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 Impact of Adherence to Cancer Prevention Recommendations on Cancer Incidence and Mortality in a Cohort of Canadian Adults.","authors":"Samuel Selorm Fiati Kenston, Rachel A Murphy, Jerry M Spiegel, Trevor J B Dummer","doi":"10.1158/1055-9965.EPI-26-0590","DOIUrl":"10.1158/1055-9965.EPI-26-0590","url":null,"abstract":"<p><strong>Background: </strong>Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations has been associated with reduced cancer risk; however, Canadian evidence remains limited. We examined associations between adherence to these recommendations and cancer incidence and mortality in a Canadian cohort.</p><p><strong>Methods: </strong>We conducted a prospective cohort analysis of 16,053 participants in the British Columbia Generations Project with no cancer diagnosis at recruitment. Participants were followed from 2009 to 2022 through linkage with the British Columbia Cancer Registry. Adherence to five behavioral factors (body weight, physical activity, fruit and vegetable intake, alcohol consumption, and smoking) was scored (1 = full, 0.5 = partial, and 0 = nonadherence) to generate a composite adherence score (range, 0-5). Multivariable Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for cancer incidence and mortality.</p><p><strong>Results: </strong>During follow-up, 2,171 incident cancers and 516 cancer deaths were identified. Compared with nonadherence, full adherence was associated with lower overall cancer incidence (HR = 0.68; 95% CI, 0.54-0.78) and cancer mortality (HR = 0.66; 95% CI, 0.49-0.88). In sex-specific analyses, full adherence was associated with lower cancer incidence and mortality among both females and males. Full adherence was also associated with reduced breast, colorectal, and lung cancer risk. Findings were robust in sensitivity analyses excluding cancers diagnosed within the first 2 years of follow-up.</p><p><strong>Conclusions: </strong>Greater adherence to cancer prevention recommendations was associated with lower cancer incidence and mortality.</p><p><strong>Impact: </strong>These findings support integrated, multi-behavior cancer prevention strategies in Canadian populations.</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":"1582-1589"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274368","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":"Creating outdoor air pollution exposome metrics for assessing breast and lung cancer risks in the United States.","authors":"Joseph Boyle, Rena R Jones, Alexandra J White, Junfeng Jim Zhang, Verónica M Vieira, Bernard F Fuemmeler","doi":"10.1158/1055-9965.EPI-26-0493","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0493","url":null,"abstract":"<p><strong>Background: </strong>Air pollution (AP) is a known cause of lung cancer (LC); growing evidence links AP with breast cancer (BC) risk. Many epidemiological studies analyze PM2.5, though AP is a complex mixture of many pollutants. New metrics are necessary to fully represent the carcinogenic constituents of AP. Therefore, we aimed to develop cancer-specific metrics to determine where and what types of AP drive incident cancers.</p><p><strong>Methods: </strong>We combined databases of AP across the continental US in 2005-2020, including the Risk-Screening Environmental Indicators (RSEI) model and CACES land-use regression-estimated concentrations of criteria air pollutants (CAP). We joined AP concentrations at census tracts and employed meta-analytic cancer-specific risk estimates to weight the CAP and produce a set of combined metrics (AP for BC (APBC), AP for LC (APLC)) from numerous sources.</p><p><strong>Results: </strong>APBC and APLC exhibited positive skew, with certain tracts having values approximately an order of magnitude above the mean, and were typically highest in large cities and along transportation corridors. Relative to RSEI, APBC and APLC were larger in certain regions including Los Angeles and New York City. Both varied with respect to race, ethnicity, and housing and exhibited significant spatial clustering.</p><p><strong>Conclusion: </strong>We developed novel AP metrics incorporating emissions from industrial facilities, along transportation corridors, and from power plants to characterize cancer-specific risks.</p><p><strong>Impact: </strong>Future research will use these metrics that represent multiple simultaneous sources of AP to identify specific constituents of the AP exposome relevant for BC and LC, informing strategies to reduce their incidence and disparities.