Cancer Epidemiology Biomarkers & Prevention最新文献

{"title":"INCREASED PREVALENCE OF PANCREATIC CYSTS IN NONSECRETOR (FUT2 NULL) INDIVIDUALS UNDER PANCREATIC SURVEILLANCE.","authors":"Yuto Hozaka, Masataka Hayashi, Emy Abou Sleiman, Bryson W Katona, Randall E Brand, Sapna Syngal, Matthew B Yurgelun, James J Farrell, Amitabh Chak, Elena M Stoffel, Tamas A Gonda, Mohamad Dbouk, Elham Afghani, Jin He, Ralph H Hruban, James R Eshleman, Marcia Irene Canto, Michael G Goggins","doi":"10.1158/1055-9965.EPI-26-0807","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0807","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic surveillance commonly detects pancreatic cysts, most of which are presumed intraductal papillary mucinous neoplasms (IPMN). FUT2, the gene responsible for secretor status, has been implicated in IPMN development, although not with pancreatic cancer risk.</p><p><strong>Methods: </strong>We evaluated the association between inactivating variants in FUT2, FUT3 and ABO and pancreatic cysts in 1,865 patients in the multicenter Cancer of the Pancreas Screening (CAPS) cohort. Multivariable logistic regression was performed to estimate adjusted odds for presumed IPMN prevalence. A Johns Hopkins surgical cohort of 1582 patients with IPMN, pancreatic ductal adenocarcinoma (PDAC), or carcinoma arising from IPMN was analyzed to examine trend in variant proportion by malignant progression.</p><p><strong>Results: </strong>In the CAPS cohort, older age (OR per year; 1.06 [1.05-1.07]; p < 0.001), FUT2-null (non-secretors) (OR: 1.66 [1.30-2.12]; p<0.001), non-O blood group (OR: 1.31 [1.06-1.62]; p=0.012), having familial-only vs. genetic/familial risk (OR: 1.49 [1.20-1.85] p<0.001), and participating site (OR; 2.20 [1.78-2.73], p<0.001) were associated with having pancreatic cysts. There were no significant FUT2/ABO presumed IPMN prevalence interactions. In the combined cohort, the proportion of FUT2-null patients with IPMN without carcinoma (by imaging or pathology) was 319 (27.4%) of 1162; 57 (24.3% of 234) with IPMN and carcinoma, and 225 (22.5%) of 998 with PDAC alone (p=0.009 for trend).</p><p><strong>Conclusions: </strong>IPMN is more prevalent in FUT2-null patients under pancreas surveillance, but the increased FUT2-null prevalence is not observed in patients with IPMN with carcinoma.</p><p><strong>Impact: </strong>Pancreatic cancer risk conferred by having IPMN may be lower in FUT2-null compared to FUT2-intact individuals.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual and Occupational Factors Associated with Receipt of Guideline-Concordant Cancer Screening in California Firefighters.","authors":"Jamie Gabriel, Derek Urwin, Tony Trong Nguyen, Ethan Rohlf, Beth A Glenn, Laura Fejerman, Sheri Belafsky, Jose Luis Lopez Garcia, Mira Miles, Mariela Alaniz, Justin Valdoria, Kyoungmi Kim, Shehnaz K Hussain","doi":"10.1158/1055-9965.EPI-26-0709","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0709","url":null,"abstract":"<p><strong>Background: </strong>Firefighters face elevated cancer risk due to occupational exposures, yet cancer screening adherence and associated factors remain poorly characterized.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of survey data from 3,076 active-duty career firefighters in California without a prior cancer diagnosis. Screening adherence was evaluated against U.S. Preventive Services Task Force (USPSTF) and National Fire Protection Association (NFPA) guidelines for colorectal (CRC), breast, cervical, prostate, skin, and lung cancer. Multivariable logistic regression was used to assess the associations between screening receipt and demographic, occupational, behavioral, clinical, and health belief factors.</p><p><strong>Results: </strong>Overall, screen-eligible participants were racially/ethnically diverse (25% Hispanic; 37% non-White), had a mean age of 41 years, and a mean tenure in the fire service of 17 years. Receipt of guideline-concordant screening varied by cancer type and guideline: CRC (54% NFPA, 68% USPSTF), breast (76%), cervical (75%), prostate (59% NFPA, 78% USPSTF), skin (29%), and lung (ever low-dose computed tomography, 10%). Older age (odds ratio [OR]=1.19-2.65 per 5 years), 1+ years since a routine doctor's visit (OR=0.36-0.58), and family history of cancer (OR=1.33-1.77) were consistently associated with receipt of cancer screening.</p><p><strong>Conclusions: </strong>Firefighters who were younger (yet within eligibility age range), had not recently engaged in routine healthcare, and did not have a family history of cancer were less likely to be screened.</p><p><strong>Impact: </strong>This is the first broad characterization of cancer screening among career firefighters, identifying potentially actionable targets for interventions to close screening gaps in this high-risk population.