Cancer Incidence Research Articles

Small area estimation of prostate-specific antigen testing in U.S. states and counties.

In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended against prostate cancer screening using the prostate-specific antigen (PSA) test for all age groups. In 2018 the USPSTF's recommendation shifted from a "D" (not recommended) to a "C" (selectively offering PSA-based screening based on professional judgment and patient preferences) in men ages 55-69. Limited reliable county-level prostate cancer screening data is available for cancer surveillance purposes. Utilizing data from the National Health Interview Survey (NHIS) and Behavioral Risk Factor Surveillance System (BRFSS) collected in 2012-2019, state- and county-level small area models were developed for estimating PSA testing. Model diagnosis, internal validation, and external validation examining associations of PSA testing and prostate cancer incidence were conducted. Model-based estimates of PSA testing rate were produced for all U.S. states and 3,142 counties for two data periods: 2012-2016 and 2018-2019. Geographic variations across counties were demonstrated through maps. Moderate positive correlations between PSA-based screening and prostate cancer incidence were observed, for example, the state-level weighted Pearson's correlation coefficients were 0.5025 (p-value=0.0002) and 0.3691 (p-value=0.0077) for 2012-2016 and 2018-2019, respectively. These modeled estimates showed improved precision and adjusted for the differences between BRFSS and NHIS. The approach of combining NHIS and BRFSS utilized strengths of the larger sample size of BRFSS and generally higher response rates and better household coverage from the NHIS. The resulting small area estimates offer a valuable resource for the cancer surveillance community, aiding in targeted interventions, decision-making, and further research endeavors.

Causal relationship between gout and liver cancer: A Mendelian randomization and transcriptome analysis.

Gout is an inflammatory arthritis resulting from urate crystal deposition, now recognized as part of metabolic syndrome. Hyperuricemia, a hallmark of gout, is associated with various health complications, including liver cancer. Observational studies indicate a link between gout and increased cancer incidence. However, the causal relationship between gout and hepatocellular carcinoma remains uncertain. This study utilizes Mendelian randomization (MR) to explore this connection, minimizing confounding factors commonly present in observational studies. Genome-wide association study data for gout and liver cancer were sourced from the UK Biobank. We selected single nucleotide polymorphisms that are strongly associated with gout and liver cancer as instrumental variables for the analysis. We conducted 2-sample MR analysis using multiple MR methods (MR-Egger, weighted median, inverse variance weighting, and weighted mode) to evaluate causality. Co-localization and transcriptomic analyses were employed to identify target genes and assess their expression in hepatocellular carcinoma tissues. The 2-sample MR analysis indicated a significant causal relationship between gout and heightened liver cancer risk (P_IVW = .014). Co-localization analysis identified phosphatidylethanolamine N-methyltransferase (PEMT) as a crucial gene associated with gout (pH4 = 0.990). Transcriptomic data showed that PEMT expression was significantly higher in normal liver tissues compared to malignant samples (P < .001), and higher PEMT levels correlated with improved survival outcomes (P = .045). Immunohistochemical analysis revealed lower PEMT expression in hepatocellular carcinoma from patients with concurrent gout compared to those without (P < .05). The results indicate that gout increases the risk of hepatocellular carcinoma, with PEMT potentially playing a key role. Although this study focused on European populations, indicating a need for further research in diverse groups, the results emphasize the potential for liver cancer screening in newly diagnosed gout patients. Understanding the relationship between these conditions may inform future clinical practices and cancer prevention strategies.

Sex- and site-specific associations of circulating lipocalin 2 and incident colorectal cancer: Results from the EPIC cohort.

Experimental research has uncovered lipocalin 2 (LCN2) as a novel biomarker implicated in the modulation of intestinal inflammation, metabolic homeostasis, and colon carcinogenesis. However, evidence from human research has been scant. We, therefore, explored the association of pre-diagnostic circulating LCN2 concentrations with incident colorectal cancer (CRC) in a nested case-control study within the in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. LCN2 was measured in 1267 incident CRC cases matched to 1267 controls using incidence density sampling. Conditional logistic regression was used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) according to tumor subsite and sex. Weighted Cox proportional hazard regression was used to explore associations by adiposity status. In multivariable-adjusted analyses, the IRR [95% CI] per doubling in LCN2 concentration was 1.16 [0.98-1.37] for CRC overall, 1.26 [1.00-1.59] for colon cancer, and 1.08 [0.85-1.38] for rectal cancer. The association for colon cancer was more pronounced in women (IRR [95% CI], 1.66 [1.20-2.30]) and for proximal colon cancer (IRR [95% CI], 1.96 [1.15-3.34]), whereas no association was seen in men and distal colon cancer. The association for colon cancer was positive in individuals with high waist circumference (hazard ratio [95% CI], 1.69 [1.52-1.88]) and inverse in individuals with low waist circumference (hazard ratio [95% CI], 0.86 [0.76-0.98], P interaction<0.01). Overall, these data suggest that pre-diagnostic LCN2 concentrations were positively associated with colon cancer, particularly occurring in the proximal colon, in women and among individuals with abdominal adiposity.