</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":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877194","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":"Patterns of Multimorbidity among Older Adults with Colorectal Cancer Living in Puerto Rico.","authors":"Maira A Castañeda-Avila, Axel J Gierbolini-Bermúdez, Jonggyu Baek, Karen J Ortiz-Ortiz, Karim Alavi, Kate L Lapane","doi":"10.1158/1055-9965.EPI-26-0397","DOIUrl":"10.1158/1055-9965.EPI-26-0397","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity among Hispanic patients with colorectal cancer in Puerto Rico remains poorly understood despite their potential impact on patient outcomes. We examined patterns of chronic conditions at colorectal cancer diagnosis and their associations with sociodemographic factors, stage at diagnosis, and tumor location.</p><p><strong>Methods: </strong>We used the Puerto Rico Central Cancer Registry-Health Insurance Linkage Database (2012-2020). Adults ≥50 years of age with a first colorectal cancer diagnosis were included. Chronic conditions were identified using Medicare and Medicaid Chronic Conditions Data Warehouse algorithms. Latent class analysis and regression models assessed multimorbidity patterns and associations with sociodemographic and tumor characteristics.</p><p><strong>Results: </strong>Among 6,543 adults with colorectal cancer (mean age, 67.7 years; 45.7% female), 52.7% had no additional chronic conditions, 18.7% had 1, and 28.6% had ≥2 conditions. The most prevalent comorbidities were hypertension (20.6%), diabetes (14.4%), and hyperlipidemia (12.2%). Three multimorbidity patterns were identified: hypertensive-vision-joint, diabetic renal, and cardiopulmonary severe. Advanced age, female sex, and Medicare insurance predicted class membership. Older age was associated with membership in the cardiopulmonary severe group [adjusted prevalence ratio (aPR) = 1.75 for ages 76-85 years; aPR = 2.86 for ≥86 years]. Females were more likely to belong to the hypertensive-vision-joint group (aPR = 1.42). Multimorbidity patterns were not associated with tumor location or stage at diagnosis.</p><p><strong>Conclusions: </strong>Multimorbidity is common among older Hispanic adults with colorectal cancer in Puerto Rico and forms distinct patterns associated with sociodemographic factors, highlighting heterogeneity in medical complexity.</p><p><strong>Impact: </strong>Identifying multimorbidity patterns among older patients with colorectal cancer in Puerto Rico underscores the need for integrated, patient-centered care for aging Hispanics.</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":"1565-1572"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348622","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":"Tobacco and opium use and risk of liver and colorectal cancer mortality: Analysis of the Golestan Cohort Study (GCS).","authors":"Hao Larissa Wang, Monireh Sadat Seyyedsalehi, Hossein Poustchi, Mahdi Sheikh, Akram Pourshams, Farin Kamangar, Christian C Abnet, Arash Etemadi, Reza Malekzadeh, Paolo Boffetta","doi":"10.1158/1055-9965.EPI-26-0662","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0662","url":null,"abstract":"<p><strong>Background: </strong>Tobacco and opium consumption are prevalent in Iran and have been linked to increased risk of upper GI cancers. To investigate their role in lower GI cancers, the associations of tobacco and opium use with liver and colorectal cancer mortality were examined in this study.</p><p><strong>Methods: </strong>From 2004-2008, participants aged 40 to 75 years were recruited through random systematic cluster sampling and primary healthcare worker contact in Golestan, Iran. Baseline assessment of tobacco and opium use, demographic information and cancer-relative risk factors were conducted through validated questionnaires. Cancer diagnoses and deaths were collected through regular follow-up between 2004 and March 6, 2023. Multivariate Cox proportional regression model evaluated the association between tobacco and opium use and liver and colorectal cancer mortality.</p><p><strong>Results: </strong>During a median 15 years of follow up, 112 participants developed liver cancer and 201 developed colorectal cancer. Cigarette smoking (hazard ratio [HR] = 1.76, 95% confidence interval [CI] 1.05, 2.94) and water-pipe smoking (HR = 3.20, 95% CI 1.12, 9.13) were associated with liver cancer. Opium was not associated with liver cancer. We observed no associations between tobacco or opium use and risk of colorectal cancer.</p><p><strong>Conclusions: </strong>Cigarette and water-pipe smoking were associated with increased liver cancer mortality, whereas no significant associations were observed for tobacco and opium use and colorectal cancer mortality.</p><p><strong>Impact: </strong>Tobacco control could be a strategy for reducing liver cancer mortality in high-risk populations. Larger prospective studies are required to confirm the associations of tobacco and opium use with lower GI cancers.