Cancer Death Research Articles

Heat Propagation in Multiple Malignant Tumours using the Hyperthermia Therapy

Cancer is a growing concern in Malaysia, with a significant increase in the number of breast cancer cases and deaths from 2007 to 2016. This study used computational fluid dynamics (CFD) to analyse heat application in breast tissue models by examining three tumour stages at 40°C, 45°C, 50°C, 55°C, and 60°C. The simulation was conducted using several models such as the energy equation, the k-epsilon viscous model, and the radiation surface-to-surface model. The SIMPLE method was used to solve the equations in this simulation. Findings reveal that larger tumours exhibit reduced heat penetration owing to their size, while smaller tumours, with higher surface-to-volume ratios, respond better to heat. The heat transfer coefficient increases with tumour size due to a greater surface area. Optimal treatment temperatures are identified between 40°C and 45°C, effectively treating tumours without harming healthy tissue. The Specific Absorption Rate (SAR) is a measure of the energy deposited in body tissues upon exposure to radiofrequency (RF) electromagnetic. The result showed that with an increase in the size and number of tumours, the SAR values increased. This result indicates that large tumours can absorb more energy, resulting in high SAR values. This trend was similar at all tested temperatures, thus indicating relation of characteristics of the tumours to their ability to absorb energy. In conclusion, this study successfully examined various models representing different stages of malignant breast tumours. This study investigated heat propagation and evaluated SAR values, providing insights into how tumour size and number affect energy absorption.

Characterization of a drug resistant MCF-7 breast cancer cell line developed by repeated cycles of 5-Fluorouracil (5-FU) therapy

Breast cancer accounts for 14% of cancer fatalities and 23% of all cancer diagnoses, making it the most common cause of cancer death among women and one of the most frequently diagnosed cancers. This disease is a life-threatening public health concern because of its significant influence on the general population. Therefore, further molecular research is required to determine its prognosis and create tailored treatments. Since it closely resembles mammary epithelium, the human breast cancer cell line MCF-7, which expresses genes for oestrogen, progesterone, and glucocorticoid receptors, is the most appropriate in vitro model for cancer research. Resistant cell lines were created by repeatedly cultivating MCF-7 wild-type cells in media containing 5-fluorouracil, a first-line treatment for breast cancer. The resistant cell lines were found to be cross-resistance to other anticancer medications in addition to being resistant to 5-fluorouracil, according to the in vitro MTT cytotoxicity assay.

Self-Acceptance in Breast Cancer Patients: A Concept Analysis

Breast cancer is still one of the fears for most women in the world and ranks first regarding the number of cancers in Indonesia and is one of the first contributors to cancer deaths. Breast cancer patients with low self-acceptance will cause stress, lack of confidence, lack of enthusiasm for recovery and will affect poor health management. Self-acceptance is directly proportional to the patient's quality of life. The greater the patient's self-acceptance of their disease, the better the quality of life of breast cancer patients. The purpose of this analysis is to explain self-acceptance in breast cancer patients. An analysis of the concept of self-acceptance was conducted on articles published between 2019 and 2024. The databases used include Google Scholar, Proquest, Pubmed, and Science Direct. The results of the analysis show that the concept of self-acceptance has four attributes, namely, acceptance of physical changes, acceptance of physical and emotional limitations, accepting social and role limitations, accepting the healing process and uncertainty. Based on these attributes, nurses assess self-acceptance in breast cancer sufferers comprehensively. The results of the assessment will be the basis for nurses in determining appropriate diagnoses and nursing interventions to improve self-acceptance in breast cancer patients, by reducing psychological burden to improve quality of life.

