Incidence Of Cancer In Patients Research Articles

Activation of cardiac sarcoidosis associated with development of gastric cancer: a case report

BackgroundThe high 18F-fluorodeoxyglucose (FDG) uptake in sarcoidosis lesions reflects infiltration of inflammatory cells such as macrophages. An increased incidence of cancer in patients with sarcoidosis has been suggested, and some combination of the following mechanisms has been proposed: chronic inflammation, immune dysfunction, shared aetiologic agents, and genetic susceptibility to both cancer and autoimmune diseases.Case summaryA 73-year-old man was admitted to our hospital due to effort dyspnoea. Initial investigations showed complete atrioventricular block on electrocardiography, basal thinning of the interventricular septum, and preserved left ventricular (LV) systolic function on echocardiography, and late gadolinium enhancement (LGE) in all layers of the basal interventricular septum on cardiac magnetic resonance imaging. FDG positron emission tomography/computerized tomography (FDG-PET/CT) showed no abnormal uptake in the whole-body including myocardium. After discussion, corticosteroid was not initiated then. One year later, he developed stomach adenocarcinoma. Repeated investigations demonstrated enlargement of the LV (LV diastolic diameter 63 mm) and diffuse systolic impairment of LV function (LV ejection fraction 31%) on echocardiography, and abnormal focal uptake at the lateral walls of LV and hilar lymph nodes on FDG-PET/CT imaging. One more year after the surgery for gastric cancer and corticosteroid initiation, echocardiography showed recovery of systolic function and FDG-PET/CT showed no uptake in either the myocardium or hilar lymph nodes.DiscussionIn the present case, it is speculated that the first inflammation which left scarred areas showing LGE was already completed before the first FDG-PET/CT. The development of gastric cancer may be associated with the reactivation of cardiac sarcoidosis.

Effects of cancer on patients with COVID-19: a systematic review and meta-analysis of 63,019 participants.

Objective:Patients with underlying diseases are more vulnerable to coronavirus disease 2019 (COVID-19). The purpose of this study was to investigate cancer incidence in patients with COVID-19 and to determine whether cancer was associated with mortality among patients with COVID-19.Methods:Electronic searches of PubMed, Embase, Cochrane, Web of Science, and medRxiv were conducted to collect studies that provided data regarding the incidence and mortality of cancer patients with COVID-19. Meta-analyses were used to estimate pooled incidences, risk ratios (RRs), and 95% confidence intervals (CIs) using a random-effects model. Heterogeneity among studies was detected using I2 statistics.Results:A total of 19 retrospective studies involving 63,019 patients (2,682 patients with cancer) were included. Meta-analysis showed that the pooled incidence of cancer in COVID-19 patients was 6% (95% CI: 3%–9%). The mortality rate of COVID-19 patients with cancer was higher than that of those without cancer [risk ratio (RR): 1.8, 95% CI: 1.38–2.35, P < 0.01]. Studies on specific types of cancer showed that among COVID-19 patients, the mortality rate of lung cancer patients was higher than that of patients without lung cancer (RR: 1.8, 95% CI: 0.85–3.80, P = 0.02).Conclusions:Patients with cancer were more susceptible to COVID-19. As a risk factor, cancer increased mortality among COVID-19 patients. Among COVID-19 patients with cancer, those who had lung cancer had a higher mortality than those without lung cancer. Our findings suggested that clinicians should pay more attention to cancer patients diagnosed with COVID-19 and provide useful information for their clinical management.

Oral Cancer Incidence in Patients visiting Government Medical College and Hospital, Nizamabad, Telangana: A Prospective Study

Oral Cancer Incidence in Patients visiting Government Medical College and Hospital, Nizamabad, Telangana: A Prospective Study