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indigenous Strengths, Community Care, and Cancer Disparities: Insights from Talking Circles with American Indian Tribes in North Carolina.","authors":"Yadurshini Raveendran, Andrea Thoumi, M J Gathings, Tony Locklear, Vivette Jeffries-Logan, Laura J Fish, Clare Meernik, Ryan Dial, Rachel L Denlinger-Apte, Stephanie B Wheeler, Ronny A Bell, Tomi Akinyemiju","doi":"10.1158/1055-9965.EPI-26-0416","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0416","url":null,"abstract":"<p><strong>Background: </strong>American Indian communities experience disproportionally higher cancer incidence and mortality rates compared to other populations in North Carolina (NC). As part of the SAICEP (Southeastern American Indian Cancer health Equity Partnership) initiative, talking circles were conducted to understand and address cancer-related health needs among NC American Indian communities.</p><p><strong>Methods: </strong>Between February and September 2023, members from the Coharie, Haliwa-Saponi and Lumbee tribes participated in six culturally grounded talking circles (approximately 1.5 hours each). Talking circles are a well-established cultural practice for research in American Indian communities rooted in voice equality. American Indian community facilitators led each session and co-developed a discussion guide. Discussions were transcribed and analyzed using the Penchansky and Thomas healthcare access framework via thematic analysis in NVivo 12.</p><p><strong>Results: </strong>A total of 81 participants participated in talking circle sessions. Participants highlighted cultural resiliency and community assets as protective factors. Key challenges included affordability, inadequate local health infrastructure, and limited geographic accessibility. Recommendations included increasing local cancer education and awareness, promoting regular talking circles to foster community care and traditional healing, and expanding access through culturally competent clinical providers.</p><p><strong>Conclusions: </strong>Enduring community networks, faith traditions, and indigenous healing practices are foundational to shaping how NC American Indian communities experience cancer. However, culturally responsive healthcare and improved access to quality care are needed to meet American Indian cancer care needs.</p><p><strong>Impact: </strong>Advancing cancer equity in American Indian communities demands approaches that honor indigenous knowledge systems and redesign healthcare delivery through authentic, sustained partnership with American Indian nations.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of periprostatic adipose tissue measures obtained post-androgen deprivation therapy with prostate tumor aggressiveness and gene expression profiles.","authors":"Sarah J Winter, Suneil Jain, Gillian Prue, Michelle Leech, Alan R Hounsell, Conor K McGarry, Emma H Allott","doi":"10.1158/1055-9965.EPI-26-0664","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-26-0664","url":null,"abstract":"<p><strong>Background: </strong>Higher periprostatic adipose tissue (PPAT) quantity has been associated with increased prostate cancer aggressiveness. However, PPAT definitions vary between studies, and few examined associations of PPAT with tumor biology.</p><p><strong>Methods: </strong>Using radiation-planning computed tomography scans from 316 prostate cancer patients treated with androgen deprivation therapy at the Northern Ireland Cancer Centre, we contoured PPAT according to three anatomical definitions. Associations of adipose tissue quantity and density (continuous measures and tertiles) with disease aggressiveness (Gleason grade ≥4+3 vs ≤3+4) were examined using logistic regression. Exploratory gene set enrichment analysis identified PPAT-associated pathways enriched in prostate tumors.</p><p><strong>Results: </strong>Among men with prostate cancer, an elevated total quantity of pelvic adipose tissue (ORT3vsT1 1.97; 95%CI 1.10-3.56) and higher density of PPAT in closest proximity to the prostate (ORT3vsT1 2.36; 95%CI 1.00-5.68), were associated with increased odds of high-grade disease. Higher waist circumference was also associated with increased tumor aggressiveness (ORT3vsT1 1.99; 95%CI 1.04-3.86). Men with higher quantity of total pelvic adipose tissue had enriched glucose and lipid signalling-related pathways in their tumors.</p><p><strong>Conclusions: </strong>Greater total pelvic adipose tissue quantity and higher PPAT density were associated with increased tumor aggressiveness among men with prostate cancer. Exploratory analyses identified tumor glucose and lipid metabolism as potential contributing mechanisms.