Highlights of This Issue

Abstract

In this study, Phillips and colleagues estimated the population-level burden of morbidity in individuals diagnosed with cancer as children (ages 0–19 years). SEER data from 1975 to 2011 and prevalence data from the U.S. Childhood Cancer Survivor Study were both used to obtain estimates of morbidity burden and population-level estimates. Within the U.S. population of childhood cancer survivors, the prevalence of any chronic condition was generally high, ranging from 66% (ages 5–19) to 88% (ages 40–49). Efforts to decrease morbidity burden and optimize longevity and well-being in this population should be a priority.Lung cancer screening using low-dose computed tomography (LDCT) reduces overall mortality. Lewis and colleagues assessed lung cancer screening attitudes among primary care providers (PCPs) in the era of new LDCT screening guidelines. Few PCPs reported ordering lung cancer screening, and only 47% of PCPs knew three or more of six guideline components. PCPs report ordering chest x-rays, a nonrecommended screening test, more often than LDCT. PCPs also had a limited understanding of lung cancer screening guidelines and LDCT effectiveness. Provider educational interventions are needed to facilitate shared decision-making with patients.In U.S. women, lifetime risk of ovarian cancer is 1.37%, but some women are at a substantially lower or higher ovarian cancer risk due to both genetic and lifestyle factors. Pearce and colleagues characterized the distribution of lifetime ovarian cancer risk in the U.S. general population and report that the lifetime risk estimates range from 0.35% to 8.78%. This work demonstrates that there are indeed women in the general U.S. population who have a much higher than average lifetime risk of ovarian cancer. As effective ovarian cancer screening becomes available, this report indicates that women with higher than average ovarian cancer risk can be identified and closely monitored.New biomarkers for early detection of cancer offer population benefits and harms. Birnbaum and colleagues used simulation modeling of prostate cancer antigen 3 (PCA3) to project the impact of adding PCA3 to prostate-specific antigen (PSA) screening on prostate cancer detection and mortality in the United States. The authors identified several PSA-PCA3 strategies that substantially reduced false-positive tests and overdiagnoses while preserving the majority of lives saved. The authors report that adding PCA3 to PSA screening can significantly reduce adverse screening outcomes. Strategies can be identified that preserve most of the lives saved relative to PSA-based screening.