Cancer Epidemiology Biomarkers & Prevention最新文献

{"title":"Density of T-cell Subsets in Colorectal Cancer in Relation to Disease-Specific Survival.","authors":"Claire E Thomas, Yasutoshi Takashima, Daniel D Buchanan, Evertine Wesselink, Conghui Qu, Li Hsu, Andressa Dias Costa, Steven Gallinger, Robert C Grant, Jeroen R Huyghe, Sushma Thomas, Satoko Ugai, Yuxue Zhong, Kosuke Matsuda, Tomotaka Ugai, Ulrike Peters, Shuji Ogino, Jonathan A Nowak, Amanda I Phipps","doi":"10.1158/1055-9965.EPI-25-0287","DOIUrl":"10.1158/1055-9965.EPI-25-0287","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have demonstrated that the overall density of T cells in colorectal tumors is favorably associated with colorectal cancer survival; however, few studies have considered the potentially distinct roles of heterogeneous T-cell subsets in different tissue regions in relation to colorectal cancer outcomes.</p><p><strong>Methods: </strong>Including 1,113 colorectal cancer tumors from three observational studies, we conducted in situ T-cell profiling using a customized nine-plex [CD3, CD4, CD8, CD45RA, CD45RO, FOXP3, KRT (keratin), MKI67 (Ki-67), and DAPI] multispectral immunofluorescence assay. Multivariable-adjusted Cox proportional hazards models were used to estimate HRs and 95% confidence intervals for the associations of T-cell subset densities in both epithelial and stromal tissue areas in colorectal cancer with disease-specific survival.</p><p><strong>Results: </strong>Higher CD3+CD4+ and CD3+CD8+ naïve, memory, and regulatory T-cell densities were significantly associated with better colorectal cancer-specific survival in both epithelial and stromal tissue areas (HR highest quantile vs. lowest quantile ranging 0.41-0.68). These associations persisted in models further adjusted for stage at diagnosis and were largely consistent when stratified by microsatellite instability status. However, the further stratification into CD4+ or CD8+ T-cell subsets beyond CD3+ subsets did not significantly improve the performance of our model in explaining colorectal cancer prognosis.</p><p><strong>Conclusions: </strong>The density of T cells in colorectal cancer tissue, both overall and for several T-cell subset populations, is significantly associated with colorectal cancer-specific survival independent of microsatellite instability status and stage at diagnosis.</p><p><strong>Impact: </strong>Higher levels of T-cell densities in different locations with different functions are associated with better colorectal cancer-specific survival.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1122-1133"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967300","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":"Nativity and Healthy Lifestyle Index in a Pooled Cohort of Female Breast Cancer Survivors from Northern California.","authors":"Rhonda-Lee Aoki, Stacey E Alexeeff, Bette J Caan, Lawrence H Kushi, Scarlett Lin Gomez, Jacqueline M Torres, Alison J Canchola, Brittany N Morey, Candyce H Kroenke","doi":"10.1158/1055-9965.EPI-24-1871","DOIUrl":"10.1158/1055-9965.EPI-24-1871","url":null,"abstract":"<p><strong>Background: </strong>In the United States, breast cancer is common in Asian, Hispanic, and non-Hispanic White (NHW) women, many of whom are immigrants. A healthy lifestyle is vital to survival, but it is unknown how lifestyle varies by nativity among survivors.</p><p><strong>Methods: </strong>The study included 4,754 racially diverse, female breast cancer survivors from the Northern California, Exploring Networks in a Cohort of Latina and Asian Emigrants, Lifestyle, and Vital Status (ENCLAVE) study. We generated a healthy lifestyle index (HLI) based on World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations. Log-binomial regression models, controlling for sociodemographics, were used to evaluate associations between nativity and the highest tertile of HLI, as well as the optimal category of each HLI component.