Plasma metals and cancer incidence in patients with type 2 diabetes

There is limited evidence on the relationships between plasma levels of multiple metals and risk of incident cancer in patients with type 2 diabetes mellitus (T2DM). We examined the associations between plasma levels of 12 metals (iron, copper, zinc, selenium, chromium, manganese, molybdenum, cobalt, nickel, arsenic, cadmium, and lead) and cancer risk in 4573 T2DM patients using Cox proportional hazards models. With a median follow-up of 10.2 years, 541 incident cancers were identified. The multiple-metals model revealed that each 1-SD increase in ln-transformed plasma copper (HR: 1.14; 95%CI: 1.02, 1.27) and lead (HR:1.20; 95%CI:1.03, 1.39) were significantly associated with increased cancer incidence while each 1-SD increase in ln-transformed plasma zinc (HR: 0.82; 95%CI: 0.71, 0.96) and chromium (HR: 0.88; 95%CI: 0.82, 0.94) were significantly associated with decreased cancer incidence. When all participants were further stratified into four subgroups by the quartile levels (Q1–4) of plasma metals, manganese showed significant positive associations with cancer incidence in the upper two quartiles (P trend = 0.003) while nickel showed significant negative associations with cancer incidence in Q2 and 4 groups (P trend = 0.033) compared with participants in Q1 group. Collectively, monitoring of metal levels in diabetic patients needs to be strengthened, which is of great significance for the prevention of incident cancer.

Development of Cancer in Patients With Heart Failure: How Systemic Inflammation Can Lay the Groundwork.

In the last decade, cardiologists and oncologists have provided clinical and experimental evidence that cancer, and not only chemotherapeutic agents, can cause detrimental effects on heart structure and function, a consequence that has serious clinical implications for patient management. In parallel, the intriguing idea that heart failure (HF) may be an oncogenic condition has also received growing attention. A number of epidemiological and clinical studies have reported that patients with HF have a higher risk of developing cancer. Chronic low-grade systemic inflammation has been proposed as a major pathophysiological process linking the failing heart to the multi-step process of carcinogenesis. According to this view, pro-inflammatory mediators secreted by the damaged heart generate a favorable milieu that promotes tumor development and accelerates malignant transformation. HF-associated inflammation synergizes with tumor-associated inflammation, so that over time it is no longer possible to distinguish the effects of one or the other. Experimental studies have just begun to search for the molecular effectors of this process, with the ultimate goal that of identifying mechanisms suitable for anti-cancer target therapy to reduce the risk of incident cancer in patients already affected by HF. In this review we critically discuss strengths and limitations of clinical and experimental studies that support a causal relationship between HF and cancer, and focus on HF-associated inflammation, cardiokines and their endocrine functions linking one and the other disease.

Cáncer y desfibrilador automático implantable ¿causalidad, confusión o casualidad?

Introduction and Objectivesimplantable cardiac defibrillator (ICD) has been established as a therapy for malignant ventricular arrhythmias in patients at high risk of suffering them.Some studies suggest a possible relationship between the development of cancer and some prosthetic materials. Likewise, some investigations describe a higher incidence of cancer in patients with an ICD that suggest a potential relationship. MethodsRetrospective cohort study of patients that underwent implantation of an ICD in the Complejo Hospitalario de Navarra between 2000 and 2016. The follow-up finished in June 2018.Sociodemographic, comorbidities and oncological data was analysed. Cancer incidence rates were estimated and compared with the general population data and with data of a cohort of patients with reduced LVEF heart failure. Risk of cancer models were adjusted by competitive risk models. Results497 patients were included, mostly male (89.1%), with a mean age of 59.98 (14.98) years and a proportion of smokers of 67.6% and of ischaemic heart disease of 51.6%. The cancer incidence rate in the sample was 1230.9 per 100.000 person-year. In our study, features associated with cancer were older age, higher tobacco use and ischaemic cardiopathy. ConclusionsIn our sample of ICD carriers the incidence of cancer is high. This finding mainly seems to be related to tobacco usage and higher age.

