Cancers最新文献

{"title":"RETRACTED: Li et al. TRIM10 Is Downregulated in Acute Myeloid Leukemia and Plays a Tumor Suppressive Role via Regulating NF-κB Pathway. <i>Cancers</i> 2023, <i>15</i>, 417.","authors":"Lin Li, Qi Li, Zhengrong Zou, Zoufang Huang, Yijian Chen","doi":"10.3390/cancers18101507","DOIUrl":"10.3390/cancers18101507","url":null,"abstract":"<p><p>The journal retracts the article \"TRIM10 is downregulated in acute myeloid leukemia and plays a tumor suppressive role via regulating NF-κB pathway\" [...].</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 10","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Insulin Resistance: Exploring the Centrality of the Gut-Liver Axis in Mediating Immunometabolic Dysregulation Driving Hepatocellular Carcinoma in MASLD and Diabetes.","authors":"Mario Romeo, Claudio Basile, Giuseppina Martinelli, Fiammetta Di Nardo, Carmine Napolitano, Alessia De Gregorio, Paolo Vaia, Luigi Di Puorto, Mattia Indipendente, Alessandro Federico, Marcello Dallio","doi":"10.3390/cancers18081316","DOIUrl":"10.3390/cancers18081316","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) represents a major global health challenge and the third leading cause of cancer-related mortality worldwide. Its epidemiological burden is rapidly increasing, largely driven by the rising prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), which is now recognized as the most common chronic liver disease globally. Notably, MASLD frequently coexists with type 2 diabetes mellitus (T2DM), sharing several features, including the interplay of common genetic, metabolic, and environmental factors, thus contributing to a complex multifactorial pathogenesis. Relevantly, patients affected by both conditions represent a subgroup at particularly high risk of liver disease progression and hepatocarcinogenesis. In this population, metabolic and inflammatory disturbances act synergistically to create a pro-tumorigenic hepatic environment where insulin resistance (IR) plays a crucial role, by driving hepatic lipotoxicity, mitochondrial dysfunction, and inflammatory signaling with oxidative stress, thereby establishing a permissive environment for worsening steatosis and malignant transformation. Increasing evidence supports the concept of MASLD as a multisystem disorder reflecting the systemic nature of metabolic dysfunction. Within this framework, beyond IR, extrahepatic factors have also emerged as important contributors to steatosis progression, worsening of T2DM, and modulation of HCC risk. In particular, the gut-liver axis has gained recognition as a key regulator of hepatic homeostasis, integrating signals from the intestinal microbiota, immune responses, and metabolic pathways. Dysregulation of this crosstalk promotes systemic inflammation and metabolic imbalance, exacerbating IR and fostering a pro-oncogenic hepatic environment. This review examines the interconnected metabolic and immune mechanisms linking IR and gut-liver axis dysfunction to HCC development in patients with MASLD and T2DM, highlighting their implications for risk stratification and precision-based therapeutic strategies.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Right Hemicolectomy Provides Equivalent Oncologic Outcomes and Improved Perioperative Recovery Compared with Open Surgery.","authors":"Hatice Altin, Thorsten Brechmann, Metin Mazgaldzhi, Anna-Marie Wilk, Benno Mann, Alexander Wilk","doi":"10.3390/cancers18081310","DOIUrl":"10.3390/cancers18081310","url":null,"abstract":"<p><p><b>Background/objectives</b>: Open right hemicolectomy (ORH) remains the standard approach for locally advanced right-sided colon cancer. Minimally invasive techniques are increasingly applied in earlier disease stages; however, evidence regarding long-term oncologic outcomes in advanced tumors remains limited. This study aimed to compare the perioperative and oncologic outcomes of ORH versus robotic right hemicolectomy (RRH). <b>Methods</b>: In this single-center study, a prospectively maintained database of consecutive right hemicolectomy patients (2010-2020) was analyzed. The primary endpoint was overall survival (OS). Secondary endpoints included disease-free survival (DFS), perioperative outcomes, and histopathological quality. Additionally, a subgroup analysis was performed for T4 tumors. <b>Results</b>: A total of 198 patients was included, comprising 77 that underwent ORH and 121 that underwent RRH. RRH achieved oncologic outcomes