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":"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}

{"title":"Association of high birth weight with risk of early-onset colorectal cancer.","authors":"Amrita Mukherjee, Lanfang Xu, Darios Getahun, Jessica Chubak, Jane C Figueiredo, Kimberly L Cannavale, Alec D Gilfillan, Bechien U Wu, Chun R Chao","doi":"10.1158/1055-9965.EPI-25-1658","DOIUrl":"10.1158/1055-9965.EPI-25-1658","url":null,"abstract":"<p><strong>Background: </strong>Early-onset colorectal cancer (eoCRC), particularly rectal cancer, is increasing. We evaluated the association between high birth weight and eoCRC in a nested case-control study.</p><p><strong>Methods: </strong>We included patients aged 15-49 years diagnosed with colorectal adenocarcinoma at Kaiser Permanente Southern California (2009-2021). Cancer-free controls were matched 10:1 on age, sex, and length of health plan membership. Record linkage with California Department of Public Health's birth registry was performed. Conditional logistic regression was used to evaluate associations between high birth weight, measured using (1) macrosomia (birth weight >4,000grams), and (2) large for gestational age (LGA; birth weight above the 90th percentile for gestational age and sex), and overall eoCRC, colon, and rectal cancer. Two-stage model adjustments were performed: first adjusting for pre-specified potential confounders, then adjusting for potential intermediates.</p><p><strong>Results: </strong>Of 1,400 eligible cases and matched 13,608 controls, 471 eoCRC cases (mean diagnosis age: 41.1 years) and 1,931 controls with linked birth certificate were included. Adjusted odds ratio (OR) for eoCRC was 1.32 (95% CI: 0.95-1.84) for macrosomia and 1.38 (0.97-1.98) for LGA. Macrosomia and LGA were associated with a marginal, non-statistically significant elevated risk of rectal cancer [OR (95%CI): 1.69 (0.97-2.97) and 1.81 (0.96-3.41), respectively], but not colon cancer [OR (95%CI): 1.18 (0.78-1.80) and 1.20 (0.77-1.86) for macrosomia and LGA, respectively].</p><p><strong>Conclusions: </strong>An elevated risk of early-onset rectal cancer was suggested in individuals with high birth weight.</p><p><strong>Impact: </strong>The impact of intrauterine conditions on eoCRC risk should be further evaluated.</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":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709454","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":"Personal Talc Use and Incident Lung Cancer.","authors":"Maya S Deshmukh, Kaitlyn G Lawrence, Dale P Sandler, Katie M O'Brien","doi":"10.1158/1055-9965.EPI-26-0751","DOIUrl":"10.1158/1055-9965.EPI-26-0751","url":null,"abstract":"<p><strong>Background: </strong>Talc is a known risk factor for some lung diseases due to its small particle size, commonly aerosolized form, and possible contamination with asbestos, a known lung carcinogen. Personal talc-based body powder (talc) use is common among U.S. women, but the association of talc use and lung cancer has not been studied in non-occupational settings.</p><p><strong>Methods: </strong>At enrollment (2003-2009), Sister Study participants reported talc use in the last year and ages 10-13. We used Cox proportional hazards models to estimate covariate-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs) for the associations between talc use and incident lung cancer.</p><p><strong>Results: </strong>Among 49,592 eligible women, 41% reported using talc in the last year and 641 reported a new lung cancer diagnosis. Self-reported talc use was not consistently associated with incident lung cancer: HR=0.91 (95% CI: 0.78-1.07) for talc use in the last year; HR=0.94 (0.80, 1.10) for talc use ages 10-13.</p><p><strong>Conclusions: </strong>No consistent associations were observed between talc use and lung cancer overall, though some suggestive positive associations observed among never-smokers and for lung adenocarcinomas may warrant further investigation.</p><p><strong>Impact: </strong>Population-based research on personal care product use is critical to improving our understanding of the impacts of potentially harmful substances, and their known or unknown contaminants, on human health.</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":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709136","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":"A Pan-Cancer Target Trial Emulation of Exercise and Distant Disease-Free Recurrence.","authors":"Jessica A Lavery, Whitney P Underwood, Catherine P Lee, Chaya S Moskowitz, Lee W Jones","doi":"10.1158/1055-9965.EPI-26-0680","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0680","url":null,"abstract":"<p><strong>Background: </strong>We leveraged observational data to conduct a target trial emulation (TTE) framework evaluating the association of exercise on distant disease-free survival (DDFS) in a pan-cancer cohort.