S0205 Association of Cancer With Comorbid Inflammatory Diseases in Lynch Syndrome and Lynch-Like Syndrome Individuals

INTRODUCTION: Individuals with Lynch syndrome (LS) and Lynch-Like Syndrome (LLS) develop microsatellite unstable colorectal tumors that produce neo-antigens. Neo-antigens are highly immunogenic, resulting in enhanced immune surveillance of tumors. The impact of inflammatory, auto-immune conditions on cancer in these patients is not known. We compared the cancer incidence in patients with and without comorbid inflammatory diseases (CID). METHODS: Patients with LS (pathogenic variant in a mismatch repair gene), or LLS (Amsterdam positive family history with MSI-H tumor) from a hereditary cancer registry undergoing surveillance were identified. Those with a CID disease (IBD/rheumatic disease) based on ICD-10 criteria were selected and considered “cases”. LS and LLS patients without a comorbid inflammatory disease were matched for age, gender, and genetic mutation in a 2:1 ratio and considered “controls”. We compared proportion of patients with cancer at the time of last follow up visit between the two groups. RESULTS: 21 patients with LS/LLS and CID were compared to 43 controls. Mean age for cases was 53.9 ± 15.7 yrs compared to controls 53.8 ± 7.8 yrs. There was no major difference in race, sex, smoking and family history between the two groups (Table 1). Colonoscopies per yr following LS/LLS diagnosis was 0.89 in cases compared to 0.86 in controls (P = 0.86). 76.2% cases vs 53.5% controls had a history of complete or partial colectomy. 83% of female cases compared to 76% of female controls had a TAH-BSO prophylactically or for endometrial cancer. Mean age at CID diagnosis was 38.9 ± 13.4 yrs. Diseases included: Crohn’s 5 (23.8%), ulcerative colitis 2 (9.5%), inflammatory/rheumatoid arthritis 7(33.3%), psoriatic arthritis 1(4.8), psoriasis 3(14.3%), and one case each of dermatomyositis, ankylosing spondylitis, and sarcoidosis. 84.2% cases developed any cancer compared to 76.7% in controls (P = 0.74). Age at 1st cancer diagnosis was 45.5 ± 14.6 yrs in cases and 43.8 ± 7.1 yrs in controls (P = 0.67). Cancer incidence after CID diagnosis was 57.1% in cases with median 10(6.0-16.5) yr follow-up versus 46.5% in controls (P = 0.42) when followed for 10 yrs prior to their last follow up or death. Most of these were LS specific cancers: 52.4% of cases vs 44.2% of controls (P = 0.54).Table 1Table 2Figure 3CONCLUSION: Our data does not demonstrate substantially different incidence rates of cancer between LS/LLS patients with and without comorbid inflammatory disease.

S0313 Psychiatric Diagnosis May Result in a Higher Incidence of Colorectal Cancer in Patients With a Positive Fecal Immunochemical Test in a Veteran Patient Population

S0313 Psychiatric Diagnosis May Result in a Higher Incidence of Colorectal Cancer in Patients With a Positive Fecal Immunochemical Test in a Veteran Patient Population

Abstract PO-062: Early impact of COVID-19 in cancer care: The experience of a Brazilian outpatient clinic

Abstract The first confirmed case of coronavirus disease 2019 (COVID-19) in Latin America was reported on February 25th, 2020, in Brazil. As COVID19 disease incidence escalated in the country, management of cancer patients required immediate action and oncology clinics were urged to establish a contingency plan. We were the first oncology clinic in Brazil to install a COVID-19 Management Committee to elaborate and implement best practices to assist cancer outpatients as well as to provide a safe environment for clinical staff and other employees at the outpatient clinics. We started monitoring our staff and employees on March 13th, a day after we installed a contingency plan for COVID-19 management and WHO declared COVID-19 a pandemic. So far, out of 1,022 staff and employees of our group, we have registered 12.3% suspected and 3.8% confirmed COVID-19 cases, and only 1 case severe enough to require hospitalization. As COVID-19 testing is not widely available, not all patients were tested and/or we did not have access to results, as tests might have been conducted somewhere other than the clinic. Out of 98 patients with suspected COVID-19 being monitored by SCIA (ranging from 29 to 90yo), 68% were tested and 43% of these were positive. As for the monitored population (n=98), 62.6% were undergoing treatment, 31.8% tested positive, and 9.9% died due to COVID-19 (31% of the confirmed cases, matching literature data). All deaths by COVID-19 (n=9) occurred in patients above 68yo, and 77% (n=6) were undergoing cancer treatment. To the best of our knowledge, this is the first report of COVID-19 incidence in cancer patients in Brazil. The challenges of cancer treatment in the midst of a global pandemic highlight the importance of a rapid response by institutions, where organizational structure, strategic planning, agility in guidelines implementation, and alternative ways to protect and support clinical staff, employees, and patients may be the keys to mitigate pandemic effects. Citation Format: Cinthya Sternberg, Bianca Vivas, Thamine Lessa Andrade, Ana Paula Vila Nova, Ana Paula Fernandes, Camila Alves, Adriana Alvez, Lise Hizumi, Simone Dias, Pablicio Nobre, Aknar Calabrich, Anelisa Coutinho, Alex Pimenta. Early impact of COVID-19 in cancer care: The experience of a Brazilian outpatient clinic [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-062.