comparable with ORH, with similar R0 resection rates (96% vs. 97.5%, <i>p</i> = 0.547) and lymph node yields (median of 18 nodes in both groups, <i>p</i> = 0.828). OS did not differ significantly (ORH, 45.3 months vs. RRH, 49.9 months, <i>p</i> = 0.130). DFS was longer in RRH (ORH, 42.2 months vs. RRH, 49.1 months, <i>p</i> = 0.029; HR = 0.575, 95% CI 0.349-0.947); however, this difference disappeared after adjustment for tumor stage. No survival advantage was observed in the T4 subgroup. <b>Conclusions</b>: RRH provides oncologic outcomes comparable to open surgery while offering perioperative advantages, even in locally advanced colon cancer. When performed in experienced high-volume centers, RRH represents a safe and oncologically sound alternative to ORH and may contribute to expanding MIC beyond early-stage disease.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Tumor DNA in Ovarian Cancer: Emerging Roles in Early Detection, Risk Stratification, and Disease Monitoring.","authors":"Ludovica Pepe, Valeria Zuccalà, Walter Giuseppe Giordano, Giuseppe Giuffrè, Maurizio Martini, Vincenzo Cianci, Cristina Mondello, Massimiliano Berretta, Stefano Cianci, Vincenzo Fiorentino, Antonio Ieni","doi":"10.3390/cancers18081312","DOIUrl":"10.3390/cancers18081312","url":null,"abstract":"<p><p>Early diagnosis of ovarian cancer remains one of the most important unmet needs in gynecologic oncology because survival is strongly stage-dependent and most patients still present with disseminated disease. Conventional non-invasive tools, particularly CA-125, transvaginal ultrasound, and composite triage algorithms, remain clinically useful but are limited by suboptimal sensitivity for stage I disease and by reduced specificity in premenopausal women and in benign inflammatory or endometriosis-associated conditions. Circulating tumor DNA (ctDNA) has therefore emerged as a candidate biomarker capable of extending liquid biopsy beyond conventional serology. In ovarian cancer, however, ctDNA implementation is constrained by low tumor shedding in early-stage disease, marked biologic heterogeneity across histotypes, clonal hematopoiesis-related background noise, and major pre-analytical and analytical sources of variability. This narrative review, informed by structured searches of PubMed, Scopus, and Web of Science, examines the evolving evidence for ctDNA mutations, methylation-based assays, multi-omic platforms, and machine-learning models across three distinct clinical contexts: population screening, preoperative triage of adnexal masses, and post-treatment assessment of molecular residual disease. We also discuss positive predictive value, false-positive harms, health-economic implications, standardization initiatives, and ongoing prospective studies. Overall, current evidence suggests that the most plausible near-term role for liquid biopsy in ovarian cancer is not as a universal stand-alone screening test, but as an integrated component of risk stratification and disease-monitoring frameworks that combine molecular signals with clinicopathologic and imaging data.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PSA Density and PIRADS 5 Lesions as Key Determinants of Upstaging After Radical Prostatectomy.","authors":"Patryk Patrzałek, Mikołaj Kisiała, Marcel Dawidowicz, Jakub Wieland, Karol Zagórski, Jakub Karwacki, Adam Gurwin, Jan Łaszkiewicz, Wojciech Tomczak, Wojciech Urbański, Dawid Janczak, Wojciech Krajewski, Tomasz Szydełko, Bartosz Małkiewicz","doi":"10.3390/cancers18081319","DOIUrl":"10.3390/cancers18081319","url":null,"abstract":"<p><p><b>Introduction</b>: Clinical staging based on digital rectal examination is imprecise, leading to pathological upstaging in patients with prostate cancer (PCa). Accurate preoperative assessment remains a challenge despite the use of multiparametric magnetic resonance imaging (mpMRI) and fusion-guided biopsy. This study aims to identify key predictors of upstaging in preoperative patients. <b>Materials and Methods</b>: A retrospective analysis of 924 patients who underwent radical prostatectomy between July 2012 and January 2025 was performed. Variables included prostate-specific antigen, prostate volume, biopsy type, MRI, body mass index and age. Upstaging was defined as ≥pT3 in patients staged clinically as cT1-2. Optimal cut-offs for continuous variables were defined statistically. Multivariable logistic regression was applied to identify independent predictors of upstaging