Cancer Epidemiology最新文献

{"title":"Quality of data from cancer registries in Italy: An appraisal","authors":"Buzzoni Carlotta ,&nbsp;Russo Antonio Giampiero ,&nbsp;Zarcone Maurizio ,&nbsp;Fusco Mario ,&nbsp;Contiero Paolo ,&nbsp;Tagliabue Giovanna ,&nbsp;Fabiano Sabrina ,&nbsp;Perotti Viviana ,&nbsp;Stracci Fabrizio ,&nbsp;Mazzucco Walter ,&nbsp;Crocetti Emanuele ,&nbsp;AIRTUM Working Group","doi":"10.1016/j.canep.2025.102829","DOIUrl":"10.1016/j.canep.2025.102829","url":null,"abstract":"<div><div>We report the results of the quality assessment on data collected by cancer registries belonging to the Italian network of Cancer Registries (AIRTUM). For all malignant cancers diagnosed in 2013–2017, overall percentages of cases known from the death certificate only (DCO), and those of cases with cyto-histological confirmation (MV), were provided. The overall percentage of DCOs was small (1.2 %). The percentage of microscopic verification was overall high (87.6 %), with some variations among registries. DCO proportion varied from 0.1 % for cutaneous melanoma to 3.8 % for liver and pancreatic tumours. Differences across sites in MV proportion were linked to the different diagnostics. The rate of cases lost to follow-up was on average very low (0.7 %). This quality evaluation confirmed that data provided by the Italian cancer registries were affordable.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102829"},"PeriodicalIF":2.4,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of prediction models for early relapse in advanced epithelial ovarian cancer using Australian and Dutch population-based data","authors":"Sherin A. Said ,&nbsp;Joanna IntHout ,&nbsp;Hendrik Koffijberg ,&nbsp;Joanne A. de Hullu ,&nbsp;Simon E. Hyde ,&nbsp;Maaike A. van der Aa ,&nbsp;Anne M. van Altena","doi":"10.1016/j.canep.2025.102824","DOIUrl":"10.1016/j.canep.2025.102824","url":null,"abstract":"<div><h3>Objective</h3><div>To externally validate the published postoperative and <em>BRCA</em> models predictive of early relapse in patients with advanced-stage epithelial ovarian cancer (EOC) using independent Australian and Dutch cohorts.</div></div><div><h3>Methods</h3><div>Advanced-stage EOC patients diagnosed between January 1, 2002, and June 1, 2006, in Australia, and between January 1, 2016, and December 31, 2017, in the Netherlands were included. Data from patients who underwent cytoreductive surgery and platinum-based chemotherapy were used to validate both models. Missing data were addressed through multiple imputation. Model updates included recalibration-in-the-large, recalibration, and model revision, with a closed testing procedure to identify the most suitable approach. Model performance was assessed for calibration, discrimination, and the Brier score.</div></div><div><h3>Results</h3><div>The Australian cohort (N = 1334) included 457 early relapsers and 859 late or non-relapsers, showing baseline differences compared to the development cohort. Discrimination was adequate for both the postoperative and <em>BRCA</em> models (c-statistics: 0.69 and 0.70, respectively). The postoperative model required full revision, while recalibration-in-the-large was sufficient for the <em>BRCA</em> model in the Australian cohort. The Dutch cohort (N = 1212) included 283 early relapsers and 929 late or non-relapsers, with baseline characteristics similar to those of the development cohort. Both models demonstrated adequate discrimination (c-statistics: 0.71 and 0.70, respectively). Recalibration-in-the-large corrected miscalibration in the Dutch cohort.</div></div><div><h3>Conclusion</h3><div>The postoperative and <em>BRCA</em> model were successfully validated for predicting early relapse in advanced-stage EOC patients, confirming their robustness. However, local data updates are advised to enhance accuracy across clinical settings. Online calculators were built for clinical use (<span><span>Link 1</span><svg><path></path></svg></span>; <span><span>Link 2</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102824"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive geriatric assessment and early treatment failure in nonagenarian patients with cancer, a retrospective monocentric study","authors":"Aglaé Guerin ,&nbsp;Zoé ap Thomas ,&nbsp;Céline Nagera-Lazarovici ,&nbsp;Geoffroy Beraud-Chaulet ,&nbsp;Mariana Iacob ,&nbsp;Florence Canoui-Poitrine ,&nbsp;Elena Paillaud ,&nbsp;Capucine Baldini ,&nbsp;Arnaud Pagès ,&nbsp;Maxime Frélaut","doi":"10.1016/j.canep.2025.102830","DOIUrl":"10.1016/j.canep.2025.102830","url":null,"abstract":"<div><h3>Background</h3><div>The incidence of cancer among patients aged over 90 is increasing, but this population is poorly described in literature. This underrepresentation complicates decision-making for cancer treatments, despite the contribution of comprehensive geriatric assessment (CGA). This study aimed to describe early failure of specific anti-cancer treatments in a population of nonagenarians treated in a Comprehensive Cancer Center after undergoing a CGA.