Abstract PO-060: COVID-CANCER HUIL STUDY: Registry of oncologic patients diagnosed with Covid-19 in Infanta Leonor University Hospital in Madrid, Spain

Abstract Background: Covid-19 has been shown to present more complications in immunosuppressed patients. We determine whether differences exist in Covid-19-related mortality between cancer patients and general population in our hospital, and we also describe associated risk factors. Methods: We reviewed 2,216 medical records of all patients admitted to hospitalization in Infanta Leonor University Hospital in Madrid, Spain, with Covid-19 diagnosis between 5 March and 13 May, 2020. Study data were collected and managed using REDCap electronic data capture tools. We described Covid-19 cumulative incidence in cancer patients, treatment outcome, mortality, and associated risk factors. Results: We detected 85/2,216 cancer patients between all Covid-19 diagnoses. Mortality rate: 40/85 cancer patients vs. 260/2,131 in general ward (p&amp;lt;0.001). Median age: 76 years old (34-94), 50/85 male patients. Most frequent histologies were lung cancer (22/85), colorectal cancer (19/85), prostate cancer (15/85), and breast cancer (10/85). Most frequent staging was metastatic disease (32/85). Only 2/85 patients were admitted to ICU. Mortality was associated with older median age (79.5 vs. 73, p=0.03), high d dimer levels (1630 vs. 830, p=0.03), high LDH levels (315.5 vs. 224, p=0.003), bilateral pneumonia (24/42 vs. 5/22 with unilateral pneumonia, p=0.02), ARDS (12/13 vs. 28/72 without ARDS, p&amp;lt;0.0001), and metastatic disease (20/32 metastatic vs. 20/53 non-metastatic patients, p=0.02). Differences were maintained in multivariate analyses regarding ARDS (OR 23.7, p=0.007) and metastatic disease (OR 2.5, p=0.05). Conclusions: Covid-19 had a significant mortality in cancer patients. High D dimer and LDH levels and ARDS development in elderly metastatic patients carry an elevated risk of death in cancer patients diagnosed with Covid-19. However, only 2/85 patients were admitted to ICU and these data were decisive. It is a priority to create measures to avoid Covid-19 transmission in oncologic patients. Citation Format: Jacobo Rogado, Berta Obispo, Gloria Serrano-Montero, Almudena Martin Merino, Ana Lopez-Alfonso, Cristina Pangua, Mar Pérez-Pérez, Mario Fontán-Vela, Miguel Ángel Lara. COVID-CANCER HUIL STUDY: Registry of oncologic patients diagnosed with Covid-19 in Infanta Leonor University Hospital in Madrid, Spain [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-060.

FDG-PET/CT Incidental Detection of Cancer in Patients Investigated for Infective Endocarditis.

