{"title":"Statistically significant association does not imply improvement in prediction of clinical outcomes.","authors":"Shu Jiang, Bernard A Rosner, Graham A Colditz","doi":"10.1158/1940-6207.CAPR-25-0056","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-25-0056","url":null,"abstract":"<p><p>In the current landscape of clinical studies, the concept of statistically significant association is often mixed up with the expectation of improved prediction performance. We discuss the two concepts, association and prediction, and present the epidemiologic principles and statistical constructs that underlie the discrepancy between statistically significant associations and the rationale for their lack of impact on improving prediction in terms of discrimination. This issue is illustrated using an existing breast cancer dataset. The concept of statistically significant association should not be mixed up with the expectation of improved discrimination performance. While some markers may not markedly improve discrimination, they can still have substantial clinical relevance by identifying critical biological pathways that inform novel treatment or prevention strategies. Development of models for both association and prediction assessments should be directly tied to clinical translation to move adoption forward to advance precision medicine.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194006","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}
Julie M Clarke, Trevor J Lockett, Karen L Harrap, Brooke E Flanders, Virginia Bird, Alex Boussioutas, Mark Appleyard, David Williams, Sophie Zaloumis, Arun Gupta, Suresh Sivanesan, Aysha Al-Ani, Ralley Prentice, Allan D Spigelman, Digsu N Koye, Patrick M Lynch, Finlay A Macrae
{"title":"The effect of butyrylated starch on bowel polyps in Familial Adenomatous Polyposis: results of a randomized, double-blind, placebo-controlled crossover trial.","authors":"Julie M Clarke, Trevor J Lockett, Karen L Harrap, Brooke E Flanders, Virginia Bird, Alex Boussioutas, Mark Appleyard, David Williams, Sophie Zaloumis, Arun Gupta, Suresh Sivanesan, Aysha Al-Ani, Ralley Prentice, Allan D Spigelman, Digsu N Koye, Patrick M Lynch, Finlay A Macrae","doi":"10.1158/1940-6207.CAPR-24-0513","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-24-0513","url":null,"abstract":"<p><p>Butyrate may reduce risk of colorectal cancer and can be delivered to the colon using butyrylated starch (HAMSB). This trial evaluated effects of HAMSB on polyp burden in participants with Familial Adenomatous Polyposis. The study was a randomized, double-blind, placebo-controlled crossover trial. In three-6-month periods participants ingested 40 g/day of HAMSB or low amylose starch, followed by the alternative, and then a washout. Participants underwent 4 video-recorded colonoscopies to assess polyp burden as the primary endpoint. At baseline two distal bowel tattoos were placed: tattoo one where polyps were cleared at each scope; tattoo two where polyps were left in situ. Generalized linear mixed models were used to estimate the ratio of mean polyp counts in intervention compared to placebo periods. 72 participants were randomized (33 female) with 49 completing the study. In the intention-to-treat analysis HAMSB did not reduce mean global (0.9-fold change, 95% CI: 0.77-1.06, P=0.218) or small (<2.4 mm) polyp numbers (0.88-fold change, 95% CI: 0.71-1.1, P = 0.267). There was a trend for reduction of small polyps in tattoo one (0.72-fold change, 95% CI: 0.5-1.03, P=0.074). In the per-protocol analysis there was a strong trend for HAMSB to reduce mean global small polyp numbers (0.79-fold change, 0.62-1, P=0.051). HAMSB may reduce polyp initiation in the distal bowel without causing regression or growth of existing polyps. However, the 95% CI indicate large uncertainty to the true direction of the treatment effect and the P values provide only weak evidence against the null hypothesis of no treatment effect.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066598","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}
David Zahrieh, Carrie A Strand, Paul J Limburg, Aminah Jatoi, Sumithra J Mandrekar
