Cancer Prevention Strategies Research Articles

USE OF COMBINED ORAL CONTRACEPTIVES AND THE RISK OF CERVICAL CANCER IN YOUNG WOMEN

The relationship between the use of combined oral contraceptives and the risk of cervical cancer in young women has been the subject of intense scrutiny in the scientific literature. This topic, which is extremely important for women's health, has sparked debates and investigations due to the prevalence of the use of these contraceptives and the significant incidence of cervical cancer in young women. Understanding this possible association is crucial to inform contraceptive practices and cervical cancer prevention strategies. Objective: To evaluate and consolidate the available evidence on the relationship between the use of combined oral contraceptives and the risk of cervical cancer in young women, using studies and articles published in the last 10 years. Methodology: strictly adhered to the PRISMA checklist, using the PubMed, Scielo and Web of Science databases to identify relevant studies. The selected descriptors were combined oral contraceptives, cervical cancer, young women, risk and association. The search covered articles published in the last 10 years. The inclusion criteria included studies that focused exclusively on young women, directly investigated the relationship between the use of combined oral contraceptives and cervical cancer, and were published in the last 10 years. On the other hand, studies with participants outside the specific age range, research that did not directly address the association in question and articles that were not fully available or did not qualify as systematic reviews or primary studies were excluded. This methodological approach provided a comprehensive and careful analysis of the existing evidence on the topic. Results: 18 articles were selected. Analysis of studies revealed a diversity of perspectives on the association between combined oral contraceptives and cervical cancer risk in young women. Key topics included possible biological mechanisms, variations in the types of contraceptives used, and the influence of confounding factors. Conclusion: Given the complexity of the data analyzed, this review highlights the need for careful approaches in interpreting the relationship between combined oral contraceptives and cervical cancer in young women. Future research is crucial to fully clarify this association and provide more precise guidance for clinical practice.

Cost-Effectiveness of Gene-Specific Prevention Strategies for Ovarian and Breast Cancer

Pathogenic variants (PVs) in BRCA1, BRCA2, PALB2, RAD51C, RAD51D, and BRIP1 cancer susceptibility genes (CSGs) confer an increased ovarian cancer (OC) risk, with BRCA1, BRCA2, PALB2, RAD51C, and RAD51D PVs also conferring an elevated breast cancer (BC) risk. Risk-reducing surgery, medical prevention, and BC surveillance offer the opportunity to prevent cancers and deaths, but their cost-effectiveness for individual CSGs remains poorly addressed. To estimate the cost-effectiveness of prevention strategies for OC and BC among individuals carrying PVs in the previously listed CSGs. In this economic evaluation, a decision-analytic Markov model evaluated the cost-effectiveness of risk-reducing salpingo-oophorectomy (RRSO) and, where relevant, risk-reducing mastectomy (RRM) compared with nonsurgical interventions (including BC surveillance and medical prevention for increased BC risk) from December 1, 2022, to August 31, 2023. The analysis took a UK payer perspective with a lifetime horizon. The simulated cohort consisted of women aged 30 years who carried BRCA1, BRCA2, PALB2, RAD51C, RAD51D, or BRIP1 PVs. Appropriate sensitivity and scenario analyses were performed. CSG-specific interventions, including RRSO at age 35 to 50 years with or without BC surveillance and medical prevention (ie, tamoxifen or anastrozole) from age 30 or 40 years, RRM at age 30 to 40 years, both RRSO and RRM, BC surveillance and medical prevention, or no intervention. The incremental cost-effectiveness ratio (ICER) was calculated as incremental cost per quality-adjusted life-year (QALY) gained. OC and BC cases and deaths were estimated. In the simulated cohort of women aged 30 years with no cancer, undergoing both RRSO and RRM was most cost-effective for individuals carrying BRCA1 (RRM at age 30 years; RRSO at age 35 years), BRCA2 (RRM at age 35 years; RRSO at age 40 years), and PALB2 (RRM at age 40 years; RRSO at age 45 years) PVs. The corresponding ICERs were -£1942/QALY (-$2680/QALY), -£89/QALY (-$123/QALY), and £2381/QALY ($3286/QALY), respectively. RRSO at age 45 years was cost-effective for RAD51C, RAD51D, and BRIP1 PV carriers compared with nonsurgical strategies. The corresponding ICERs were £962/QALY ($1328/QALY), £771/QALY ($1064/QALY), and £2355/QALY ($3250/QALY), respectively. The most cost-effective preventive strategy per 1000 PV carriers could prevent 923 OC and BC cases and 302 deaths among those carrying BRCA1; 686 OC and BC cases and 170 deaths for BRCA2; 464 OC and BC cases and 130 deaths for PALB2; 102 OC cases and 64 deaths for RAD51C; 118 OC cases and 76 deaths for RAD51D; and 55 OC cases and 37 deaths for BRIP1. Probabilistic sensitivity analysis indicated both RRSO and RRM were most cost-effective in 96.5%, 89.2%, and 84.8% of simulations for BRCA1, BRCA2, and PALB2 PVs, respectively, while RRSO was cost-effective in approximately 100% of simulations for RAD51C, RAD51D, and BRIP1 PVs. In this cost-effectiveness study, RRSO with or without RRM at varying optimal ages was cost-effective compared with nonsurgical strategies for individuals who carried BRCA1, BRCA2, PALB2, RAD51C, RAD51D, or BRIP1 PVs. These findings support personalizing risk-reducing surgery and guideline recommendations for individual CSG-specific OC and BC risk management.