Background: Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is an imaging technique largely used in the management of infective endocarditis and in the detection and staging of cancer. We evaluate our experience of incidental cancer detection by PET/CT during IE investigations and follow-up.Methods and Findings: Between 2009 and 2018, our center, which includes an “endocarditis team,” managed 750 patients with IE in a prospective cohort. PET/CT became available in 2011 and was performed in 451 patients. Incidental diagnosis of cancer by PET/CT was observed in 36 patients and confirmed in 34 of them (7.5%) (colorectal n = 17; lung n = 7; lymphoma n = 2; melanoma n = 2; ovarian n = 2; prostate n = 1; bladder n = 1; ear, nose, and throat n = 1; brain n = 1). A significant association has been found between colorectal cancer and Streptococcus gallolyticus and/or Enterococcus faecalis [12/26 vs. 6/33 for other cancers, p = 0.025, odds ratio = 3.86 (1.19–12.47)]. Two patients had a negative PET/CT (a colon cancer and a bladder cancer), and two patients, with positive PET/CT, had a benign colorectal tumor. PET/CT had a sensitivity of 94–100% for the diagnosis of cancer in this patient.Conclusions: Whole-body PET/CT confirmed the high incidence of cancer in patients with IE and could now be proposed in these cases.

1826P Thrombosis incidence in cancer patients treated with antiangiogenic therapy

1826P Thrombosis incidence in cancer patients treated with antiangiogenic therapy

1685P Is cancer what determines COVID-19 oncological patient’s outcome or are other external factors involved? Experience in a hospital in Madrid, Spain

There are no large reported series determining the outcome of cancer patients with COVID-19. We aimed to determine whether differences exist in COVID-19 related mortality between cancer patients and the general population in our hospital, and we also describe associated risk factors. We reviewed 2216 medical records of all patients admitted to hospital with COVID-19 diagnosis between 5 March and 13 May 2020. Study data were collected using REDCap electronic data capture tools. We described COVID-19 cumulative incidence in cancer patients, treatment outcome, mortality and associated risk factors. We detected 85/2216 cancer patients in all COVID-19 diagnoses. Mortality rate: 40/85 cancer patients vs 260/2131 patients in the general ward (P<0.001). Median age: 76 years old (34-94), 50/85 male patients. Most frequent histologies: lung cancer (22/85), colorectal cancer (19/85) and prostate cancer (15/85). Most frequent staging: metastatic disease (32/85). Only 2/85 patients were admitted to ICU. Mortality was associated with older median age (79.5 vs 73, P=0.03), high d dimer levels (1630 vs 830, P=0.03), high LDH levels (315.5 vs 224, P=0.003), bilateral pneumonia (24/42 vs 5/22 with unilateral pneumonia, P=0.02), acute respiratory distress syndrome (ARDS) (12/13 vs 28/72 without ARDS, P<0.0001) and metastatic disease (20/32 metastatic vs 20/53 non-metastatic, P=0.02). Differences were maintained in multivariate analyses regarding ARDS (OR 23.7, P=0.007) and metastatic disease (OR 2.5, P=0.05). Combined treatment with hydroxychloroquine and azithromycin showed a better outcome in uni and multivariate analyses with only 21/61 dead patients (OR 0.13, P=0.005), adjusted by sex, histology, staging, ARDS and comorbidities. COVID-19 had significant mortality in cancer patients. High D dimer and LDH levels and ARDS development in elderly metastatic patients carry an elevated risk of death in cancer patients diagnosed with COVID-19. However, only 2/85 patients were admitted to ICU and this data was decisive. Combined hydroxychloroquine and azithromycin could be a good treatment option in COVID-19 cancer patients. It is a priority to create measures to avoid COVID-19 transmission in oncological patients.

Differential risk of incident cancer in patients with heart failure: A nationwide population-based cohort study

BackgroundHeart failure (HF) and cancer are currently two leading causes of mortality, and sometimes coexist. However, the relationship between them is not completely elucidated. We aimed to investigate whether patients with HF are predisposed to cancer development using the large Korean National Health Insurance claims database. MethodsThis study included 128,441 HF patients without a history of cancer and 642,205 age- and sex-matched individuals with no history of cancer and HF between 1 January 2010 and 31 December 2015. ResultsDuring a median follow-up of 4.06 years, 11,808 patients from the HF group and 40,805 participants from the control were newly diagnosed with cancer (cumulative incidence, 9.2% vs. 6.4%, p < 0.0001). Patients with HF presented a higher risk for cancer development compared to controls in multivariable Cox analysis [hazard ratio (HR) 1.64, 95% confidence interval (CI) 1.61−1.68]. The increased risk was consistent for all site-specific cancers. To minimize potential surveillance bias, additional analysis was performed by eliminating participants who developed cancer within the initial 2 years of HF diagnosis (i.e. 2-year lag analysis). In the 2-year lag analysis, the higher risk of overall cancer remained significant in patients with HF (HR 1.09, 95% CI 1.05−1.13), although the association was weaker. Among the site-specific cancers, three types of cancer (lung, liver/biliary/pancreas, and hematologic malignancy) were consistently at higher risk in patients with HF. An exploratory analysis showed that patients with repeated HF hospitalization had a higher risk of cancer development compared to those without, in a pattern of stepwise increases across the three groups [controls vs. HF without re-hospitalization vs. HF with re-hospitalization ≥1; HR (95% CI), 1.00 (reference) vs. 1.55 (1.51–1.59) vs. 1.96 (1.89–2.03), respectively]. ConclusionsCancer incidence is higher in patients with HF than the general population. Active surveillance of coexisting malignancy needs to be considered in these patients.