Modeling HPV self-sampling impact on cervical cancer in East African immigrants

IntroductionCervical cancer screening uptake among East African immigrants (EAI) in the US is low. Offering self-collected samples for human papillomavirus (HPV) testing increases screening coverage among underserved populations, but the potential impact on cervical cancer incidence and mortality is understudied. MethodsA Markov cohort state-transition model was used to predict the impact of primary HPV screening with self-sampling on cervical cancer incidence and mortality among EAI women in Washington state. The model estimated cervical cancer cases and deaths for a hypothetical cohort from ages 25-80 years under alternative screening, diagnostic colposcopy and treatment scenarios. Base case scenarios compared primary HPV testing by clinician-sampling exclusively (standard-of-care, SOC) with self-sampling exclusively, assuming higher screening coverage (70% vs. 63%) but lower colposcopy adherence with self-sampling (67% vs. 83%) with equal treatment coverage of 85%, based on Washington state patient data. Sensitivity analyses with varied coverages, and also the combinations of the two strategies were evaluated. The model was developed and fitted between 2022 and 2024 ResultsIn the base case scenario, an exclusive self-sampling strategy results in 4% higher cervical cancer incidence and mortality compared to the SOC. Self-sampling results in lower cancer incidence and mortality if colposcopy adherence is raised to the level of the SOC and/or if coverage is increased beyond 90%. In scenarios combining clinician- with self-sampling, the benefits of reaching more women with self-sampling are attenuated if more than 34% of screening is done by self-sampling. ConclusionsSelf-sampling has the potential to improve cervical cancer prevention for underserved populations. The impact of the strategy can be enhanced with stronger linkage to follow-up care.

Comparison of Population Attributable Fractions of Cancer Incidence and Mortality Linked to Excess Body Weight in Korea from 2015 to 2030.

The increasing rate of excess body weight (EBW) in the global population has led to growing health concerns, including cancer-related EBW. We aimed to estimate the population attributable fraction (PAF) of cancer incidence and deaths linked to EBW in Korean individuals from 2015 to 2030 and to compare its value with various body mass index cutoffs. Levin's formula was used to calculate the PAF; the prevalence rates were computed using the Korean National Health and Nutrition Examination Survey data, while the relative risks of specific cancers related to EBW were estimated based on the results of Korean cohort studies. To account for the 15-year latency period when estimating the PAF in 2020, the prevalence rates from 2015 and attributable cases or deaths from 2020 were used. The PAF attributed to EBW was similar for both cancer incidence and deaths using either the World Health Organization (WHO) Asian-Pacific region standard or a modified Asian standard, with the WHO standard yielding the lowest values. In the Korean population, the PAFs of EBW for cancer incidence were 2.96% in men and 3.61% in women, while those for cancer deaths were 0.67% in men and 3.06% in women in 2020. Additionally, PAFs showed a gradual increase in both sexes until 2030. The EBW continues to have a significant impact on cancer incidence and deaths in Korea. Effective prevention strategies targeting the reduction of this modifiable risk factor can substantially decrease the cancer burden.

Deep learning-based classifier for carcinoma of unknown primary using methylation quantitative trait loci.

Cancer of unknown primary (CUP) constitutes between 2% and 5% of human malignancies and is among the most common causes of cancer death in the United States. Brain metastases are often the first clinical presentation of CUP; despite extensive pathological and imaging studies, 20%-45% of CUP are never assigned a primary site. DNA methylation array profiling is a reliable method for tumor classification but tumor-type-specific classifier development requires many reference samples. This is difficult to accomplish for CUP as many cases are never assigned a specific diagnosis. Recent studies identified subsets of methylation quantitative trait loci (mQTLs) unique to specific organs, which could help increase classifier accuracy while requiring fewer samples. We performed a retrospective genome-wide methylation analysis of 759 carcinoma samples from formalin-fixed paraffin-embedded tissue samples using Illumina EPIC array. Utilizing mQTL specific for breast, lung, ovarian/gynecologic, colon, kidney, or testis (BLOCKT) (185k total probes), we developed a deep learning-based methylation classifier that achieved 93.12% average accuracy and 93.04% average F1-score across a 10-fold validation for BLOCKT organs. Our findings indicate that our organ-based DNA methylation classifier can assist pathologists in identifying the site of origin, providing oncologists insight on a diagnosis to administer appropriate therapy, improving patient outcomes.

The mediating role of remnant cholesterol in the associations of Angiopoietin-like 8 with all-cause, CVD, and cancer death: the China Cardiometabolic Disease and Cancer Cohort (4C) study.

