Cancer Causes & Control最新文献

{"title":"Cervical cancer screening rates in females living with HIV at three healthcare settings in the United States, 2010-2019.","authors":"Leigh Sheridan, Gaia Pocobelli, Melissa Anderson, Christopher I Li, Gina R Kruse, Jasmin A Tiro, Aruna Kamineni","doi":"10.1007/s10552-024-01937-6","DOIUrl":"10.1007/s10552-024-01937-6","url":null,"abstract":"<p><strong>Purpose: </strong>Females living with human immunodeficiency virus (FLWHIV) are at increased risk of cervical cancer and U.S. guidelines, first published in 2009 and updated since then, recommend more frequent screening in this population. We examined screening rates among FLWHIV in the U.S. during 2010-2019.</p><p><strong>Methods: </strong>This cohort study included 18-89-year-old FLWHIV during 2010-2019 at three U.S. healthcare settings. Sociodemographics, comorbidities, and cervical cancer screening tests were ascertained from administrative and clinical databases. We reported cervical cancer screening rates overall and by modality. Generalized estimating equations with Poisson distribution were used to estimate screening rate ratios (SRRs) and 95% confidence intervals (CIs) for the associations between screening rates and calendar year, age, race and ethnicity, and comorbidity.</p><p><strong>Results: </strong>Among 3,556 FLWHIV, a total of 7,704 cervical cancer screening tests were received over 18,605 person-years during 2010-2019 (screening rate = 41.4 per 100 person-years). Relatively lower screening rates were associated with later calendar years (SRR = 0.71 [95% CI 0.68-0.75] for 2017-2019 versus 2010-2013), older age (SRR = 0.82 [95% CI 0.74-0.89] for 50-65-year-olds versus 18-29-year-olds), non-Hispanic white race versus non-Hispanic Black race (SRR = 0.89 [95% CI 0.81-0.98]) and greater comorbidity burden (SRR = 0.89 [95% CI 0.82-0.98] for ≥ 9 versus 0-6 comorbidity score).</p><p><strong>Conclusion: </strong>The decrease in cervical cancer screening rates during 2010-2019 in this large cohort of FLWHIV may be explained at least partly by guideline changes during the study period recommending longer screening intervals. Our findings of relatively lower screening rates in FLWHIV who were non-Hispanic white, older, and with greater comorbidity burden should be confirmed in other U.S.</p><p><strong>Settings: </strong></p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"275-284"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis impact and clinical findings in renal cancer patients: comparative analysis between public and private health coverage in a cross-sectional and multicenter context.","authors":"Eduardo Barrera-Juarez, Antonio Nassim Halun-Trevino, Manuel Ruelas-Martinez, Andres Madero-Frech, Victor Camacho-Trejo, Miguel Estrada-Bujanos, David Bojorquez, Jhonatan Uribe-Montoya, Francisco Rodriguez-Covarrubias, Cynthia Villarreal-Garza","doi":"10.1007/s10552-024-01891-3","DOIUrl":"10.1007/s10552-024-01891-3","url":null,"abstract":"<p><strong>Purpose: </strong>Research on disparities in prognosis and clinical characteristics between public and private healthcare sectors in developing countries remains limited. The study aimed to determine whether patients with public health coverage (1) have a greater mean tumor size at diagnosis compared to those with private health coverage; (2) exhibit differences in clinical staging and TNM classification between groups; and (3) show variations in demographic, clinical characteristics, histopathological findings, and surgical approaches among cohorts.</p><p><strong>Methods: </strong>A cross-sectional, multicenter study was conducted on 629 patients from both private and public healthcare sectors, all histologically confirmed and surgically treated for Renal Cell Carcinoma (RCC), between 2011 and 2021 in high-volume hospitals in Monterrey, Mexico. To compare variables between groups, we employed independent samples t-tests, Mann Whitney U nonparametric test, along with Pearson's chi-square test complemented by post hoc analyses.</p><p><strong>Results: </strong>Mean tumor size in the public group was 1.9 cm greater than in the private group (7.39 vs. 5.51 cm, p < 0.001). Patients in the public sector more frequently presented with larger tumors, a higher prevalence of risk factors (excluding BMI and hypertension), advanced disease (OR 2.12, 95% CI 1.43-3.16, p < 0.001), presence of symptoms, elevated TNM, lymphovascular invasion and a lower prevalence of minimally invasive surgery. A male-to-female ratio of 2.6:1 was noted in the private coverage group.