</p><p><strong>Impact: </strong>Our findings support a potential role for PPAT in prostate cancer aggressiveness. Associations of increased PPAT density with higher tumor grade, and of higher quantity of pelvic fat with enhanced tumor glucose and lipid signalling, suggest potential contributing mechanisms to be explored in future studies.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highly Sensitive DNA Testing of Fusobacterium nucleatum in Colorectal Tumors.","authors":"Meredith A J Hullar, Orsalem J Kahsai, Courtney Hill, Lisa Levy, Rachel C Malen, Keith R Curtis, Hamza Ammar, Arthur Sillah, Adriana M Reedy, Johanna W Lampe, Shuji Ogino, John D Potter, Polly A Newcomb, Amanda I Phipps","doi":"10.1158/1055-9965.EPI-24-1020","DOIUrl":"10.1158/1055-9965.EPI-24-1020","url":null,"abstract":"<p><strong>Background: </strong>Fusobacterium nucleatum (Fn) has been associated with the risk of colorectal cancer, poor colorectal cancer survival, and tumor attributes. Accurate and sensitive detection of Fn in tumor tissue is critical for evaluating their role in colorectal cancer.</p><p><strong>Methods: </strong>We developed a droplet digital PCR (ddPCR) assay for detecting Fn using the transcription termination/antitermination gene (nusG) normalized for host tissue (solute carrier organic anion transporter family member 2A1). We assayed Fn(nusG) in matched tumor and normal tissues for 613 participants in the Seattle site of the Colon Cancer Family Registry. We used logistic regression to determine the odds of Fn enrichment in tumor tissue according to the tumor site and stage, adjusting for age, sex, and body mass index.</p><p><strong>Results: </strong>The limit of quantitation for Fn(nusG) was 4.1 copies/10 ng host tissue. Detection of Fn was quenched and poor at low levels in formalin-fixed, paraffin-embedded tissues using qPCR. There was a low agreement between qPCR and ddPCR (Cohen's kappa = 0.46). Fn(nusG) was detected in tumor (21%) and normal (10%) tissues and was enriched in 19% of tumors. Individuals with tumors enriched in Fn were more likely to be female (59% vs. 48%, respectively; P = 0.04) with proximal colon tumors (57% vs. 43%; P = 0.026). In multivariable-adjusted analyses, proximal colon tumors were significantly associated with Fn enrichment (OR vs. rectal tumors: 1.86; 95% confidence interval, 1.11-3.24).</p><p><strong>Conclusions: </strong>We established a sensitive and specific method to detect Fn enrichment in human tissues.</p><p><strong>Impact: </strong>ddPCR enhanced detection of Fn(nusG) for studies targeting tumor-associated bacteria.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1377-1385"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary Levels of Endocrine-Disrupting Chemicals and Breast Density in Young Women.","authors":"Jennifer E Carroll, Hannah E Guard, David March, Kathleen F Arcaro, Carin Huset, Raji Balasubramanian, Despina Kontos, Susan R Sturgeon","doi":"10.1158/1055-9965.EPI-24-1694","DOIUrl":"10.1158/1055-9965.EPI-24-1694","url":null,"abstract":"<p><strong>Background: </strong>Endocrine-disrupting chemicals (EDC) found in many household and personal care products have hormonal properties and effects on the mammary gland. It is unclear whether urinary concentrations of EDCs are associated with higher percent breast density, a major risk factor of breast cancer.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 97 college-aged women. We quantified individual levels of bisphenol A, bisphenol S, bisphenol F, triclosan, triclocarban, 3-benzophenone, seven phthalate metabolites, four parabens, and two other phenols in three 24-hour urine samples combined into a single pooled sample. Each woman had non-enhanced MRI to assess percent breast density. Associations between estimated concentrations of individual EDCs and percent breast density were analyzed using adjusted linear regression.</p><p><strong>Results: </strong>There was no evidence of a statistically significant increase in mean percent breast density in the middle or highest tertile for any EDC measured. There was a suggestion that the mean percent breast density was elevated in individuals in the middle and highest tertile levels of ethyl paraben compared with those in the lowest tertile, with a relative increase in mean percent breast density of 16% (β = 1.16; 95% CI, 0.92-1.46) in tertile 2 and 24% (β = 1.24; 95% CI, 0.99-1.57) in tertile 3, relative to tertile 1 (Ptrend = 0.07). Similar trends in percent breast density were observed for methylparaben, propylparaben, and butylparaben.</p><p><strong>Conclusions: </strong>Urinary levels of EDCs were not associated with percent breast density in college-aged women.