Risk of malignancy with non-TNFi biologic or tofacitinib therapy in rheumatoid arthritis: A meta-analysis of observational studies

ObjectivesTo assess the risk of developing cancer in patients with rheumatoid arthritis (RA) exposed to non-TNF inhibitors (TNFi) biologics or tofacitinib therapy. MethodsSystematical search of PubMed, EMBASE and Cochrane Library plus a hand search of conference proceedings were performed. Observational studies that reported cancer incidence in patients with RA treated with biologics or tofacitinib with active comparator of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) or TNFi were eligible for inclusion. The pooled relative risk (RR) and 95% confidence interval (CI) were calculated with fix-effects or random-effects model. ResultsOf 2,819 identified articles, a total of 10 studies involving over 40,587 patients with more than 87,622 patient-years of exposure to non-TNF inhibitors (TNFi) biologics and 2,221 patients with more than 4,506 patient-years of exposure to tofacitinib were included. Pooled analysis showed there was no increased risk of developing cancer in general or specific cancer types in RA patients receiving treatment with rituximab (pooled RR 0.87, 95% CI 0.74–1.03), tocilizumab (pooled RR 0.92, 95% CI 0.79–1.06), or tofacitinib, compared with those receiving csDMARDs or TNFi. But abatacept was associated with a slightly increased overall cancer risk (pooled RR 1.13, 95% CI 1.02–1.24) and non-melanoma skin cancer (pooled RR 1.26, 95% CI 1.09–1.45), relative to csDMARDs or TNFi in RA patients. ConclusionAmong RA patients, a small statistically significant increase in developing cancer was observed for abatacept exposure, while no increased cancer risk for rituximab, tocilizumab or tofacitinib, in comparison with csDMARDs or TNFi.

Abstract 1103: Aspirin reduces the incidence of metastasis in a preclinical study of Braf mutant colorectal cancer