Cancer disparities by age: a focus on sexual and gender minorities.

The purpose of this study is to examine the age at which sexual and gender minorities are diagnosed with cancer relative to heterosexual cisgender individuals. We use population-based representative Behavioral Risk Factor Surveillance Survey data with self-reported sexual orientation, gender identity, cancer diagnoses, and the age at diagnosis. We determined the mean age at diagnosis and used logistic regression modeling to obtain odds ratios, reporting significant differences defined as p < 0.05. Separately, we adjusted for race/ethnicity and corrected for underlying differences in the age of survey respondents. Compared to heterosexual cisgender populations, sexual and gender minorities are diagnosed about 4-11years earlier, with bisexual women and transgender individuals reporting the youngest age, 43.9 and 52.1years, respectively. When focusing on select cancer types, lesbian and bisexual women are diagnosed earlier with breast, melanoma, other skin cancers, and leukemia & lymphoma. Gay and bisexual men are diagnosed earlier with colorectal cancers, and transgender individuals earlier with breast, prostate, melanoma, and other skin cancers compared to heterosexual men and women. These findings suggest that sexual and gender minorities experience earlier onset of cancer and many of these age differences remained even after adjustments were made. These findings need to be confirmed in oncology settings that have cancer incidence and sexual orientation and gender identity data and call for greater attention to sexual and gender minorities in cancer research.

State of oncology care in Russia: pancreatic cancer (C25). Diagnosis, prevalence, quality of patient registration, and annual mortality. Part 1. (clinical-population study)

The study focuses on pancreatic cancer (C25), a malignant neoplasm arising from the ductal epithelium or glandular tissue of the pancreas, which accounts for 3% of the overall cancer incidence in Russia. The rates of incidence and mortality are rising, with the number of newly registered patients in Russia being lower than the number of recorded deaths, although the one-year mortality rate among patients is decreasing. The direct cause of pancreatic cancer (C25) remains unknown. Risk factors for developing this condition include genetics, smoking, alcohol abuse, a sedentary lifestyle, excessive meat consumption, and a lack of plant-based foods in the diet. Diseases associated with a high risk of this pathology include long-standing chronic pancreatitis, newly diagnosed type 2 diabetes in individuals aged 50-70, and cystic neoplasms of the pancreas. The aim of the study is to examine the patterns of incidence and mortality, the quality of patient registration, the characteristics of tumor localization, and the histological structure of pancreatic cancer (C25). The study will also track the nature of annual mortality among patients and explore the possibilities, methods, and techniques of modern diagnosis and treatment for these patients. The research confirmed the significant burden of pancreatic cancer (C25), primarily due to the late detection of this disease. The study provided sufficient material to analyze age-related risk factors, as well as the patterns of incidence and mortality in the population. It also examined and presented mortality rates among patients, including during the first year of observation.

Examining the Effect of Parental COVID-19 Vaccination Prior to Birth and the Association Between COVID-19 and Cancer in Children Under Six.