Anticancer Activity Of Guava Leaf Extract (Psidium Guajava)

Free radicals are chemical compounds that are highly reactive and have the possibility of being detrimental to the body's cells. At high levels, free radicals can pose a serious risk to health, inflicting damage to major components of cells. Cell damage caused by free radicals, especially to Deoxyribonucleic Acid (DNA), can result in the development of cancer and other health problems. Guava seed leaves (Psidium guajava) are the focus of research because of their potential in reducing the growth of breast cancer cells. The study details the results of two literature review studies that support this claim. The bioactive compounds such as polyphenols, flavonoids, phenolic acids, and ascorbic acid found in guava seeds have been linked to antioxidant and anti-inflammatory properties. The first study by showed that guava leaf extract has anti-proliferative activity against breast cancer cells (MDA-MB-231 and MG-63). The second study highlighted the cytotoxic activity of 70% ethanol extract from guava leaves against T47D breast cancer cells. The results of both studies showed that guava seeds have the potential to inhibit the growth of breast cancer cells, indicating a possible role for guava seeds in breast cancer prevention strategies.

Utilization and associated factors of cervical cancer screening service among eligible women attending maternal health services at Adare General Hospital, Hawassa city, Southern Ethiopia

This particular study aimed to assess the magnitude of cervical cancer screening service utilization and associated factors among eligible women attending maternal health services at Adare General Hospital, Hawassa city, Southern Ethiopia, 2022. Institution-based cross-sectional study was conducted using a systematic random sampling technique among 299 eligible women from March 1- to April 30, 2022. Data was collected through face-to-face interviews using a pretested structured questionnaire. Data was also entered into Epi-data version 3.1 and exported to SPSS version 25.0 for analysis. Both bivariable and multi-variable logistic regression model was fitted and the presence of association was declared at a p value of less than 0.05. The strenth of association was determined using adjusted odd ratios together with a 95% confidence interval. Among interviewed women, 19.8% (95% CI 15.5%, 24.0%) of them had screened for cervical cancer at least once within the past five years. Place of residence (AOR = 0.37; 95% CI 0.14–0.96), modern contraception use (AOR = 2.49; 95% CI 1.04–5.96), discussion about cervical cancer with healthcare providers (AOR = 2.34; 95% CI 1.08–5.07), and comprehensive knowledge about cervical cancer (AOR = 0.25; 95% CI 0.10–0.62) were independently associated with cervical cancer screening service utilization. The study depicted relatively low utilization of cervical cancer screening services. The women were more likely to utilize the service if they are dwellers of urban residences, used modern contraception, had discussion about cervical cancer with healthcare providers, and had good comprehensive knowledge about cervical cancer. Thus, women living in rural areas should get more emphasis on cervical cancer prevention strategies, and improving consistent discussion about cervical cancer with clients visiting for maternal health services by healthcare providers in health facilities also be recommended.

Abstract B027: Exploring how aging-associated changes in autophagy dictate the development of leukemic disease

