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

{"title":"Barriers to Diagnostic Colonoscopy After a Positive Stool-Based Screening Test: A Scoping Review.","authors":"Manali Patel, Paul Gerardo Yeh, Thomas F Imperiale, Victoria L Champion, David R Lairson","doi":"10.1158/1940-6207.CAPR-26-0159","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0159","url":null,"abstract":"<p><p>Non-invasive stool-based colorectal cancer (CRC) screening (e.g., fecal immunochemical test [FIT], guaiac fecal occult blood test [gFOBT], multitarget stool DNA [mt-sDNA]) reduces CRC mortality only when a positive result is followed by timely diagnostic colonoscopy. We synthesized barriers and facilitators to completing diagnostic colonoscopy after a positive stool-based screening test. Guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we searched PubMed and MEDLINE (Ovid) for English-language, peer-reviewed studies (October 2008- June 2025) reporting barriers, facilitators, or determinants of colonoscopy completion after a positive non-invasive stool-based CRC screening test (FIT, gFOBT, or mt-sDNA). Two reviewers independently abstracted study characteristics and coded barriers/facilitators, which were categorized using a socioecological framework (intrapersonal, interpersonal, organizational, community/environmental, policy). 38 studies directly examined colonoscopy follow-up after a positive non-invasive test. Recurrent barriers included fear/anxiety and low perceived risk (intrapersonal), weak provider recommendation and support (interpersonal), referral and tracking failures and scheduling delays (organizational), transportation and distance (community/environmental), and cost-sharing/coverage gaps (policy). Evidence specifically assessing rural-urban differences was limited. Barriers to diagnostic colonoscopy after a positive stool-based CRC screening test are multi-level and potentially modifiable through improved communication, navigation, and closed-loop tracking. Multicomponent approaches that combine clear communication, navigation and reminder systems, transportation supports, and reduced financial barriers may improve diagnostic completion and equity.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852014","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":"Lung cancer screening uptake in patients with rheumatoid arthritis in community settings.","authors":"Maria A Lopez-Olivo, Zhigang Duan, Huifang Lu, Robert J Volk, Edwin J Ostrin, Ying Xu, Sharon Giordano, Hui Zhao","doi":"10.1158/1940-6207.CAPR-26-0030","DOIUrl":"10.1158/1940-6207.CAPR-26-0030","url":null,"abstract":"<p><p>Individuals with rheumatoid arthritis (RA), particularly those with a history of smoking, are at increased risk for lung cancer. However, real-world data on the use of low dose computed tomography (LDCT) screening for lung cancer in this population are lacking. Therefore, we assessed the rates, trends, and predictors of LDCT screening among patients with a smoking history and RA. A retrospective cohort study using the IQVIA PharMetrics® Plus for Academics Closed Health Plan claims database was conducted. Patients with RA diagnosed in 2014-2023, aged 50-77 years, and with a history of smoking and no prior cancer or advanced respiratory illness were identified. LDCT screening was identified using Healthcare Common Procedure Coding System codes. Among 15,341 eligible patients, 997 (6.5%) received LDCT screening; median time from RA diagnosis to first LDCT claim was 452 days. In a sensitivity analysis of 12,301 patients with continuous insurance coverage during the 12 months after RA diagnosis, only 367 (3%) underwent LDCT within the first year after RA diagnosis. Demographic factors such as male sex (aOR=1.24; p=0.003), age 55-69 (aOR=~1.90; p<0.0001), and residence outside the West region (p<0.0001) increased uptake. Clinical characteristics and healthcare utilization such as COPD (aOR=2.85; p<0.0001), more outpatient visits (aOR=2.15-2.41; p< 0.001) and DMARD use (aOR=1.27-1.52; p≤ 0.001) also increased odds, whereas greater comorbidity burden reduced screening (aOR=0.79-0.39; p≤0.006). In conclusion, LDCT rates in patients with RA remained low overall and varied according to demographic and clinical factors. Targeted efforts may be needed to improve screening uptake in this high-risk population.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801742","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":"The Immunological Landscape of Colorectal Pre-Cancers: A Systematic Review.","authors":"Gabriel A Del Carmen, Gregory Deeb, Nan Deng, Krishna M Sinha, Marco Matejcic, Eduardo Vilar, Stephanie L Schmit","doi":"10.1158/1940-6207.CAPR-26-0037","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0037","url":null,"abstract":"<p><p>Colorectal cancer (CRC) develops predominantly through the adenoma-to-carcinoma sequence with immunological processes playing a central yet incompletely understood role in this progression. A systematic review was conducted of published academic literature using Medline, Embase, and Cochrane Library databases to identify studies which examined immune cell infiltration, cytokine profiling, and immune surveillance in colorectal pre-cancers. Studies published between October 1974 and July 2021 were included. Adaptive immune cells demonstrate dynamic infiltration patterns at various points along the adenoma-carcinoma sequence, with certain subsets of these lymphocytes facilitating tumor progression through immunosuppression while others confer protection. In contrast, innate immune cells demonstrate context-dependent roles in which pre-cancers may or may not develop into malignancies. Cytokine networks, particularly IL-6, IL-8, and IL-17, further modulate the tumor microenvironment. The immunological landscape of colorectal pre-cancers is complex, bidirectional, and non-linear in its relationships. Understanding these mechanisms provides a foundation for the development of immunologically informed prevention and early detection and intervention to mitigate CRC burden.