The biology of COVID-19 has intricate links to childhood cancer, exacerbated by pandemic disturbances. This research aims to explore the association between childhood cancer in children under 6 years old and COVID-19 immunisation, in addition to the effects of vaccination on parents before delivery. The study employs a case-control approach, gathering informed consent and matching factors like age, marital status, and socioeconomic status between cases and controls. A survey was distributed, culminating in 191 children under six, with data from 136 diagnosed cancer cases collected in 2023, adhering to methodological standards in epidemiological research. The analysis utilised SPSS28, employing chi-square testing and logistic regression. Chi-square testing confirmed a significant rise in childhood cancer rates post-COVID-19 pandemic compared to pre-pandemic rates. Key factors influencing cancer incidence include the mother's age at childbirth, parental vaccination history before pregnancy, maternal vaccination details during pregnancy, the child's COVID-19 infection status, and maternal marriage age. Notably, younger mothers faced higher COVID-19 infection risks, but vaccination appears to mitigate paediatric cancer risk. The post-pandemic surge in childhood cancer underscores a complex interplay of early exposures and maternal viral infections. Emphasising vaccination's protective effects before and during pregnancy, the study advocates integrating vaccination into maternal health programs. Public health measures should promote immunisation and address socioeconomic inequalities to lower paediatric cancer risk, aligning with previous studies linking parental health behaviours to childhood cancer incidence.

Self-testing for human papillomavirus as a screening method for identifying risk groups

Due to the high prevalence of cervical cancer, it is necessary to take measures aimed at reducing its frequency through vaccination, screening, detection and treatment of precancerous conditions. The article presents a systematic analysis of scientific data on the use of testing for self-sampling for human papillomavirus as a tool to improve the effectiveness of screening and detection of precancerous diseases of the cervix. It has been shown that the use of such tests, which are based on polymerase chain reaction (PCR), have similar clinical accuracy compared to sampling by a doctor, and thus this option is promising for expanding the coverage of cervical cancer screening. The presence of expected economic efficiency also determines the relevance and prospects for these tests, but further research is needed to assess their implementation in routine practice.

Prevalence and outcomes of cancer and treatment-associated toxicities for patients with Ataxia Telangiectasia

Ataxia Telangiectasia (A-T) is a DNA repair disorder with cancer predisposition. Characterize the prevalence and outcomes of hematologic and solid cancers and treatment-associated toxicities in individuals with A-T. Data was retrospectively analyzed from the Johns Hopkins Ataxia Telangiectasia Clinical Center cohort. Cumulative incidence and standardized incidence ratios of cancer, survival probability after cancer diagnosis, and standardized mortality ratios were calculated. Cox regression estimated risk of death based on chemotherapy (standard v reduced) dosing and multivariable logistic regression evaluated cancer risk associations with ATM exons and variants. Eighty-four (16.5%) of 508 individuals were diagnosed with a primary cancer, 62 (74%) were hematologic in origin and 22 (26%) were solid organ cancers. The cumulative incidence of cancer was 29% by age 35 years. Non-Hodgkin lymphoma occurred most frequently (n=39), while solid cancers disproportionately affected those ≥18 years old (n=22). The standardized mortality ratio was 24.6 (95% CI:21.1-28.4) overall and 232.9 (95% CI:178.1-299.2) among individuals with cancer. Risk of death was higher when treated with standard/unknown versus modified chemotherapy (HR 2.2, 95% CI:1.1-4.4, p=0.024). Chemotherapy-associated toxicities developed in 58% of individuals, predominantly neurologic (n=14) and gastrointestinal (n=10) systems. Three exons were enriched for cancer-associated variants. Individuals with A-T experience a wide array of blood and solid organ malignancies, high mortality rates, and treatment related toxicities, highlighting need for targeted therapies to mitigate toxicity and optimize survival. A-T patients with cancer face elevated mortality rates, underscoring the urgency for tailored therapies to minimize toxicity and improve survival outcomes.

Increased risk of breast cancer among premenopausal women with pituitary gland disorders in Taiwan: a population-based matched-cohort study.

An association between pituitary gland disorders and breast cancer remains controversial. We examined the prevalence and risk of breast cancer over a 15-year follow-up period or until diagnosed as breast cancer among premenopausal women (12-49 years old) with pituitary gland disorders in Taiwan. This retrospective matched-cohort study included 52,265 individuals each in the study group (women with pituitary gland disorders) and the matched control group from 2000 to 2004 identified using Taiwan's National Health Insurance Research Database. We compared sociodemographic characteristics and medical disorders between the two groups and examined the differences in clinicopathological characteristics of breast cancer. We also estimated the risk of breast cancer over 15 years of follow-up (median follow-up time = 11.2 years). Overall, 924 (1.8%) and 734 (1.4%) patients in the study and control groups, respectively, were diagnosed as having breast cancer (p < 0.001). Over the 15-year follow-up period, the study group had a 1.16-fold (95% confidence interval [CI] = 1.04-1.29, p < 0.05) increased risk of breast cancer compared with the control group. This risk was particularly pronounced in the 20-29 and 30-39 age groups (adjusted hazard ratio = 1.46 and 1.25, respectively; 95% CI = 1.15-1.86 and 1.07-1.44, p value < 0.01, respectively). Our findings reveal a relationship between pituitary gland disorders and breast cancer among premenopausal women in an Asian country. Physicians should check for signs of breast cancer in premenopausal women with pituitary gland disorders for early detection and treatment. Future studies should confirm our findings and clarify the causal relationship.