</p><p><strong>Results: </strong>Foreign-born (vs. US-born) women were more likely to have a high HLI [prevalence ratio (PR) = 1.44; 95% confidence interval (CI), 1.31-1.59]. In stratified models, we observed stronger associations among Hispanic (PR = 1.76; 95% CI, 1.39-2.24) and Asian (PR = 1.60; 95% CI, 1.32-1.94) versus non-Hispanic White (PR = 1.26; 95% CI, 1.08-1.47) women (P-interaction = 0.02). Foreign-born (vs. US-born) women were more likely to have a waist circumference <31.5 inches (PR = 1.19; 95% CI, 1.03-1.37); be normal weight (PR = 1.23; 95% CI, 1.11-1.37); never smoke (PR = 1.11; 95% CI, 1.06-1.17); and consume no sweets (PR = 1.44; 95% CI, 1.21-1.70), low red meat (PR = 1.46; 95% CI, 1.33-1.60), and high fruits and vegetables (PR = 1.46; 95% CI, 1.32-1.62).</p><p><strong>Conclusions: </strong>Among women diagnosed with breast cancer, foreign-born women had a healthier lifestyle than US-born women.</p><p><strong>Impact: </strong>Lifestyle differences by nativity in breast cancer survivors may help clarify prognostic differences by nativity.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1188-1198"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966551","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":"Implementing HPV Vaccination Services in People Living with HIV in Trinidad and Tobago: A Brief Report.","authors":"Tessa Galindo, Jonathan Edwards, Gaole Song, Sharon Soyer, Selena Todd, Gregory Boyce, Kimlin T Ashing, Robert J Edwards","doi":"10.1158/1055-9965.EPI-24-1611","DOIUrl":"10.1158/1055-9965.EPI-24-1611","url":null,"abstract":"<p><strong>Background: </strong>Globally, Caribbean countries are among the most heavily burdened by both human immunodeficiency virus and cancer. Due to their immunocompromised status, people living with human immunodeficiency virus (PLWH) are more susceptible to human papillomavirus (HPV)-related cancers.</p><p><strong>Methods: </strong>We conducted a preliminary study evaluating HPV vaccination rates targeting PLWH in Trinidad and Tobago using data from local clinics. This study provided descriptive analysis results, including demographic characteristics of enrolled PLWH and HPV vaccination rates.</p><p><strong>Results: </strong>A total of 5,615 PLWH (age ranged from 18 to 51 years, with 51.4% women and 48.6% men) were enrolled in this evaluation. Of these, 1,178 patients (21.0%) received HPV vaccines: 22.8% were vaccinated with one dose, 25.6% were vaccinated with two doses, and 51.6% were vaccinated with three doses. The highest uptake of 22.3% was in 2021, followed by 20.1% in 2022, but in 2023, it dropped to 15.5%. Between 2018 and 2020, the uptakes were 13.6% for 2020, 12.7% for 2019, and 5.7% for 2018.</p><p><strong>Conclusions: </strong>Overall, the HPV vaccination rates among PLWH in Trinidad and Tobago are low; only one in five was vaccinated.</p><p><strong>Impact: </strong>Results suggest that by implementing comprehensive and targeted programs, clinics have the potential to successfully implement HPV vaccinations toward significantly reducing the incidence and mortality of HPV-related cancers and saving lives. There is a trend with the highest vaccination uptake during the peak years of COVID-19 vaccinations, with HPV vaccination rates almost doubling between 2019 and 2021. Hence, our data suggest that the COVID-19 vaccination program may have boosted HPV vaccination.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1089-1092"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964244","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":"AI-assisted Diagnosis of Nonmelanoma Skin Cancer in Resource-Limited Settings.","authors":"Spencer Ellis, Steven Song, Derek Reiman, Xuan Hui, Renyu Zhang, Mohammad Hasan Shahriar, Maria Argos, Mohammed Kamal, Christopher R Shea, Robert L Grossman, Aly A Khan, Habibul Ahsan","doi":"10.1158/1055-9965.EPI-25-0132","DOIUrl":"10.1158/1055-9965.EPI-25-0132","url":null,"abstract":"<p><strong>Background: </strong>Early and precise diagnosis is vital to improving patient outcomes and reducing morbidity. In resource-limited settings, cancer diagnosis is often challenging due to shortages of expert pathologists. We assess the effectiveness of general-purpose pathology foundation models (FM) for the diagnosis and annotation of nonmelanoma skin cancer (NMSC) in resource-limited settings.