</p><p><strong>Conclusions: </strong>This study highlights a notable association between public health coverage and a higher prevalence of advanced RCC, with tumors in private coverage patients being smaller yet larger than commonly reported. There is a crucial need to develop new health policies for early detection of renal cancer in developing countries.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"265-273"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longer travel times to acute hospitals are associated with lower likelihood of cancer screening receipt among rural-dwelling adults in the U.S. South.","authors":"Arrianna Marie Planey, Sandy Wong, Donald A Planey, Fikriyah Winata, Michelle J Ko","doi":"10.1007/s10552-024-01940-x","DOIUrl":"10.1007/s10552-024-01940-x","url":null,"abstract":"<p><strong>Purpose: </strong>Given rural hospitals' role in providing outpatient services, we examined the association between travel burdens and receipt of cancer screening among rural-dwelling adults in the U.S. South region.</p><p><strong>Methods: </strong>First, we estimated network travel times and distances to access the nearest and second nearest acute care hospital from each rural census tract in the U.S. South. After appending the Centers for Disease Control's PLACES dataset, we fitted generalized linear mixed models.</p><p><strong>Results: </strong>Longer distances to the second nearest hospital are negatively associated with breast, colorectal, and cervical cancer screening receipt among eligible rural-dwelling adults. Rural-dwelling women in counties with 1 closure had reduced likelihood of breast cancer screening. Residence in a partial- or whole-county Health Professional Shortage Area (HPSA) was negatively associated with cancer screening receipt. Specialist (OB/GYN and gastroenterologist) supply was positively associated with receipt of cancer screening. Uninsurance was positively associated with cervical and breast cancer screening receipt. Medicaid expansion was associated with increased breast and cervical cancer screening.</p><p><strong>Conclusions: </strong>Rural residents in partial-county primary care HPSAs had the lowest rates of breast, cervical, and colorectal cancer screening, compared with whole-county HPSAs and non-shortage areas. These residents also faced the greatest distances to their nearest and second nearest hospital. This is notable because rural residents in the South face greater travel burdens for cancer care compared with residents in other regions. Finally, the positive association between uninsurance and breast and cervical cancer screening may reflect the CDC's National Breast and Cervical Cancer Early Detection Program's effectiveness.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"297-308"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between the mental health disorders, substance abuse, and tobacco use with head & neck cancer stage at diagnosis.","authors":"Joanna Woersching, Janet H Van Cleave, Jason P Gonsky, Chenjuan Ma, Judith Haber, Deborah Chyun, Brian L Egleston","doi":"10.1007/s10552-024-01921-0","DOIUrl":"10.1007/s10552-024-01921-0","url":null,"abstract":"<p><strong>Purpose: </strong>Mental health disorders, substance abuse, and tobacco use are prevalent in the US population. However, the association between these conditions and head and neck cancer (HNC) stage is poorly understood. This research aims to uncover the relationship between pre-existing mental health disorders, substance abuse, and tobacco use and HNC stage at diagnosis in patients receiving care in an integrated, public safety-net healthcare system.</p><p><strong>Methods: </strong>This study was a secondary data analysis of linked hospital tumor registries and electronic health record (EHR) data. The study's primary independent variables were the comorbidities of mental health disorders, substance abuse, and tobacco use. The dependent variable was HNC stage at diagnosis, operationalized as early stage (i.e., stages I, II, and III) and advanced stage (stage IV, IVA, IVB, or IVC). The analysis included multivariable logistic regression adjusted for covariates of demographic variables, tumor anato RESULTS: The study population consisted of 357 patients with median age of 59 years, and was primarily male (77%), diverse (Black or African American 41%; Hispanic 22%), and from neighborhoods with low income (median average annual household income $39,785). Patients with a history of mental health disorders with or without tobacco use had significantly lower odds of advanced stage HNC at diagnosis (adjusted OR = 0.35, 95% Confidence Interval [CI]: 0.17-0.72.) while patients with a history of substance abuse with or without tobacco use had significantly higher odds of advanced stage HNC at diagnosis (adjusted OR 1.41, 95% CI: 1.01-1.98) than patients with no history of mental health disorders, substance abuse, or tobacco use.