Abstract Old age leads to cellular maintenance decline, disrupting homeostasis and increasing disease risks, including cancer. Aging-related autophagy impairments contribute to harmful protein accumulation, reduced hematopoietic cell self-renewal, and impaired mitochondrial function. Autophagy plays a central role in maintaining cellular homeostasis and key cellular functions, such as cell death, cell cycle control, and differentiation. This research aims to investigate how aging-related microenvironmental changes influence Tet2 clonal hematopoiesis (CH) development, with a focus on understanding the roles of aging-associated autophagy changes. We hypothesize that the decline in cellular and tissue maintenance during aging, characterized by reduced autophagy function, contributes to changes in the bone marrow microenvironment. These changes, in turn, create a milieu conducive to the selection of oncogenic mutations. To test this hypothesis, we aimed to boost autophagy in older mice to investigate if it can mitigate oncogenesis, given that CH and cancers are less common in young individuals but prevalent in the elderly. 15-month-old mice were treated with a spermidine supplemented diet for 3 months, then LSK were transplanted with fluorescently tagged, CRISPR induced Tet2 mutations such that a small percent of HSPC bear mutations. We then monitored the competitive expansion of cells with Tet2. We found that old mice supplemented with spermidine show decreased Tet2 selection within the HSPC compartment similar to young (2mo) mice and compared to old mice on a control diet. We plan to test Tet2 competitive expansion in aged transgenic mice with high autophagy as well as the opposite experiment using transgenic young mice with decreased autophagy to further support our hypothesis. Our research emphasizes the role of autophagy in shaping the bone marrow microenvironment and influencing the development of CH. By examining how aging-associated changes in autophagy impact the selection of oncogenic mutations, our work contributes to a deeper understanding of the complex interplay between aging and cancer development. Our research has the potential to impact cancer treatment and the understanding of cancer evolution by shedding light on the mechanisms that drive oncogenic adaptation in the context of aging. Specifically, our findings suggest that enhancing autophagy in older individuals may mitigate the selection of oncogenic mutations, potentially reducing cancer risk. This insight could inform future therapeutic strategies for cancer prevention and treatment, especially in the elderly population. In summary, our research unveils the role of autophagy in modulating the aging bone marrow microenvironment's impact on CH development. By boosting autophagy in aged mice and observing reduced Tet2 selection, we provide evidence that autophagy plays a crucial role in shaping the oncogenic landscape. This underscores the potential of autophagy-enhancing interventions in countering age-related oncogenic effects. Citation Format: Amy N. Briggs. Exploring how aging-associated changes in autophagy dictate the development of leukemic disease [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Cancer Evolution and Data Science: The Next Frontier; 2023 Dec 3-6; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_2):Abstract nr B027.

Modifiable Risk Factors and Risk of Colorectal and Endometrial Cancers in Lynch Syndrome: A Systematic Review and Meta-Analysis.

Lynch syndrome is the most common hereditary cause of colorectal and endometrial cancers. Modifiable risk factors, including obesity, physical activity, alcohol intake, and smoking, are well-established in sporadic cancers but are less studied in Lynch syndrome. Searches were conducted on MEDLINE, Embase, and Web of Science for cohort studies that investigated the association between modifiable risk factors and the risk of colorectal or endometrial cancer in people with Lynch syndrome. Adjusted hazard ratios (HRs) and 95% CIs for colorectal and endometrial cancers were pooled using a random effects model. The protocol was prospectively registered on PROSPERO (CRD 42022378462), and the meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology reporting guidelines. A total of 770 citations were reviewed. Eighteen studies were identified for qualitative synthesis, with seven colorectal cancer (CRC) studies eligible for meta-analysis. Obesity (HR, 2.38 [95% CI, 1.52 to 3.73]) was associated with increased CRC risk. There was no increased CRC risk associated with smoking (HR, 1.04 [95% CI, 0.82 to 1.32]) or alcohol intake (HR, 1.32 [95% CI, 0.97 to 1.81]). Type 2 diabetes mellitus (T2DM) and some dietary factors might increase risk of CRC although more studies are needed. In a qualitative synthesis of three endometrial cancer cohort studies, female hormonal risk factors and T2DM may affect the risk of endometrial cancer, but obesity was not associated with an increased risk. Lifestyle recommendations related to weight and physical activity may also be relevant to cancer prevention for individuals with Lynch syndrome. Further high-quality prospective cohort studies, in particular, including endometrial cancer as an end point, are needed to inform evidence-based cancer prevention strategies in this high-risk population.

Knowledge, attitude, and practices about breast cancer among women in a high-altitude sub-Himalayan region: Are we reaching the unreached?

Breast cancer awareness and early detection are critical for reducing the global burden of the disease. This study assessed breast cancer awareness among women in a high-altitude sub-Himalayan region of North India. A cross-sectional survey was conducted among women attending the gynecology outpatient clinic in a district hospital. A structured questionnaire was used to collect data on breast cancer knowledge, attitudes, and practices. Participants received posttest health education and counseling on breast cancer prevention strategies. The study included 188 participants with a mean age of 31.0 ± 8.8 years. The findings revealed inadequate knowledge about breast cancer among a significant portion of the cohort. Misconceptions about risk factors, such as breastfeeding, oral contraceptive use, and past wrongdoings, were observed. Only half of the participants believed early-stage breast cancer could be effectively treated. Limited awareness of screening methods, including self-breast examination and mammography, was noted. Barriers to breast self-examination (BSE) included considering it unnecessary and lacking knowledge about its execution. This study highlights insufficient breast cancer awareness in the high-altitude sub-Himalayan region. Targeted interventions, including health campaigns and electronic media, should be prioritized to improve knowledge and promote early detection practices.

