Cancer Epidemiology Biomarkers & Prevention最新文献

{"title":"Disaggregated colorectal cancer mortality among Asian American subgroups between 2005-2020.","authors":"Zeel Thakkar, Mohammed A Khan, Yan Wu, Xinran Qi, George A Hung, Nicholas Kikuta, Armaan Jamal, Adrian M Bacong, Karina M Kim, Gloria S Kim, Latha P Palaniappan, Malathi Srinivasan, Robert J Huang","doi":"10.1158/1055-9965.EPI-24-1688","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-1688","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is the second-leading cause of cancer death in Asian Americans. Asian Americans are a diverse, heterogenous population composed of groups with differing cancer risk factors. Few prior studies have analyzed CRC mortality by disaggregated Asian racial subgroup.</p><p><strong>Methods: </strong>Using 2005-2020 US national mortality records linked to American Community Survey one-year population estimates, we report age-standardized mortality rates per 100,000 person-years, standardized mortality ratios (SMR), and average annual percent change trends for the six largest Asian subgroups in a serial, cross-sectional study design. We compared these rates with Non-Hispanic Whites (NHWs). We stratified rates by sex, nativity, and CRC location (colon vs. rectum).</p><p><strong>Results: </strong>Asian subgroups demonstrated substantial heterogeneity in CRC mortality. Relative to the NHW group, Asian Indian Americans had the lowest rate (female SMR 0.3, 95% CI 0.3-0.3; male SMR 0.3, 95% CI 0.3-0.3) and Japanese Americans the highest rate (female SMR 0.9, 95% CI 0.8-0.9; male SMR 0.9, 95% CI 0.9-1.0). Chinese, Filipino, Korean, and Vietnamese Americans demonstrated mortality between Asian Indian and Japanese. Over the study period, most Asian subgroups had stable or decreasing mortality. However, both Korean and Vietnamese CRC mortality increased over the period. By the end of the study period Korean Americans had the highest CRC mortality of any Asian subgroup.</p><p><strong>Conclusions: </strong>Asian subgroups demonstrate heterogeneity in patterns of CRC mortality, emphasizing the necessity of disaggregation in cancer research.</p><p><strong>Impact: </strong>Our study provides disaggregated Asian subgroup CRC mortality data, which may allow for targeted risk attenuation efforts.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977325","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":"https://doi.org/10.1158/1055-9965.EPI-24-1537","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer (LC) 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). Here, we sought to validate whether plasma glycosaminoglycan profiles (GAGomes) could predict LC independent of LLPv3 and other pre-specified co-morbidities.</p><p><strong>Methods: </strong>In this retrospective cohort-based case-control study, we included patients who were suspected of having LC at baseline and were either diagnosed with LC (cases) or remained cancer-free for 5 years after baseline (controls). Plasma GAGome were measured at baseline and used to compute a pre-specified GAGome score to discriminate LC from controls. We then applied multivariable Bayesian logistic regression to evaluate the likelihood that 7 LLPv3 predictors or 14 co-morbidities 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 LC risk prediction in a set equivalent to an LLPv3-predicted 5-year risk of ≥1.51%.</p><p><strong>Results: </strong>We included 653 LC and 653 controls. The AUC of the GAGome score was 0.63 (95% CI = 0.62-63). None of the LLPv3 predictors or co-morbidities 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>Conclusion: </strong>Plasma GAGomes identified additional LC cases beyond those predicted by LLPv3 alone.</p><p><strong>Impact: </strong>GAGomes could improve risk-stratified LC if validated in a screening population.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring temporal trends in cancer survival; choosing appropriate standards when accounting for age and other-cause mortality variation over time.","authors":"Paul C Lambert, Therese M L Andersson, Tor Åge Myklebust, Bjørn Møller, Mark J Rutherford","doi":"10.1158/1055-9965.EPI-24-1727","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-1727","url":null,"abstract":"<p><strong>Background: </strong>Along with incidence and mortality, temporal trends of cancer survival are a crucial part of cancer surveillance and control. The most common reported statistic is net survival, usually age standardized to an external reference population. However, net survival has an awkward interpretation, which has led to confusion and misunderstanding.</p><p><strong>Methods: </strong>We describe the use of reference adjusted all-cause survival and the crude probability of death as an alternative to net survival for the analysis of temporal trends in cancer survival. Reference adjusted measures aim to enable fair comparisons by incorporating additional reference expected mortality rates into the estimation process. The different approaches are illustrated using data on 95,285 women diagnosed with breast cancer in Norway 1986-2021.</p><p><strong>Results: </strong>We compare different age distributions for age standardization and describe how using a recent calendar period for both the reference expected mortality rates and age distribution for standardization leads to simple interpretation.