</div></div><div><h3>Methods</h3><div>This retrospective, monocentric cohort study included patients aged over 90 referred to an oncogeriatric team for CGA between 2019 and 2023, regardless of cancer type or planned treatment. The primary endpoint was the early treatment failure rate within 3 months of the initiation of treatment, defined as unplanned discontinuation, progression, or death.</div></div><div><h3>Results</h3><div>119 patients were included, with a median age of 91 years (range: 90–99 years), 53 % were men. The most common cancers were skin (30 %), head and neck (24 %), genito-urinary (12 %), and breast cancers (11 %). Most patients were independent for activities of daily living with a median ADL score of 6/6 and IADL score of 3/4. They had an average of 1.3 severe comorbidities. Half of them suffered from undernutrition. The geriatric oncology team recommended 53.8 % treatment modifications (94.5 % de-escalation). The most common treatments received were radiotherapy (27 %), surgery (18 %), hormonal therapy (10 %) and chemotherapy (9 %). A quarter of the patients received exclusive supportive care. Among patients receiving specific treatment, early failure occurred in 22.7 % (20/88). The 6-month survival probability from initiation of treatment was 69.2 % (95 % CI: 60.3 %, 76.8 %), varying significantly by treatment intent: 93.9 % (95 % CI: 80.4 %, 98.3 %) for curative treatments, 77.4 % (95 % CI: 64.5 %, 86.6 %) for palliative treatments, and 26.8 % (95 % CI: 14.3 %, 44.6 %) for exclusive supportive care.</div></div><div><h3>Conclusion</h3><div>In this population of nonagenarians, who benefit from a CGA to identify and manage patient frailties, anti-cancer treatments were carried out with few early treatment failures.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102830"},"PeriodicalIF":2.4,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to per- and poly-fluoroalkyl substances and hematological cancer: A systematic review and meta-analysis","authors":"Michele Sassano ,&nbsp;Sirui Zhang ,&nbsp;Elizabeth Maria Kappil ,&nbsp;Tongzhang Zheng ,&nbsp;Paolo Boffetta ,&nbsp;Monireh Sadat Seyyedsalehi","doi":"10.1016/j.canep.2025.102831","DOIUrl":"10.1016/j.canep.2025.102831","url":null,"abstract":"<div><div>Recent literature suggests that exposure to per- and polyfluoroalkyl substances (PFAS) may be associated with increased cancer risk. However, evidence regarding their association with hematological cancers is inconclusive. Hence, we aimed to summarize findings of epidemiological studies on the issue. We conducted a systematic review by searching Pubmed and Scopus in April 2025 to identify studies on the association between PFAS and cancer types other than liver, kidney, and testis. We pooled relative risks (RRs) and 95 % confidence intervals (CIs) for the association between PFAS exposure and hematological cancers with restricted maximum likelihood method. Fourteen studies were included in the review. We found pooled RRs of 1.04 (95 % CI: 0.98, 1.10; I²=12.0 %, <em>p</em>_het=0.332), 1.04 (95 % CI: 0.95, 1.14; I²=0.0 %, <em>p</em>_het=0.523), and 1.06 (95 % CI: 0.94, 1.19; I²=42.9 %, <em>p</em>_het=0.105) for the association between environmental or occupational PFAS exposure and total hematological cancer, leukemia, and lymphoma, respectively. As for types of lymphoma, environmental or occupational PFAS exposure was associated with incidence of non-Hodgkin lymphoma (RR: 1.15; 95 % CI: 1.01, 1.29; I²=0.0 %, <em>p</em>_het=0.579), while no association with its mortality or with Hodgkin lymphoma was observed. The RR for the association between high serum levels of perfluorooctanoic acid and total hematological cancer was 1.13 (95 % CI: 0.72, 1.75; I²=64.6 %%, <em>p</em>_het=0.023). Our results are suggestive of an association between PFAS exposure and non-Hodgkin lymphoma. Weak associations were also observed for total hematological cancer and leukemia among male individuals. Due to potential exposure misclassification in included studies, further evidence is needed to confirm our findings.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102831"},"PeriodicalIF":2.4,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of carcinomatosis","authors":"Kyle A. Mani ,&nbsp;Jun Lu ,&nbsp;Eric J. Lehrer ,&nbsp;Ming Wang ,&nbsp;Lauren E. Henke ,&nbsp;Richard S. Hoehn ,&nbsp;Nicholas G. Zaorsky","doi":"10.1016/j.canep.2025.102815","DOIUrl":"10.1016/j.canep.2025.102815","url":null,"abstract":"<div><h3>Background</h3><div>Carcinomatosis is an advanced form of metastatic cancer, which has been thought to be an invariantly fatal disease. We characterized prognostic factors for overall survival (OS) in patients with de-novo carcinomatosis.