The Use of Isoflavones as Lung Cancer Chemoprevention Agents and their Implications in Treatment through Radio Sensitization.

Epidemiological trends in cancer research show that lung cancer can affect up to 1 in 15 men and 1 in 17 women. With incidence rates as high as these and significant associated mortality and morbidity, it is no wonder that lung cancer is one of the main areas of research focused on cancer. Advances in targeted treatments and specialized irradiation protocols have allowed the treatment of more advanced cases. However, as the patient numbers grow, so does the need for cancer-preventive strategies. The present narrative review focuses on soy isoflavones' role in the chemoprevention of lung cancer and their possible role in therapeutic adjuncts. Laboratory studies on lung cancer cell lines have shown that isoflavones can induce apoptosis, tamper with the expression of proliferative molecular pathways, and even reduce tumor angiogenesis. Additionally, population-level studies have emerged that correlate the consumption of isoflavonoids with reduced risk for the development of lung cancer. Interestingly enough, the literature also contains small-scale studies with evidence of isoflavones being effective chemotherapeutic adjuncts that are currently understudied. Our literature review underlines such findings and provides a call for the enhancement of research regarding naturally occurring dietary products with possible anticarcinogenic effects.

Pyroptosis in cancer treatment and prevention: the role of natural products and their bioactive compounds.

Targeting programmed cell death (PCD) has been emerging as a promising therapeutic strategy in cancer. Pyroptosis, as a type of PCDs, leads to the cleavage of the gasdermin family and the secretion of pro-inflammatory factors. Gasdermin D (GSDMD) and gasdermin E (GSDME) are the two main executors of pyroptosis. Pyroptosis in tumor and immune cells is essential for tumor progression. Natural products, especially Chinese medicinal herb and their bioactive compounds have recently been regarded as anti-tumor agents that regulate cell pyroptosis under different circumstances. Here, we review the underlying mechanisms of natural products that activate pyroptosis in tumor cells and inhibit pyroptosis in immune cells. Pyroptosis activation in tumor cells leads to tumor cell death, yet pyroptosis inhibition in immune cells may prevent tumor occurrence. Elucidation of the signaling pathways involved in pyroptosis contributes to the understanding of the anti-tumor role of natural products and their potential clinical applications. Therefore, we outline a promising strategy for cancer therapy and prevention using natural products via modulation of pyroptosis.

Machine Learning as a Tool for Early Detection: A Focus on Late-Stage Colorectal Cancer across Socioeconomic Spectrums

Purpose: To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against the backdrop of socio-economic and regional healthcare disparities. Methods: An innovative theoretical framework was developed to integrate individual- and census tract-level social determinants of health (SDOH) with sociodemographic factors. A comparative analysis of the ML models was conducted using key performance metrics such as AUC-ROC to evaluate their predictive accuracy. Spatio-temporal analysis was used to identify disparities in late-stage CRC diagnosis probabilities. Results: Gradient boosting emerged as the superior model, with the top predictors for late-stage CRC diagnosis being anatomic site, year of diagnosis, age, proximity to superfund sites, and primary payer. Spatio-temporal clusters highlighted geographic areas with a statistically significant high probability of late-stage diagnoses, emphasizing the need for targeted healthcare interventions. Conclusions: This research underlines the potential of ML in enhancing the prognostic predictions in oncology, particularly in CRC. The gradient boosting model, with its robust performance, holds promise for deployment in healthcare systems to aid early detection and formulate localized cancer prevention strategies. The study’s methodology demonstrates a significant step toward utilizing AI in public health to mitigate disparities and improve cancer care outcomes.

Socio-demographic inequalities in stage at diagnosis of lung cancer: A French population-based study