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801976","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":"Validation of a Colorectal Cancer Risk Prediction Model in US Black Women.","authors":"Jessica L Petrick, Nelsy Castro-Webb, Gary R Zirpoli, Kerrie P Nelson, Julie R Palmer, Ruth M Pfeiffer","doi":"10.1158/1940-6207.CAPR-24-0151","DOIUrl":"10.1158/1940-6207.CAPR-24-0151","url":null,"abstract":"<p><p>The National Cancer Institute's Colorectal Cancer Risk Assessment Tool (NCI-CCRAT), an absolute risk prediction model, was developed using data from US White men and women. The model's performance has not been assessed for Black Americans, the US racial/ethnic group with the highest colorectal cancer incidence. We externally validated the NCI-CCRAT using data from 53,324 Black Women's Health Study (BWHS) participants aged 40 to 84 years. We predicted 5-year absolute risks using data from 2001 to 2015 in three 5-year prediction periods: 2001 to 2005, 2006 to 2010, and 2011 to 2015. To assess model performance, we computed calibration (expected over observed colorectal cancer cases, E/O) and discriminatory accuracy [area under the receiver operating curve (AUC)]. During follow-up, 433 BWHS participants developed colorectal cancer. Based on the NCI-CCRAT, 579 colorectal cancer cases were expected [E/O = 1.34; 95% confidence interval (CI), 1.22-1.47]. The NCI-CCRAT was well-calibrated in the first 5-year prediction period (2001-2005 E/O = 1.10; 95% CI, 0.94-1.29), but statistically significantly overestimated risk in later periods. We estimated discriminatory accuracy only for the 2001 to 2005 prediction period (151 colorectal cancer cases) and obtained an age-adjusted AUC = 0.62 (95% CI, 0.57-0.66). Associations of vigorous physical activity, aspirin/NSAID use, vegetable intake, and body mass index with colorectal cancer risk were weaker in the BWHS than in the studies used to develop the NCI-CCRAT. The NCI-CCRAT significantly overestimated the number of colorectal cancer cases in BWHS participants, possibly due to population-specific differences in associations of key colorectal cancer risk factors. This suggests that future research needs to determine important predictors of colorectal cancer risk in Black Americans and to develop a colorectal cancer prediction model for Black women.</p><p><strong>Prevention relevance: </strong>We found that the NCI's Colorectal Cancer Risk Assessment Tool overestimated the overall number of colorectal cancer cases by 34% in a cohort of Black women, suggesting that future research needs to determine important predictors of colorectal cancer risk in Black Americans and to develop a colorectal cancer prediction model for Black women.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"453-461"},"PeriodicalIF":2.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846831","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":"Weight Loss and Omega-3 Supplementation Modulate the Microbiome in Women with Increased Breast Cancer Risk.","authors":"Katherine L Cook, Erin D Giles, Josh J Sekela, Joshua B Simpson, Matthew R Redinbo, Adam S Wilson, Shahid Umar, Christie A Befort, Bruce F Kimler, Stephen D Hursting, Carol J Fabian","doi":"10.1158/1940-6207.CAPR-26-0021","DOIUrl":"10.1158/1940-6207.CAPR-26-0021","url":null,"abstract":"<p><p>Obesity is associated with gut dysbiosis, chronic inflammation, and insulin resistance. We assessed the proportional change in fecal microbial populations in a pilot study (n = 34) of peri/postmenopausal women with a body mass index ≥28 kg/m2 who were randomized to receive either 3.25 g/day of omega-3 fatty acids or a placebo during a weight loss intervention. Body composition was assessed using dual X-ray absorptiometry, and fecal and blood samples were collected. The median weight change was -10%. Among participants who lost ≥10% of their weight, those assigned to omega-3 fatty acids showed the greatest decrease in the Firmicutes:Bacteroidetes ratio and displayed favorable changes in systemic biomarkers. Notable increases in the proportional abundance of short-chain fatty acid (SCFA)-producing microbes including Phocaeicola vulgatus and Alistipes putredinis were observed in women receiving omega-3, which correlated with improvements in breast cancer biomarkers such as bioavailable estradiol, adiponectin:leptin ratio, and C-reactive protein levels. Women administered omega-3 fatty acids displayed increased % change in plasma SCFA propionate and decreased butyrate, suggesting that intervention differentially modulated circulating bacteria-derived SCFA metabolites. High-dose omega-3 fatty acids, when added to a behavioral weight loss intervention, promoted beneficial shifts in the gut microbiome and associated with improved breast cancer risk factor biomarkers.