</p><p><strong>Conclusions: </strong>Reference adjusted measures for monitoring temporal trends in cancer survival can lead to improved understanding and is of more relevance to patients and policy makers who live and make decisions in the real-world. Using the most recent calendar period for both the age standard and the reference expected mortality rates leads to simple and useful interpretation of the measures.</p><p><strong>Impact: </strong>Increasing the use of reference adjusted measures in the analysis of population-based cancer studies will enhance understanding of cancer survival trends. The freely available software increases the likelihood of uptake.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966135","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":"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":"https://doi.org/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 (CRC) survival; however, few studies have considered the potentially distinct roles of heterogeneous T cell subsets in different tissue regions in relation to CRC outcomes.</p><p><strong>Methods: </strong>Including 1,113 CRC tumors from three observational studies, we conducted in-situ T cell profiling using a customized 9-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 hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of T cell subset densities in both epithelial and stromal tissue areas in CRC with disease-specific survival.</p><p><strong>Results: </strong>Higher CD3+CD4+ and CD3+CD8+ naive, memory, and regulatory T cell densities were significantly associated with better CRC-specific survival in both epithelial and stromal tissue areas (HRs highest quantile versus 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 (MSI) status. However, the further stratification into CD4+ or CD8+ T cell subsets beyond CD3+ subsets did not significantly improve how well our model explains CRC prognosis.</p><p><strong>Conclusions: </strong>The density of T cells in CRC tissue, both overall and for several T cell subset populations, is significantly associated with CRC-specific survival independent of MSI 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 CRC-specific survival.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesothelioma Incidence rates in Australia since 1982: exploring age, period and cohort effects and future projections.","authors":"Karen Walker-Bone, Melissa A Goodwin, Brent Bufton, Brett Andrew Davis, Henry Wong, Justin Harvey, Sue Barker, Elizabeth Chalker, Sonja Klebe, Sarita Prabhakaran, Fraser Jh Brims, Ewan MacFarlane, Geza Benke, Kathleen Mahoney, Timothy R Driscoll","doi":"10.1158/1055-9965.EPI-24-1224","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-1224","url":null,"abstract":"<p><p>Background Use of asbestos-containing products was banned in Australia in 2003. However, rates of new cases of mesothelioma, which has a very long latent period between exposure and disease, have continued to increase. The aim of this study was to investigate mesothelioma incidence in Australia by year of birth and age-period-cohort analysis and to develop projections of expected mesothelioma cases to 2034. Methods Data came from the Australian Cancer Database which provides complete national records of mesothelioma cases notified 1982-2020. Incidence rates were age-standardised to the 2001 Australian Standard Population to enable comparisons of the population across time. Age-period-cohort models were used to examine the temporal trends of incidence rates by age, calendar year and birth cohort. Projections for incidence rates of mesothelioma 2020-34 were estimated using Nordpred models. Results Graphs of age-standardised incidence rates of mesothelioma suggest a birth cohort effect and the age-period-cohort model confirmed this. There was a birth cohort effect in all cohorts born before 1960, strongest in cohorts born 1920-1949. Projection modelling to 2034 suggested that the age-standardised rates will continue to decline while crude incidence rates of mesothelioma will stabilise and then gradually decline, mostly among people aged 60-84 years. Conclusions The findings are consistent with the greatest risk of mesothelioma in Australia occurring in cohorts with the highest levels of historical cumulative occupational exposure, showing the value of a ban on asbestos. Impact The number of new cases of mesothelioma per year is not expected to decline until after 2030.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976868","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":"p16, COX-2, and Ki67 protein expression in DCIS and risk of ipsilateral invasive breast cancer.","authors":"Thomas E Rohan, Chenxin Zhang, Yihong Wang, Fergus J Couch, Robert T Greenlee, Stacey Honda, Azadeh Stark, Larissa L White, Dhananjay A Chitale, Xiaonan Xue, Mindy Ginsberg, Olivier Loudig","doi":"10.1158/1055-9965.EPI-25-0143","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-25-0143","url":null,"abstract":"<p><strong>Background: </strong>Prior research on the associations of p16, COX-2, and Ki67 immunopositivity in ductal carcinoma in situ (DCIS) tissue with risk of subsequent ipsilateral invasive breast cancer (IBC) is limited.