High Cancer Incidence Research Articles

Abstract B034: Prevalence and implication of aflatoxin B1 expression in colon cancers diagnosed in Southern Nigeria

Abstract Introduction: Mounting evidence shows that there is a high prevalence of late-stage, aggressive, and metastatic adenocarcinoma of the colon (AdCC) in Africa, with high mortality and low survival rate among patients. Literature finger food contaminants such as mycotoxin, especially Aflatoxin, as an attributable factor to the high incidence of abdominal cancers. However, there is a paucity of studies to confirm the hypothesis. Hence, this study determined the prevalence of Aflatoxin B1 in AdCC in Southern Nigeria. Citation Format: Chiagoziem Moral Delu-mozie, Jude Ogechukwu Okoye. Prevalence and implication of aflatoxin B1 expression in colon cancers diagnosed in Southern Nigeria [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr B034.

FACTORS THAT INFLUENCE BREAST SELF-EXAMINATION BEHAVIOR (BSE) ON STUDENTS

The highest incidence of cancer in women is breast cancer (22% of all new cancer cases in women in the world). One way to detect breast cancer early is to do a breast self-examination (BSE) regularly and correctly. The purpose of this study is to find out the factors that affect the behavior of students of the DIII Midwifery Study Program FIK Unipdu in carrying out BSE on a regular basis. The research method used is cross sectional. The population in the study was all students of the DIII Midwifery Study Program and the sample used was 34 students with sampling techniques using accidental sampling. The results showed that there was no relationship between age (p value 0.097), knowledge (p value 0.136), family history (p value 0.196), family support (p value 0.017) and information sources (p value 0.064) with students' BSE behavior. It is hoped that health workers or educational institutions will motivate students to do BSE regularly and correctly.

Association between genetic clades and cancer prevalence suggested by French-wide study of oncogenic small ruminant β-retrovirus diversity

IntroductionENTV (Enzootic Nasal Tumor Virus) and JSRV (Jaagsiekte Sheep Retrovirus) are β-retroviruses responsible for respiratory cancers in sheep and goats. In this study, we analyzed the genetic features of the sheep and goat β-Retroviruses (29 JSRV and 24 ENTV strains) circulating in France to identify molecular signatures associated with disease severity in flocks.MethodsWe developed a highly specific PCR to amplify and sequence exogenous targeted regions or near full length proviruses based on limited discriminating motifs along their genomes.ResultsThe phylogenetic reconstructions based on the Long Terminal Repeat (LTR) and env regions suggest that one major strain is circulating on the French territory for ENTV-1 and ENTV-2 while not clustering with already published Spanish, Canadian or Chinese strains. JSRV strains circulating in French sheep flocks were distributed in 2 distinct genetic clades clustering with sequences originating from North America, Africa and United-Kingdom. JSRV clade I was found to be associated with a higher incidence of cancer in French flocks. Specific motifs spanning the entire JSRV genome particularly in the LTRs and in the intracytoplasmic domain of the envelope were detected between the two genetic subtypes.DiscussionThis work represents the first nationwide study describing the circulation of the three closely related β-oncogenic retroviruses JSRV, ENTV-1 and ENTV-2 in French sheep and goat flocks. Better characterization of strain genetics is a critical step in monitoring circulating - retroviruses, especially those associated with higher cancer incidence in small ruminants.

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.

Skin cancer incidence in Mexican renal transplant recipients: a cohort over 56 years.

