Selected Articles from This Issue.

Abstract

Stress is a commonly perceived cause of cancer, but the evidence to date is limited and inconclusive. Hadrévi and colleagues examined work-related stress in relation to cancer incidence in a population-based cohort, with outcome data from Swedish national registries. “High-strain” work (high demand/low control) was not associated with cancer risk compared to “low strain” work (low demand/high control): multivariable HR 1.01 (95% CI, 0.94–1.08) for men and 0.99 (95% CI, 0.92–1.07) for women. Results were also null for most cancer types assessed. The findings of this population-based, cohort study do not support a role for work-related stress in determining cancer risk.Because place of birth is strongly associated with health behaviors, access, and literacy, nativity is an important factor when describing cancer mortality among Asian Americans (AAs), the fastest growing and highly diverse ethnic group in the US. Using nationally representative death certificate data, Tripathi and colleagues present novel, nativity-specific 10-year (2008–2017) mortality statistics disaggregated by detailed AA ethnicity (Asian Indian, Chinese, Filipino, Korean, and Vietnamese). With some exceptions, foreign-born AAs had higher cancer mortality burden than US-born AAs, a result that contradicts the healthy immigrant theory, the notion that recent immigrants have a health advantage over their domestic born counterparts.Outcomes among young adults (22–39y) with Hodgkin Lymphoma (HL) are worse than younger patients; treatment at NCI-designated Comprehensive Cancer Centers (CCC) mitigates outcome disparities. Modeling cancer-related expenditures in administrative claims data among young adults with HL, Wolfson and colleagues found higher health plan expenditures among CCC patients in the year following diagnosis, but comparable out-of-pocket expenditures. Outpatient hospital utilization (monthly rates of non-therap. visits and per-visit expenditures for chemotherapy) drove CCC expenditures, likely reflecting differences in facility structure and comprehensive care. For young adults, it is plausible to consider incentivizing CCC care to achieve superior outcomes while developing approaches to achieve long-term savings.Fusobacterium nucleatum is a bacteria enriched in a subset of colorectal tumors thought to play a role in colorectal cancer (CRC) development and survival. Borozan and colleagues characterized F. nucleatum and its subspecies by deep-sequencing tumors of ∼2,000 CRC patients. The authors report that F. nucleatum subspecies animalis is associated with higher CRC-specific mortality in patients with non-hypermutated, microsatellite-stable tumors and those receiving chemotherapy. They also identified that F. nucleatum is associated with somatic mutations in POLE and ERBB3. These findings underscore the importance of the gut microbiome in CRC outcomes and implicate F. nucleatum animalis as a pathogenic subspecies.