and minor staging upgrading (MSU)-defined as any upward shift in the pathological T stage relative to the clinical T stage. Model performance was evaluated using the area under the Receiver Operating Characteristic (ROC) curve (AUC). <b>Results</b>: Upstaging occurred in 31.9% and MSU in 50.6% of patients. The mean age was 65 years. Cut-off values for PSA density (PSAD) were 0.29 for upstaging and 0.28 for MSU. In the full-cohort model (AUC = 0.628), PSAD (odds ratio (OR) = 2.55), age (OR = 1.04), and hypertension (HT) (OR = 1.47) were associated with upstaging. In PIRADS-based models, PIRADS 5 and PSAD predicted both upstaging (OR = 1.62 and 6.10, respectively; AUC = 0.664) and MSU (OR = 1.75 and 4.67, respectively; AUC = 0.659). MSU was also associated with HT and a lack of fusion biopsy (AUC = 0.622). <b>Conclusions</b>: PSAD and PIRADS 5 lesions are strong determinants of pathological upstaging and MSU in PCa. These factors should be considered in preoperative risk stratification to improve staging accuracy. Despite advances in imaging and biopsy techniques, upstaging remains a common phenomenon, underlining the need for further refinement of diagnostic protocols.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papillary Thyroid Carcinoma in the Era of De-Escalation: Toward Personalized and Less Aggressive Management.","authors":"Joaquin Gomez-Ramirez, Raquel Arranz Jiménez, Beatriz López de la Torre, Elisa York Pineda, Paola Parra Ramírez","doi":"10.3390/cancers18081317","DOIUrl":"10.3390/cancers18081317","url":null,"abstract":"<p><p><b>Background:</b> Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer and is generally associated with an excellent prognosis. Historically, treatment strategies were uniform and frequently aggressive, including total thyroidectomy and routine radioiodine ablation, even in low-risk cases. <b>Current Perspective:</b> Over the past decade, the management of PTC has shifted toward a de-escalation paradigm. This transition is driven by high evidence showing that the majority of PTCs follow an indolent course, with low recurrence and mortality rates. As a result, there is increasing emphasis on tailoring the extent of surgery and adjuvant therapy to individual patient risk profiles. Active surveillance, hemithyroidectomy, and selective use of radioiodine now represent valid alternatives to traditional radical approaches, particularly for low-risk tumors. <b>Clinical Implications:</b> The goal of this evolution is to balance oncologic safety with quality of life, reducing overtreatment and minimizing long-term complications such as hypoparathyroidism or recurrent laryngeal nerve injury. Personalized treatment decisions are now guided by tumor biology, molecular markers, and refined risk stratification systems. <b>Conclusions</b>: This article will review the current evidence supporting this shift, highlight the challenges of implementation in clinical practice, and discuss future trends in the management of papillary thyroid carcinoma.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MDK Activates the PI3K/AKT Axis to Induce AP2A1 Expression and Epithelial-Mesenchymal Transition in Colorectal Cancer.","authors":"Tengfei Li, Chengyuan Xu, Yang Guo, Yanyan Xu, Kaiji Chen, Yunsheng Cheng, Kesavamoorthy Gandhervin, Jianming Zhang, Moubin Lin","doi":"10.3390/cancers18081311","DOIUrl":"10.3390/cancers18081311","url":null,"abstract":"<p><p><b>Background:</b> Midkine (MDK), a secreted heparin-binding growth factor, is involved in tumor progression and metastasis. While serum MDK is widely recognized as a potential prognostic biomarker for colorectal cancer (CRC), its specific functional role and underlying mechanisms in CRC development are not fully understood. <b>Methods:</b> The four publicly available CRC microarray datasets-GSE41258, GSE44076, GSE81558, and GSE117606-along with TCGA-COAD and TCGA-READ datasets and their associated clinical data were obtained. MDK expression was measured at both the mRNA and protein levels using quantitative real-time PCR (qRT-PCR) and Western blotting. To investigate its oncogenic functions, a comprehensive set of assays was performed: transwell and wound healing assays for invasion and migration; CCK-8 and colony formation assays for proliferation; and tail vein/spleen injection models combined with xenograft models to study metastasis and tumor growth in vivo. To uncover underlying mechanisms, Western blotting was used to examine the