Cancer prevention research (Philadelphia, Pa.)最新文献

{"title":"Associations between calcium intake and T cell infiltration in colorectal tumours.","authors":"Evertine Wesselink, Claire E Thomas, Yasutoshi Takashima, Hiroki Mizuno, Daniel D Buchanan, Conghui Qu, Li Hsu, Andressa Dias Costa, Satoko Ugai, Yuxue Zhong, Jeroen R Huyghe, Sushma Thomas, Steven Gallinger, Robert C Grant, Loïc Le Marchand, Yohei Masugi, Fränzel Jb van Duijnhoven, Tomotaka Ugai, Shuji Ogino, Jonathan A Nowak, Ulrike Peters, Amanda I Phipps","doi":"10.1158/1940-6207.CAPR-25-0023","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-25-0023","url":null,"abstract":"<p><p>Higher T cell infiltration in colorectal tumours has been associated with better prognosis. Evidence indicates that calcium signalling is essential for T cells functioning. However, as it is unknown whether calcium intake influences T cell infiltration, we investigated the association of calcium intake with T cell subsets in the tumour microenvironment of colorectal cancer. In total, 943 participants from three cohort studies, for which data on tumour infiltrating T cells and calcium intake was available, were included for these analyses. Immune cell infiltration was quantified by digital image analyses with machine learning algorithms using a customized 9-plex multispectral immunofluorescence assay (CD3, CD4, CD8, CD45RA, CD45RO, FOXP3, KRT, MKI67, DAPI). Associations between pre-diagnostic calcium intake and densities of non-overlapping subsets of epithelial and stromal tissue area T cells were assessed using multivariable binary or ordinal logistic regression analyses. A higher dietary calcium intake was positively associated with CD3+CD4-CD8- double negative T cells density in the epithelial (OR 1.57; 95% CI 1.13-2.24) and stromal (OR 1.24; 95%CI 1.06-1.45) tumour tissue area. No other statistically significant associations were observed after correcting for multiple testing. In conclusion, dietary calcium intake was associated with a higher density of CD4-CD8- double negative T cells in the epithelial and stromal tumour tissue area, but not with infiltration of CD4+ or CD8+ T cells. More research is needed to further unravel the role of calcium in tumour immune profiles and associations with clinical outcomes. Our findings offer a promising basis for further research.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082569","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":"Mitochondrial DNA copy number assessment is a potent predictor for prostate cancer in White but not Black Individuals.","authors":"Melanie K Flores, Jessica L Janes, Mirajul Islam, Junxiang Wan, Jiali Liu, Romonia R Reams, Li-Ming Su, Kelvin Yen, Hemal H Mehta, Allison Reagan, Lauren E Howard, Emily Wiggins, Adriana C Vidal, Stephen J Freedland, Pinchas Cohen","doi":"10.1158/1940-6207.CAPR-24-0401","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-24-0401","url":null,"abstract":"<p><p>Black individuals are disproportionately burdened by prostate cancer compared to White individuals. The mitochondrion is an untapped source for prostate cancer (PCa) biomarkers, and previous work has shown altered mitochondrial DNA (mtDNA) copy number is linked to mitochondrial dysfunction and tumorigenesis. We assess whether mtDNA copy number is altered in patients with and without PCa in a racially specific manner. Circulating cell-free mtDNA copy number from plasma and mtDNA copy number from white blood cells (WBCs) were measured in 199 patients undergoing biopsy (50/50 White cases/controls and 50/49 Black cases/controls). MtDNA copy number was determined via ddPCR. Logistic regressions tested associations between mtDNA and PCa by race. The area under the curve (AUC) was compared between covariate-only models and models with mtDNA. In both plasma and WBCs, mtDNA copy number was significantly increased in cases compared to controls in White patients, but not in Black patients. Interestingly, Black controls had higher mtDNA copy number levels than White controls. Multivariable analysis revealed significant associations of Plasma mtDNA and WBC mtDNA with PCa for White patients only. Elevated mtDNA copy number was more accurate in predicting PCa in White patients than in Black patients. Higher mtDNA copy number levels were associated with PCa in both Black and White patients. Plasma mtDNA may be more accurate than WBC mtDNA in predicting PCa incidence in Black men. Overall, Black controls had higher mtDNA copy number levels than White controls, suggesting mtDNA copy number may be implicated in PCa health disparities.