To investigate the potential mediating effect of remnant cholesterol (RC) in the associations between angiopoietin-like 8 (ANGPTL8) and the risk of all-cause, cardiovascular disease (CVD), and cancer death. This prospective observational study included 3278 individuals from China. Binary logistic regression and mediation analyses were conducted to investigate the mediating effect of RC in the associations between ANGPTL8 and all-cause, CVD, and cancer death. During up to 5-year follow-up, a total of 265 deaths (8.08%) were documented. Both increased levels of ANGPTL8 and RC were associated with a higher risk of death for all-cause, CVD, and cancer risk. The level of RC ≥ 33 mg/dL could identify individuals at a higher risk of death independent of low-density lipoprotein cholesterol (LDL-C) levels in Chinese general populations. Furthermore, RC significantly mediated the relationship between increased ANGPTL8 levels and higher risk of all-cause, CVD, and cancer death (proportion of mediation effect: 13.10%, 9.22%, and 6.07%, respectively, all p < 0.05). Both increased circulating levels of ANGPTL8 and RC are the risk factors for all-cause, CVD, and cancer death and RC partially mediates the association between ANGPTL8 and death risk.

Novel Strategies for Lung Cancer Interventional Diagnostics.

Lung cancer is a major global health issue, with 2.21 million cases and 1.80 million deaths reported in 2020. It is the leading cause of cancer death worldwide. Most lung cancers have been linked to tobacco use, with changes in cigarette composition over the years contributing to shifts in cancer types and tumor locations within the lungs. Additionally, there is a growing incidence of lung cancer among never-smokers, particularly in East Asia, which is expected to increase the global burden of the disease. The classification of non-small cell lung cancer (NSCLC) into distinct subtypes is crucial for treatment efficacy and patient safety, especially as different subtypes respond differently to chemotherapy. For instance, certain chemotherapeutic agents are more effective for adenocarcinoma than for squamous carcinoma, which has led to the exclusion of squamous carcinoma from treatments like Bevacizumab due to safety concerns. This necessitates accurate histological diagnosis, which requires sufficient tissue samples from biopsies. However, acquiring adequate tissue is challenging due to the complex nature of lung tumors, patient comorbidities, and potential complications from biopsy procedures, such as bleeding, pneumothorax, and the purported risk of local recurrence. The need for improved diagnostic techniques has led to the development of advanced technologies like electromagnetic navigation bronchoscopy (ENB), radial endobronchial ultrasound (rEBUS), and robotic bronchoscopy. ENB and rEBUS have enhanced the accuracy and safety of lung biopsies, particularly for peripheral lesions, but both have limitations, such as the dependency on the presence of a bronchus sign. Robotic bronchoscopy, which builds on ENB, offers greater maneuverability and stability, improving diagnostic yields. Additionally, new imaging adjuncts, such as Cone Beam Computed Tomography (CBCT) and augmented fluoroscopy, further enhance the precision of these procedures by providing real-time, high-resolution imaging. These advancements are crucial as lung cancer is increasingly being detected at earlier stages due to screening programs, which require minimally invasive, accurate diagnostic methods to improve patient outcomes. This review aims to provide a comprehensive overview of the current challenges in lung cancer diagnostics and the innovative technological advancements in this rapidly evolving field, which represents an increasingly exciting career path for aspiring pulmonologists.

Patterns of Childhood Cancer Mortality in Hungary Since the Turn of the Millennium, Including the Two Years of the COVID-19 Pandemic.

Objectives: We aimed to analyse the pattern of childhood cancer mortality among children under 15 years in Hungary between 2001 and 2021. In addition, annual and cyclical trends were examined. Methods: The number of deaths was obtained from the nationwide population register over the study period by gender, age group, and region for each year. Data were analysed using the Poisson regression method and cyclic trends were investigated using the Walter-Elwood method. Results: Overall, 14,931 childhood deaths (1092 from cancers) were registered between 2001 and 2021. The cancer mortality risk was significantly higher among boys than girls. A significantly decreasing trend was detected for yearly childhood cancer mortality rates, with an annual IRR of 0.976 (95% CI: 0.966-0.986; p < 0.001). This tendency was not influenced by the pandemic. However, different patterns of seasonal variation were revealed in childhood cancer mortality rates during 2020-2021 and 2001-2019. Conclusions: The annual trend in childhood cancer mortality was not affected by the coronavirus pandemic. However, there was a different pattern of childhood cancer mortality during the pandemic and non-pandemic period in Hungary. Considering the seasonal variation in monthly childhood cancer mortality rates, we hypothesized that environmental factors might play an important role in the aetiology of childhood cancer deaths.