</p><p><strong>Methods: </strong>We evaluated three pathology FMs (UNI, PRISM, and Prov-GigaPath) using deidentified NMSC histology images from the Bangladesh Vitamin E and Selenium Trial to predict cancer subtype based on zero-shot whole-slide embeddings. In addition, we evaluated tile aggregation methods and machine learning models for prediction. Lastly, we employed few-shot learning of PRISM tile embeddings to perform whole-slide annotation.</p><p><strong>Results: </strong>We found that the best model used PRISM's aggregated tile embeddings to train a multilayer perceptron model to predict NMSC subtype [mean area under the receiver operating characteristic curve (AUROC) = 0.925, P < 0.001]. Within the other FMs, we found that using attention-based multi-instance learning to aggregate tile embeddings to train a multilayer perceptron model was optimal (UNI: mean AUROC = 0.913, P < 0.001; Prov-GigaPath: mean AUROC = 0.908, P < 0.001). We finally exemplify the utility of few-shot annotation in computation- and expertise-limited settings.</p><p><strong>Conclusions: </strong>Our study highlights the important role FMs may play in confronting public health challenges and exhibits a real-world potential for machine learning-aided cancer diagnosis.</p><p><strong>Impact: </strong>Pathology FMs offer a promising pathway to improve early and precise NMSC diagnosis, especially in resource-limited environments. These tools could also facilitate patient stratification and recruitment for prospective clinical trials aimed at improving NMSC management.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1080-1088"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980740","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":"A Scoping Review on Barriers to Cancer Diagnosis and Care in Low- and Middle-Income Countries.","authors":"Kwabena Agbedinu, Sylvester Antwi, Livingstone Aduse-Poku, Patrick Kafui Akakpo, Harriet Larrious-Lartey, Valerie Ofori Aboah, Samuel Mensah, Veneranda Nyarko, Forster Amponsah-Manu, Josephine Nsaful, Rose Dampson, Michael Nortey, Ijeoma Aja, Mohammed Sheriff, Moses Abdulai Dokurugu, Nelson Affram, Alex Mremi, Theresia Mwakyembe, Moses Kamita, Linda Kaljee, Evelyn Jiagge","doi":"10.1158/1055-9965.EPI-25-0120","DOIUrl":"10.1158/1055-9965.EPI-25-0120","url":null,"abstract":"<p><p>Cancer remains a significant global health challenge, with low- and middle-income countries (LMIC) disproportionately burdened by high mortality rates despite a lower overall incidence. Barriers to timely diagnosis and care exacerbate these disparities. This scoping review synthesizes existing literature on barriers for women in LMICs following the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies on women in LMICs reporting barriers to accessing care for breast, colorectal, lung, cervix uteri, thyroid, corpus uteri, and stomach cancers were included. Twenty-nine studies involving 7,031 participants were included. The most common barriers included financial challenges (65.5%), geographic obstacles (34.5%), health system limitations (55.2%), and low health literacy (51.7%). Patients experienced significant delays, averaging 7.4 months from symptom onset to diagnosis and 4.9 months from diagnosis to treatment initiation. Structural issues such as limited diagnostic services, inadequate healthcare infrastructure, and healthcare provider shortages were widespread. Addressing the multifaceted barriers to cancer care in LMICs requires comprehensive strategies, including increasing financial support, decentralizing care services, improving healthcare infrastructure, and enhancing education for patients and providers. Policymakers and stakeholders should prioritize investments in cancer care to reduce disparities and improve outcomes. These findings will inform strategies for improving cancer care in low-resource settings globally.