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030101","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":"Genetic polymorphisms of TP53 and ApoB genes and risk of biliary tract cancer: A case-cohort study in Japan.","authors":"Takao Asai, Taiki Yamaji, Shiori Nakano, Norie Sawada, Manami Inoue, Shoichiro Tsugane, Yasuo Tsuchiya, Toshikazu Ikoma, Kazutoshi Nakamura, Motoki Iwasaki","doi":"10.1158/1940-6207.CAPR-24-0536","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-24-0536","url":null,"abstract":"<p><p>Although several retrospective studies have investigated the association of TP53 rs1042522 and ApoB rs693 with risk of biliary tract cancer (BTC), results have been inconsistent. Here, to provide evidence from a prospective study, we analyzed the association of these two genetic polymorphisms with BTC risk using data from the Japan Public Health Center-based Prospective Study. We conducted a case-cohort study with 152 BTC cases and 12,159 subcohort subjects, and estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using a weighted Cox proportional hazards model. TP53 rs1042522 showed a statistically significant association with risk of BTC (HR, 1.89; 95% CI, 1.27-2.82, in the recessive genetic model), whereas ApoB rs693 showed no apparent association. Of interest, TP53 rs1042522 appeared to be associated with BTC risk in a recessive model, but not in a dominant model. On comparison of three BTC subtypes, TP53 rs1042522 appeared to be associated with the incidence of gallbladder cancer and extrahepatic bile duct cancer (HR, 2.21; 95% CI, 1.14-4.28; and HR, 1.97; 95% CI, 1.00-3.88, respectively), but showed only a non-significant association with intrahepatic bile duct cancer (HR, 1.58; 95% CI, 0.63-3.96). In this prospective case-cohort study, we found evidence to support an association between TP53 rs1042522 polymorphism and risk of BTC. The null finding for ApoB rs693 might be due to the extremely low T allele frequency (4.4%) in the study population.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047582","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":"Chronic Cigarette Smoke Exposure Masks Pathological Features of Helicobacter pylori Infection While Promoting Tumor Initiation.","authors":"Maeve T Morris, Benjamin C Duncan, M Blanca Piazuelo, I Mark Olfert, Xiaojiang Xu, Salik Hussain, Richard M Peek, Jonathan T Busada","doi":"10.1158/1940-6207.CAPR-24-0378","DOIUrl":"10.1158/1940-6207.CAPR-24-0378","url":null,"abstract":"<p><p>Gastric cancer is the fifth most common cancer and the fifth leading cause of cancer deaths worldwide. Chronic infection by the bacterium Helicobacter pylori is the most prominent gastric cancer risk factor, but only 1% to 3% of infected individuals will develop gastric cancer. Cigarette smoking is another independent gastric cancer risk factor, and H. pylori-infected smokers are at a 2- to 11-fold increased risk of gastric cancer development, but the direct impacts of cigarette smoke (CS) on H. pylori pathogenesis remain unknown. In this study, male C57BL/6 mice were infected with H. pylori and began smoking within 1 week of infection. The mice were exposed to CS 5 days/week for 8 weeks. CS exposure had no notable impact on gross gastric morphology or inflammatory status compared with filtered-air (FA) exposed controls in mock-infected mice. However, CS exposure significantly blunted H. pylori-induced gastric inflammatory responses, reducing gastric atrophy and pyloric metaplasia development. Despite blunting these classic pathological features of H. pylori infection, CS exposures increased DNA damage within the gastric epithelial cells and accelerated H. pylori-induced dysplasia onset in the INS-GAS gastric cancer model. These data suggest that cigarette smoking may clinically silence classic clinical symptoms of H. pylori infection but enhance the accumulation of mutations and accelerate gastric cancer initiation. Prevention Relevance: These findings suggest that cigarette smoking suppresses pathophysiological hallmarks of H. pylori infection while accelerating gastric carcinogenesis. Therefore, smokers should receive screening for H. pylori infection to reduce gastric cancer risk. See related Spotlight, p. 257.