</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":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868392","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":"The KPROCS Study: A Real-World and Research Resource to Investigate Multilevel Determinants of Ovarian Cancer Treatment and Survival.","authors":"Elisa V Bandera, Jennifer A Doherty, Valerie S Lee, Lindsay J Collin, Juraj Kavecansky, Farzin Khosrow-Khavar, Jia Li, Lisa M Moy, Ekaterina Chirikova, Pushkar P Inamdar, Salma Shariff-Marco, Laurie Grieshober, Martin Köbel, Scarlett Lin Gomez, Lawrence H Kushi","doi":"10.1158/1055-9965.EPI-26-0765","DOIUrl":"10.1158/1055-9965.EPI-26-0765","url":null,"abstract":"<p><strong>Background: </strong>Compared with non-Hispanic White (NHW) women, Black women with epithelial ovarian cancer (EOC) experience poorer survival, partly due to differences in treatment and access to care. However, these factors do not fully explain survival disparities, and outcomes among other groups remain understudied. Emerging evidence also suggests racial differences in molecular subtypes. The Kaiser Permanente Northern California (KPNC) Research on Ovarian Cancer Survival (KPROCS) Study was established to evaluate how multilevel factors contribute to differences in EOC treatment and survival.</p><p><strong>Methods: </strong>KPROCS includes women diagnosed at KPNC between 2000 and 2022 with invasive epithelial ovarian, fallopian tube, or peritoneal cancers at age ≥18 years. Diagnostic slides underwent centralized pathology review to classify histotypes according to the 2020 WHO criteria. Addresses at diagnosis were linked to geospatial data to assess healthcare accessibility to chemotherapy infusion centers and neighborhood characteristics. In 540 women with high-grade serous EOC, gene expression molecular subtypes are being characterized.</p><p><strong>Results: </strong>The cohort includes 6,067 women with EOC, including 359 Black, 798 Hispanic, 906 non-Hispanic Asian American and Pacific Islander (AAPI), and 3,971 NHW women. Descriptive analyses demonstrate subpopulation differences that may influence survival. For example, Black women were least likely to receive surgery (75%), while AAPI women were the most likely (91%). Overall, 19% of the cohort received neoadjuvant chemotherapy, with the highest proportion among Black women (25%).</p><p><strong>Conclusions: </strong>This integrative approach will provide new insights into persistent differences in EOC treatment and survival across population subgroups.</p><p><strong>Impact: </strong>KPROCS is a unique resource for EOC disparities research.</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":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868376","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":"Association of Food Insecurity with Reduced History of U.S. Cancer Screening Rates.","authors":"Mohammed Shah, Shahidul Islam, Maheen Imran, Samuel Zverev, Marc J Braunstein","doi":"10.1158/1055-9965.EPI-26-0024","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0024","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) influence cancer prevention and outcomes. Among SDOH, economic stability-including food insecurity, income, employment, and housing stability-has a major impact on health. However, data linking food security status with cancer screening completion remain limited. We examined whether lower food security status was associated with lower completion of colorectal, breast, cervical, and prostate cancer screening.</p><p><strong>Methods: </strong>We performed a retrospective analysis of the 2018-2023 National Health Interview Survey. Analyses were limited to cancer-specific complete-case cohorts: colorectal (N = 59,849), breast (N = 30,867), cervical (N = 56,229), and prostate (N = 20,518). Food security was categorized as high, marginal, or low/very low. Screening completion was the dependent variable. Multivariable logistic regression estimated adjusted odds ratios (aORs) for screening by food security status, controlling for sociodemographic and clinical covariates. Sensitivity analyses used age-stratified eligibility definitions across survey years.</p><p><strong>Results: </strong>Compared with high food security, marginal food security was associated with lower odds of screening across cancers (aOR range, 0.63-0.88), and low/very low food security showed similar or larger deficits (aOR range, 0.60-0.88). Associations were significant for all four cancers and were similar in sensitivity analyses.</p><p><strong>Conclusions: </strong>Lower food security status was associated with lower completion of cancer screening. Addressing food insecurity may improve screening equity and reduce cancer disparities.</p><p><strong>Impact: </strong>Lower food security status was associated with lower completion of guideline-recommended screening across four cancers, even after multivariable adjustment. Future work should test whether interventions addressing food insecurity can improve screening.