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No studies so far have prospectively examined whether circulating immune cells in healthy individuals determines pancreatic cancer risk. Using qPCR assays of DNA methylation, Katzke and colleagues measured relative immune cell counts in stored blood from EPIC cohort participants. Higher relative counts of FOXP3+-regulatory and lower proportion of CD8+-cytotoxic T-cells were associated with pancreatic cancer risk diagnosed within first five years of follow-up. Whether immune cell composition is associated to pancreatic cancer risk, or rather with relatively late-stage tumor development, remains unclear. If further epidemiologic studies confirm findings, this might open up novel avenues for cancer prevention by optimizing individuals’ immune defense.Self-reported information may not accurately capture smoking exposure. Yu and colleagues aimed to evaluate whether smoking-associated DNA methylation markers improve urothelial cell carcinoma (UCC) risk prediction. Conditional logistic regression was used to assess associations between blood-based methylation and UCC risk using two matched case-control samples. Results were pooled using fixed-effects meta-analysis. The authors developed methylation-based predictors of UCC and evaluated their prediction accuracy on two replication datasets using the area under the curve. The results suggested that the combination of smoking methylation markers may improve the prediction of urothelial cancer risk. These findings need further evaluation using larger datasets.Lung cancer has not been well studied as a subsequent malignant neoplasm (SMN) in childhood cancer survivors. Ghosh and colleagues assessed incidence, risk factors, and outcomes for lung SMN among 25,654 survivors from the Childhood Cancer Survivor Study (CCSS) cohort. The authors found survivors of childhood cancer are at increased risk for lung cancer with greatest risk observed among survivors who received chest radiotherap. or with primary diagnoses of Hodgkin lymphoma or bone cancer. This study describes the largest number of observed lung cancers in childhood cancer survivors and elucidates need for further study in this aging and growing population.Physical activity is associated with increased risk and improved survival in colorectal cancer. There is some evidence that physical activity may affect the immune system and immune cell infiltration of the tumor microenvironment in a prognostically favorable manner. In this study by Renman and colleagues, based on a population-based cohort, self-reported recreational physical activity >3 times/week was associated with a higher density of CD8+ T cells in the tumor front and center, independent of factors such as age, tumor site, and lifestyle factors. The results provide some evidence on how physical activity may alter the prognosis in colorectal cancer.