</p><p><strong>Conclusions: </strong>The relationship between HNC stage at diagnosis and the comorbidities of mental health disorders, substance abuse, or tobacco differs depending on the type and co-occurrence of these comorbidities. These findings demonstrate the need for innovative care delivery models and education initiatives tailored to meet the needs of patients with mental health disorders, substance abuse, and tobacco use that facilitate early detection of HNC.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"231-242"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: remaining questions on moderate alcohol drinking and cancer risk.","authors":"Edward Giovannucci","doi":"10.1007/s10552-025-01975-8","DOIUrl":"https://doi.org/10.1007/s10552-025-01975-8","url":null,"abstract":"<p><p>In January 2025, the United States Surgeon General issued an advisory describing the scientific evidence for the causal link between alcohol consumption and increased cancer risk. The report is timely as the link between alcohol and cancer is well established. Few would dispute the generally adverse effects of alcohol consumption on cancer risk and overall health with excessive levels of intake. More controversy exists at light-to-moderate levels of intake, such as not exceeding 2 drinks per day for men or 1 drink per day for women. Cancer risk may be the biggest concern in the low-moderate range of drinking as about one-quarter of cancer cases attributable to alcohol consumption arise in those consuming two or fewer alcoholic drinks daily. In moderate alcohol consumers, four modifying factors merit consideration, tobacco use, drinking frequency, whether drinking is with meals or on an empty stomach, and beverage type. Conclusions based simply on the overall dose-response without considering these factors is inadequate. A more thorough synthesis of the current literature and new studies and analyses designed to address these questions is imperative for developing practical recommendations for low-to-moderate alcohol drinking.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of prolonged treatment delay among patients with common cancers in the Philippines.","authors":"Jansen M Cambia, Arnat Wannasri, Edmund Cedric A Orlina, Gehan Alyanna C Calvez, Wilma M Grafilo, Jason J Liu","doi":"10.1007/s10552-025-01969-6","DOIUrl":"https://doi.org/10.1007/s10552-025-01969-6","url":null,"abstract":"<p><strong>Purpose: </strong>Prolonged treatment delay often leads to adverse cancer prognosis. However, the demographic and clinical predictors of higher treatment delay burden in the Philippines have not been thoroughly evaluated.</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study on patients diagnosed with common cancers who received cancer treatment, to quantify the burden of prolonged treatment delay in the Philippines among this population. We analyzed 20,654 patients with common cancers from the Department of Health-Rizal Cancer Registry. The Poisson regression model with robust variance was used to identify demographic and clinical predictors of prolonged treatment delay. In addition, we examined the associations among those receiving different initial treatment types, including surgery, radiotherapy, and chemotherapy.</p><p><strong>Results: </strong>We found 35.1 % of the studied cancer patients experienced initial treatment delay of more than 30 days, as well as 25.2 % and 20.0 % experiencing treatment delays exceeding 60 and 90 days, respectively. We found higher risk of prolonged treatment delay of more than 90 days in those with 0-19 years of age at diagnosis, male gender, cancer treatment at non-private hospitals, diagnoses during the 1990s, more advanced cancer stages, and non-surgical initial treatments. For patients with surgery as the initial treatment, younger age at cancer diagnosis was not significantly associated with increased burden of prolonged treatment delay, unlike for those initially treated with radiotherapy or chemotherapy.