</div></div><div><h3>Methods</h3><div>Patients were identified from the SEER database from 1/1/2016–12/31/2020. Kaplan–Meier method and log-rank test were used to evaluate OS and a Cox proportional hazards model was used to calculate adjusted hazard ratios (aHR) with 95 % confidence intervals (CIs).</div><div>We included patients with carcinomatosis across 30 primary sites. The most common primary tumors were colorectal, pancreas, ovary, and lung &amp; bronchus, and stomach.</div></div><div><h3>Results</h3><div>Among newly diagnosed cancer patients in SEER, a total of 3131 (59.7 % female, 80.1 % White) patients with carcinomatosis were identified, corresponding to an incidence of 9.0 per 1000,000 persons. Of all patients with metastatic disease, only 0.17 % were diagnosed with carcinomatosis. Compared to patients with de novo metastatic disease without carcinomatosis (i.e., those with metastases limited to the brain, bone, liver, or lung), patients with carcinomatosis were associated with over twice the risk of mortality (aHR = 2.3, 95 % CI: 2.2–2.5). The 1-year OS for patients with carcinomatosis was 35.8 % (95 % CI: 34.0 %–37.7 %). The most common primary sites included: colorectal (14.8 %), pancreas (14.8 %), ovary (9.8 %), and lung &amp; bronchus (8.9 %). Patients with appendiceal (1-year OS: 88.2 %, 95 % CI: 81.8 %–95.1 %) and ovarian (1-year OS: 58.7 %, 95 % CI: 53.0 %–65.0 %) carcinomatosis had markedly longer survival compared to patients with carcinomatosis from other primary sites. Patients who were at highest risk of death are more likely to be older; male; Black; have more advanced T and N categories; and/or have synchronous metastases (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Carcinomatosis is associated with poorer OS compared to other forms of metastases. Patients with ovarian and appendiceal tumors have markedly longer survival.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102815"},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individuals from culturally and linguistically diverse backgrounds have more advanced prostate cancer at diagnosis in Victoria, Australia","authors":"Koku Sisay Tamirat ,&nbsp;Michael James Leach ,&nbsp;Nathan Papa ,&nbsp;Jeremy Millar ,&nbsp;Eli Ristevski","doi":"10.1016/j.canep.2025.102827","DOIUrl":"10.1016/j.canep.2025.102827","url":null,"abstract":"<div><h3>Introduction</h3><div>The Australian Cancer Plan prioritises individuals from culturally and linguistically diverse (CALD) backgrounds as a focus of interventions aimed at improving cancer care experiences and outcomes. We aimed to investigate differences in the National Comprehensive Cancer Network (NCCN) risk category classification at prostate cancer (PCa) diagnosis between CALD and non-CALD populations.</div></div><div><h3>Methods</h3><div>We included Victorian Prostate Cancer Outcomes Registry registrants with a PCa diagnosis (February 2009-August 2022) and country-of-birth data. CALD status was defined as birth in a mainly non-English-speaking country (CALD) versus Australia or a mainly English-speaking country (MESC). CALD individuals were further sub-grouped by preferred spoken language: English-speaking and non-English-speaking. We estimated the effect of CALD status on NCCN risk categories using partial proportional ordinal logistic regression.</div></div><div><h3>Results</h3><div>There were 25,951 individuals: 18,392 (71 %) Australian-born, 5046 (19 %) CALD and 2513 (10 %) MESC-born. Of 4872 CALD individuals with preferred-language data, 498 (10 %) preferred speaking a language other than English. Compared to Australian-born individuals, non-English-speaking CALD individuals presented with less low-risk (15 % vs 22 %) but more high-risk (32 % vs 21 %) and metastatic (18 % vs 8 %) disease. CALD individuals had significantly more advanced (regional or metastatic) disease than Australian-born individuals (adjusted odds ratio [aOR]=1.17, 95 % confidence interval [CI]=1.06–1.29). Non-English-speaking CALD individuals had significantly more advanced PCa (aOR=1.54, 95 % CI=1.23–1.94).</div></div><div><h3>Conclusions</h3><div>Individuals from CALD backgrounds had greater odds of presenting with high-risk or advanced PCa. Improving early detection of PCa for CALD individuals requires investigation of underlying factors to plan effective interventions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102827"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximal weight change during adulthood and breast cancer risk: A 14-year follow-up of the Guangzhou Biobank Cohort Study","authors":"Xiao Yi Lin ,&nbsp;Jiao Wang ,&nbsp;Wei Sen Zhang ,&nbsp;Chao Qiang Jiang ,&nbsp;Ya Li Jin ,&nbsp;Kar Keung Cheng ,&nbsp;Tai Hing Lam ,&nbsp;Lin Xu","doi":"10.1016/j.canep.2025.102825","DOIUrl":"10.1016/j.canep.2025.102825","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a risk factor for breast cancer (BC) after menopause, but the association of weight fluctuation during adulthood with BC risk remains unknown.