Racial/ethnic differences in risk factors for non-cardia gastric cancer: an analysis of the Multiethnic Cohort (MEC) Study.

Gastric cancer (GC) incidence rates show notable differences by racial/ethnic groups in the US. We sought to determine whether stratification by race/ethnicity would reveal unique risk factors for development of non-cardia gastric cancer (NCGC) for US population. Analysis included 1,112 incident cases of NCGC and 190,883 controls from the Multiethnic Cohort Study, a prospective US cohort study that recruited individuals living in Hawaii and California, aged 45-75years from 5 races/ethnicities. Descriptive analysis and Cox regression models examined the association of risk factors for GC and calculate hazard ratios for each race/ethnicity, adjusting for sociodemographic and dietary variables. Increasing age and male sex were risk factors for NCGC for most race/ethnicities. Higher risk was associated with: GC family history for Latino and Japanese American individuals [HRs range from 1.75 to 1.98]; foreign-born for Japanese American individuals [HR: 1.52, 95% CI 1.11-2.09]; lower education for African American, Japanese American, and Native Hawaiian individuals [HRs range from 1.30 to 1.74]; daily alcohol consumption for African American individuals[HR: 1.56, 95% CI 1.04-2.35]; current smoking for Latino and Japanese American individuals [HRs range from 1.89 to 1.94]; sodium consumption in the highest quartile for White individuals [HR: 2.55, 95% CI 1.23-5.26] compared to the lowest quartile; fruit consumption in the 2nd, 3rd, and 4th highest quartile for Native Hawaiian individuals [HRs range from 2.19 to 2.60] compared to the lowest quartile; diabetes for African American individuals [HR: 1.79, 95% CI 1.21-2.64]; and gastric/duodenal ulcers for Native Hawaiian individuals [HR: 1.82, 95% CI 1.04-3.18]. Analyses by racial/ethnic group revealed differing risk factors for NCGC. Increased knowledge of the varying pathways to GC can support personalized GC prevention strategies and risk stratification tools for early detection.

Long-term trends in the burden of breast cancer in China over three decades: a joinpoint regression and age-period-cohort analysis based on Global Burden of Disease 2021.

We analyzed the trends in breast cancer (BC) morbidity, prevalence, and mortality among Chinese residents from 1990 to 2021. We then used joinpoint regression to further assess BC morbidity and mortality. We screened the morbidity, mortality, and prevalence of BC in Chinese residents (1990-2021) from the Global Burden of Disease. We used age-period-cohort (APC) modeling to assess the effects of age, period, and cohort on BC morbidity and mortality separately. We also used the joinpoint model to characterize trends in BC morbidity and mortality in China. From 1990 to 2021, age-standardized rates of morbidity have risen significantly, whereas mortality has declined. We discovered that the risk of morbidity and death rose with age by using the APC model. We also found that mortality and morbidity roughly continued to increase over time, and finally, we found that the later the birth cohort, the lower the mortality and the higher the morbidity. From 1990 to 2021, the burden of BC disease in China will continue to rise, and the situation of BC prevention and control will remain severe. Therefore, regular imaging and palpation examinations should be performed in the regular population over 40 years of age. When treating patients with BC, healthcare workers should develop individualized treatment plans to further reduce mortality.

Differences in Trends in Cancer Incidence Rates Among People with HIV during 2001-2019 By Race and Ethnicity and By Risk Group in the United States.

