: </strong>These findings identify a substantial generational shift in SGM cancer burden and may inform oncology workforce capacity, culturally responsive cancer care, and health-system preparation for this growing population.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019460","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":"Expected late-stage reduction under extended screening in the first multicancer screening trial.","authors":"Kemal Caglar Gogebakan, Jane Lange, Roman Gulati, Ruth Etzioni","doi":"10.1158/1055-9965.EPI-26-0942","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0942","url":null,"abstract":"<p><p>The first multi-cancer screening trial did not meet its primary endpoint of reducing late-stage (stage III/IV) incidence after three screening rounds. We used a previously developed multi-cancer natural history model to assess whether continued annual screening could have produced larger benefit. The model was calibrated to match observed late-stage reductions by screening round and aggregate episode sensitivity for the trial's 12 prespecified cancers, then used to project late-stage reductions over 10 annual screening rounds. Among the 15 best-calibrated models, early-stage preclinical detectable period ranged from 0.46 to 1.36 years, and per-cancer early-stage sensitivities from 30%-60% of previously reported sensitivities for clinically diagnosed cancers. The calibrated models reproduced the excess late-stage incidence in round 1 and increasing reductions thereafter. With continued screening, late-stage reductions by screening round plateaued at 13%-17% (range across 15 models), while cumulative late-stage reduction reached 9%-13% by round 10.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984562","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":"AACR Cancer Disparities Progress Report 2026.","authors":"Elizabeth L Blackman, Kristin M Primm, Brett M Sansbury, Sayyed Kaleem Zaidi, Rajarshi Sengupta","doi":"10.1158/1055-9965.EPI-26-0885","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0885","url":null,"abstract":"<p><p>Advances in cancer prevention, early detection, and treatment have led to substantial improvements in cancer outcomes in the United States over the past several decades. Despite this progress, these gains have not been equitably distributed, and many populations continue to experience a disproportionate burden of cancer. Persistent disparities, rooted in structural inequities, social disadvantage, and unequal access to health care, remain a major challenge to achieving health equity. The American Association for Cancer Research (AACR) Cancer Disparities Progress Report 2026 highlights both the progress made toward reducing cancer disparities and the critical gaps that remain. Addressing these disparities will require coordinated efforts across research, clinical care, public health, and policy to ensure that advances in cancer science benefit all populations. See AACR Cancer Disparities Progress Report 2026 .</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":"OF1-OF5"},"PeriodicalIF":3.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964146","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":"Association of Area-level Broadband Access and Non-Small Cell Lung Cancer Diagnosis and Guideline-Concordant Care in the US.","authors":"Qinjin Fan, Muwu Xu, Margaret Katana Ogongo, Xin Hu, Leticia M Nogueira, Xuesong Han, K Robin Yabroff","doi":"10.1158/1055-9965.EPI-26-0708","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0708","url":null,"abstract":"<p><strong>Background: </strong>Access to broadband is a social driver of health facilitating healthcare access and reducing travel-related burdens. This study examined associations between area-level broadband access and non-small cell lung cancer (NSCLC) stage at diagnosis, receipt of timely treatment, and guideline-concordant treatment (GCT) before and during the COVID-19 pandemic in the US.</p><p><strong>Methods: </strong>Patients aged ≥18 years with newly diagnosed NSCLC (2018-2022) were identified from the National Cancer Database. Residential ZIP code-level broadband access, collected from the American Community Survey (2018-2022), was categorized into quartiles. Multivariable logistic regression models examined associations between broadband quartiles and stage at diagnosis, time-to-treatment initiation (TTI), and GCT, stratified by metropolitan status and pandemic period, adjusting for sociodemographic and clinical characteristics.</p><p><strong>Results: </strong>Among 525,114 patients, compared with those in the lowest broadband quartile, patients in the highest quartile had higher odds of early-stage diagnosis before and during the pandemic (adjusted odds ratio [AOR]=1.18, 95% confidence interval [CI]=1.13-1.22; AOR=1.21, 95%CI=1.17-1.24), timely treatment (AOR=1.13, 95%CI=1.09-1.17; AOR=1.14, 95%CI=1.11-1.18), and GCT (AOR=1.14, 95%CI=1.10-1.19; AOR=1.11, 95%CI=1.07-1.15), with significant positive trends across broadband quartiles. In non-metropolitan areas, significant associations with timely treatment and GCT emerged only during the pandemic.</p><p><strong>Conclusion: </strong>Higher area-level broadband access was associated with better NSCLC outcomes, especially in non-metropolitan areas during the pandemic. Although broadband access may partly reflect socioeconomic conditions, it may also independently support cancer care access.</p><p><strong>Impact: </strong>Increased broadband access, combined with telehealth waivers during the pandemic may have supported greater access to and continuity of high-quality cancer care, particularly among patients in non-metropolitan areas.</p>","PeriodicalId":520580,"journal":{"name":"Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946248","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}