</p><p><strong>Conclusion: </strong>By identifying the characteristics of treated cancer patients with higher risk of protracted treatment delay, our findings will inform the national cancer control program to especially target those patients for treatment delay reduction.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing motivational interviewing to improve endocrine therapy adherence among breast cancer patients: a qualitative process evaluation of the getset pilot intervention.","authors":"Victoria J Dunsmore, Charlotte Ellis, Sarah Drier, Austin R Waters, Niasha Fray, Christina Stylianou, Jennifer C Spencer, Katherine E Reeder-Hayes, Stephanie B Wheeler","doi":"10.1007/s10552-025-01971-y","DOIUrl":"https://doi.org/10.1007/s10552-025-01971-y","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the implementation of the GETSET (Guiding Endocrine Therapy Success through Empowerment and Teamwork) pilot, a motivational interviewing (MI) intervention aimed at improving endocrine therapy (ET) adherence among patients with breast cancer.</p><p><strong>Methods: </strong>Using the Consolidated Framework for Implementation Research (CFIR), qualitative interviews were conducted with site staff (N = 2), patients (N = 4), and counselors (N = 2).</p><p><strong>Results: </strong>The thematic analysis identified facilitators such as high-quality materials, ease of scheduling sessions, and effective communication among staff. However, barriers included lack of personalization and systemic issues like understaffing.</p><p><strong>Conclusions: </strong>The study underscores the need to adapt implementation of behavioral interventions in a healthcare setting to improve ET adherence. As this was a process evaluation of a pilot study, future work should evaluate the barriers and facilitators to a larger clinical trial to identify if the same strategies should be refined.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating healthcare utilization databases for cancer ascertainment in a prospective cohort in a limited resource setting: the Mexican Teachers' Cohort.","authors":"Liliana Gómez-Flores-Ramos, Marion Brochier, Dalia Stern, Antonio García-Anaya, Adrian Cortés-Valencia, Jocelyn Jaen, Hugo R Sánchez-Blas, Susana Lozano-Esparza, Andrés Catzin-Kuhlmann, Juan Eugenio Hernández-Ávila, Angélica Pon, Olga Rivera-Ontiveros, Pabel Miranda-Aguirre, Patricia Pérez-Escobedo, Alberto Castellanos, Mildred Chávez-Cárdenas, Oscar Arrieta, Alejandro Mohar, Ruy López-Ridaura, Isabelle Romieu, Mauricio Hernández-Avila, Martín Lajous","doi":"10.1007/s10552-025-01973-w","DOIUrl":"https://doi.org/10.1007/s10552-025-01973-w","url":null,"abstract":"<p><strong>Purpose: </strong>Prospective cohort development in low-resource settings may be limited by cancer registry population coverage; however, information routinely collected in health systems may offer opportunities to advance cancer research. We aim to illustrate in a cohort study in Mexico, a cancer ascertainment strategy that integrates multiple sources of information including healthcare utilization databases.</p><p><strong>Methods: </strong>The Mexican Teachers' Cohort (MTC) includes 114,545 female teachers aged 25 years and older who completed a baseline questionnaire between 2006 and 2010 and were breast cancer free. We used healthcare utilization databases (including electronic health records), self-reported breast cancer, mortality, and cancer registries to identify women with incident breast cancer. We estimated the positive predictive value for self-reported breast cancer and age-specific and age-standardized incidence rates for breast cancer and corresponding 95% confidence intervals (95%CI) calculating person-time from the date of baseline questionnaire response to diagnosis, death, or December 31, 2019.</p><p><strong>Results: </strong>Between baseline and 2019, we identified 1,313 women with incident breast cancer. We established the diagnosis in 88% using healthcare utilization databases, 6% using cancer and mortality registries, and 6% directly by contacting participants. The positive predictive value of self-reported diagnosed and treated breast cancer was 94% (95%CI 91, 97). The age-standardized incidence was 77.0 per 100,000 person-years (95%CI 75.9, 84.3). The highest incidence was observed in women aged 65-69 years (185.3 per 100,000 person-years).