Colorectal Cancer and Gut Microbiota

Colorectal cancer is the third most diagnosed cancer globally, accounts for 9.6% 0f all cancer diagnosed and 9.3% of all cancer deaths. Most cases of colorectal cancer, about 80% are sporadic in origin, and the remaining 20 % are hereditary. Colorectal cancer have the risk factors like family history, diet, comorbities, smoking, alcohol, medication research also shows that there is alteration in the gut microbiota of colorectal cancer. Gold standard investigation for diagnosis of colorectal cancer is colonoscopy with biopsy for histopathology. Human gut microbiota is the colony of comprises more than 1014 microbes like bacteria, virus and fungi. The normal commensal microorganism present in the gut microbiota have symbiotic association with the intestine helps in digestion and absorbtion. Colorectal cancer as it involve chronic inflammatory response leads to decrease in the biodiversity of microorganism and presence of pathological microorganism and this is used as a biomarker for the colorectal cancer. Fecal sample metagenomic analysis shown increase in Fusobacterium nucleatum, Parvimonas, Peptostreptococcus, Porphyromonas, and Prevotella, are part of the CRC microbiota. This is a promising noninvasive biomarker for colorectal cancer. Keywords: Colorectal cancer, Gut microbiota, Fusobacterium nucleatum, Bacteroides fragilis

Recent trends and therapeutic potential of phytoceutical-based nanoparticle delivery systems in mitigating non-small cell lung cancer.

Lung cancer is the leading cause of cancer death globally, with non-small cell lung cancer accounting for the majority (85%) of cases. Standard treatments including chemotherapy and radiotherapy present multiple adverse effects. Medicinal plants, used for centuries, are traditionally processed by methods such as boiling and oral ingestion, However, water solubility, absorption, and hepatic metabolism reduce phytoceutical bioavailability. More recently, isolated molecular compounds from these plants can be extracted with these phytoceuticals administered either individually or as an adjunct with standard therapy. Phytoceuticals have been shown to alleviate symptoms, may reduce dosage of chemotherapy and, in some cases, enhance pharmaceutical mechanisms. Research has identified many phytoceuticals' actions on cancer-associated pathways, such as oncogenesis, the tumour microenvironment, tumour cell proliferation, metastasis, and apoptosis. The development of novel nanoparticle delivery systems such as solid lipid nanoparticles, liquid crystalline nanoparticles, and liposomes has enhanced the bioavailability and targeted delivery of pharmaceuticals and phytoceuticals. This review explores the biological pathways associated with non-small cell lung cancer, a diverse range of phytoceuticals, the cancer pathways they act upon, and the pros and cons of several nanoparticle delivery systems.

Ultra-Processed Food and Prostate Cancer Risk: A Systemic Review and Meta-Analysis.

Background/Objectives: Prostate cancer is the second leading cause of cancer death among American men, following lung cancer. While diet and exercise have been extensively studied in relation to prostate cancer prevention, the evidence remains inconclusive. Methods: A comprehensive literature search was performed to identify observational studies investigating the association between ultra-processed food (UPF) consumption and prostate cancer risk and mortality, determined by the NOVA classification system. In addition, we conducted subgroup analyses to assess the association based on study design, age, and data collection methods. Results: Six studies were identified, including four cohort studies and two case-control studies. No significant association was found between high UPF consumption and increased risk of prostate cancer [RR = 1.02, 95% confidence interval (CI) = 0.96-1.08, n = 5]. However, there was a slight increase in mortality (RR = 1.15, 95% CI = 0.99-1.35, n = 2). A subgroup analysis by the dietary assessment method revealed an RR of 1.01 (95% CI = 0.93-1.09) for studies using the food frequency questionnaire (FFQ) and 1.04 (95% CI = 0.93-1.16) for studies using 24-h recalls. There was no significant heterogeneity among the studies (I2 = 0, p = 0.82). Conclusions: This meta-analysis suggests no significant association between high UPF consumption and prostate cancer risk. Given the known associations with other chronic diseases, the potential public health implications of reducing UPF consumption remain important. Further research with the use of more robust food assignment systems and more precise dietary assessments is needed to clarify the role of UPF in prostate cancer development.