Cancer risk among people with HIV (PWH) has declined over time as a result of antiretroviral therapy, but it is unclear whether all racial/ethnic groups and transmission risk groups have experienced equal declines. We used data on PWH aged ≥20 years old from the HIV/AIDS Cancer Match Study during 2001-2019. We used Poisson regression to assess time trends in incidence rates for each cancer site by racial/ethnicity and risk group, adjusting for age, registry, and sex. We also estimated adjusted rate ratios across racial and ethnic and risk groups in 2001-2004 and 2015-2019. Trends in age-standardized rates differed across Black, White and Hispanic PWH, and across risk groups for some cancers. For example, liver cancer rates declined 23% per 5-year period among White PWH, 11% in Black PWH and 18% in Hispanic PWH. Anal cancer rates declined among men who have sex with men, were stable among people who inject drugs, and increased among other risk groups Between 2001-2004 and 2015-2019, relative difference in cancer incidence rates by race/ethnicity increased for HL and liver cancer but decreased for NHL; by risk group, relative differences increased for NHL and liver cancer, and decreased for HL, lung and anal cancers. Among PWH in the US, during 2001-2019, HL, lung, liver, and cervical cancer rate trends were different across racial/ethnic groups. HL, lung, anal, and liver cancer rates trends were different across risk groups. Future work should examine underlying causes of the differences in trends.

Fraction of Cancer Attributable to Carcinogenic Drugs in Korea from 2015 to 2030.

This study aims to estimate and project the Population Attributable Fraction (PAF) of cancer incidence and death due to carcinogenic drug use in Korea from 2015 to 2030, to estimate the degree of cancer prevention from exposure to carcinogenic drugs in Korea. Selected carcinogenic drugs were immunosuppressive and antineoplastic drugs classified as group I by the International Agency for Research on Cancer (IARC). Systematic review and meta-analyses were conducted to estimate the relative risk (RR) of cancer associated with carcinogenic drug use. Age was standardized using the annual prevalence rate of the National Health Insurance Service sample cohort (NHIS-NSC) from 2002 to 2013 to calculate the standardized prevalence rate of carcinogenic drug use each year. The PAF of specific cancer incidence and death were calculated using Levin's formula and Monte Carlo methods. The prevalence rates were extrapolated to estimate the trend of PAF from 2015 to 2030. In 2015, carcinogenic drugs attributed to 0.003% and 0.002% among the causes of cancer incidence and death in Korea. However, carcinogenic drugs attributed to 1.1% among the causes of both cancer incidence and death in patients with clinical indications of carcinogenic drugs. The PAF in patients with clinical indications of carcinogenic drugs were significantly high and expected to increase rapidly over time. Since these drugs are listed as essential by the World Health Organization (WHO), and may be difficult to replace, a surveillance system on susceptible populations using group I carcinogenic drugs must be discussed and implemented.

Synchronous primary ovarian tumours in postmenopausal women: A rare case report and literature review

The reported incidence of synchronous primary cancers of genital tract is 1-2%, among this synchronous primary ovarian tumour is rarest. Herein, a postmenopausal woman, who had previously undergone abdominal hysterectomy, presented with vague lower abdominal pain persisting for six months. A computed tomography scan confirmed the presence of an 8.1 x 8.2 cm cyst on her right ovary. Despite her CA125 levels being normal, she was scheduled for laparoscopic cystectomy. During the surgery, the left ovary was found to be enlarged, prompting bilateral salpingo-oophorectomy. Histological analysis revealed a serous cystadenoma in the left ovary and a mucinous cystadenoma in the right ovary.Most reported synchronous ovarian tumors are malignant, with only a few cases of benign synchronous ovarian tumors documented in the literature. Early diagnosis and reporting of such cases are crucial for improving our understanding of synchronous ovarian neoplasms, which can impact management strategies and help prevent complications.

Oral Cancer Incidence Among Adult Males With Current or Former Use of Cigarettes or Smokeless Tobacco: Population-Based Study.