</p><p><strong>Impact: </strong>The estimated effect of EDCs on the breast tissue of young women is unclear and warrants larger studies.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1306-1313"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food Insecurity and Clinical Biomarkers of Inflammation among Cancer Survivors in the All of Us Research Program.","authors":"Cecily A Byrne, Sage J Kim, Greg Kopetsky, Evgenia Karayeva, Vanessa M Oddo","doi":"10.1158/1055-9965.EPI-24-1757","DOIUrl":"10.1158/1055-9965.EPI-24-1757","url":null,"abstract":"<p><strong>Background: </strong>Food insecurity is associated with a 40% increase in the prevalence of chronic conditions, including cancer. Stress-evoked inflammation is a hypothesized mechanism driving these associations. This study tested the association between food insecurity and inflammation in cancer survivors.</p><p><strong>Methods: </strong>Our sample included individuals with a history of lung, breast, prostate, and colorectal cancers from the All of Us Research Program. Food insecurity was measured using validated questions, and inflammatory biomarkers were obtained from electronic health records (EHR). Our primary analysis tested the association between food insecurity and C-reactive protein (CRP; n = 413) using multivariable regression models, controlling for sociodemographics and current cancer treatment.</p><p><strong>Results: </strong>The primary cohort was 69.8 ± 9.5 years in age, 61.0% female, 89.3% non-Hispanic White, and 9.9% had food insecurity. A higher proportion of racial/ethnic minorities (40.8%) and individuals with lower annual household income (33.3%) and education (29.4%) had food insecurity. The mean CRP was higher among those with food insecurity (14.5 ± 18.5) than among food-secure individuals (10.4 ± 17.8), but it was not significantly associated with CRP in our fully adjusted models.</p><p><strong>Conclusions: </strong>Lung, breast, prostate, and colorectal cancer survivors had moderate levels of inflammation measured by CRP; however, food insecurity was not associated with CRP in fully adjusted models.</p><p><strong>Impact: </strong>In this cohort, there was no association between food insecurity and CRP; however, given that food insecurity and inflammation are plausible contributors to chronic disease, future studies should include underrepresented survivors with EHR data and a broader range of cancers.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1350-1358"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Efficacy of Cervical HPV-HR DNA Testing as Alternative to PET/CT Imaging for Posttreatment Cancer Surveillance: Retrospective Proof-of-Concept Study.","authors":"Cameron Huddleston, Chinnadurai Mani, Naresh Sah, Emerald Courtney, Kimberly Reese, Stephanie Stroever, Komaraiah Palle, Mark B Reedy","doi":"10.1158/1055-9965.EPI-24-1828","DOIUrl":"10.1158/1055-9965.EPI-24-1828","url":null,"abstract":"<p><strong>Background: </strong>High-risk human papillomaviruses (HPV-HR) are implicated in more than 99% of cervical/vaginal malignancies. Despite this strong association, current guidelines recommend PET/CT imaging over HPV-HR DNA testing as the standard prognostic tool following definitive therapy. This retrospective, single-institution, proof-of-concept study evaluated HPV-HR DNA testing as a potential alternative to PET/CT imaging for posttreatment surveillance in cervical and vaginal cancers.</p><p><strong>Methods: </strong>Female patients with cervical or vaginal cancer treated between 2010 and 2023 at our institution were retrospectively analyzed. Eligible patients had complete documentation of pre- and posttreatment PET/CT imaging and HPV-HR DNA testing. Of more than 100 patients identified, only 53 met the inclusion criteria, and both radical hysterectomy and chemoradiation patients were included. Statistical analyses, including sensitivity, specificity, and predictive values, were conducted using Stata, with significance set at 0.05.</p><p><strong>Results: </strong>Posttreatment HPV-HR DNA testing demonstrated a superior sensitivity (92.31%) and negative predictive value (97.44% NPV) compared with PET/CT imaging (76.92% sensitivity and 92.31% NPV). Although PET/CT imaging maintained higher specificity over HPV-HR DNA testing (100% vs. 95%) and positive predictive value (100% vs. 85.71%), HPV-HR DNA testing offers a more sensitive and cost-effective method for identifying patients requiring further evaluation.</p><p><strong>Conclusions: </strong>HPV-HR DNA testing is a promising, cost-effective surveillance tool with higher sensitivity and NPV than PET/CT. Its clinical use may reduce PET/CT need, improve safety, and lower costs and require further validation.