Skin cancer is a primary health concern in renal transplant recipients (RTRs). Existing research mainly stems from North America, Europe, and Australia, with limited data from Latin America. This 56-year (1967-2023) retrospective cohort study explores skin cancer incidence in Mexican RTRs. Our objective was to assess the long-term incidence of malignant cutaneous neoplasms in Mexican RTRs. Over 56 years, 1642 RTRs (58% male) were studied. Median follow-up was 8.4 years; median age at transplantation was 32.6 years. Skin cancer incidence was 6.6% (95% CI: 5.5-7.9), with an incidence density rate of 6.5 (95% CI: 5.4-7.9) per 1000 person-years and a median latency of 9.8 years. Incidence increased with longer transplantation-related immunosuppression (TRI), with a relative risk for >30 years of TRI of 4.8 (95% CI: 2.6-9.1) for any skin cancer and 7.5 (95% CI: 3.8-14.6) for squamous cell carcinoma (SCC). SCC was the most common malignancy (76.1%), followed by basal cell carcinomas (BCC), with a 3.6:1 ratio. Metastatic SCC occurred in 6.5% of skin cancer patients, with a skin cancer-related mortality rate of 2.7%. Limitations of the study include its single-center and retrospective design and unassessed factors such as human papillomavirus infection and sun exposure. Our study provides unique insights into the epidemiology of skin cancer among Mexican RTRs. It constitutes the largest cohort of skin cancer cases among RTRs in Mexico and, to our knowledge, in Latin America. Despite the lack of recognition of a high skin cancer incidence in non-White RTRs, our 6.6% incidence underscores the need to enhance surveillance programs.

PENGETAHUAN REMAJA PUTRI TENTANG KANKER PAYUDARA

The most common cancer case in Indonesia is breast cancer, with 58,256 cases or 16.7% of the total 348,809 cancer cases. Lack of education about breast cancer since adolescence to prevent breast cancer is one of the factors causing the high incidence of breast cancer. This study aimed to determine the knowledge of teenage girls about breast cancer at SMP Negeri 02 Mandor. This research employs a descriptive-quantitative design. The sample is determined using the stratified random sampling method followed by a simple random sampling method with a total of 116 respondents. Data collection was conducted by a questionnaire divided into respondent characteristics and knowledge about breast cancer. The data analysis technique involves frequency distribution and percentage. The univariate analysis results indicated that the majority of respondents were 13 years old, numbering 52 individuals (44,8%), there were 59 individuals (50,9%) in grade 8,63 individuals (54,3%) had never received information about breast cancer, and 116 individuals (100%) had no family history of breast cancer. There were 65 individuals (56,0%) with a poor knowledge category.

Abiraterone and Galeterone, Powerful Tools Against Prostate Cancer: Present and Perspective

Due to the high prostate cancer incidence worldwide, the development of different methods of treatment continues to be a hot research topic. Since its first clinical application at the beginning of the 2010s, abiraterone in the form of prodrug abiraterone acetate continues to be the most used hormone derivative in the treatment of castration-resistant prostate cancer. This is the reason behind the publication of many scientific results regarding its synthesis, biological activity, metabolism, novel designed steroid derivatives based on its structure, etc. A similar steroid compound with a heterocycle in the C17 position, called galeterone, also designed to treat prostate cancer, continues to be in clinical studies, which provides further proof of the importance of these steroid derivatives. Besides prostate cancer treatment, abiraterone showed indications for possible clinical application in the treatment of breast, ovarian, lung, kidney, salivary gland, and adrenocortical cancer, congenital adrenal hyperplasia, Cushing’s syndrome, and COVID-19, while galeterone is investigated for its use against prostate, pancreatic, and breast cancer. Herein, we report a review comprising methods of synthesis, possible clinical applications, and mechanisms of action, as well as structures and bioactivities of derivatives of these two important steroids.

Role of CD34, SMA &amp; Ki-67 Immunohistochemistry– An Important Diagnostic Tool in Differentiating Early Well Differentiated Hepatocellular Carcinoma from Benign Hepatic Mimickers: A Retrospective Study from North East India