Abstract Background. Aspirin is a well-studied chemopreventive agent for the prevention of conventional colorectal adenomas and cancer. Post hoc analyses of cardiovascular prevention trials demonstrate a long-term reduction in colorectal cancer incidence and mortality with aspirin treatment. Randomized controlled trials have shown a long-term benefit for reducing colorectal cancer incidence in patients with Lynch Syndrome, a form of hereditary colorectal cancer. These findings have led to the recommendation of aspirin as a chemopreventive for colorectal cancer by the U.S. Preventive Services Task Force and Cancer Council Australia. However, future research questions have noted a lack of knowledge of the differential benefits of aspirin in preventing sessile serrated lesions versus conventional adenomas and cancer. In our study, we hypothesized that aspirin will be an effective long-term treatment for the prevention of colorectal cancer resulting from sessile serrated lesions. We aimed to investigate this in a preclinical study utilizing a murine model of Braf mutant serrated neoplasia with a primary end-point investigating cancer incidence. Methods. BrafV637E/+/Villin-CreERT2/+ mice were injected with tamoxifen (i.p. 75mg/kg) at 2 weeks of age to activate the Braf mutation within the intestine, then commenced on an aspirin-supplemented (n=78) or control standard (n=83) diet at wean. Aspirin was supplemented into the diet and provided ad libitum, at a human equivalent dose of 80-120mg per day, until sacrifice at 14 months. The gastrointestinal tract was excised and evaluated for the presence of carcinoma. In addition, the peritoneal and thoracic cavities were inspected for metastatic disease. A gastrointestinal pathologist (CL) assessed all histology sections. Results. At sacrifice, 14 months post induction of mutant Braf, all mice developed murine serrated lesions reminiscent of human sessile serrated lesions. We observed a carcinoma incidence of 31% (26/83) of which 35% (9/26) had metastasized to the liver or peritoneal cavity. When mice were treated with an aspirin-supplemented diet there was no significant reduction in carcinoma incidence (22/78, 28%, P = 0.7315). However, there was a significant reduction in the incidence of metastasis (1/22, 5%, P = 0.0134). Mice in the control group had lesions of a significantly greater size when compared to aspirin treated mice (P=0.0032). Conclusions. Aspirin resulted in a 7-fold decrease in metastases. This study demonstrates that the benefit of aspirin in preventing Braf mutant serrated neoplasia occurs at the carcinoma-metastasis phase of colorectal carcinogenesis. This could have potential clinical benefit in reducing recurrence and mortality. Citation Format: Alexandra Kane, Cheng Liu, Lochlan Fennell, Diane McKeone, Jennifer Borowsky, Barbara Leggett, Vicki Whitehall. Aspirin reduces the incidence of metastasis in a preclinical study of Braf mutant colorectal cancer [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1103.

Bariatric surgery decreases the number of first-time hospital admissions for cancer in severely obese patients. A retrospective analysis of the National Inpatient Sample database.

According to the U.S. Centers for Disease Control, cancers linked to overweight or obesity accounted for roughly 40% of all U.S. malignancies in2014. The primary aim of this epidemiologic study was to assess whether bariatric surgery might have any preventative role against obesity-linked cancers among individuals with obesity. Hospitals across the United States participating in the National Inpatient Sample database, created, updated, and monitored by the U.S. Healthcare Cost and Utilization Project. National Inpatient Sample data collected from 2010 to 2014 were examined to identify any difference in the number of first cancer-related hospitalizations, as a proxy for cancer incidence, between patients with a history of prior bariatric surgery (cases) and those without (controls). Patients with any prior cancer diagnosis were excluded. To match the body mass index ≥35 kg/m2 generally required for bariatric surgery, all controls had to have a body mass index ≥35 kg/m2. International Classification of Diseases-9 codes were employed to identify admissions for 13 obesity-linked cancers. Multivariate logistic regression analysis was performed to identify any case-control differences, after matching for all baseline demographic, co-morbidity, and cancer risk-factor variables. All percentages and means (with confidence intervals) were weighted, per Healthcare Cost and Utilization Project guidelines. Among 1,590,579 controls and 247,015 bariatric surgery cases, there were 29,822 (1.93%; 95% confidence interval 1.91-1.96) and 3540 (1.43%; 1.38-1.47) first hospitalizations for cancer (adjusted odds ratio 1.17; 1.13-1.23; P < .0001). Preliminary findings from a large U.S. database suggest that bariatric surgery may reduce the incidence of cancer in patients considered at high risk because of severe obesity.

Risk of cancer incidence in patients with idiopathic pulmonary fibrosis: A nationwide cohort study.

IPF shares common risk factors and has pathogenic similarities with cancer. However, limited population-based data are available on cancer risk among patients with IPF. Herein, we investigated whether IPF is associated with an increased risk for cancer incidence from a nationwide database in South Korea. In this population-based cohort study, patients with IPF were enrolled from 2009 to 2014, and matched controls were randomly selected at a control-to-case ratio of 3:1. In both groups, individuals diagnosed with any malignancy before the index date were excluded. The incidence rates of cancer were measured as the number of events per 1000 person-years. Multivariable Cox regression models were used to assess the cancer incidence risk. This study included 25 241 patients with IPF and 75 723 matched controls. The overall cancer incidence in patients with IPF was 29.0 cases per 1000 person-years, and it was significantly higher in the IPF group than in the non-IPF group (HR, 2.09; 95% CI, 1.96-2.16). Lung cancer showed the highest HR (5.89; 95% CI, 5.40-6.42), followed by lymphoma, skin, uterine cervical, multiple myeloma, thyroid, leukaemia, pancreatic, liver and prostate cancer. Moreover, adjustment for the effects of smoking and other cancer-associated covariates had little effect on the HR of overall and specific cancers. The cancer incidence risk was higher in the IPF group than in the non-IPF group. Therefore, healthcare providers should be aware of this risk when treating patients with IPF.