</p><p><strong>Prevention relevance: </strong>Obesity is a modifiable risk factor for breast cancer, characterized by chronic inflammation and altered adipokines. This trial addresses the need to enhance weight loss by targeting underlying metabolic and inflammatory drivers. We show that omega-3 polyunsaturated fatty acids (eicosapentaenoic acid/docosahexaenoic acid) shift SCFA-producing microbiota, increase propionate, and correlate with improved breast cancer risk factor biomarkers.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"473-488"},"PeriodicalIF":2.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719018","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":"Simvastatin Treatment in Patients with Liver Cirrhosis: A Phase II Randomized Placebo-Controlled Trial Shows Reduction in IL6 Levels.","authors":"Shehnaz K Hussain, Walid S Ayoub, Marcia Cruz-Correa, Laura M Kulik, Coleman Smith, Luz Maria Rodriguez, Ellen Richmond, Asad Umar, Sandra Davey, Kelly Benante, Tia Schering, Masha Kocherginsky, Ruohui Chen, Xinlei Mi, Seema A Khan, Marc T Goodman","doi":"10.1158/1940-6207.CAPR-25-0241","DOIUrl":"10.1158/1940-6207.CAPR-25-0241","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is a lethal cancer with an increasing burden. Few clinical trials have evaluated preventive strategies for HCC in high-risk patients with liver cirrhosis. Observational studies show that statins are associated with a reduced HCC risk although a causal link has yet to be established. This multicenter randomized double-blinded, placebo-controlled phase II trial of 40 mg/day oral simvastatin to reduce the likelihood of hepatocarcinogenesis was conducted at four sites in the United States. The primary outcome was the change in serum α-fetoprotein (AFP)-L3% from baseline to 6 months. Secondary biomarker endpoints include changes in serum AFP, serum IL6, serum deoxycholic acid, liver stiffness, Model for End-Stage Liver Disease score, and Fibrosis-4 index score. Comparisons were made using paired t tests or the Wilcoxon rank-sum test. Forty-five participants completed the intervention and final study assessments [mean age, 58 years; female, 42%; Asian, 2.2%; Black or African American, 11%; White, 87%; Hispanic or Latino, 51%; Child-Pugh (CP) A, 69%; CP B, 16%]. Of 45 participants, 10 (22%) had detectable AFP-L3%, which did not differ between the intervention arms. Serum IL6 levels, detectable in all participants, decreased significantly in the simvastatin group compared with the placebo group (P = 0.02). The number and grade of adverse events did not differ between groups. In this randomized controlled trial, simvastatin was well tolerated in patients with liver cirrhosis but did not result in a decrease in AFP-L3%, potentially owing to the low number of participants with detectable AFP/AFP-L3%. Simvastatin did result in a decrease in IL6, offering one potential anticancer mechanism of simvastatin in the setting of cirrhosis.</p><p><strong>Prevention relevance: </strong>Increasing liver cancer incidence parallels cirrhosis related to nonalcoholic steatohepatitis. Statins have the potential to arrest cirrhosis progression and prevent liver cancer. In a phase IIB trial randomizing patients with cirrhosis to simvastatin versus placebo, we found that simvastatin decreased the inflammation biomarker IL6, but not the primary endpoint of AFP-L3.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"463-471"},"PeriodicalIF":2.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273954","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":"Editors' Selections from Relevant Scientific Publications.","authors":"","doi":"10.1158/1940-6207.CAPR-19-8-HFL","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-19-8-HFL","url":null,"abstract":"","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"19 8","pages":"433"},"PeriodicalIF":2.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665067","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":"Early Detection of Cancer in Medically Underserved Populations.","authors":"Ernest T Hawk, Stephanie L Martch","doi":"10.1158/1940-6207.CAPR-26-0078","DOIUrl":"10.1158/1940-6207.CAPR-26-0078","url":null,"abstract":"<p><p>Limited access to healthcare due to poverty, lack of insurance, and/or excessive distance from healthcare services has been highlighted as a significant contributor to poor outcomes related to cancer incidence and cancer-related morbidity, survival, and mortality. Moreover, America's primary reliance on employer-based health insurance means that those living without employment or in poverty frequently cannot afford healthcare and therefore experience poorer health outcomes. Because cancer screening that allows for early cancer detection saves lives, it is imperative that research on how to improve and increase cancer-related screening and early detection services for the medically underserved be prioritized and acted upon by policymakers and others responsible for implementing scientific discoveries to improve cancer-related population health.