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1066-1073"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966550","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":"Aboriginal and Torres Strait Islander Females and Survival from Breast Cancer.","authors":"Alice R T Bergin, Luc Te Marvelde, Roger L Milne, Luis E Lara Gonzalez, Katie Meehan, Lisa J Spalding, Leanne Pilkington, Benjamin Dessauvagie, Jia-Min B Pang, Franco Caramia, Peter Savas, Jasmine Kay, Jianan Wang, Stephen J Luen, Jay Hamman, Andrea Casey, Nicole Watt, Roberto Salgado, Andrew D Redfern, Sue Evans, Gail Garvey, Sherene Loi","doi":"10.1158/1055-9965.EPI-24-1526","DOIUrl":"10.1158/1055-9965.EPI-24-1526","url":null,"abstract":"<p><strong>Background: </strong>Despite access to universal health care, Aboriginal and Torres Strait Islander females (hereafter respectfully referred to as Aboriginal) in Australia have higher breast cancer incidence and mortality rates. We investigated the factors contributing to these survival disparities.</p><p><strong>Methods: </strong>Aboriginal females (n = 395; 0.7%) and non-Aboriginal females (n = 57,618; 99.3%) with breast cancer were identified from Victoria, Australia. Clinical, pathologic, demographic, and socioeconomic variables were analyzed. Endpoints were all-cause and breast cancer-specific mortality. HRs were estimated using Cox regression. Stromal tumor-infiltrating lymphocytes were evaluated from a subset of Aboriginal females and compared with females in The Cancer Genome Atlas.</p><p><strong>Results: </strong>Registry data revealed that Aboriginal females were younger (P < 0.001), had more advanced stage disease (P = 0.007), and were more likely to live in nonmetropolitan areas (P < 0.001) and in areas of greater disadvantage (P < 0.001) compared with other females at diagnosis. Age-adjusted multivariate analysis revealed a higher all-cause mortality risk (HR 1.27; 95% confidence interval, 1-1.61) for Aboriginal females, but this risk diminished for breast cancer-specific mortality and after adjustment for stage and grade. Breast cancers from Aboriginal females had significantly reduced stromal tumor-infiltrating lymphocytes in the luminal and triple-negative subtypes compared with The Cancer Genome Atlas.</p><p><strong>Conclusions: </strong>Mortality for females with breast cancer was influenced by socioeconomic, geographic, and clinical factors. Notably, Aboriginal females with tumor features typically associated with favorable outcomes experienced poorer outcomes. The reduced immune infiltrate warrants further investigation.</p><p><strong>Impact: </strong>These findings highlight the need to address socioeconomic inequities and ensure culturally safe cancer care. Further research should explore biological and environmental factors influencing outcomes for Australian Aboriginal females.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1167-1176"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981227","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":"Prevalence and Review of Major Modifiable Cancer Risk Factors, HPV Vaccination, and Cancer Screenings in the United States: 2025 Update.","authors":"Priti Bandi, Jessica Star, Natalia Mazzitelli, Nigar Nargis, Farhad Islami, Rebecca L Siegel, K Robin Yabroff, Ahmedin Jemal","doi":"10.1158/1055-9965.EPI-24-1835","DOIUrl":"10.1158/1055-9965.EPI-24-1835","url":null,"abstract":"<p><p>This study presents national- and state-level prevalence of major modifiable cancer risk factors, human papillomavirus vaccination, and cancer screenings among US adults in the years during and after the COVID-19 pandemic compared with prepandemic years. Smoking prevalence declined to 11% in 2023 from 14.2% in 2019, but prevalence remained higher among American Indian/Alaska Native individuals, Black males, lower-educated individuals, and bisexual females. Menthol-flavored cigarettes, which increase smoking uptake and reduce cessation success, were used by 36.3% of currently smoking adults in 2023; this level is more than double in Black individuals (75.6%). Excess body weight prevalence during August 2021 to August 2023 (overweight: 31.8%; obesity: 40.4%) was stable compared to levels during 2017 to March 2020. Remaining unchanged from 2020, more than half (51.5%) of adults reported not meeting recommended aerobic activity levels, and 6.4% reported heavy alcohol use in 2022. Diverging from the previously increasing trend, up-to-date human papillomavirus vaccination prevalence was flat between 2021 and 2023 (61.4% in ages 13-17 years). Rebounding from declines or flat trends noted during the COVID-19 pandemic, the United States Preventive Services Task Force recommendation-concordant prevalence increased from 2019 to 2023 for breast (79.9%) and colorectal (60.4%) cancer screening. Ongoing surveillance with reliable population-representative survey datasets is essential to track progress and develop effective cancer prevention and control efforts.