</p><p><strong>Methods: </strong>To emulate a randomized controlled trial (RCT), a \"historical\" exercise assessment (Th) identified non-exercising (<10 metabolic equivalent of task-hours per week [MET-h/week]) patients. Repeat assessment 9-15 months later (T0) was used to classify patients into an exercise group (≥10 MET-h/week: increased exercise from Th) and a control group (up to 10 MET-h/week: minimal increase in exercise from Th). Kaplan-Meier methods and Cox proportional hazards models from the T0 assessment were used to estimate hazard ratios (HRs) for the exercise versus control group on DDFS and overall survival (OS).</p><p><strong>Results: </strong>A total of 3,022 patients were classified into the exercise group and 1,183 into the control group. With 5.2 years (IQR 2.7, 7.0 years) median follow-up from T0, the 5-year DDFS was 95% (95% CI, 93-96) in the exercise group and 92% (95% CI, 91-94) in the control group. Compared with the control group, the adjusted HR for the exercise group was 0.80 (95% CI, 0.59-1.09, p=0.20) for DDFS and 0.78 (95% CI, 0.55-1.11, p=0.20) for OS.</p><p><strong>Conclusions: </strong>In this pan-cancer TTE, we estimated a potential 20-30% improvement in DDFS in the exercise group compared to control.</p><p><strong>Impact: </strong>These data add to a growing body of evidence supporting further development of exercise as a therapeutic-intent strategy in primary solid tumors.</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":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709383","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":"Trends in Gastric Cancer Incidence, Mortality, and Survival by Histologic Subtype in the United States (2000-2022) and a Contemporary Chinese Cohort.","authors":"Kailai Yin, Shanshan Wang, Yanan Wang, Yubo Ma, Nianhang Chen, Zhixiang Ren, Zhengchen Jiang, Xiangdong Cheng, Li Yuan","doi":"10.1158/1055-9965.EPI-26-0241","DOIUrl":"10.1158/1055-9965.EPI-26-0241","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is a major global health burden, but histologic subtype-specific epidemiologic and survival trends remain unclear. We aimed to characterize these trends in the United States and compare stage and survival in a Chinese cohort.</p><p><strong>Methods: </strong>We analyzed data from the US Surveillance, Epidemiology, and End Results (SEER) 17 registries (2000-2022) to estimate age-adjusted incidence, incidence-based mortality, and mortality-to-incidence ratio (MIR) for five histologic subtypes: gastric adenocarcinoma, gastric neuroendocrine tumor (G-NET), gastric neuroendocrine carcinoma/mixed neuroendocrine-non-neuroendocrine neoplasm (G-NEC/MiNEN), gastric carcinoma with squamous component (GCSC), and undifferentiated gastric carcinoma. Joinpoint regression was used to estimate the average annual percentage change (AAPC). Stage, 5-year overall survival (OS), and relative survival were assessed in SEER (2000-2017), and stage and 5-year OS in a Chinese cohort (2010-2020).</p><p><strong>Results: </strong>From 2000 to 2022, the case composition of gastric cancer shifted by histologic subtype: Gastric adenocarcinoma remained predominant but declined proportionally. Incidence decreased for gastric adenocarcinoma (AAPC, -1.74%) and GCSC (-1.37%) but increased for G-NET (4.37%) and G-NEC/MiNEN (3.67%). Mortality increased for G-NET and G-NEC/MiNEN, whereas MIR increased for gastric adenocarcinoma and G-NET. Stage distributions differed across subtypes. In SEER, 5-year OS was the highest for G-NET (83.3%) and lowest for GCSC (12.3%). In the Chinese cohort, 5-year OS was higher for gastric adenocarcinoma (48.4%) but lower for G-NEC/MiNEN (22.4%) than in SEER, paralleling fewer stage IV gastric adenocarcinoma and fewer stage I G-NEC/MiNEN.</p><p><strong>Conclusions: </strong>Gastric cancer subtypes show distinct epidemiologic and prognostic patterns.</p><p><strong>Impact: </strong>These findings support histology-based prevention, early detection, and treatment 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":"1265-1275"},"PeriodicalIF":3.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978568","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":"Impact of Comorbidities on Survival among American Indian and Alaska Native People with Cancer: A Surveillance, Epidemiology, and End Results-Medicare Study.","authors":"Sarah H Nash, Bradley T Loeffler, Jennifer Erdrich, Elizabeth Verhage, Jamie Sorensen, Vanessa E Slater, Faith Elenwa, Jerreed D Ivanich, Brian J Smith, Keely K Ulmer, Bradley D McDowell","doi":"10.1158/1055-9965.EPI-26-0182","DOIUrl":"10.1158/1055-9965.EPI-26-0182","url":null,"abstract":"<p><strong>Background: </strong>American Indian and Alaska Native (AIAN) people experience lower cancer survival than other racial/ethnic groups for several cancer sites. We explored predictors of cancer survival among AIAN people, with a specific focus on the potential impact of comorbidities.