</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":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805307","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":"Advancing Evidence of the Associations between specific Benign Breast Diagnoses and Future Breast Cancer Risk.","authors":"Olivia Sattayapiwat, Donald L Weaver, Alexander D Borowsky, Theresa H M Keegan, Brian L Sprague, Karla Kerlikowske, Diana L Miglioretti","doi":"10.1158/1055-9965.EPI-26-0640","DOIUrl":"10.1158/1055-9965.EPI-26-0640","url":null,"abstract":"<p><strong>Background: </strong>Benign breast disease (BBD) increases breast cancer risk; however, associations between specific BBD diagnoses and breast cancer risk are insufficiently studied.</p><p><strong>Methods: </strong>We analyzed 131,075 benign breast biopsy episodes from 1994-2022 identified from eight Breast Cancer Surveillance Consortium registries. Pathological diagnoses were classified into 38 BBDs within 4 categories. For comparison, women with no prior breast biopsy and a negative screening mammogram (N=1,599,694) were identified. Associations of BBDs with invasive breast carcinoma and ductal carcinoma in situ (DCIS) were estimated using Fine-Gray competing risk models.</p><p><strong>Results: </strong>Over a median follow-up of 7.5 years, 35,251 invasive breast cancers and 9,743 DCIS cases occurred. Lobular carcinoma in situ was associated with a 5.61-fold (95% confidence interval [CI]: 4.10-7.68) increased risk of invasive carcinoma and an 8.82-fold (95% CI: 5.39-14.4) increased risk of DCIS. Among proliferative changes with atypia BBDs, invasive cancer hazard ratios (HRs) ranged from 2.76-4.85; DCIS HRs, 5.07-8.51. Among proliferative changes without atypia BBDs, invasive HRs ranged from near-null (papillomatosis) to moderate and strong associations (e.g., HR=1.55 for usual ductal hyperplasia and 2.84 for multiple papillomas); DCIS HRs=1.37-5.04. Nonproliferative BBDs were associated with low-to-moderate risk (invasive HRs=0.63 for atrophy to 2.16 for benign breast parenchyma; DCIS HRs=0.66-4.29). Most associations declined with increasing time since biopsy.</p><p><strong>Conclusions: </strong>Associations between BBDs and breast cancer varied widely within commonly used histologic categories.</p><p><strong>Impact: </strong>Advancing knowledge of specific BBD diagnoses may improve breast cancer risk prediction and support targeted screening and prevention strategies.</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":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805186","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":"Impact of Beta Blockers, Statins, and Cholinergic Agents on Clinical Outcomes in Pancreatic Cancer: A Retrospective VA Cohort Study.","authors":"Jason Cham, Eunyoung Yang, Jiheum Park, Ruth A White, Tito Fojo, Keith Sigel, Susan E Bates","doi":"10.1158/1055-9965.EPI-26-0062","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0062","url":null,"abstract":"<p><strong>Background: </strong>Neural regulation contributes to pancreatic ductal adenocarcinoma (PDAC) development but effects of neural-targeting medications on presentation or outcomes remain unclear.</p><p><strong>Methods: </strong>We conducted a retrospective study using the Veterans Affairs (VA) Corporate Data Warehouse (CDW) to identify patients with pancreatic cancer (2000-2020). Exposure to beta blocker, cholinergics or statins was defined by active prescriptions within 6 months before or 1 month after diagnosis. Outcomes included histologic subtype, stage, and overall survival (OS). Propensity score matching was performed for each medication class, with survival assessed using Kaplan-Meier and Cox regression models.</p><p><strong>Results: </strong>Among 7,578 Veterans with pancreatic cancer, 76% had adenocarcinoma and 60% presented with stage IV disease. Beta blocker use was associated with lower odds of advanced stage (OR 0.55, 95% CI 0.5-0.63, p<0.0001) and improved OS (HR 0.89, 95%CI 0.84-0.95, p<0.0001). Cholinergic agonist use was associated with reduced likelihood of adenocarcinoma histology (OR 0.64, 95% CI 0.41-1.01, p=0.051) and advanced stage (OR 0.53, 95%CI 0.34-0.85, p=<0.0001), but not OS. Statin use was associated with adenocarcinoma histology (OR 1.24, 95%CI 1.09-1.43, p=0.002) and lower odds of advanced stage (OR 0.77, 95%CI 0.68-0.88, p=<0.0001).</p><p><strong>Conclusions: </strong>Beta blockers were associated with earlier stage and improved survival. Cholinergic agonists and statins were associated with earlier stage. Cholinergic agonists were linked to lower likelihood of adenocarcinoma histology, while statins to higher likelihood. These findings suggest neural and metabolic pathways may shape early PDAC biology.</p><p><strong>Impact: </strong>Autonomic and metabolic pathways may influence PDAC biology. Beta blockers merit mechanistic and clinical evaluation as adjunctive therapies.