</div></div><div><h3>Methods</h3><div>A total of 20,056 female participants aged 50 years or older from the Guangzhou Biobank Cohort Study (2003–2008) were followed up until 2020 through linkage with the cancer registry. At baseline, maximal weight change was defined as the difference between the highest and lowest weight since age 18. Cox proportional hazards regression was used, adjusting for potential confounders.</div></div><div><h3>Results</h3><div>During an average follow-up of 14.2 years, 326 BC cases were identified. A maximal weight gain of 5 kg or more since age 18 was associated with a higher BC risk, compared to a weight change of less than 5 kg (adjusted hazard ratio [adHR] 1.36, 95 % confidence interval [CI] 1.02–1.81; <em>P</em> = 0.03). Among participants who gained 5 kg or more, each additional kilogram was associated with a 2 % higher BC risk (adHR 1.02 per 1 kg, 95 % CI 1.00–1.04; <em>P</em> = 0.02). Similar patterns were found in women who reached the highest weight before the age of 50 (adHR 1.06 per 1 kg, 95 % CI 1.03–1.08; <em>P</em> &lt; 0.001). Additionally, a 1-kg increase in weight was associated with a 10 % (95 % CI 1.05–1.16; <em>P</em> &lt; 0.001) higher risk of BC in women who weighed more than peers at age 20.</div></div><div><h3>Conclusions</h3><div>These findings suggest that preventing excessive weight gain in adulthood, particularly among women who reached their highest weight before 50 years of age and who were heavier than peers at age 20, may reduce BC risk. Weight management should be emphasized, both at the highest and earliest adult years, in mitigating BC risk.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102825"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect adjustment of tobacco smoking in occupational studies of lung cancer: A systematic review of the available methods and their applications","authors":"Behzad Heibati ,&nbsp;Jo S. Stenehjem ,&nbsp;Elisabeta Pletea ,&nbsp;Michelle C. Turner ,&nbsp;Eva S. Schernhammer ,&nbsp;Damien M. McElvenny ,&nbsp;Tom Loney ,&nbsp;Kurt Straif ,&nbsp;Irina Guseva Canu","doi":"10.1016/j.canep.2025.102820","DOIUrl":"10.1016/j.canep.2025.102820","url":null,"abstract":"<div><div>Tobacco smoking is an important risk factor and potentially a major confounding factor in occupational lung cancer studies. However, as individual information on tobacco smoking is often not available, indirect adjustment methods may be used to account for potential confounding from smoking. Therefore, we aimed at providing an overview of the available indirect adjustment methods for smoking in studies of occupational exposures and lung cancer risk. We conducted a systematic search of relevant studies that applied statistical methods for indirect adjustment of tobacco smoking and were published between 1-Jan-2000 and 2-Apr-2025 to capture developments in recent decades. Studies were retrieved from Embase, MEDLINE, and Web of Science. Fifteen studies fulfilled our inclusion criteria and were included. We grouped the studies into four methods of indirect smoking adjustment: (1) without distributions for adjusted data; (2) distributions for adjusted data; (3) negative control outcomes; (4) factor analysis models. For studies with an external comparison group, percentage change in estimates from before to after indirect adjustment ranged −36.1 %_to_+ 17.3 %, while the corresponding range for those with internal comparison was −16.2 %_to_+ 47.8 %. The choice of indirect adjustment method depends on the use of reference group (external vs. internal) and the data available. Adjustment methods 1 and 2 use partial cohort data or ancillary data from other similar workers and may be preferable over methods 3 and 4, if such data are available. Methods 3 and 4 may be well suited if such data are lacking but have stronger assumptions.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102820"},"PeriodicalIF":2.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes by breast cancers diagnostic modes: A comprehensive evaluation of a national breast cancer screening programme","authors":"Quentin Rollet ,&nbsp;Isabelle Robert ,&nbsp;Sophie Couffignal ,&nbsp;Fanny Lorin ,&nbsp;Yaiza Rivero ,&nbsp;Claudine Backes","doi":"10.1016/j.canep.2025.102821","DOIUrl":"10.1016/j.canep.2025.102821","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer is the leading cause of diagnosis and cancer-related death among women in almost every country worldwide. To reduce and to control breast cancer mortality, Luxembourg implemented the <em>Programme Mammographie</em>, a population-based organised programme in 1992. We aimed to compare the clinical and screening characteristics of breast cancers diagnosed in Luxembourg’s eligible screening population by detection modes.