</p><p><strong>Methods: </strong>We analyzed the Surveillance, Epidemiology, and End Results-Medicare linked database. AIAN people diagnosed with breast (female only), lung, and colorectal cancers from 2000 to 2019, ages 66+ years at diagnosis, and with at least 1 year of Medicare coverage prior to diagnosis were included in the study. We used multivariable-adjusted Cox proportional hazards models to assess associations of comorbidity class, previously defined using latent class analysis, with overall and cancer-specific survival, adjusted for sociodemographic characteristics and area-based social measures.</p><p><strong>Results: </strong>The sample included 831 individuals with female breast cancer, 1,009 individuals with colorectal cancer, and 1,195 individuals with lung cancer. Comorbidity class was associated with 5-year hazard of death from any cause for patients with breast and colorectal cancers but not patients with lung cancer. Furthermore, we only observed associations of comorbidity class with 5-year cancer-specific death for lung cancer, in which the class associated with heart and vascular-related conditions experienced increased hazard of death.</p><p><strong>Conclusions: </strong>Higher comorbidity prevalence among AIAN people compared with other racial/ethnic groups did not contribute to observed disparities in cancer-specific survival; however, AIAN people with comorbid conditions may be more likely to experience death from any cause than those without these conditions.</p><p><strong>Impact: </strong>Differences in prevalence of comorbid conditions are unlikely to drive disparities in cancer-specific survival observed among AIAN people.</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":"1317-1328"},"PeriodicalIF":3.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145956","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":"Integrating In Situ Immune Expression Landscape with Gene Expression-Based Subtyping to Characterize Breast Cancer Heterogeneity.","authors":"Mustapha Abubakar, Hela Koka, Priscilla Ming Yi Lee, Hiu Yu Natalie Tang, Scott Lawrence, Karun Mutreja, Feng Wang, Cherry Wu, Koon-Ho Tsang, Yee-Kei Tsoi, W C Chan, Sze Hong Law, Ray Ka Wai Hung, Gary M K Tse, Kristine Jones, Aurelie Vogt, Maria Brown, Belynda D Hicks, Difei Wang, Bin Zhu, Lap Ah Tse, Xiaohong R Yang","doi":"10.1158/1055-9965.EPI-25-2068","DOIUrl":"10.1158/1055-9965.EPI-25-2068","url":null,"abstract":"<p><strong>Background: </strong>We previously identified three clinically relevant immune [i.e., low-tumor-infiltrating lymphocyte (TIL), high-TIL, and high-interferon-stimulated gene (ISG)] subtypes of luminal breast cancer using RNA sequencing in a cohort of women from Hong Kong. In this study, we evaluated whether standard, in situ immunohistochemistry (IHC), a more clinically accessible approach, could capture similar immune heterogeneity across intrinsic (PAM50) subtypes.</p><p><strong>Methods: </strong>In 148 patients with invasive breast cancer, we performed dual IHC staining for eight markers (CD3, CD8, CD20, FOXP3, CD68, CD163, PDL1, and IDO1) with pan-cytokeratin and quantified immune-positive cells in stromal regions by digital image analysis.</p><p><strong>Results: </strong>IHC marker expression strongly correlated with gene expression-based immune and intrinsic subtypes. Compared with luminal tumors classified as low-TIL, high-TIL tumors showed higher levels of CD3, CD8, CD20, PDL1, and IDO1. Similarly, high-ISG tumors expressed higher CD3, CD8, CD20, PDL1, and IDO1 than low-TIL tumors but were distinguished from high-TIL tumors by elevated CD163. Immune marker expression was generally higher in HER2-enriched and basal-like tumors than in luminal A and B tumors, though substantial variability existed within each subtype. Luminal B tumors expressed higher levels of CD3, CD8, CD20, and CD163 compared with luminal A tumors. Notably, immune infiltration was more strongly aligned with aggressive tumor features such as high grade, risk of recurrence scores, and TP53 mutations than with estrogen receptor/progesterone receptor expression.</p><p><strong>Conclusions: </strong>These findings confirm that subsets of luminal tumors harbor inflamed or macrophage-driven immune microenvironments.</p><p><strong>Impact: </strong>Parsimonious IHC panels can perform immune classification, supporting their potential utility in refining subtype stratification and informing clinical decision-making, particularly in resource-limited settings.</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":"1358-1367"},"PeriodicalIF":3.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990779","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}