</p><p><strong>Methods: </strong>In a case-control study nested in a cohort of women diagnosed with DCIS, immunostaining for p16, COX-2, and Ki67 was performed on DCIS tissue from those who developed subsequent ipsilateral IBC (cases; n=146) and on matched subjects who did not develop IBC (controls; n=273). Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between immunopositivity for p16, COX-2, and Ki67 and risk of subsequent ipsilateral IBC.</p><p><strong>Results: </strong>There was no association between p16, COX-2, and Ki67 immunopositivity, examined either individually or in combination, with risk of ipsilateral IBC. Compared to all other groups, the multivariable OR (95% CI) for women who were triple positive for the three markers was 1.16 (0.38, 3.54).</p><p><strong>Conclusions: </strong>p16, COX-2, and Ki67 immunopositivity were not associated with altered risk of ipsilateral IBC in women with DCIS.</p><p><strong>Impact: </strong>p16, COX-2, and Ki67 may not be prognostic for ipsilateral IBC in women with DCIS.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964756","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":"The risk of type 2 diabetes among older Asian, Native Hawaiian and Pacific Islander colorectal cancer survivors:a population-based study using SEER-Medicare database.","authors":"Kuangyu Liu, Chun-Pin Esther Chang, Shane Lloyd, Randa Tao, Timothy Nguyen, Zuo-Feng Zhang, Mia Hashibe","doi":"10.1158/1055-9965.EPI-25-0037","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-25-0037","url":null,"abstract":"<p><strong>Background: </strong>While colorectal cancer (CRC) survival rates are improving, the risk of incident type 2 diabetes (T2D) among Asian, Native Hawaiian, and Pacific Islander (ANHPI) ethnic groups is poorly understood. This study aims to identify high-risk groups and quantify the risk across different periods.</p><p><strong>Methods: </strong>Using the SEER-Medicare database, CRC survivors who were ANHPI were matched to non-Hispanic White (NHW) survivors at a 1: up to 3 ratio. Multivariable Cox regression models computed hazard ratios (HR) and 95% confidence intervals (CI) for incident T2D.</p><p><strong>Results: </strong>The study included 6463 NHW and 2901 ANHPI CRC survivors diagnosed between 2000 and 2017. Among them, 715 NHW and 484 ANHPI developed T2D during 39,097 and 10,769 person-years of follow-up, respectively. ANHPI CRC survivors had an elevated T2D risk compared to NHW across all follow-up periods (HRoverall: 1.84, 95% CI: 1.51, 2.25; HR1-5 years: 1.83, 95%CI: 1.45, 2.30). Southeast and East Asians demonstrated the highest T2D risks. Colon cancer was linked to early post-diagnosis T2D risk, while rectal cancer was associated with later risk. No significant association was observed for Native Hawaiian and Pacific Islanders.</p><p><strong>Conclusions: </strong>ANHPI CRC survivors face a greater risk of T2D, particularly Southeast and East Asians. These findings highlight the need for evidence-based survivorship strategies to prevent T2D and reduce ethnic disparities.</p><p><strong>Impact: </strong>This is the first study to examine T2D risk among ANHPI CRC survivors, providing critical insights to inform tailored diabetes prevention and survivorship care.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976847","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":"Causal effects of breast cancer risk factors across hormone receptor breast cancer subtypes: A two-sample Mendelian randomization study.","authors":"Renée M G Verdiesen, Mehrnoosh Shokouhi, Stephen Burgess, Sander Canisius, Jenny Chang-Claude, Stig E Bojesen, Marjanka K Schmidt","doi":"10.1158/1055-9965.EPI-24-1440","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-1440","url":null,"abstract":"<p><strong>Background: </strong>It is unclear if established breast cancer risk factors exert similar causal effects across hormone receptor breast cancer subtypes. We estimated and compared causal estimates of height, body mass index (BMI), type 2 diabetes, age at menarche, age at menopause, breast density, alcohol consumption, regular smoking, and physical activity across these subtypes.</p><p><strong>Methods: </strong>We used a two-sample Mendelian randomization approach and selected genetic instrumental variables from large-scale GWAS. Publicly available summary-level BCAC data (n = 247,173; 133,384 cases, 113,789 controls) for the following subtypes were included: luminal A-like (45,253 cases); luminal B/HER2-negative-like (6,350 cases); luminal B-like (6,427 cases); HER2-enriched-like (2,884 cases); triple negative (8,602 cases). We employed multiple MR methods to evaluate the strength of causal evidence for each risk factor-subtype association.</p><p><strong>Results: </strong>Collectively, our analyses indicated that increased height and decreased BMI are probable causal risk factors for all five subtypes. For the other risk factors, the strength of evidence for causal effects differed across subtypes. Heterogeneity in the magnitude of causal effect estimates for age at menopause and breast density was explained by null findings for triple negative tumours. Regular smoking was the sole risk factor for which there was no evidence for a causal effect on any subtype.</p><p><strong>Conclusions: </strong>This study suggests that established breast cancer risk factors differ across hormone receptor subtypes.