North East India has higher incidence of cancers than rest of the country&amp; with advent of early screening, Hepatocellular carcinoma is getting detected at an early stage. Core needle biopsies have become indispensible tool for diagnosis of HCC and it is difficult to identify cell thickness in early well-differentiated HCC from benign mimickers on histomorphology. To overcome this difficulty, present study was designed to see the utility of CD 34, SMA &amp; Ki-67 in this regard and also to see role of these markers in differentiating Early well differentiated hepatocellular carcinoma from benign hepatic mimickers. 48 FFPE blocks of various lesions of liver were retrieved from Oncopathology Department, BBCI Guwahati in last one year. Cases were divided into Group A (n=28-HCC) Group B (n=20-benign mimickers). IHC CD34, SMA &amp; Ki-67 were done on all cases. Demographic &amp;clinical details with histomorphological findings were correlated. In Group A- 26 out of 28 HCC cases (92.8%), CD34 was strongly, completely &amp; diffusely expressed by sinusoidal vessels with more than 3 cell plate thickness. Group B- In normal liver (10 out of 20), hepatic sinusoids are negative to weak positive for CD34.In 7 out of 20 (35.1%) benign conditions, it is sparsely expressed in capillarized sinusoids at periportal &amp; perinodular area&amp; high-grade dysplastic nodules showed peripheral and focal staining for CD34. Stromal cells are strongly Positive for SMA in 85.7% (group A 24 out of 28). Ki-67 was slightly increased in Group A (6-10%) than in Group B (1-2 %). Our data demonstrates that CD34, SMA &amp; Ki-67 has significant increased expression in early WD HCC as compared to benign mimickers. Hence, CD34, SMA &amp; ki-67 are significant helpful IHC tool for reaching to a definite diagnosis of Early WD HCC when disease is yet at early stage &amp; and ideal for setup where specific markers of malignant hepatic tumors are not available. Thus, immunohistochemical markers essentially expressed in HCC in a specific ...

Novel Perspectives in the Management of Colorectal Cancer: Mechanistic Investigations Into the Reversal of Drug Resistance via Active Constituents Derived From Herbal Medicine.

The high incidence and mortality rate of colorectal cancer have become a significant global health burden. Chemotherapy has been the traditional treatment for colorectal cancer and has demonstrated promising antitumor effects, leading to significant improvements in patient survival. However, the development of chemoresistance poses a major challenge during chemotherapy in colorectal cancer, significantly impeding treatment efficacy and affecting patient prognosis. Despite the development of a variety of novel anticolorectal cancer chemotherapy agents, their effectiveness and side effects vary, possibly due to the complex mechanisms of resistance in colorectal cancer. Abnormal drug metabolism or protein targets are the most direct causes of resistance. Further studies have revealed that these resistance mechanisms involve biochemical processes such as altered protein expression, autophagy, and epithelial-mesenchymal transitions. Herbal active ingredients offer an alternative treatment option and have shown promise in reversing colorectal cancer drug resistance. This paper aims to summarize the role of various biochemical processes and key protein targets in the occurrence and maintenance of resistance mechanisms in colorectal cancer. Additionally, it elaborates on the mechanisms of action of herbal active ingredients in reversing colorectal cancer drug resistance. The article also discusses the limitations and opportunities in developing novel anticolorectal cancer drugs based on herbal medicine.

Proteogenomic analysis of air-pollution-associated lung cancer reveals prevention and therapeutic opportunities

Air pollution significantly impacts lung cancer progression, but there is a lack of a comprehensive molecular characterization of clinical samples associated with air pollution. Here, we performed a proteogenomic analysis of lung adenocarcinoma (LUAD) in 169 female never-smokers from the Xuanwei area (XWLC cohort), where coal smoke is the primary contributor to the high lung cancer incidence. Genomic mutation analysis revealed XWLC as a distinct subtype of LUAD separate from cases associated with smoking or endogenous factors. Mutational signature analysis suggested that Benzo[a]pyrene (BaP) is the major risk factor in XWLC. The BaP-induced mutation hotspot, EGFR-G719X, was present in 20% of XWLC which endowed XWLC with elevated MAPK pathway activations and worse outcomes compared to common EGFR mutations. Multi-omics clustering of XWLC identified four clinically relevant subtypes. These subgroups exhibited distinct features in biological processes, genetic alterations, metabolism demands, immune landscape, and radiomic features. Finally, MAD1 and TPRN were identified as novel potential therapeutic targets in XWLC. Our study provides a valuable resource for researchers and clinicians to explore prevention and treatment strategies for air-pollution-associated lung cancers.

Proteogenomic analysis of air-pollution-associated lung cancer reveals prevention and therapeutic opportunities.