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"836-849"},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974580","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":"A Comparison of Neighborhood Socioeconomic Deprivation Measures and the Association with Survival among Black and White Women with Endometrial Cancer.","authors":"Anna Gottschlich, Jamaica R M Robinson, Julie J Ruterbusch, Kaitlin Burchett, Rebecca M Adams, Ariel Washington, Michele L Cote, Ann G Schwartz, Kristen S Purrington, Mike R Wilson","doi":"10.1158/1055-9965.EPI-24-1833","DOIUrl":"10.1158/1055-9965.EPI-24-1833","url":null,"abstract":"<p><strong>Background: </strong>Black women with endometrial cancer have twice the mortality compared with White. Survival disparities remain after accounting for individual-level socioeconomic and cancer-related factors. We investigated associations between area-based deprivation and survival and explored whether area-based deprivation attenuates the association between race and survival, among a cohort of Black and White women.</p><p><strong>Methods: </strong>Data from endometrial cancers diagnosed between 2013 and 2022 were collected from a comprehensive cancer registry covering Metropolitan Detroit. Addresses at diagnosis were linked to the area deprivation (ADI) and social vulnerability (SVI) indices. Adjusted Fine and Gray models and Cox proportional hazard models were run investigating associations between area-based deprivation measures and survival; analyses were conducted estimating the proportion of the association between race and survival that was attenuated by area-based measures.</p><p><strong>Results: </strong>Higher deprivation was associated with poorer survival, adjusted for race, insurance status, and tumor characteristics. Compared with the least disadvantaged quartile, the quartile with the highest disadvantage using ADI and SVI had 1.18 [95% confidence interval (CI), 0.99-1.43] and 1.40 (1.14-1.71) times the hazard of endometrial cancer-specific mortality, respectively. ADI and SVI attenuated 18% (3%-38%) and 27% (10%-48%) of associations between race and mortality overall and 24% (95% CI, 3%-61%) and 40% (95% CI, 16%-78%) among those with high-grade histology.</p><p><strong>Conclusions: </strong>This study demonstrates a clear association between neighborhood-level disadvantage and survival among women with endometrial cancer living in Metropolitan Detroit. Neighborhood disadvantage attenuates the relationship between race and survival, particularly among those with high-grade histology.</p><p><strong>Impact: </strong>These findings serve as motivation to understand how neighborhood affects cancer outcomes.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"885-894"},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673377","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":"Modeling the Economic and Health Impact of Lowering the Recommended Colorectal Cancer Screening Age in Canada Using Fecal Immunochemical Test versus Colonoscopy.","authors":"Brendan J Chia, Yibing Ruan, Carl J Brown, Robert J Hilsden, John M Hutchinson, Darren R Brenner, Jonathan M Loree","doi":"10.1158/1055-9965.EPI-24-1488","DOIUrl":"10.1158/1055-9965.EPI-24-1488","url":null,"abstract":"<p><strong>Background: </strong>The increasing rates of early-onset colorectal cancer in Canada suggest that earlier screening may be warranted. Canadian guidelines recommend biennial screening at 50 years of age with a fecal immunochemical test (FIT).</p><p><strong>Methods: </strong>OncoSim was used to project the outcomes of revised colorectal cancer screening guidelines in Canada for four cohorts born between 1973 and 1992. Cohort risk ratios were calibrated to Canadian incidence data to reflect early-onset trends. We evaluated the incremental colonoscopy burden of earlier FIT screening and primary colonoscopy screening compared with a reference scenario screening with FIT biennially at 50 years of age (FIT 50). Sensitivity analyses were performed by adjusting screening participation and discount rates.