Tobacco use has been identified as a risk factor for oral cancer worldwide. However, relative oral cancer incidence among adults who smoke cigarettes, use smokeless tobacco products (ST), have transitioned from cigarettes to ST, quit cigarettes and/or ST ("quitters"), or never used tobacco has not been well studied. We aim to present population-based oral cancer incidence rates for adults who smoke cigarettes, use ST, are former smokers who now use ST, or quit. We estimated cross-sectional incidence rates and incidence rate ratios (IRRs) using data from statewide cancer registries (Colorado, Florida, North Carolina, and Texas) and population counts derived from national surveys using combined data from 2014-2017. A random-effect meta-analysis approach was used to summarize estimates among these groups, based on multiple imputation-based IRR estimates by state and age group while considering potential heterogeneity. A total of 19,536 oral cancer cases were identified among adult males 35 years and older in the study geographies and period. The oral cancer incidence rate among adults who smoke was significantly higher than the ST group (2.6 times higher, 95% CI 2.0-3.3, P<.001), 3.6 (95% CI 3.2-4.1, P<.001) times higher than the never users, and 2.4 (95% CI 1.8-3.1, P<.001) times higher compared to former smokers who now use ST. The IRR among the ST group relative to never users was 1.4 (95% CI 1.1-1.9, P=.02). The IRR between former smokers who now use ST and those who quit was 1.4 (95% CI 1.0-2.1, P=.08). Findings from this population-based study with a large number of oral cancer cases support significantly high oral cancer incidence among adults who smoke and a lower risk of oral cancer incidence among never users, quitters, users of ST, and former smokers who now use ST compared to cigarettes. Future studies with detailed control of tobacco history and other relevant confounders are needed to confirm these findings.

Long-Term Cancer Outcomes Following Bariatric Surgery: A Comparative Analysis of Surgical Procedures

Background/Objectives: Metabolic and bariatric surgery (MBS) is known to reduce cancer risk. However, the association between specific bariatric procedures and cancer incidence is not well-studied. This study examined the association between four different MBS procedures and cancer incidence. Methods: Bariatric surgery registry data were linked with statewide cancer registry data from 1979 to 2018. The study included 27,092 adult subjects (aged ≥ 18 years old at surgery) who underwent MBS (BMI ≥ 30 kg/m2 at surgery) from 1979 to 2017. Cancer records were linked to MBS patient records, resulting in 1547 cancer cases. Cox proportional hazards regression was used to examine the association between MBS procedure types and cancer incidence. Results: Of all patients, 75% underwent Roux-en-Y gastric bypass (RYGB), 9% adjustable gastric banding (AGB), 10% sleeve gastrectomy (SG), and 6% duodenal switch (BPD-DS). The overall cancer incidence during the follow-up period was 6.4% for RYGB, 4.6% for AGB, 1.6% for SG, and 5.9% for BPD-DS. The mean follow-up duration from surgery to cancer incidence or censoring was 167 months (standard deviation = 121 months). Compared to RYGB, patients who underwent AGB (Hazard Ratio [HR] = 1.26, p = 0.03) and BPD-DS (HR = 1.91, p &lt; 0.01) had a significantly higher hazard of developing cancer, while SG (HR = 1.17, p = 0.33) showed no significant difference. Conclusions: These findings suggest that AGB and BPD-DS may be associated with higher cancer risks compared to RYGB. Additional large population studies are needed to better understand the long-term cancer risks and mechanisms associated with different MBS types.

The Diverse Aspects of Uterine Serous Cancer: An NCI workshop on the status of and opportunities for advancement of research.

The marked increase in incidence and mortality in endometrial cancer over the last two decades is driven in part by rising rates of higher grade, more aggressive endometrial cancers with mutations in TP53, uterine serous cancers and their dedifferentiated component, uterine carcinosarcomas (collectively USC). USC rates have been increasing among all racial and ethnic groups, with higher rates of this aggressive uterine cancer in Black women. The National Cancer Institute (NCI) hosted a workshop in June 2023 to examine the diverse aspects of USC across epidemiology, biology, and molecular genetics, and to advance knowledge from basic to preclinical and translational efforts. Key stakeholders came together including basic scientists, clinical investigators, and patient advocates to identify critical research gaps that, when addressed, would facilitate more comprehensive and rapid progress in understanding and ultimately treating USC across all patients. NCI released a supplemental funding opportunity (NOT-CA-24-044) in Spring 2024 to facilitate rapid translation of these recommendations.

Total testosterone, sex hormone-binding globulin, and free testosterone concentrations and risk of primary liver cancer: A prospective analysis of 200,000 men and 180,000 postmenopausal women.