</div></div><div><h3>Methods</h3><div>1618 women aged 50–71 diagnosed with a first breast cancer between 2013 and 2018 were included from Luxembourg National Cancer Registry (<em>Registre National du Cancer, RNC)</em>. The detection mode (screen-detected, interval-detected, and diagnosis-detected) is determined by linking RNC data with 144,270 participations in the <em>Programme Mammographie</em> between 2011 and 2018.</div></div><div><h3>Results</h3><div>Screen-detected breast cancers were diagnosed at younger ages, more often found <em>in situ</em>, at a lower stage at diagnosis, smaller, showed less lymph node invasion, and were more frequently treated with conservative surgery than diagnosis-detected. Interval-detected cases had the lowest proportion of <em>in situ</em> cancers and displayed distinct molecular subtypes usually considered as more aggressive. Cancers found after the initial round of participation had worse prognosis than those found after subsequent rounds. Interval cancers diagnosed during the second year had worse prognosis than those diagnosed in the first year after participation. The best prognosis was identified in screen-detected cases whose participation was on time regarding the penultimate, and the worst in diagnosis-detected with no participation over the period.</div></div><div><h3>Conclusions</h3><div>Regular participation in the <em>Programme Mammographie</em> is associated with earlier detection and less advanced forms of breast cancer at diagnosis. However, healthier behaviors among screening participants might also contribute to these outcomes. The indicators produced supports public health policies to further increase its level of effectiveness.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102821"},"PeriodicalIF":2.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying environmental factors and biological metrics associated with cancer prevalence and mortality: An environment-wide association study","authors":"Zongyuan Li ,&nbsp;Cheng Yu ,&nbsp;Jianqi Hao ,&nbsp;Yueli Shu ,&nbsp;Jian Zhang ,&nbsp;Kejia Zhao ,&nbsp;Qiang Pu ,&nbsp;Lunxu Liu","doi":"10.1016/j.canep.2025.102828","DOIUrl":"10.1016/j.canep.2025.102828","url":null,"abstract":"<div><h3>Background</h3><div>Present knowledge about determinants of oncogenesis and cancer mortality remains incomplete, inconsistent, and controversial. We aimed to conduct an environment-wide association study (EWAS) to systematically investigate and tentatively validate correlations of environmental factors and biological metrics with prevalence and mortality of cancer.</div></div><div><h3>Methods</h3><div>All eligible participants were selected from the US National Health and Nutrition Examination Survey (NHANES) and randomly split into training and testing sets by survey years. Environmental and biological exposures were assessed through either physical examinations or laboratory tests. We conducted survey-weighted logistic regression and COX proportional hazards regression models to investigate the relationships of 398 factors with cancer prevalence and 380 factors with cancer mortality, respectively. To adjust for multiple comparisons, positive findings in the training set (false discovery rate [FDR] &lt; 5 %) were tentatively validated in the testing set (P value &lt; 0.05). Random forest models were further fitted to evaluate the importance and diagnostic value of identified factors in relation to cancer prevalence.</div></div><div><h3>Results</h3><div>Overall, 55,021 general participants and 5163 cancer survivors were included in the study of cancer prevalence and mortality, respectively. After adjusting potential confounders, we identified 7 environmental or biological factors (e.g. total bilirubin, testosterone, and beta-cryptoxanthin) associated with cancer prevalence in the general population, as well as 21, 8, and 6 indicators associated with all-cause (e.g. C-reactive protein), cancer-specific (e.g. blood selenium), and noncancer mortality (e.g. albumin) among individuals with cancer, respectively. EWAS-identified factors contributed to better performance of random forest models in predicting cancer prevalence.</div></div><div><h3>Conclusions</h3><div>Employing an EWAS approach, this study provided novel insights into potential targets for prevention and control of cancer.</div></div>","PeriodicalId":56322,"journal":{"name":"Cancer Epidemiology","volume":"97 ","pages":"Article 102828"},"PeriodicalIF":2.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}