Evaluation of TP53TG1 and PANDA lncRNAs expression in association with adjuvant chemotherapy response in the peripheral blood of invasive ductal carcinoma patients.

Breast cancer is the most common malignancy in women. Breast cancer, the second leading cause of cancer deaths, affects 2.1 million women each year and is estimated to have killed 627,000 women worldwide in 2018. Unfortunately, the age of onset of this cancer in our country IRAN is about 10 years lower than the global average and is close to 45 years. Chemotherapy is one of the basic treatments for cancer. Predicting the benefits of chemotherapy is challenging. Studies are now underway to use gene expression tests to pinpoint patients who are most likely to benefit from adjuvant chemotherapy. In the present study, the expression of two long non-coding RNAs TP53TG1 and PANDA in the blood of breast cancer patients before and after receiving chemotherapy compared with this amount in the blood of normal people using Real-Time RT PCR technique to find a meaningful relationship ¬ Compared statistically. Compared to normal samples, the expression level of TP53TG1 in the blood of patients was reduced. Although it was not statistically significant. Its expression also increased after receiving chemotherapy. Compared to normal samples, the expression of PANDA in the blood of patients was increased, which was statistically significant. Also, its expression decreased after receiving chemotherapy. These findings suggest that PANDA and TP53TG1 expression levels may be possible markers associated with tumorigenesis and may also be considered as possible indicators of response to chemotherapy.

Systemic treatment of hepatocellular carcinoma secondary to non-alcoholic fatty liver disease.

Hepatocellular carcinoma (HCC) is the third leading cause of cancer death globally, with 15% of cases arising on a background of non-alcoholic fatty liver disease (NAFLD). NAFLD is a heterogenous condition ranging from fatty liver to cirrhosis and is itself a growing global problem, with estimated worldwide prevalence of 50% in 2040. Pathophysiology of NAFLD-HCC is not well understood, there are no dedicated screening programs, and there have been no clinical studies of anti-cancer treatments in this population specifically. However, the NAFLD-HCC population appears different than other aetiologies - patients tend to be older, diagnosed at more advanced stages, have more comorbidities, and overall worse prognosis. Understanding of best treatment options for this group of patients is an urgent unmet clinical need. This narrative review discusses NAFLD-HCC pathophysiology and systemic treatment, and offers suggestions for future directions in this therapy area.

Changing Patterns of Lung Cancer Mortality in Andalusia: Insights From Age-period-cohort Analysis and Historical Smoking Trends

IntroductionLung cancer remains one of the leading causes of cancer death worldwide. This study examines lung cancer mortality trends in Andalusia, Spain, from 2003 to 2022, focusing on gender differences and the influence of age, period and cohort effects. Material and methodsThis longitudinal ecological study analyzed lung cancer mortality data in Andalusia from 2003 to 2022, using age-period-cohort (A-P-C) and joinpoint regression models. Mortality rates were calculated by sex, age group, and standardized to the 2013 European Standard Population. ResultsBetween 2003 and 2022, Andalusia recorded 68,480 lung cancer deaths, with a significant gender disparity. Male mortality decreased (−1.9%), while female mortality increased (3.5%). Joinpoint analysis revealed a notable rise in female mortality rates after 2015. Age-specific analyses showed decreasing rates for men across all age groups, with a sharper decline for younger men. Women experienced increasing rates, particularly among those aged 35–64. The A-P-C model identified significant cohort effects, with decreasing rate ratios for men and increasing ones for women, reflecting historical smoking patterns. ConclusionsLung cancer mortality in Andalusia has exhibited a stark gender divide, reflecting the region's historical smoking patterns. While declining rates among men and younger women indicate the efficacy of tobacco control measures, the persistent rise in female mortality underscores the enduring effects of past smoking habits. These findings emphasize the imperative for ongoing public health initiatives and gender-specific interventions to mitigate the burden of lung cancer in Andalusia.