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"19 8","pages":"435-441"},"PeriodicalIF":2.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665049","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":"Oral Microbiota in Early- and Late-Onset Tongue Cancers: A Pilot Case-Control Study.","authors":"Krithiga Shridhar, Arvind Krishnamurthy, Vijayalakshmi Ramshankar, Siddhartha Mandal, Toral Vaishnani, Spandan Chaudhary, Aastha Aggarwal, Rupak Shivakoti","doi":"10.1158/1940-6207.CAPR-25-0538","DOIUrl":"10.1158/1940-6207.CAPR-25-0538","url":null,"abstract":"<p><p>Evidence for the role of oral microbiota in tongue cancers is limited despite early-onset and unexplained etiology. We assessed oral microbiota profiles in saliva among participants with tongue cancers in the oral cavity compared with cancer-free controls. We conducted a case-control study in a tertiary care cancer hospital in Chennai, South India. Cases (N = 31) were those with newly diagnosed, pretreatment, biopsy-confirmed, early-stage (<4 cm size) tongue cancers, further classified as early-onset [diagnosed at 20-49 years (N = 12)] or late-onset cancers [diagnosed ≥50 years (N = 19)] for secondary exploratory analyses. Cancer-free controls (N = 31) were unrelated and frequency-matched to the cases on age and sex. Bacterial characterization of saliva was performed using 16S rRNA sequencing. Analyses (n = 175 genera) included linear regression for α-diversity, constrained analysis of principal coordinates, permutational multivariable analysis of variance for β-diversity, and analysis of compositions of microbiomes with bias correction for taxa abundance. We also examined differences in established bacterial pathogens selected a priori. The median age of participants was 52 years, and a third were women. Although there was no difference in α-diversity, β-diversity showed distinct clustering of bacterial genera in controls, early-onset, and late-onset cases. In overall and early-onset cases (vs. controls), genera Eikenella and Campylobacter showae were enriched. Furthermore, in early-onset cases (vs. controls), genera Alloprevotella, Comamonas, and Aggregatibacter were enriched, Oribacterium was depleted, and W5053 had differentially absent patterns. Beyond the established pathogens, this study offers important leads for future etiologic investigations, particularly in exploratory analyses of early-onset tongue cancers in the oral cavity.</p><p><strong>Prevention relevance: </strong>This pilot study identified differences in overall microbiota and specific bacteria between cancer-free controls and tongue cancer cases in the oral cavity, specifically for early-onset cancers. The identified bacteria, including novel ones, can further be studied as salivary biomarkers for early-onset tongue cancers and to determine causality for prevention.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"443-451"},"PeriodicalIF":2.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846813","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":"TP53-mutated preneoplastic colonies, adaptive immune response, and risk for lung cancer and COPD.","authors":"James C Willey, Andrew R Boring, Erin L Crawford, Kevin N Lei, Thomas M Blomquist, Christopher I Amos, Stephen A Deppen, Eric L Grogan, Heidi Chen, Mohamed Omballi, Daniel J Craig","doi":"10.1158/1940-6207.CAPR-26-0112","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0112","url":null,"abstract":"<p><p>Our purpose was to better characterize the prevalence and size distributions of TP53-mutated preneoplastic colonies in relationship to risk for lung cancer (LC) and chronic obstructive pulmonary disease (COPD). Ultra-sensitive next-generation sequencing (US-NGS) was used to assess TP53-mutated preneoplastic colonies comprising as few as 100 cells in airway epithelium. Specimens from 59 subjects with heavy smoking history were assessed in four cohorts: LC with (N=14) or without COPD (N=16) and non-LC with (N=7) or without COPD (N=22). TP53-mutated preneoplastic colony prevalence was higher in LC subjects with or without COPD and in COPD subjects without LC (P<0.01). A higher prevalence of colonies driven by the subset of TP53 mutations known to be neoantigenic in cancer tissue was nominally significant (P<0.05). TP53-mutated colony distributions skewed to larger sizes among LC subjects and skewed greater among subjects with both COPD and active cigarette smoking (P<0.01), each of which is associated with adaptive immune inflammation. Thus, consistent with prior studies, TP53-mutated colony prevalence and size distribution measured in non-malignant airway epithelium improved characterization of LC and COPD risk. Further, these colonies may stimulate adaptive immune response and inflammation that is mechanistically associated with COPD. A skew to larger colonies is consistent with selection for immune surveillance avoidance characteristics and may provide a metric for both LC risk and immune surveillance function. Among healthier non-COPD smokers who are ineligible for lung cancer screening based on demographic criteria, a positive TP53 biomarker test may identify LC risk sufficiently high to warrant screening eligibility.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581240","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}