</p><p><strong>Conclusion: </strong>Leveraging healthcare utilization databases to establish cancer diagnoses within prospective cohorts may offer an opportunity to advance global cancer research.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index and colorectal cancer screening among cancer survivors: the role of sociodemographic characteristics.","authors":"Tsai Meng-Han, Pollard Elinita, Vernon Marlo, Chen Jie","doi":"10.1007/s10552-025-01970-z","DOIUrl":"https://doi.org/10.1007/s10552-025-01970-z","url":null,"abstract":"<p><p>We examined the association between body mass index (BMI) and guideline-concordant colorectal cancer (CRC) screening utilization among cancer survivors while considering the role of sociodemographic characteristics using a representative sample of the United States. We conducted a cross-sectional analysis utilizing data from the 2022 and 2020 Behavioral Risk Factor Surveillance System. Our outcome of interest was guideline-concordant CRC screening utilization and our exposure of interest was BMI. We performed weighted descriptive statistics and multivariable logistic regression analysis to examine the mentioned associations. Among 44,244 eligible cancer survivors, those who were overweight (84%) had the greatest CRC screening use, followed by those who were obese (81.3%), and underweight/normal weight (79.2%; p values < 0.001). Multivariable logistic regression analysis revealed those who were overweight or obese compared to underweight/normal weight had 1.2-1.3-fold increased odds of having guideline-concordant CRC screening (overweight: OR: 1.27; 95% CI: 1.09-1.49; obese: OR: 1.18; 95% CI: 1.00-1.39). Our subpopulation analyses within the levels of BMI showed that females who were overweight (OR: 0.83; 95% CI: 0.69-1.00) and non-Hispanic other (NHO) survivors who were underweight/normal weight (OR: 0.47; 95% CI: 0.24-0.91) were 17%-53% less likely to be screened for CRC. Our findings indicate that BMI was positively associated with guideline-concordant CRC screening use among cancer survivors. However, female survivors who were obese and NHO survivors who were underweight/normal weight were less likely to be screened for CRC. Cancer survivorship care that integrates weight management and specific sociodemographic characteristics has potential for improving CRC screening adherence.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic differences in early-onset breast cancer incidence trends in the USA, 2001-2020, is it time for a geographic risk score?","authors":"Rebecca D Kehm, Josephine M Daaboul, Parisa Tehranifar, Mary Beth Terry","doi":"10.1007/s10552-025-01968-7","DOIUrl":"https://doi.org/10.1007/s10552-025-01968-7","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer (BC) incidence is increasing in US women under 40, with variation across racial and ethnic groups. It is not yet known if incidence trends also vary by geography within the USA, which may inform whether place-based exposures contribute to BC risk in younger women.</p><p><strong>Methods: </strong>Using the US Cancer Statistics database, we analyzed age-adjusted BC incidence rates from 2001 to 2020 in women aged 25-39. We calculated the average annual percent change (AAPC) using Joinpoint regression and performed age-period-cohort analyses.</p><p><strong>Results: </strong>From 2001 to 2020, BC incidence in women under 40 increased by more than 0.50% per year in 21 states, while remaining stable or decreasing in the other states. Incidence was 32% higher in the five states with the highest rates compared to the five states with the lowest rates. The Western region had the highest rate of increase (AAPC = 0.76, 95% CI 0.56-0.96), despite having the lowest absolute incidence rate from 2001 to 2020. The Northeast had the highest absolute rate of BC among women under 40 and experienced a significant increase over time (AAPC = 0.59, 95% CI 0.36-0.82). The South was the only region where BC under 40 did not increase from 2001 to 2020.</p><p><strong>Conclusion: </strong>These findings support that BC incidence trends in US women under 40 vary by geography, and the range of state-specific risks was comparable in magnitude to other risk measures, such as polygenic risk scores. This suggest that incorporating place-based factors alongside established risk factors into risk prediction may improve our ability to identify groups of younger women at higher risk for early-onset BC.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}