Selected Articles from This Issue

Abstract

While many cancer risk prediction models have been developed, very few have been externally validated, and almost none are used routinely in clinical practice beyond identification of family risk. To address the gap in translation to practice, Rosner and colleagues simplified a summary of breast cancer risk factors, added mammographic breast density, and a 77 SNP polygenic risk score to predict 10-year risk of breast cancer. This simplified model performed well in external validation in the Mayo Mammography Health Study (AUC=0.687). Adding simplified questionnaire data and polygenic risk each improved performance over mammographic breast density and age. This approach can be easily implemented in routine mammography screening clinics.Identification and management of cancer patients' financial concerns is essential as cancer care costs rise. McLouth and colleagues aimed to describe the prevalence of financial screening, sources of financial navigation services, and availability of cancer-specific financial navigators within the National Cancer Institute's Community Oncology Research Program (NCORP). Most NCORP community oncology practice group. had a financial screening process. Practice groups reported multiple potential sources of financial navigation services, but cancer-specific financial navigators were available at only half of the practice groups. Critically, fewer NCORP practice groups serving a higher proportion of racial and ethnic minority patients screened for financial concerns and had a designated financial navigator for cancer patients. Results highlight several opportunities to improve identification of cancer patients who may be vulnerable to financial hardship and to increase services to address financial hardship in community cancer care.Observational studies suggest that men engaged in high levels of physical activity have lower risk of clinically significant prostate cancer. To investigate potential mechanisms, Pernar and colleagues evaluated molecular differences in prostate tissue in men with prostate cancer according to physical activity level. The authors identified several biological pathways that were altered between men with different levels of vigorous physical activity in adjacent normal prostate tissue, such as cancer- and immune-related pathways. These results help illuminate how physical activity may influence the prostate tissue in men with prostate cancer.Inflammation and insulin resistance/hyperinsulinemia are important pathways in hepatocarcinogenesis. Diet and lifestyle behaviors modulate inflammation and insulin response and may thus be crucial modifiable factors in primary prevention for hepatocellular carcinoma (HCC). In a cohort study that followed 119,316 US adults for 25.6 years, participants who consumed diet or had lifestyle behaviors with higher inflammatory and insulinemic potential had higher of developing HCC. These findings by Yang and colleagues suggest that inflammation and insulin resistance/hyperinsulinemia may partly underline the influence of diet and other lifestyle on HCC development, and interventions to reduce the adverse effect of pro-inflammatory and hyper-insulinemic lifestyle may reduce HCC risk.