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"271-281"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959785","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":"Use Patterns of Levonorgestrel-Releasing Intrauterine System among American Women.","authors":"Paul G Yeh, Allen Haas, Charlotte C Sun, Karen H Lu, Larissa A Meyer, Iakovos Toumazis","doi":"10.1158/1940-6207.CAPR-24-0302","DOIUrl":"10.1158/1940-6207.CAPR-24-0302","url":null,"abstract":"<p><p>Levonorgestrel-releasing intrauterine system (LNG-IUS) use is approved by the FDA for contraception and heavy menorrhagia. More importantly, it effectively treats endometrial hyperplasia, a precursor to endometrial cancer. Therefore, LNG-IUS use is associated with potential endometrial cancer risk reduction, but current use patterns in the United States are unknown. We analyzed LNG-IUS use prevalence among women ages 18 to 50 years using a weighted statistical analysis of the 2017 to 2019 National Survey of Family Growth. Summary statistics were stratified by race and ethnic group and known endometrial cancer sociodemographic and health risk factors and assessed statistically with bivariate Rao-Scott χ2 tests. A multivariable logistic regression model was developed to explore LNG-IUS use predictors. Current LNG-IUS use in the United States was 6.9% [95% confidence interval (CI), 5.9%-8.1%]. LNG-IUS use was lower in Hispanic women compared with White women [adjusted OR (AOR), 0.7; 95% CI, 0.5-1.0]. Compared with women with ≤high school education, LNG-IUS use was higher for women with ≥college degree (AOR, 2.0; 95% CI, 1.3-3.1). Parous (AOR, 2.6; 95% CI, 1.7-3.9) and insured (AOR, 1.7; 95% CI, 1.0-3.1) women had higher odds of LNG-IUS use, whereas women with diabetes (AOR, 0.3; 95% CI, 0.1-0.7) had lower odds of LNG-IUS use. No differences in LNG-IUS use were observed by endometrial cancer risk factors of women's body mass index, age of menarche, hypertension, and personal history of cancer. More research is needed to establish the potential benefits of LNG-IUS use on endometrial cancer, which will further highlight potential opportunities for population-level primary prevention to address the growing incidence of endometrial cancer. Prevention Relevance: This study describes the characteristics of American women using the LNG-IUS. Reproductive-age women (especially Hispanic, with lower education, nulliparous, uninsured, and with diabetes) have lower LNG-IUS use odds. These groups may benefit from LNG-IUS use for endometrial cancer primary prevention, conditioned that LNG-IUS use is proven effective in reducing endometrial cancer incidence.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"299-306"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392646","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":"Solvent Exposure, Genetic Susceptibility, and Risk of Bladder Cancer.","authors":"Deborah A Tadesse, Nathaniel Rothman, Shuai Xie, Lauren M Hurwitz, Melissa C Friesen, Dalsu Baris, Molly Schwenn, Alison Johnson, Margaret R Karagas, Debra T Silverman, Stella Koutros","doi":"10.1158/1940-6207.CAPR-24-0434","DOIUrl":"10.1158/1940-6207.CAPR-24-0434","url":null,"abstract":"<p><p>The New England Bladder Cancer Study has recently reported an increased bladder cancer risk with occupational exposure to mononuclear aromatic organic solvents, including exposure to benzene, toluene, and xylene and their combination BTX. However, the mechanisms by which BTX influence bladder cancer are unclear. In this study, we evaluated the interaction between BTX and genetic markers in known bladder cancer susceptibility loci and in variants shown to impact the metabolism of these solvents. We used multivariate logistic regression to calculate the ORs, 95% confidence intervals, and P values for multiplicative interaction in 1,182 cases and 1,408 controls from a population-based case-control study from New England. Lifetime occupational exposure to benzene, toluene, xylene, and BTX were assessed using occupational histories and exposure-oriented modules in conjunction with a job-exposure matrix. Buccal cells from mouthwash samples were used to conduct genotyping. Subjects with the highest cumulative exposure to benzene and who carried a risk allele in rs72826305 (CASC15) had an increased risk of bladder cancer (OR = 2.56, 95% confidence interval, 1.28-5.12) compared with those never exposed with no risk alleles (P interaction = 0.03). Additional suggestive joint effects with benzene were evident for those carrying genetic risk variants in FGFR3 (P value = 0.01) and GSTT1 (P interaction = 0.007). Bladder cancer risk is higher among those exposed to BTX-containing solvents who also harbor common variants in CASC15, FGFR3, and GSTT1, adding to the evidence of a plausible link between these exposures and bladder cancer risk. Prevention Relevance: Our findings suggest that bladder cancer risk is higher among those exposed to BTX-containing solvents who also harbor common genetic polymorphisms associated with bladder cancer. The joint contribution of genetics and occupational exposures may play an important role in the etiology of bladder cancer.