</p><p><strong>Impact: </strong>Our results are valuable for the development of primary prevention strategies, improvement of breast cancer risk stratification in the general population, and for the identification of novel breast cancer risk factors.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984383","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":"Sensitivity Measures in Studies of Cancer Early Detection Biomarkers.","authors":"Yibai Zhao, Roman Gulati, Jane Lange, Antonio Olivas-Martinez, Sana Raoof, Yingye Zheng, Ziding Feng, Ruth Etzioni","doi":"10.1158/1055-9965.EPI-24-1849","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-1849","url":null,"abstract":"<p><strong>Background: </strong>The sensitivity of a cancer screening biomarker to detect prevalent preclinical cancer drives screening benefit. Studies estimate sensitivity at different points in the biomarker development process. We examine how closely these estimates reflect the sensitivity to detect preclinical cancer (preclinical sensitivity).</p><p><strong>Methods: </strong>We posit that preclinical sensitivity is inversely proportional to the preclinical sojourn time. We simulate studies and estimates of sensitivity corresponding to the Early Detection Research Network's Phases of Biomarker Development. Sensitivity estimates based on clinically diagnosed cases (Phase 2, clinical sensitivity), archived-sample studies (Phase 3, archived-sample sensitivity), and prospectively screened cohorts (Phases 4 and 5, prospective empirical sensitivity) are defined and compared against the corresponding expected preclinical sensitivity.</p><p><strong>Results: </strong>Clinical sensitivity is generally optimistic. Archived-sample sensitivity is optimistic near clinical diagnosis but may be pessimistic at longer look-back intervals, with bias dependent also on test specificity. Prospective empirical sensitivity is optimistic when the sojourn time is long relative to the screening interval. Bias in prospective empirical sensitivity depends also on the frequency and accuracy of confirmation testing following a positive screening test.</p><p><strong>Conclusions: </strong>Sensitivity estimates from different phases of biomarker development should be distinguished and labeled accordingly to facilitate realistic assessment of diagnostic performance and prediction of potential benefit.</p><p><strong>Impact: </strong>Our study highlights the need for clearer terminology to describe sensitivity of cancer early detection biomarkers. We introduce new labels, explain biases in sensitivity estimates, and advocate for improved communication to enhance understanding of diagnostic test performance.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980869","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 Randomized Control Trial of Two Interventions Compared to Usual Care for Increasing Cervical Cancer Screening Among Women Living in the Rural Midwest.","authors":"Erika B Biederman, Timothy E Stump, Patrick O Monahan, Mira L Katz, Ryan D Baltic, Eric A Vachon, Victoria L Champion, Electra D Paskett","doi":"10.1158/1055-9965.EPI-24-0971","DOIUrl":"https://doi.org/10.1158/1055-9965.EPI-24-0971","url":null,"abstract":"<p><strong>Background: </strong>Lower cervical cancer (CC) screening rates are associated with higher CC mortality among women living in rural compared to urban areas (defined by Rural-Urban Community Codes). The study purpose was to examine the effectiveness of mailed DVD vs. DVD plus patient navigation (PN) vs. Usual Care (UC) on increasing the percentage of rural women up to date (UTD) with CC screening guidelines.</p><p><strong>Methods: </strong>Rural women (aged 50-74) who were not UTD for CC screening (n=553) were consented and randomized 2:2:1 (DVD, DVD+PN, UC, respectively). Baseline and 12-month surveys included sociodemographic characteristics, history of previous CC screening, and CC screening knowledge and beliefs. Screening status was assessed by medical record review at baseline and 12-months post-randomization.</p><p><strong>Results: </strong>Mean age of participants was 59.8 years. After controlling for covariates, women randomized to the DVD+PN group had greater odds (OR=5.01;95%CI =2.38,11.50) of being UTD with CC screening compared to UC at 12-months post-randomization. Other significant covariates in the model included having a college vs. high school or lower education (OR=2.36;95%CI=1.08,5.63); private (OR=4.16; 95%CI=1.28,19.1) or no insurance (OR=8.74;95%CI=1.77,51.9) vs. public insurance; normal (OR=3.25; 95%CI=1.46,7.24) or overweight (OR=2.15; 95%CI=1.05, 4.42) vs. obese BMI; and positive screening intention in the next six months (OR=2.59;95%CI=1.48,4.52).</p><p><strong>Conclusions: </strong>A DVD+PN intervention increased the percentage of rural women UTD with CC screening compared to UC or DVD only.</p><p><strong>Impact: </strong>Women who have a high school or lower education, were on public insurance, obese, and not planning to be screened need increased attention to become UTD with CC screening.</p>","PeriodicalId":9458,"journal":{"name":"Cancer Epidemiology Biomarkers & Prevention","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802551","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}