Selected Articles from This Issue

Abstract

Racial/ethnic disparities in cancer mortality are well-described and are partly attributable to later stage of diagnosis. It is unclear to what extent reductions in the incidence of late-stage cancer could narrow these relative and absolute disparities. To better understand the potential of enhanced cancer screening in the population at large, Clarke and colleagues previously assessed the population-level potential of earlier detection of common cancer types by examining current rates of diagnosis after metastasis and hypothesizing reductions in deaths that could occur if cancers were diagnosed at earlier stages. Here, that assessment is expanded by estimating these absolute and relative reductions separately for eight contemporary U.S. population subgroups defined by race/ethnicity and sex. Across population subgroups, non-Hispanic Black males have the highest burden of stage IV cancer and would have the most deaths averted from improved detection of cancer before metastasis. Detecting cancer before metastasis could meaningfully reduce deaths in all populations, but especially in non-Hispanic Black populations.This study by Lipshultz and colleagues assessed the burden of potentially modifiable cardiometabolic risk factors among childhood cancer survivors previously treated with anthracycline-containing regimens, compared with population-matched controls. Overall, survivors had similar cardiometabolic profiles compared with general population controls. Survivors had higher rates of pre-hypertension/hypertension, reinforcing the importance of close attention to blood pressure management, even in early adulthood. With more favorable lifestyle habits in this cohort, survivors had a lower predicted cardiovascular risk when applying general population risk factor models, but nonetheless a moderate or greater risk of subsequent symptomatic cardiovascular disease predicted by childhood cancer survivor-specific risk models. Further strategies supporting optimal cardiometabolic risk factor control and risk assessment are warranted in survivors.Breast cancers in recently postpartum women may have worse outcomes, but studies examining tumor molecular features by pregnancy recency have shown conflicting results. This analysis used Carolina Breast Cancer Study data to examine clinical and molecular tumor features among women <50 years of age who were recently (≤10 years prior), or remotely (>10 years prior) postpartum, or nulliparous. Prevalence odds ratios (PORs) and 95% confidence intervals (CIs) were estimated using multivariable models. The results suggest a dominant effect of parity (vs. nulliparity) and a lesser effect of pregnancy recency on tumor molecular features, although tumor immune microenvironments were altered in association with pregnancy recency. This study by Vohra and colleagues is unique in examining tumor immune microenvironment and RNA-based markers according to time since last childbirth.Asian Americans (AA) are the fastest growing and highly diverse population group in the U.S., yet few studies have examined cancer mortality burden by AA ethnicity. Using SEER cancer registry data, Karia and colleagues examined differences in gynecologic cancer mortality between White and AA women by ethnicity (Filipino, Chinese, Japanese, Korean, Vietnamese, Indian/Pakistani). AA women had a lower risk of ovarian and cervical cancer mortality and a higher risk of uterine cancer mortality than White women, with substantial heterogeneity across AA ethnicity. These findings underscore the importance of disaggregation of data by ethnicity to fully understand cancer burden among the diverse AA population.