Air pollution significantly impacts lung cancer progression, but there is a lack of a comprehensive molecular characterization of clinical samples associated with air pollution. Here, we performed a proteogenomic analysis of lung adenocarcinoma (LUAD) in 169 female never-smokers from the Xuanwei area (XWLC cohort), where coal smoke is the primary contributor to the high lung cancer incidence. Genomic mutation analysis revealed XWLC as a distinct subtype of LUAD separate from cases associated with smoking or endogenous factors. Mutational signature analysis suggested that Benzo[a]pyrene (BaP) is the major risk factor in XWLC. The BaP-induced mutation hotspot, EGFR-G719X, was present in 20% of XWLC which endowed XWLC with elevated MAPK pathway activations and worse outcomes compared to common EGFR mutations. Multi-omics clustering of XWLC identified four clinically relevant subtypes. These subgroups exhibited distinct features in biological processes, genetic alterations, metabolism demands, immune landscape, and radiomic features. Finally, MAD1 and TPRN were identified as novel potential therapeutic targets in XWLC. Our study provides a valuable resource for researchers and clinicians to explore prevention and treatment strategies for air-pollution-associated lung cancers.

Early Onset Pancreatic Adenocarcinoma (EOPAC): presentation, clinical course and treatment outcomes in comparison to Average Onset Pancreatic Adenocarcinoma (AOPAC): a retrospective cohort study

BackgroundPancreatic adenocarcinoma (PAC) is a disease of decimal prognosis, with around 50% of patients presenting with metastatic disease. Previous trials reported a high incidence of early onset pancreatic cancer (EOPAC) in Egypt, presenting about 25% of patients with PAC. The clinic-pathological features and prognosis of EOPAC needs more study.Patients and methodsA retrospective analysis of patients’ records at Shefa Al-Orman comprehensive cancer center database. Patients with histo-pathologically confirmed diagnosis of PAC. We categorized patients according to the age at diagnosis into EOPAC (≤ 50 years) and average onset PAC (AOPAC). Data on risk factors, family history, presenting symptoms, clinic-pathological features, treatment, and prognosis were extracted. Patients with histopathologically confirmed diagnosis of pancreatic cancer diagnosed between December 2016-December 2022 were included.ResultsThe study cohort consisted of 412 patients. EOPAC represented 20.3% of patients, with no significant differences in risk factors and family history compared to AOPAC. Duration of symptoms before diagnosis is longer in EOPAC, with the majority of EOPAC presenting with localized disease (23.8%) and locally advanced tumors (28.5%) compared to AOPAC. AOPAC presented more with metastatic disease (64% vs. 45.2%, p = 0.003). EOPAC are usually submitted to more aggressive treatment including radical surgery, neoadjuvant therapy, and aggressive chemotherapy regimens in metastatic disease. Disease free survival (DFS) of EOPAC was shorter than AOPAC (11 months vs. 17 months, p = 0.889), but overall survival OS was significantly longer in EOPAC (10 months vs. 6 months, p = 0.013).ConclusionPatients with EOPAC in Egypt represent around 25% of cases. EOPAC tend to have a shorter disease free survival (DFS) in patients presenting with localized disease. The overall survival (OS) is longer in EOPAC compared to AOPAC. Further studies are mandatory to identify the epidemiological and risk factors of EOPAC in Egypt.

Disparities in lungcancerscreening utilization attwo health systems in the Southeastern USA.