involvement of epithelial-mesenchymal transition (EMT) and the PI3K/AKT signaling pathway. <b>Results:</b> MDK is significantly overexpressed in CRC tissues and cells compared to normal tissues and cells. Notably, patients with high MDK levels show poorer overall survival (OS). Overexpression of MDK increases CRC invasion, migration, proliferation, and metastasis both in vivo and in vitro, while its knockdown reverses these effects. Mechanistically, MDK activates the PI3K/AKT pathway, leading to increased AP2A1 expression and promotion of EMT in CRC. <b>Conclusions:</b> MDK promotes invasion, migration, proliferation, metastasis, and EMT in CRC cells through the PI3K/AKT pathway by inducing AP2A1 expression, which could serve as a diagnostic marker. The PI3K inhibitor LY294002 significantly reduces AP2A1 levels and inhibits MDK-induced malignant behaviors. Targeting MDK-related signaling pathways may offer new strategies for CRC treatment.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence Mapping of ctDNA Reporting in Pancreatic Ductal Adenocarcinoma: Toward a Shared Quantitative Language for ctDNA.","authors":"Daniel Croagh, Saeed Aslani","doi":"10.3390/cancers18081318","DOIUrl":"10.3390/cancers18081318","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Circulating tumour DNA (ctDNA) assays enable non-invasive assessment of tumour burden and treatment response in oncology. However, quantitative ctDNA outputs (such as variant allele frequency, tumour fraction, and aggregate burden scores) remain difficult to interpret and compare across platforms. This evidence-mapping review evaluates current quantitative reporting approaches in pancreatic ductal adenocarcinoma (PDAC) and examines the potential role of KRAS mutant ctDNA as a biologically grounded reference metric. <b>Methods</b>: A systematic literature search was conducted across PubMed/MEDLINE and Scopus to identify studies reporting quantitative ctDNA metrics in PDAC. Eligible studies included those measuring plasma KRAS mutations and/or reporting variant allele frequency, tumour fraction, or multi-locus aggregate metrics. Additional relevant primary studies identified through broader manual searching of PubMed were assessed against the same prespecified eligibility and classification criteria before inclusion. Data were synthesised narratively, focusing on reporting frameworks, units of measurement, assay characteristics, and the interpretability of quantitative outputs across platforms. <b>Results</b>: Substantial heterogeneity was observed in ctDNA quantification methods and reporting standards. Ratio-based metrics such as variant allele frequency and tumour fraction were commonly used but varied according to assay design, plasma input volume, and background cell-free DNA levels. Few studies reported absolute mutant molecule counts per unit volume. Given that approximately 90-95% of PDACs harbour truncal activating KRAS mutations, plasma KRAS was consistently represented across platforms and demonstrated potential as a shared quantitative anchor. Limited standardisation was noted in distinguishing detectability from quantifiability based on sampling depth and counting statistics. <b>Conclusions</b>: Current ctDNA reporting in PDAC lacks a shared quantitative reference, limiting cross-study comparability. Reporting KRAS mutant molecules per millilitre and adopting an assay-agnostic framework distinguishing detection from quantification may improve interpretability, support harmonisation across platforms, and facilitate cumulative learning in pancreatic cancer ctDNA research.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance of STING Expression in Extramammary Paget's Disease.","authors":"Yoko Amagata, Natsuko Saito-Sasaki, Yu Sawada","doi":"10.3390/cancers18081314","DOIUrl":"10.3390/cancers18081314","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Extramammary Paget's disease (EMPD) is a rare cutaneous malignancy with a highly variable clinical behavior. While early-stage disease is often indolent, progression to dermal invasion and lymph node metastasis is associated with a poor prognosis. Reliable biomarkers that reflect tumor aggressiveness and predict clinical outcomes are lacking. The stimulator of interferon genes (STING) pathway plays a central role in innate immune signaling and antitumor immunity; however, its clinical significance in EMPD remains unclear. <b>Methods</b>: We retrospectively analyzed STING expression using