</p><p><strong>Impact: </strong>HPV-HR DNA testing offers a cost-effective alternative to PET/CT, reducing costs, unnecessary imaging, and improving accessibility.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1264-1268"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rurality of Residence and Distance to Clinic Are Risk Factors for Non-engagement in Childhood Cancer Survivor Care.","authors":"Liberty F Strange, Rebecca S Williamson Lewis, Xu Ji, Karen E Effinger","doi":"10.1158/1055-9965.EPI-25-0023","DOIUrl":"10.1158/1055-9965.EPI-25-0023","url":null,"abstract":"<p><strong>Background: </strong>Childhood cancer survivors (CCS) are at risk of chronic health conditions due to their cancer and treatment. Cancer survivor programs offer screening services; however, there are disparities in care. Rurality has been understudied; thus, we examined whether rural CCS are at increased risk for non-engagement in survivor care compared with their urban counterparts.</p><p><strong>Methods: </strong>This retrospective analysis of an institutional CCS cohort evaluated noninitiation of survivor care within 3 years of eligibility and noncontinuation (i.e., no subsequent visit within 18 months of an initial visit). Rurality was defined using rural-urban commuting area codes. Distance from clinic was defined as near (<25 miles) or far (≥25 miles). Outcomes were compared among rural versus urban and urban-near, urban-far, and rural-far CCS using multivariable logistic regressions and cumulative event analysis.</p><p><strong>Results: </strong>Of 1,515 CCS, 10.7% were rural. Compared with urban CCS, rural CCS had higher odds of survivor care noninitiation [27% vs. 35%; adjusted OR (aOR) = 1.55 (1.06-2.23)] and noncontinuation [23% vs. 32%; aOR = 1.87 (1.17-2.93)]. When including distance, rural-far and urban-far survivors were more likely to not initiate care compared with urban-near survivors [rural-far aOR = 1.95 (1.30-2.90); urban-far aOR = 1.66 (1.28-2.15)], whereas only rural-far CCS were more likely to not continue care [aOR = 2.14 (1.26-3.56)].</p><p><strong>Conclusions: </strong>A higher proportion of rural CCS did not initiate or continue survivor care compared with urban-near CCS. Rurality and distance to clinic are important in survivor care.</p><p><strong>Impact: </strong>This analysis reveals that rural CCS are at risk for disparate care. Further studies are needed to determine barriers to care.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1332-1340"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Validation of Plasma Glycosaminoglycans as Biomarkers to Improve Lung Cancer Risk Stratification.","authors":"Michael P A Davies, John K Field, Francesco Gatto","doi":"10.1158/1055-9965.EPI-24-1537","DOIUrl":"10.1158/1055-9965.EPI-24-1537","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer screening excludes individuals not considered at an increased risk for lung cancer, as predicted by risk models like the Liverpool Lung Project version 3 (LLPv3). In this study, we sought to validate whether plasma glycosaminoglycan profiles (GAGomes) could predict lung cancer independent of LLPv3 and other prespecified comorbidities.</p><p><strong>Methods: </strong>In this retrospective cohort-based case-control study, we included patients who were suspected of having lung cancer at baseline and were either diagnosed with lung cancer (cases) or remained cancer-free for 5 years after baseline (controls). Plasma GAGomes were measured at baseline and used to compute a prespecified GAGome score to discriminate lung cancer from controls. We then applied multivariable Bayesian logistic regression to evaluate the likelihood that 7 LLPv3 predictors or 14 comorbidities had an effect on the GAGome score. We tested the independence of the GAGome score from LLPv3-predicted 5-year risk using the likelihood ratio test and assessed whether it improved lung cancer risk prediction in a set equivalent to an LLPv3-predicted 5-year risk of ≥1.51%.</p><p><strong>Results: </strong>We included 653 lung cancer and 653 controls. The AUC of the GAGome score was 0.63 (95% confidence interval, 0.62-63). None of the LLPv3 predictors or comorbidities were compatible with a significant effect on the score. The GAGome score was independent of LLPv3 (P < 0.001) and improved its sensitivity (72% vs. 69%) and specificity (61% vs. 59%).</p><p><strong>Conclusions: </strong>Plasma GAGomes identified additional lung cancer cases beyond those predicted by LLPv3 alone.</p><p><strong>Impact: </strong>GAGomes could improve risk-stratified lung cancer if validated in a screening population.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1219-1225"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}