Low-dose computed tomography lung cancer screening is effective for reducing lung cancer mortality. It is critical to understand the lung cancer screening practices for screen-eligible individuals living in Alabama and Georgia where lung cancer is the leading cause of cancer death. High lung cancer incidence and mortality rates are attributed to high smoking rates among underserved, low income, and rural populations. Therefore, the purpose of this study is to define sociodemographic and clinical characteristicsof patients who were screened for lung cancer at an Academic Medical Center (AMC) in Alabama and a Safety Net Hospital (SNH) in Georgia. A retrospective cohort study of screen-eligible patients was constructed using electronic health records between 2015 and 2020 seen at an Academic Medical Center (AMC) and a Safety Net Hospital (SNH) separately. Chi-square tests and Student t tests were used to compare screening uptake across patient demographic and clinical variables. Bivariate and multivariate logistic regressions determined significant predictors of lung cancer screening uptake. At the AMC, 67,355 were identified as eligible for LCS and 1,129 were screened. In bivariate analyses, there were several differences between those who were screened and those who were not screened. Screening status in the site at Alabama-those with active tobacco use are significantly more likely to be screened than former smokers (OR: 3.208, p < 0.01). For every 10-unit increase in distance, the odds of screening decreased by about 15% (OR: 0.848, p < 0.01). For every 10-year increase in age, the odds of screening decrease by about 30% (OR: 0.704, p < 0.01). Each additional comorbidity increases the odds of screening by about 7.5% (OR: 1.075, p < 0.01). Those with both private and public insurance have much higher odds of screening compared to those with only private insurance (OR: 5.403, p < 0.01). However, those with only public insurance have lower odds of screening compared to those with private insurance (OR: 0.393, p < 0.01). At the SNH-each additional comorbidity increased the odds of screening by about 11.9% (OR: 1.119, p = 0.01). Notably, those with public insurance have significantly higher odds of being screened compared to those with private insurance (OR: 2.566, p < 0.01). The study provides evidence that LCS has not reached all subgroups and that additional targeted efforts are needed to increase lung cancer screening uptake. Furthermore, disparity was noticed between adults living closer to screening institutions and those who lived farther.

Educating and Retaining the Cancer-Focused Biomedical Workforce from Rural Appalachian Kentucky: The Impact of Experiential Learning and Scholarship Funding.

Kentucky postsecondary education levels are significantly below the national level, with lower levels in the Appalachian region of the state. Health disparities, including high cancer incidence and mortality, make educating and retaining students from the region a priority. The Appalachian Career Training in Oncology (ACTION) program offers cancer-related experiential opportunities and scholarships to Appalachian students. This study examines the ACTION program and its scholarship impact on undergraduate and professional school students' decisions to attend the University of Kentucky, pursue a career in science/medicine, and pay for schooling. Thirty-three ACTION participants and alumni received scholarships through a need-based application process in academic years 2023-2024 and 2024-2025. All students receiving the scholarship were asked to complete a REDCap survey. The survey evaluated both quantitative and qualitative variables, such as the impact of various factors on college decision, the influence of ACTION programs on career choice, and the effect of ACTION scholarship on financial burden. The two most influential factors affecting students' college choice are finances and experiential opportunities. Students in both the high school and undergraduate programs said their experiences significantly encouraged them to attend the University of Kentucky and pursue a career in science/medicine. Although the scholarship did not eliminate financial concerns, it lessened the burden. The ACTION program and scholarship encouraged Appalachian Kentucky students to attend the University of Kentucky and ameliorated financial concerns. This research demonstrates the program's positive impact on rural, Appalachian students and provides evidence for similar programs that may benefit underserved communities.

Uncovering novel pathogenic variants and pathway mutations in triple-negative breast cancer among the endogamous mizo tribe.

The incidence of triple-negative breast cancer (TNBC) in India is higher compared to Western populations. The objective of this study is to identify novel and less reported variants in TNBC in Mizoram, a state with a high cancer incidence in India. We analysed whole exome sequencing data from triple-negative breast cancer (TNBC) patients in the Mizo population to identify key and novel variants. Moreover, we analysed reported breast cancer-related genes and pathway alterations. Somatic mutation analysis revealed that TP53 was the most frequently mutated gene and TP53, CACNA1E, IGSF3, RYR1, and FAM155A as significantly mutated driver genes. Based on the ACMG guidelines, we identified a rare pathogenic germline variant of BRCA1 (p.C1697R) in 13% and a likely pathogenic frameshift insertion in RBMX (p.P106Ffs) in 73% of the patients. We also found that the ATM, STK11, and CDKN2A genes were significantly mutated in germline TNBC samples compared to healthy samples. Moreover, we identified novel somatic variants in CHEK2 (p.K182M) and NF1 (p.C245X), and novel germline variants RB1 (p.D111G), CDH1 (p.A10Gfs), CDKN2A (p.V96G), CDKN2A (p.S12Afs*22), MAP3K1 (CAAdelins0), MSH6 (p.L1226_L1230del), and PMS2 (TTCdelins0). Pathway analysis revealed that most somatic mutations were highly associated with PI3K-Akt signalling pathway and MAPK signalling pathways in TNBC. These findings identified novel variants and key genes contributing to disease development and progression. Further analysis of less studied genes, including RBMX, MRC1, ATM, CTNNB1, and CDKN2A, in TNBC may reveal new potential genes for targeted therapeutic strategies and contribute to clinical advancements in the treatment of TNBC.