Association Between Nocturnal Hypoxemia and Cancer Incidence in Patients Investigated for OSA: Data From a Large Multicenter French Cohort

Previous studies have yielded inconsistent findings regarding the association between OSA and cancer in humans. Is there an association between indexes of sleep-disordered breathing severity and cancer incidence in patients investigated for suspected OSA? Data from a large multicenter cohort of cancer-free patients investigated for OSA were linked to health administrative data to identify new-onset cancer. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate the association of cancer incidence with OSA severity and nocturnal hypoxemia. After a median follow-up period of 5.8 years (interquartile range, 3.8-7.8), 718 of 8,748 patients (8.2%) had received a diagnosis of cancer. On unadjusted Kaplan-Meier survival analyses, cancer incidence was associated with increasing severity of OSA (log-rank test, P< .0005) and nocturnal hypoxemia (log-rank test, P< .0001 for both oxygen desaturation index and percent night time with oxygen saturation< 90%[T90]). After adjustment for anthropomorphic data, smoking and alcohol consumption, comorbid cardiac, metabolic, and respiratory diseases, marital status, type of sleep study, and study site, only T90 was associated with cancer incidence (adjusted hazard ratio, 1.33; 95%CI, 1.05-1.68 for T90≥ 13%vs< 0.01%; P= .02). On stratified analyses, the association between T90 and cancer appeared stronger in older patients with obesity and no adequate OSA therapy. Among the most frequent cancer sites, nocturnal hypoxemia was associated with lung and breast malignancies. Nocturnal hypoxemia was associated with all-cancer incidence in patients investigated for OSA. Whether OSA therapy might reduce the risk of cancer needs further evaluation.

Effectiveness of Helicobacter pylori eradication in preventing metachronous gastric cancer and preneoplastic lesions. A systematic review and meta-analysis.

Helicobacter pylori is a significant risk factor for gastric cancer. Recent trials show eradication decreases the incidence of gastric cancer in patients with early-stage gastric cancer. However, data on gastric cancer prevention are inconsistent for patients with precancerous lesions such as atrophic gastritis and intestinal metaplasia. The aim of the study is to assess the efficacy of H. pylori eradication in gastric cancer prevention in patients with varying risk factors for gastric cancer at baseline. A systematic review and meta-analysis were performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Medline, and Google Scholar were searched from inception through March 2019 for randomized controlled trials (RCTs) studying H. pylori eradication on gastric cancer prevention. We estimated the odds ratio (OR) with 95% confidence interval (CI) for each outcome using a random-effects model. P values of less than 0.05 were considered significant. Nine RCTs with total of 6967 patient were included in the analysis. There was significant reduction in gastric cancer incidence in the H. pylori group for patients with early gastric cancer status post endoscopic mucosal resection OR, 0.47; 95% CI, 0.33-0.67; P < 0.0001; I = 0%. There was no difference in gastric cancer incidence in patients with atrophic gastritis and intestinal metaplasia at baseline for H. pylori arm OR, 0.67; 95% CI, 0.42-1.07; P = 0.09; I = 0%). Atrophic gastritis and intestinal metaplasia improved from baseline in the H. pylori arm compared to placebo OR, 2.61; 95% CI, 1.41-4.81; P = 0.002; I = 88 and OR, 2.61; 95% CI, 1.66-4.11; P ≤ 0.0001; I = 0%, respectively. H. pylori eradication is associated with reduced gastric cancer incidence in patients with early-stage gastric cancer and improvement in atrophic gastritis and intestinal metaplasia. There was no difference in gastric cancer incidence in patients with atrophic gastritis and intestinal metaplasia at baseline.