In most countries, males have ~2-3 times higher incidence of primary liver cancer than females. Sex hormones have been hypothesized to contribute to these differences, but the evidence remains unclear. Using data from the UK Biobank, which included ~200,000 males and ~180,000 postmenopausal females who provided blood samples at recruitment, we estimated hazard ratios (HR2) and 95% confidence intervals (CI) for a doubling in hormone concentration from multivariable adjusted Cox regression for circulating total testosterone, sex-hormone binding globulin (SHBG), and free testosterone concentrations and risk of primary liver cancer. After a median of 11.8 years of follow-up, 531 cases of primary liver cancer were observed, of which 366 occurred in males and 165 occurred in females. Total testosterone and SHBG were shown to be positively associated with liver cancer risk in both males and females (Total testosterone HR2: 3.42, 95% CI:2.42-4.84 and 1.29, 0.97-1.72, respectively; SHBG HR2: 5.44, 4.42-6.68 and 1.52, 1.09-2.12, respectively). However, free testosterone was inversely associated with primary liver cancer in males (HR2: 0.42, 0.32-0.55) and no association was observed in females. When analyses compared two main liver cancer subtypes, hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), there was evidence of heterogeneity; associations for total testosterone and SHBG concentrations were only positively associated with HCC in both males (HR2: 3.56, 2.65-4.79 and 7.72, 6.12-9.73, respectively) and females (HR2: 1.65, 1.20-2.27 and 6.74, 3.93-11.5, respectively) but not with ICC. Further research understanding the mechanisms of how sex-steroids may influence liver cancer risk is needed.

Prevalence of human papilloma virus in head and neck mucous squamous cell carcinoma and genotypes by location: an observational study.

Human papillomavirus (HPV) is a factor in oropharyngeal cancer, but data regarding other head and neck locations are scarce in France. The main objective of the study was to determine the prevalence of HPV in head and neck cancers at all locations. As a secondary objective, we aimed to investigate the HPV genotypes. We retrospectively included in a tertiary center between 2014 and 2020 mucosal squamous cell carcinomas of the head and neck in adult. First outcome was the prevalence of HPV cancer. Secondary outcomes were overall survival (OS) at 2 and 5 years and disease-free survival (DFS). A total of 508 patients were enrolled, resulting in 537 cases of mucous squamous cell carcinoma of the head and neck (n = 29 synchronous carcinomas). Clinical, pathological, and survival data were collected, and a double PCR for HPV with genotyping was performed on most of the samples. The HPV prevalence in the cohort was 28.2%, with HPV 16 being the predominant genotype (87%). However, HPV-positive status did not significantly improve OS at 2 and 5 years or DFS (P = 0.1, P = 0.64, and P = 0.07, respectively). It was also observed that HPV-positive patients had significantly fewer second tumor localizations (P < 0.01). The prevalence of HPV continues to rise, and the complexities surrounding HPV status and its association with clinical outcomes in head and neck squamous cell carcinoma highlight the impact of vaccination.

Artificial Intelligence in Lung Cancer Detection: Clinical and Economic Assessment of Retrospective CT Analysis Two Years Post-COVID-19 Pandemic

BACKGROUND: The use of chest computed tomography (CT) scans in Krasnoyarsk Krai, Russia, has increased since 2020, during the COVID-19 pandemic. This period also saw a 5.2% decrease in lung cancer (LC) incidence. The potential for missed LC cases has led to the investigation of new diagnostic methods, including the use of artificial intelligence (AI) for analyzing retrospective data. AIM: The study aimed to evaluate the effectiveness of an AI algorithm in identifying patients at high risk for LC using chest CT data from the COVID-19 pandemic. METHODS: A retrospective analysis was conducted on chest CTs from patients diagnosed with COVID-19 in the Krasnoyarsk region, using scans from November 1, 2020, to February 28, 2021. The AI algorithm "Chest-IRA" was applied to detect pulmonary nodules larger than 100 mm³. Radiologists classified the nodules detected by AI into three categories based on LC probability. The economic assessment of the AI algorithm included salary costs and potential savings from early LC treatment. RESULTS: Out of 10,500 CTs, the AI algorithm found nodules in 484 cases. Of these, 192 were highly likely to have LC, 103 showed no signs, and 60 were inconclusive. 112 patients with high or intermediate risk did not seek treatment. The AI confirmed lung cancer in 100 cases, 28.2% of those detected. Early-stage LC was found in 35% of cases, while 65% were at later stages. AI could save about 25.04 months of radiologist work, costing 2.43 million RUB. Early detection savings are estimated at 10.6 to 12.5 million RUB per 10,500 CTs, with a five-year economic impact of 259.4 to 305.1 million RUB. CONCLUSION: AI has proven effective in identifying pulmonary nodules amidst COVID-19, highlighting its potential to improve early detection and diagnostic accuracy, leading to earlier and more precise treatments.