The incidence of nonampullary duodenal cancer in Japan 2016-2020: analysis of a national cancer registry.

Epidemiological research is scarce in Asian countries including Japan. We aimed to clarify the epidemiological trend of nonampullary duodenal cancer (NADC) in Japan using a national database. All patients with NADC diagnosed between 2016 and 2020 were identified from the Japanese national cancer registry. The crude and age-adjusted incidences were determined and temporal trends including diagnostic mode, tumor stage, and treatments were analyzed. A total of 14 484 patients were included. The crude and age-adjusted incidences were 21.8-23.5 and 10.7-12.1 per 1 000 000 person-years. Male-to-female ratio was 1.7:1, and the incidence increased with age. The number of patients was highest among 70-79year age group in both sexes. In total, 55% of patients were diagnosed during screening or surveillance for other diseases. In 54% of patients, the tumor stage was localized. The major treatment was surgery (32%), followed by endoscopic resection (27%). The trends for detection mode, tumor stage, and treatment were consistent during 2016-2020. This study clarified and confirmed the high incidence of duodenal cancer in Japan. Characteristically, many NADC cases are diagnosed asymptomatically and treated by endoscopic or surgical treatment.

The Utility of an Human Papillomavirus Genotype Assay for Cancer Screening in Self-Collected Urine and Vaginal Samples from Japanese Women

Objectives: The high incidence of invasive cervical cancer among those who have not undergone cancer screening is a serious problem. This study aimed to investigate the utility of human papillomavirus (HPV) test results from self-collected urine and vaginal samples as screening tools. Design: The study was conducted in two steps. First, the appropriate storage container, temperature, and time until urine HPV assay performance were verified. Second, the results of spot urine testing under those conditions and of gynecologist-collected cervical and self-collected vaginal samples were compared to verify the feasibility of using the BD Onclarity® HPV assay for individuals with abnormal cervical cytology. Participants/Materials, Setting, Methods: The participants were 121 women with abnormal cervical cytology. Self-collected urine and vaginal samples, along with gynecologist-collected cervical samples, were tested for HPV using the BD Onclarity® HPV assay. The optimal conditions for urine sample storage were identified by comparing the HPV detection rates under various conditions. Results: Urine stored in a BD Probe Tec™ (QxUPT) for less than 72 h at room temperature was found to have the highest HPV positivity rate. Under these conditions, the detection rates of HPV in urine, cervical, and vaginal samples were examined. HPV type 16 was detected in 41.7% of the cervical samples, type 18 in 10%, and types 31 and 52 in 12.6% each. The concordance rate for HPV testing between clinician-collected cervical and urine samples was 63.9% (kappa: 0.34; 95% CI: 0.21–0.47), and that between clinician-collected cervical and self-collected vaginal samples was 77.8% (kappa: 0.68; 95% CI: 0.53–0.83), indicating good concordance. In a population with an HPV-related lesion/tumor prevalence of approximately 70%, the sensitivity of HPV testing was 82.7% for the cervix, 46.4% for urine, and 75.7% for vaginal samples. Limitations: The primary limitation is the lower detection rate of HPV in spot urine samples than in other sample types, indicating room for methodological improvement. The study’s findings are based on a specific population, which may limit generalizability. Conclusions: We investigated the optimal self-collected urine-to-testing time and temperature. Self-collected vaginal and urine HPV tests show moderate-high concordance with clinician-collected cervical HPV tests, suggesting their potential utility for women who do not undergo regular cancer screening. However, the sensitivity was not high in spot urine. Therefore, further large-scale studies are needed to verify these findings and optimize testing methods to encourage broader participation in cancer screening programs.