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"283-290"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494939","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":"Gastric Cancer Origins: Stem Cells, Metaplasia, and Environmental Interactions.","authors":"Hiroto Kinoshita, Guodong Lian, Yoku Hayakawa","doi":"10.1158/1940-6207.CAPR-25-0072","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-25-0072","url":null,"abstract":"<p><p>The study by Morris and colleagues provides new insights into gastric cancer development, challenging the traditional Correa cascade model. Their findings show that cigarette smoke exposure accelerates dysplasia formation while reducing Helicobacter pylori-associated inflammation and metaplasia. This suggests that dysplasia may arise from tissue-resident stem cells rather than metaplastic cells. The study also supports the idea that metaplasia may play a protective role in maintaining epithelial integrity under chronic stress. These findings contribute to a better understanding of how environmental factors influence gastric carcinogenesis and may help refine approaches to prevention and treatment. See related article by Morris et al., p. 271.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"18 5","pages":"257-259"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045623","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":"High-Resolution Anoscopy Referral Rates Adopting Different Anal Cancer Screening Strategies for Men Who Have Sex with Men.","authors":"Maria Benevolo, Massimo Giuliani, Paolo Giorgi Rossi, Francesca Rollo, Eugenia Giuliani, Christof Stingone, Laura Gianserra, Mauro Zaccarelli, Alessandra Latini, Maria Gabriella Donà","doi":"10.1158/1940-6207.CAPR-24-0435","DOIUrl":"10.1158/1940-6207.CAPR-24-0435","url":null,"abstract":"<p><p>The International Anal Neoplasia Society (IANS) has generated recommendations for anal cancer screening, identifying men who have sex with men (MSM) living with human immunodeficiency virus (HIV; MSM-LWH) ≥35 years and MSM not living with HIV (MSM-noHIV) ≥45 years as groups to prioritize. As high-resolution anoscopy (HRA) availability is still limited across Europe, a retrospective study was conducted to estimate the potential HRA referral rates of the Sexually Transmitted Infections (STI)/HIV center of a European capital city using IANS-recommended strategies. The study included participants in a program for the surveillance of anal intraepithelial neoplasia and anal human papillomavirus (HPV) natural history. MSM-LWH ≥35 years and MSM-noHIV ≥45 years with valid results for liquid-based anal cytology and HPV test at baseline were included. The following strategies were evaluated: cytology as a standalone test or with high-risk HPV (hrHPV) triage; hrHPV (with/without HPV16 genotyping) as a standalone test or with cytology triage; and cotesting with cytology and hrHPV (with/without HPV16 genotyping). Overall, 307 MSM were included (244 LWH, 79.5%). hrHPV as a standalone test led to the highest referral rate in both MSM-LWH and MSM-noHIV (74.6% and 55.6%, respectively). Cytology with hrHPV triage (without genotyping) and hrHPV with cytology triage resulted in the same referral rates (44.3% in MSM-LWH and 27.0% in MSM-noHIV). In settings with insufficient HRA capacity, only high-grade squamous intraepithelial lesions (HSIL) or atypical squamous cells-cannot exclude HSIL (4.9% and 9.5% for MSM-LWH and MSM-noHIV, respectively) and HPV16+ MSM (27.0% and 20.6%, respectively) would be referred to HRA. Adoption of IANS recommendations should balance the sensitivity of the screening algorithm and the HRA referral rate because the latter is a matter of concern in settings with limited HRA capacity. Prevention Relevance: Adopting the recent IANS recommendations for anal cancer screening in MSM may be challenging when HRA availability is limited. Estimating the HRA referral rates we would have using 12 different screening algorithms, we highlighted that application of these recommendations implies a careful analysis of the local resource capacity.