{"title":"Was it Worth It? Response Data from >650 United States and International Participants in Chemoprevention Trials.","authors":"David Zahrieh, Carrie A Strand, Paul J Limburg, Aminah Jatoi, Sumithra J Mandrekar","doi":"10.1158/1940-6207.CAPR-25-0180","DOIUrl":"10.1158/1940-6207.CAPR-25-0180","url":null,"abstract":"<p><p>The aim was to assess whether subject's participation in early-phase chemoprevention trials was satisfactory and to identify features associated with subjects' satisfaction. Thirteen trials that investigated a range of candidate agents from 2006-2021 by the Cancer Prevention Network were included. The 5-item \"Was It Worth It?\" (WIWI) questionnaire was administered to all subjects at the end of each trial's intervention or at early termination. Satisfied overall was defined as a participant response of \"yes\" to the first three questions. Six hundred ninety-one participants from the United States, Canada, Puerto Rico, and Honduras enrolled on a trial. Six hundred fifty-two (94.4%) completed the WIWI. Of these, 493 (75.6%) were White, non-Hispanic/Latino; 39 (6.0%) Black, non-Hispanic/Latino; 98 (15.0%) Hispanic/Latino; and 8 (1.2%) of another race/ethnicity. One hundred ninety-three were women (29.6%), 121 (17.5%) were ≥65 years, and 517 (79.3%) participated in a placebo-controlled trial. Eighty-five percent indicated being satisfied overall. Compared with White, non-Hispanic/Latino, the odds of not satisfied overall were 2.96 times higher for Black/Asian/>1race, non-Hispanic/Latino (P<0.001) and 0.40 times lower for Hispanic/Latino (P=0.004). The odds of not satisfied overall was 1.9 times higher when the number of preintervention adverse events (AEs) experienced was ≥1 (P=0.012); 1.8 times higher when the percentage of the intervention duration with AEs was >5% (P=0.024); and 7.4 times higher for subjects who terminated the intervention early (P<0.001). These findings can inform the design of future chemoprevention trials and help investigators improve accrual, retention, adherence, and diversity in this underexplored research setting.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980204","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":"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":"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 the risk of biliary tract cancer (BTC), results have been inconsistent. In this study, 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 HRs and 95% confidence intervals (CI) using a weighted Cox proportional hazards model. TP53 rs1042522 showed a statistically significant association with the 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 seemed to be associated with BTC risk in a recessive model, but not in a dominant model. On comparison of three BTC subtypes, TP53 rs1042522 seemed 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 nonsignificant 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 the TP53 rs1042522 polymorphism and the 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><p><strong>Prevention relevance: </strong>This prospective study highlights the effect of TP53 rs1042522 on BTC risk in Japanese individuals. Identifying carriers of the high-risk CC genotype may facilitate targeted surveillance and early detection strategies, potentially reducing mortality and improving outcomes. Further large-scale studies are required to clarify environmental interactions and optimize prevention.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"551-559"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","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}
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, Loϊc Le Marchand, Yohei Masugi, Fränzel J B van Duijnhoven, Tomotaka Ugai, Shuji Ogino, Jonathan A Nowak, Ulrike Peters, Amanda I Phipps
{"title":"Associations between Calcium Intake and T-cell Infiltration in Colorectal Tumors.","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, Loϊc Le Marchand, Yohei Masugi, Fränzel J B van Duijnhoven, Tomotaka Ugai, Shuji Ogino, Jonathan A Nowak, Ulrike Peters, Amanda I Phipps","doi":"10.1158/1940-6207.CAPR-25-0023","DOIUrl":"10.1158/1940-6207.CAPR-25-0023","url":null,"abstract":"<p><p>Higher T-cell infiltration in colorectal tumors has been associated with better prognosis. Evidence indicates that calcium signaling is essential for T-cell 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 tumor microenvironment of colorectal cancer. In total, 943 participants from three cohort studies, for which data on tumor-infiltrating T cells and calcium intake were 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, and di-(4-amidinophenyl)-1H-indole-6-carboxamidine). Associations between prediagnostic calcium intake and densities of nonoverlapping 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-cell density in the epithelial (OR, 1.57; 95% confidence interval, 1.13-2.24) and stromal (OR, 1.24; 95% confidence interval, 1.06-1.45) tumor tissue areas. 