Barriers to the Completion of Radiation Therapy in Cervical Cancer Treatment in Nigeria: A Review of Socioeconomic, Geographical, and Psychosocial Factors.

Cervical cancer is a major health concern in Nigeria, where it is one of the primary causes of cancer-related deaths among women. Despite the crucial role of radiation therapy in treating cervical cancer, many patients in Nigeria do not complete their prescribed treatment courses. This review examines the barriers contributing to this issue. Factors such as low awareness and utilization of Pap smears, inadequate HPV vaccination, financial constraints, insufficient radiotherapy infrastructure, and the psychological burden of cancer treatment are explored. Limited screening and vaccination efforts exacerbate the high incidence of cervical cancer in Nigeria. Financial barriers are a primary obstacle, with many patients unable to afford the high cost of radiotherapy. Nigeria's radiotherapy infrastructure is severely lacking leading to significant treatment delays and cancellations. Geographical barriers further complicate access, as many patients must travel long distances to reach treatment centers. Psychosocial issues, including anxiety and depression, significantly impact treatment adherence and completion. These psychological factors, coupled with the physical side effects of radiotherapy, contribute to high rates of treatment interruption. To address these challenges, the review suggests enhancing cervical cancer prevention through increased human papillomavirus (HPV) vaccination and screening, expanding radiotherapy capacity by increasing the number of treatment centers, and providing comprehensive support systems to address financial and psychosocial barriers. By implementing these strategies, it is possible to improve treatment adherence and outcomes for cervical cancer patients in Nigeria.

Technological architecture for interoperability in cancer studies

Introduction: Given the high incidence of colorectal cancer among patients at the Holguín Oncology Center and the insufficient interoperability that hinders data collection and analysis, affecting the accuracy of studies, the importance of a technological architecture that enables access to integrated clinical data is emphasized.Objective: To design and evaluate a technological interoperability architecture that optimizes the organization and analysis of clinical data to improve survival studies of colorectal cancer at the Territorial Oncology Center of Holguín.Methods: Using the architecture development method proposed by the TOGAF framework, an interoperability technology architecture was designed. The Kaplan-Meier method was employed for survival analysis, and a study was conducted with a sample of 206 patients diagnosed with colorectal cancer between 2019 and 2024, analyzing variables such as age, sex, histological type, and treatment regimen.Results: Improved interoperability was achieved, reflecting enhanced analysis in cancer survival studies. This allowed for a better understanding of treatment efficacy, disease demographics, and the impact of chemotherapy and surgical treatment.Conclusions: The designed interoperability architecture has facilitated data exchange between systems, improving the collection and organization of clinical information, which has had a significant impact on the optimization of treatments and patient outcomes

Real-Time Gastric Juice Analysis in Cirrhotic Patients: Can We Avoid Unrewarding Gastric Biopsies?

Background: To search for H. pylori infection and gastric precancerous lesions in cirrhotic patients is worthwhile when considering the high incidence of peptic ulcers and gastric cancer in these patients. We tested if gastric juice analysis allows to avoid unrewarding gastric biopsies. Methods: This prospective study enrolled consecutive patients with liver cirrhosis who underwent upper endoscopy with standard gastric biopsies. Real-time gastric juice analysis was performed with a specific device (EndoFaster®) that test ammonium concentration for H. pylori diagnosis, and pH values to suspect extensive atrophy/metaplasia involving gastric body mucosa. Sensitivity, specificity, positive predictive value, negative predictive value (NPV), the overall accuracy, and the likelihood ratio were calculated for both H. pylori infection and extensive precancerous lesions on gastric mucosa. Results: A total of 78 cirrhotic patients (males: 55; mean age: 66 ± 12 years) were enrolled. When considering as positive EndoFaster® results when at least one of two (ammonium and pH levels) tests were positive, the NPVs were as high as 89% and 86%, respectively, to rule out H. pylori and extensive precancerous lesions on gastric mucosa, with an overall accuracy of 83% and 74%. Conclusions: This study supports the evidence that real-time gastric juice analysis allows to avoid clinically unrewarding and potentially unsafe gastric biopsies in a definite portion of cirrhotic patients, but more data are needed.