Analysis on trends of mortality rate and disease burden of liver cancer in Tianjin, China from 1999 to 2021

Objective: To explore the trends and distribution of liver cancer between sexes, ages, and urban-rural areas in Tianjin, China from 1999 to 2021, and provide data for targeted prevention and control strategies of liver cancer in Tianjin. Methods: Liver cancer mortality data of Tianjin during 1999-2021 were from the Tianjin population based mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC), and the population data of permanent Tianjin residents were from Tianjin Municipal Public Security Bureau. Liver cancer mortality, years of life lost (YLL), years lived with disability (YLD), and disability adjusted life years (DALY) were calculated using the cause of death surveillance data collected by Tianjin Centers for Disease Control and Prevention. The distributions of these data among residents of different sexes, ages, and regions were analyzed. Segi's world standard population was used for standardization. Joinpoint regression was used for trend analysis on the mortality rate of liver cancer and the disease burden. Results: The liver cancer mortality rate in Tianjin decreased by 46.75% from 1999 to 2021, with distinct phased characteristics. From 1999 to 2010, the age-sex-standardized mortality rate (SMR) decreased from 12.62/100 000 to 11.64/100 000 with an annual percent change (APC) of -1.32% (P=0.003). From 2010 to 2021, the SMR decreased from 11.64/100 000 to 6.72/100 000 (APC=-3.89%, P＜0.001). The age-sex-standardized DALY rates(SDR) decreased by 50.63% from 1999 to 2021, also with distinct phased characteristics. From 1999 to 2010, the SDR decreased from 388.67/100 000 to 349.38/100 000 (APC=-1.35%, P=0.002). From 2010 to 2021, the SDR decreased from 349.38/100 000 to 191.88/100 000 (APC=-4.43%, P＜0.001). The liver cancer mortality rate declined most rapidly in the age group under 45 years; the APC for those under 35 years was -5.07% (P＜0.001), and for those aged 35-44 years, the APC was 0.63% (P=0.707) and -8.21% (P＜0.001) before and after 2007, respectively. Both SMR and SDR were significantly higher in males than in females (P＜0.01). Both SMR and SDR were significantly higher in urban areas than in rural areas from 1999 to 2007 (P＜0.05), but they became similar after 2008. Liver cancer DALY are predominantly YLL, accounting for 99%. The median age of liver cancer deaths in Tianjin during 1999-2021 was 64-68 years old, with males lower than females (P＜0.05), and rural areas lower than urban areas (P＜0.05), generally showing an increasing trend (1999-2014: APC=0.11%, P=0.047; 2014-2021: APC=0.51%, P=0.005). Conclusions: Liver cancer mortality rate and disease burden decreased from 1999 to 2021 in Tianjin, with an especially accelerated decline after 2010. Further efforts to reduce liver cancer mortality in Tianjin are needed, and special attention should be focused on the elderly, male, and rural residents.

Experiences of women living with cervical cancer in Ghana: challenges and coping strategies

BackgroundCervical cancer is a leading cause of morbidity and mortality among women globally. The condition is both preventable and treatable yet remains a leading cause of cancer death in Ghana. This study aims to explore the unique experiences of women living with cervical cancer with a focus on the challenges and coping strategies.MethodsThe study employed a qualitative approach with an exploratory, descriptive design. This study was conducted among women with cervical cancer aged 18 years and above who have been diagnosed with the disease for at least 3 months. A total of 16 participants were purposively sampled based on the eligibility criteria and individually interviewed using a semi-structured guide. The six-step technique for qualitative analysis by Braun and Clarke guided data analysis.ResultsMost participants resorted to self-medication, over-the-counter drugs and herbal preparations as a first line of defense against the disease. The presence of cervical cancer affected participants’ physical and mental well-being. Other challenges included financial burden and frequent equipment breakdowns which affected patients’ treatment. Participants adopted different coping strategies such as taking blood tonic, increased rest and sleep, spiritual prayers and recreational activities. Family members, friends, the church and health workers provided support in the area of finance, advice, meal preparation and house chores, prayers and counseling to participants.ConclusionsCervical cancer affects the quality of life of many women and their significant others. The condition puts a lot of financial burden on its victims and there is the need for a system to reduce the burden on patients. It is recommended that the treatment of cervical cancer should be covered by the National Health Insurance Scheme to ease the financial burden on patients. There is a need for expansion of access to cervical cancer treatment across the country to reduce patients’ burden and relieve the pressure on the few pieces of equipment at the current treatment centres.

The role of PM2.5 exposure in lung cancer: mechanisms, genetic factors, and clinical implications.