</p><p><strong>Results: </strong>FIT at 45 and 40 years of age (FIT 45 and FIT 40, respectively) increased the colonoscopy demand by 3.9% and 6.6%, respectively, over the lifetime of screening. Colonoscopy screening resulted in 89.0% to 116.7% more colonoscopies than FIT 50. Screening and total costs increased in all scenarios, but treatment costs decreased. FIT 45 and FIT 40 reduced the incidence by 103 and 161 and colorectal cancer deaths by 43 and 71 per 100,000, respectively. Colonoscopy screening led to 858 to 954 fewer cases and 260 to 303 fewer deaths per 100,000, resp. FIT 45and FIT 40 had incremental cost-effectiveness ratios of $5,850 per quality-adjusted life year (QALY) and $7,038 per QALY, respectively, compared with FIT 50. Colonoscopy scenarios had incremental cost-effectiveness ratios of $2,743 to $7,509 per QALY.</p><p><strong>Conclusions: </strong>Updated screening can reduce the colorectal cancer burden in younger populations. Increasing FIT screening with earlier initiation is more feasible logistically than increasing colonoscopy first approaches.</p><p><strong>Impact: </strong>These findings may inform future guideline revisions in Canada addressing early-onset colorectal cancer.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"990-997"},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779241","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":"Incidence of Depression and Anxiety in Kidney Cancer Survivors: A Nationwide Population-Based Cohort Study.","authors":"Minji Jung, Mingyi Li, Eunjung Choo, Sukhyang Lee, David Spiegel, Michael Baiocchi, Zhengyi Deng, Jinhui Li, Marvin E Langston, Melissa L Bondy, Benjamin I Chung","doi":"10.1158/1055-9965.EPI-24-1879","DOIUrl":"10.1158/1055-9965.EPI-24-1879","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety have a high prevalence among kidney cancer survivors. We aimed to evaluate their cumulative incidence trajectories and associations between kidney cancer diagnosis and incidence of these conditions.</p><p><strong>Methods: </strong>This population-based cohort study used the Korean Nationwide Health Insurance and Medical Checkup Linkage Database. We included adults (≥20 years) diagnosed with kidney cancer (2010-2020; i.e., cancer survivors), along with age- and sex-matched noncancer comparators. We quantified the empirical risk trajectory of depression and anxiety for up to 5 years following diagnosis and conducted weighted Cox regressions to estimate time-dependent HRs with 95% confidence intervals (CI) within three time intervals: 0 to 1, 1 to 3, and 3 to 5 years.</p><p><strong>Results: </strong>For the empirical risks, survivors (n = 24,310) had higher risks of depression (2.8% vs. 2.2%) and anxiety (3.3% vs. 2.6%) compared with comparators (n = 173,471). For the associations, survivors (n = 16,049) had an increased hazard of depression (HR = 1.92; 95% CI, 1.52-2.42) and anxiety (HR = 1.63; 95% CI, 1.31-2.02) compared with comparators (n = 100,782) in the first year. During the subsequent 1 to 3 years, survivors experienced an increased hazard of anxiety (HR = 1.32; 95% CI, 1.07-1.62). Trends of decreasing HRs for both disorders were observed across successive time intervals.</p><p><strong>Conclusions: </strong>Kidney cancer survivors had a higher rate of depression and anxiety, especially during the early phase following diagnosis, compared with the noncancer population.</p><p><strong>Impact: </strong>Our findings emphasize the need for early identification and treatment of psychiatric disorders, highlighting the integration of mental health care into oncology settings. They also inform future research on prevention and treatment strategies, focusing on timing and high-risk groups.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":"1027-1035"},"PeriodicalIF":3.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966553","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}