Highlights of This Issue

Abstract

Although coffee drinking is associated with reduced risk of all-cause mortality, associations with cancer death overall and from specific types are unclear, in part due to confounding by smoking. In our large, prospective study of U.S. men and women, there was a nonlinear, U-shaped association between coffee consumption and overall cancer mortality among current and former smokers, and no association among never smokers. Among nonsmokers, coffee consumption was associated with reduced risk of death from head and neck, colorectal, liver, and female breast cancers, and higher risk of esophageal cancer death. These findings underscore the importance of examining associations between coffee drinking and cancer risk by smoking status.To prevent cervical cancer, World Health Organization guidelines support human papillomavirus (HPV) testing alone (followed by treatment with cryotherapy) or in conjunction with visual inspection with acetic acid (VIA) triage testing. This study by Campos and colleagues used mathematical simulation modeling to evaluate the cost-effectiveness of HPV testing alone versus HPV testing with VIA triage in India, Nicaragua, and Uganda. In all three countries, HPV testing alone was more effective than HPV followed by VIA triage, and was also very cost-effective. VIA triage of HPV-positive women is not likely to be cost-effective in settings with a high burden of cervical cancer.Inflammation and tissue injury/regeneration have been proposed to drive the development of prostate cancer. Prior studies to examine whether the presence of inflammation correlates with prostate cancer in biopsy tissues have been cross-sectional. To test the inflammation–prostate cancer hypothesis prospectively, Platz and colleagues linked two clinical trials, such that men with negative biopsies in the PCPT trial who subsequently joined the SELECT trials were studied. Using men in SELECT found to have cancer as cases, and a matched set of men in SELECT that were negative on biopsy (controls), risk of prostate cancer (Gleason grade < 4 + 3 = 7) increased with percent tissue area with inflammation. Taken together, these and the authors' prior findings support the role of intraprostatic inflammation in the development of prostate cancer.Both colon cancer and dementia are prevalent among the elderly and have a high risk of co-occurrence. Limited studies have examined the relationship between dementia and survival after diagnosis of nonmetastatic colon cancer, with treatment choice as a possible mediating factor. In this study, we provide the first estimate of the mediating effect of diminished chemotherapy in patients with stage III colon cancer and dementia, simultaneously demonstrating the cancer-specific survival benefit of chemotherapy in the presence of dementia. Adherence to cancer care guidelines generated from populations with normal cognition may yield limited survival benefits for elderly with advanced dementia.