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"291-298"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Health Disparity and Risk of Multiple Myeloma: Implications for Energy Balance Interventions.","authors":"Amber J Normann, Rebekah L Wilson, Ellaney Matarese, Chuan Lu, Brett P Ranieri, John R Gardiner, Catherine R Marinac, Christina M Dieli-Conwright","doi":"10.1158/1940-6207.CAPR-24-0199","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-24-0199","url":null,"abstract":"<p><p>Established risk factors for multiple myeloma, including obesity and sedentary lifestyles, are associated with well-known racial/ethnic disparities in disease risk. This review examines established risk determinants for multiple myeloma in Black adults, summarizes evidence linking lifestyle factors, including obesity, physical inactivity, and diet, to disease risk, and discusses energy balance interventions, including cultural tailoring, to mitigate multiple myeloma risk. We summarize current evidence for racial/ethnic disparities in risk factors for multiple myeloma, including unmodifiable heritable factors, modifiable contributors to obesity, including diet and physical activity, and barriers to meeting physical activity and healthful diet guidelines. With this evidence, we present considerations to research lifestyle interventions directed toward risk factors for multiple myeloma. Current foundational scientific evidence in energy balance interventions for cancer risk management is primarily supported in non-Hispanic White populations. Evidence for preventative exercise, diet, or lifestyle interventions for multiple myeloma among underrepresented populations is scarce. Research considerations are proposed to provide strategies utilizing community engagement, primary care education, and importantly, availability of exercise and dietary resources. The importance of tailoring exercise and dietary interventions is also underscored, in addition to generating clinical trial-based evidence to be equitable and beneficial for all populations.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"18 5","pages":"261-269"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059322","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":"Stage at Diagnosis for Common Cancers According to Rurality, Area Deprivation and Insurance, 2017-2021.","authors":"Kathleen M Fairfield, Kimberly Murray, Lise M Cloutier, John L Daggett, Benjamin R Felix, Christina A Kapala, Renee M Fay-Leblanc, Adriana E Nadeau, Bridget K Rauscher, Kathryn Rensenbrink, Debra A Rothenberg, Kevin D Stein","doi":"10.1158/1940-6207.CAPR-24-0587","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-24-0587","url":null,"abstract":"<p><p>Poor access to care among rural and vulnerable populations may result in later stage cancer diagnoses. Using Maine Cancer Registry data (2017-2021) we examined relationships between rurality, insurance, area deprivation index (ADI), and stage for breast, colorectal, lung/bronchus, and prostate cancers. Among 21,208 cancers, regional/distant spread at diagnosis was present among 24% of breast, 60% colorectal, 69% lung/bronchus, and 25% of prostate. In multivariable model we modeled odds of being diagnosed with regional/distant (vs in situ/local spread) according to insurance, rurality, and ADI. Compared to commercial insurance, we observed higher odds of diagnosis at regional/distant stage (vs in situ/localized) associated with having Medicaid insurance for breast (AOR 1.65, 95% CI 1.33-2.04), colorectal (AOR 1.46, 95% CI 1.09-1.98), and prostate (AOR 1.88, 95% CI 1.30-2.70) cancers but no association for lung cancer. People living in isolated rural areas had higher odds of being diagnosed with later stage colorectal(AOR 1.24, 95% CI 1.01-1.53), lung/bronchus (AOR 1.22, 95% CI 1.04-1.43) and prostate cancers (AOR 1.24, 95% CI 1.04-1.47) compared to urban dwellers. Living in isolated rural areas or being insured by Medicaid was associated with later stage cancer diagnoses compared with those in more urban areas and with commercial insurance. This suggests an opportunity to improve early detection among these vulnerable populations.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024779","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}