Lung cancer is one of the most critical global health threats, as the second most common cancer and leading cause of cancer deaths globally. While smoking is the primary risk factor, an increasing number of cases occur in nonsmokers, with lung cancer in nonsmokers (LCNS) now recognized as the fifth leading cause of cancer mortality worldwide. Recent evidence identifies air pollution, particularly fine particulate matter (PM2.5), as a significant risk factor in LCNS. PM2.5 can increase oxidative stress and inflammation, induce genetic alterations and activation of oncogenes (including the epidermal growth factor receptor, EGFR), and contribute to lung cancer progression. This review summarizes the current understanding of how exposure to PM2.5 induces lung carcinogenesis and accelerates lung cancer development. It underscores the importance of prevention and early detection while calling for targeted therapies to combat the detrimental effects of air pollution. An integrated approach that combines research, public health policy, and clinical practice is essential to reduce the lung cancer burden and improve outcomes for those affected by PM2.5 exposurrre.

Effectiveness and Safety of Irreversible Electroporation When Used for the Ablation of Stage 3 Pancreatic Adenocarcinoma: Initial Results from the DIRECT Registry Study.

Overall survival for patients with Stage 3 pancreatic ductal adenocarcinoma (PDAC) remains limited, with a median survival of 12 to 15 months. Irreversible electroporation (IRE) is a local tumor ablation method that induces cancerous cell death by disrupting cell membrane homeostasis. The DIRECT Registry study was designed to assess the effectiveness and safety of IRE when combined with standard of care (SOC) treatment for Stage 3 PDAC versus SOC alone in a real-world setting after at least 3 months of induction chemotherapy; Methods: Patients with Stage 3 PDAC treated with IRE plus SOC or SOC alone were prospectively enrolled in a multicenter registry study. Enrollment required 3 months of active multi-agent chemotherapy with no progression before enrollment. Endpoints were 30- and 90-day mortality and adverse events (AEs). Eighty-seven IRE and 27 SOC subjects were enrolled in the registry. Mean ages were 64.0 ± 8.4 and 66.4 ± 9.9 years, and mean anterior/posterior tumor diameters were 2.2 ± 0.7 cm and 3.2 ± 1.3 for the IRE and SOC groups respectively (p = 0.0066). All IRE procedures were performed using an open approach. The 90-day all-cause mortality was 5/83 (6.0%) and 2/27 (7.4%) for the IRE and SOC groups, respectively. Two subjects in the IRE group died from treatment-related complications, and one patient in the SOC group died due to chemotherapy-related complications. Initial results from the DIRECT registry study indicate the use of IRE for curative intent tumor ablation in combination with induction chemotherapy has equivalent morbidity and mortality rates when compared to standard-of-care chemotherapy alone.

A Community-Engaged Research Study to Inform Tailored Programming for Smoking Cessation and Lung Cancer Screening Among At-Risk LGBTQ+ Elders.

Purpose. Lung cancer is the leading cause of cancer death, with most cases attributable to cigarette smoking. Many communities within the lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) umbrella have high rates of smoking, but focused lung cancer prevention is limited. Our objective was to utilize a community-based participatory research (CBPR) approach to guide the development of a program focused on lung cancer prevention in LGBTQ+ elders. Methods. Through community partnerships, we recruited participants who self-identified as LGBTQ+ and were eligible for lung cancer screening (LCS) to participate in semi-structured qualitative discussions with complementary surveys. Qualitative guides were developed to collect data on determinants of smoking cessation and LCS and to elicit feedback on interventions to support lung cancer prevention through a tailored approach to patient navigation. Qualitative data were analyzed using rapid templated analysis to elucidate themes. Results. The 21 enrolled participants had diverse sexual and gender identities and 57% were of minoritized race/ethnicity. Most (81%) had experience with smoking cessation but few (10%) had undergone LCS. Overall themes suggest interest in personalized (to individuals), tailored (to the LGBTQ+ community) and integrated longitudinal programs to support lung cancer prevention. Themes suggest strong endorsement of focused messaging to LGBTQ+ persons and reducing stigma related to LGBTQ+ identity and smoking. Conclusions. Themes highlight the need for integrated tobacco and LCS programming which can provide longitudinal support, and ideally, center community settings and peer support. This formative work will be utilized to adapt a patient navigation program to assist screen-eligible LGBTQ+ elders.