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 tumor tissue areas but not with the infiltration of CD4+ or CD8+ T cells. More research is needed to further unravel the role of calcium in tumor-immune profiles and associations with clinical outcomes. Our findings offer a promising basis for further research.</p><p><strong>Prevention relevance: </strong>Our research contributes to the understanding of how diet could influence immune cell infiltration in and around the tumor. Understanding which factors influence antitumor immune responses is of importance in the prevention of cancer recurrence and/or progression.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"561-571"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082569","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}
Laura Palmieri, Fernando T Zamuner, Dieila Giomo de Lima, Keerthana Gosala, Eli Winkler, Yash Prashar, Ana Purcell-Wiltz, Amanda García-Negrón, Ashley Ramos-Lopez, Josefina Romaguera, Bruce J Trock, Teresa Díaz-Montes, David Sidransky, Mariana Brait, Rafael Guerrero-Preston
{"title":"CervicalMethDx: A Precision DNA Methylation Test to Identify Risk of High-Grade Intraepithelial Lesions in Cervical Cancer Screening Algorithms.","authors":"Laura Palmieri, Fernando T Zamuner, Dieila Giomo de Lima, Keerthana Gosala, Eli Winkler, Yash Prashar, Ana Purcell-Wiltz, Amanda García-Negrón, Ashley Ramos-Lopez, Josefina Romaguera, Bruce J Trock, Teresa Díaz-Montes, David Sidransky, Mariana Brait, Rafael Guerrero-Preston","doi":"10.1158/1940-6207.CAPR-25-0029","DOIUrl":"10.1158/1940-6207.CAPR-25-0029","url":null,"abstract":"<p><p>Cervical cancer is one of the most common cancers in women. Despite progress in prevention and success in early detection through cytologic screening and human papillomavirus (HPV) detection, there remains a challenge in triaging women appropriately to colposcopy and biopsy. We sought to validate the CervicalMethDx test, a precision DNA methylation classifier for cervical cancer detection, as a reflex test in women with HPV-positive samples. A blinded retrospective study was performed on well-characterized samples in PreservCyt media from a large referral clinical laboratory in the United States. DNA methylation was assessed in three gene promoters (ZNF516, FKBP6, and INTS1) and a control gene (β-actin) by quantitative real-time methylation-specific PCR (qMSP) analysis, using machine learning algorithms. We compared DNA methylation levels in HPV-positive patients presenting with lesions in the Pap test and cervical intraepithelial neoplasia grade 2 (CIN2) or CIN3 histologic diagnosis with DNA methylation levels in HPV-positive patients with lesions in the Pap test but no intraepithelial lesion or malignancy. The CervicalMethDx test correctly classified 95% of the CIN2 samples (n = 210), with 91% sensitivity, 100% specificity, and an area under the ROC curve (AUC) of 0.96, and 94% of CIN3 samples (n = 141), with 90% sensitivity, 100% specificity, and an AUC of 0.96. Moreover, the CervicalMethDx test correctly classified 94% of combined CIN2/CIN3 samples (n = 351), with 93% sensitivity, 97% specificity, and an AUC of 0.96. CervicalMethDx demonstrated strong discriminatory power for identifying CIN2/CIN3 risk and may complement current triage strategies for colposcopy referral. Prospective, population-based studies, including those in low-resource settings, are needed for further evaluation.</p><p><strong>Prevention relevance: </strong>The CervicalMethDx test integrates DNA methylation analysis and machine learning to improve early detection of high-grade cervical lesions (high-grade squamous intraepithelial lesions), offering a noninvasive, cost-effective screening tool. Enhanced risk stratification and overtreatment reduction expand equitable access to precision prevention programs. Further validation will clarify CervicalMethDx's alignment with global cervical cancer prevention strategies.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"531-540"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174604","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}
Sarah P Blagden, Kevin W Dodd, Karen Brown, Eva Szabo
{"title":"Precision Prevention Studies: A Targeted Approach to Cancer Prevention.","authors":"Sarah P Blagden, Kevin W Dodd, Karen Brown, Eva Szabo","doi":"10.1158/1940-6207.CAPR-25-0035","DOIUrl":"10.1158/1940-6207.CAPR-25-0035","url":null,"abstract":"<p><p>Precision prevention trials are biologically driven interception studies conducted in high cancer risk groups. These are smaller, potentially faster, cheaper, and more commercially attractive than traditional large-scale population prevention studies. In this article, we discuss the key challenges of conducting precision prevention research and their mitigations.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"499-507"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577039","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}