immunohistochemistry in formalin-fixed, paraffin-embedded tumor specimens obtained from 63 patients with EMPD. Associations between STING expression and clinicopathological features were evaluated. Overall survival was analyzed using Kaplan-Meier methods, and prognostic factors were assessed using univariate and multivariate Cox proportional hazards regression analyses. <b>Results</b>: STING expression was positive in 26 (41%) and negative in 37 (59%) patients. Loss of STING expression was significantly associated with dermal invasion and lymph node swelling. Kaplan-Meier analysis demonstrated a significantly poorer overall survival in patients with STING negativity than in those with STING positivity. In univariate analysis, lymph node swelling, dermal invasion, and STING expression were significantly associated with survival. Multivariate Cox regression analysis identified lymph node swelling as an independent adverse prognostic factor, whereas STING expression was an independent favorable prognostic factor. Loss of STING expression is closely associated with aggressive clinicopathological features and independently predicts poor prognosis in EMPD. <b>Conclusions</b>: STING expression may serve as a useful prognostic biomarker and provides insight into the immunobiology of EMPD.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organised Colorectal Cancer Screening and Changes in Mortality and Incidence Trends: A Population-Based Study.","authors":"Astrid Díez-Martín, Margarita Castro, Isolina Santiago, Raquel Almazán, Ángel Gómez-Amorín, Cristina Regueiro-Expósito, Pedro Davila-Piñón, Joaquín Cubiella","doi":"10.3390/cancers18081313","DOIUrl":"10.3390/cancers18081313","url":null,"abstract":"<p><p><b>Background:</b> Organised colorectal cancer (CRC) screening programmes have been widely implemented across Europe; however, robust population-level evaluations of their real-world effectiveness, particularly for programmes based exclusively on faecal immunochemical testing (FIT), remain limited. The Galician CRC screening programme was progressively implemented between 2013 and 2019. <b>Methods:</b> We conducted a population-based ecological time-series study using data from the Galician Tumour Registry (ICD-10 C18-C21) for 2015-2023. Age-standardised mortality (ASMR) and incidence (ASIR) rates were analysed. They were calculated using the direct standardisation method, applying age-specific rates to the 2013 European Standard Population (ESP2013). Structural changes associated with programme implementation were evaluated using interrupted time-series (ITS) models, estimating annual percent change (APC) before and after implementation and the net change in slope (ΔAPC). Absolute and relative changes in ASMR and ASIR were calculated by comparing 2015-2017 and 2019-2023. Analyses were performed for the overall population and for individuals aged 50-69 years. <b>Results:</b> Between 2015 and 2023, overall CRC mortality declined significantly (APC -3.00%; 95% CI -3.37 to -2.63). ITS analysis demonstrated a marked modification of mortality trajectories following programme implementation. Mortality shifted from an increasing pre-implementation slope (APC +13.70%; 95% CI 10.12, 17.39) to a significant annual decline post-implementation (APC -3.62%; 95% CI -4.47, -2.76), yielding a ΔAPC of -17.32. In individuals aged 50-69 years, the structural change was more pronounced (ΔAPC -19.88), with post-implementation mortality decreasing by -8.08% annually (95% CI -10.43, -5.66). Incidence showed a comparable structural modification. Overall APC changed from +15.26% (95% CI 5.48, 25.95) before implementation to -2.48% (95% CI -5.29, 0.41) afterwards (ΔAPC -17.74). In the screening-eligible population, APC shifted from +21.32% (95% CI 4.60, 40.71) to -3.74% (95% CI -7.62, 0.30), corresponding to a ΔAPC of -25.06. Descriptively, ASMR declined from 41.92 to 35.91 per 100,000 (-14.33%), and ASIR from 98.37 to 85.16 per 100,000 (-13.42%) between 2015 and 2017 and between 2019 and 2023. Relative reductions were larger in individuals aged 50-69 years and were more pronounced for colon cancer than for rectal cancer. <b>Conclusions:</b> Implementation of an organised FIT-based screening programme was associated with a structural change in CRC mortality and incidence trends, particularly among individuals aged 50-69 years.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 8","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}