</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":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805220","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":"Rule-Based Identification of a Reliable Real-World Cancer Recurrence Endpoint.","authors":"Jessica A Lavery, Samantha Brown, Chelsea Nichols, Joshua S Jolissaint, Yufei Deng, Jasme Lee, Neil J Shah, Nadia Bahadur, Andrew Niederhausern, John Philip, Kenneth L Kehl, Deborah Schrag, Katherine S Panageas","doi":"10.1158/1055-9965.EPI-26-0525","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0525","url":null,"abstract":"<p><strong>Background: </strong>Recurrence is a key oncologic endpoint but is difficult to automatically capture from electronic health records (EHR).</p><p><strong>Methods: </strong>We evaluated rule-based algorithms to detect recurrence and its timing using a publicly available clinico-genomic database of patients with breast, colorectal, non-small cell lung, or pancreatic cancer. Algorithms evaluated varying anchor dates, defined as the time at which patients were assumed eligible to recur for the purposes of the algorithm, including diagnosis and four-, six-, and twelve-months post-diagnosis, as well as varying criteria for subsequent evidence of cancer from radiology, pathology, medical oncology assessments, or cancer-directed regimen initiation. Algorithm-derived recurrence results were compared with manually curated institutional data. Performance was measured by sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and concordance of recurrence timing.</p><p><strong>Results: </strong>The best algorithms, anchored at six months post-diagnosis and requiring two reports demonstrated high sensitivity (≥0.95), PPV (≥0.81), and NPV (≥0.84), reasonable specificity (≥0.75), and estimated recurrence within a median of one month of institutional reference data.</p><p><strong>Conclusions: </strong>This scalable method enables derivation of real-world endpoints from EHR-based data.</p><p><strong>Impact: </strong>The algorithm may be used to characterize outcomes for patients treated outside of prospective clinical trials and may inform the creation of synthetic control cohorts to support regulatory approvals for new drugs in rare tumor or biomarker defined populations.</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":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763869","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":"Peripheral Absolute Lymphocyte Count, Breast Cancer-Specific and Overall Mortality According to Race, Ethnicity, and Breast Cancer Subtypes.","authors":"Candice N Thompson, Ingrid Luo, Mina Satoyoshi, Pragati Kenkare, Gunita Kashyap, Holden T Maecker, Lidia Schapira, Esther M John, Scarlett Lin Gomez, Su-Ying Liang, Summer S Han, Allison W Kurian","doi":"10.1158/1055-9965.EPI-25-1950","DOIUrl":"10.1158/1055-9965.EPI-25-1950","url":null,"abstract":"<p><strong>Background: </strong>Low absolute lymphocyte count (ALC) is associated with breast cancer-specific mortality (BCM) and overall mortality (OM) in non-Hispanic (NH) White women with triple-negative breast cancer (TNBC). However, little is known about the relationship of ALC with BCM or OM in other breast cancer subtypes, racial or ethnic groups. Here, we investigated the association of ALC with BCM and OM by breast cancer subtype and evaluated for modification by race or ethnicity.</p><p><strong>Methods: </strong>We used the Oncoshare database, linking data from electronic medical records of academic and community institutions to data from the California Cancer Registry, to identify women diagnosed with stage I-III breast cancer in 2000-2017 who had a post-diagnosis ALC within five years. We used logistic regression to identify factors associated with low ALC(<1 K/µL) and Cox models to evaluate the association of minimum ALC (minALC) post-diagnosis with BCM and OM.</p><p><strong>Results: </strong>In 11,669 women, low ALC was associated with neutropenia, chemotherapy receipt, advanced stage, more comorbidities, and aggressive tumor features (all p≤0.001). Lower minALC was associated with higher OM(HR=0.96 per 1 K/µL increase, 95% CI 0.93-0.99), most strongly in TNBC(HR=0.73, 0.59-0.91). Race and ethnicity modified associations of minALC with BCM and OM (interaction p<0.001), more strongly in NH Black and Hispanic than NH White women.</p><p><strong>Conclusions: </strong>Low peripheral ALC was associated with higher OM in women with estrogen and/or progesterone receptor-positive, HER2-negative breast cancer or TNBC.</p><p><strong>Impact: </strong>Low ALC is more strongly associated with OM and BCM in women from minoritized racial and ethnic groups.</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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763702","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}