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
{"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":"10.1158/1940-6207.CAPR-24-0401","url":null,"abstract":"<p><p>Black individuals are disproportionately burdened by prostate cancer compared with White individuals. The mitochondrion is an untapped source for prostate cancer biomarkers, and previous work has shown that 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 prostate cancer in a racially specific manner. Circulating cell-free mtDNA copy number from plasma and mtDNA copy number from white blood cells (WBC) were measured in 199 patients undergoing biopsy (50:50 White cases/controls and 50:49 Black cases/controls). mtDNA copy number was determined via Droplet Digital PCR. Logistic regressions tested associations between mtDNA and prostate cancer by race. The 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 with 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 prostate cancer for White patients only. Elevated mtDNA copy number was more accurate in predicting prostate cancer in White patients than in Black patients. Higher mtDNA copy number levels were associated with prostate cancer in both Black and White patients. Plasma mtDNA may be more accurate than WBC mtDNA in predicting prostate cancer incidence in Black men. Overall, Black controls had higher mtDNA copy number levels than White controls, suggesting mtDNA copy number may be implicated in prostate cancer health disparities.</p><p><strong>Prevention relevance: </strong>Our study shows that mtDNA copy number is a significant predictor of prostate cancer in White individuals, suggesting its potential use in early detection and prevention strategies. The absence of this association in Black individuals highlights the need for race-specific biomarkers in prostate cancer prevention efforts.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"541-550"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030101","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}
Lukmon M Raji, Monowarul M Siddique, Margaret S Bohm, Joseph F Pierre, Mary C Playdon, Scott A Summers, Bing Li, Katherine L Cook, E Angela Murphy, Liza Makowski
{"title":"Murine Models of Obesity-Related Cancer Risk.","authors":"Lukmon M Raji, Monowarul M Siddique, Margaret S Bohm, Joseph F Pierre, Mary C Playdon, Scott A Summers, Bing Li, Katherine L Cook, E Angela Murphy, Liza Makowski","doi":"10.1158/1940-6207.CAPR-24-0545","DOIUrl":"10.1158/1940-6207.CAPR-24-0545","url":null,"abstract":"<p><p>Obesity is a global menace that has impacted more than 14% of adults worldwide and more than a third of Americans. Importantly, obesity is associated with an increased risk of more than 13 types of cancer and worse outcomes, including increased mortality. This review focuses on the importance of considering obesity and metabolic dysfunction in cancer risk as part of the NCI's funded consortium known as the Metabolic Dysfunction and Cancer Risk Program. It describes previous and ongoing mouse models used in studies conducted by Metabolic Dysfunction and Cancer Risk Program consortium members, as well as other relevant studies. Most cancer studies examine tumor progression, metastasis, or recurrence, which are consequences following tumor onset; however, this approach does not consider risk per se. To truly model cancer risk, parameters to measure include the quantification of cancer onset, measured as incidence or latency. Investigators must be cognizant of many factors in study design, including the choice of cancer model and genetic strain. Preclinical approaches addressing risk typically include genetically engineered mouse models or the administration of irritants or carcinogens. We also discuss the transplantation of cells or tumors such as allografts or xenografts, with a focus on tumor rejection or regression to approximate cancer risk, not cancer progression. Herein, we highlight two cancers, breast and colorectal cancers, in which risk is associated with obesity and discussed varied murine model approaches, as well as key findings that explore cancer risk, prevention, or interception.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"509-529"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287410","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}