BackgroundDiagnosing patients at a non-advanced stage has become a mainstay of lung cancer prevention and control strategies. Understanding socio-demographic inequalities in stage at diagnosis may improve the targeting of interventions on patients at higher risk. This study aimed to identify these socio-demographic determinants in a large-scale French population-based cancer registry. MethodsAll incident lung cancers diagnosed between 2008 and 2019 identified from the Poitou-Charentes Cancer Registry (south-west France) were included. Stage at diagnosis was categorised as advanced/non-advanced (TNM III/IV vs I/II) according to the 8th TNM edition, the objective being to ensure a consistent level of prognosis over time. Socio-demographic variables included age, sex, the French European Deprivation Index (EDI) and patient’s place of residence. Their impact on stage at diagnosis was quantified by multivariate logistic regression models with subgroup analyses by histological subtype. ResultsOut of the 15,487 included patients, 75% were diagnosed at an advanced stage (66% to 95% depending on the histological subtype), 17% at a non-advanced stage and 10% at a non-specified stage. Multivariate analysis showed different patterns according to histological subtypes. In patients with adenocarcinoma, a higher risk of advanced stage was found for younger and older patients (u-shape), those most deprived, and those living in rural areas. The same effect of age was reported for squamous cell carcinomas, while no association was found for small-cell lung carcinomas. ConclusionsThis study highlighted substantial socio-demographic inequalities in stage at diagnosis, specifically for adenocarcinoma patients. Diagnosis strategies could be refined and strengthened in the non-smoker population, in which adenocarcinomas are mainly reported.

Design of the HPV-automated visual evaluation (PAVE) study: Validating a novel cervical screening strategy

Background:The HPV-automated visual evaluation (PAVE) Study is an extensive, multinational initiative designed to advance cervical cancer prevention in resource-constrained regions. Cervical cancer disproportionally affects regions with limited access to preventive measures. PAVE aims to assess a novel screening-triage-treatment strategy integrating self-sampled HPV testing, deep-learning-based automated visual evaluation (AVE), and targeted therapies.Methods:Phase 1 efficacy involves screening up to 100,000 women aged 25–49 across nine countries, using self-collected vaginal samples for hierarchical HPV evaluation: HPV16, else HPV18/45, else HPV31/33/35/52/58, else HPV39/51/56/59/68 else negative. HPV-positive individuals undergo further evaluation, including pelvic exams, cervical imaging, and biopsies. AVE algorithms analyze images, assigning risk scores for precancer, validated against histologic high-grade precancer. Phase 1, however, does not integrate AVE results into patient management, contrasting them with local standard care.Phase 2 effectiveness focuses on deploying AVE software and HPV genotype data in real-time clinical decision-making, evaluating feasibility, acceptability, cost-effectiveness, and health communication of the PAVE strategy in practice.Results:Currently, sites have commenced fieldwork, and conclusive results are pending.Conclusions:The study aspires to validate a screen-triage-treat protocol utilizing innovative biomarkers to deliver an accurate, feasible, and cost-effective strategy for cervical cancer prevention in resource-limited areas. Should the study validate PAVE, its broader implementation could be recommended, potentially expanding cervical cancer prevention worldwide.Funding:The consortial sites are responsible for their own study costs. Research equipment and supplies, and the NCI-affiliated staff are funded by the National Cancer Institute Intramural Research Program including supplemental funding from the Cancer Cures Moonshot Initiative. No commercial support was obtained. Brian Befano was supported by NCI/ NIH under Grant T32CA09168.

Design of the HPV-automated visual evaluation (PAVE) study: Validating a novel cervical screening strategy.

The HPV-automated visual evaluation (PAVE) Study is an extensive, multinational initiative designed to advance cervical cancer prevention in resource-constrained regions. Cervical cancer disproportionally affects regions with limited access to preventive measures. PAVE aims to assess a novel screening-triage-treatment strategy integrating self-sampled HPV testing, deep-learning-based automated visual evaluation (AVE), and targeted therapies. Phase 1 efficacy involves screening up to 100,000 women aged 25-49 across nine countries, using self-collected vaginal samples for hierarchical HPV evaluation: HPV16, else HPV18/45, else HPV31/33/35/52/58, else HPV39/51/56/59/68 else negative. HPV-positive individuals undergo further evaluation, including pelvic exams, cervical imaging, and biopsies. AVE algorithms analyze images, assigning risk scores for precancer, validated against histologic high-grade precancer. Phase 1, however, does not integrate AVE results into patient management, contrasting them with local standard care.Phase 2 effectiveness focuses on deploying AVE software and HPV genotype data in real-time clinical decision-making, evaluating feasibility, acceptability, cost-effectiveness, and health communication of the PAVE strategy in practice. Currently, sites have commenced fieldwork, and conclusive results are pending. The study aspires to validate a screen-triage-treat protocol utilizing innovative biomarkers to deliver an accurate, feasible, and cost-effective strategy for cervical cancer prevention in resource-limited areas. Should the study validate PAVE, its broader implementation could be recommended, potentially expanding cervical cancer prevention worldwide. The consortial sites are responsible for their own study costs. Research equipment and supplies, and the NCI-affiliated staff are funded by the National Cancer Institute Intramural Research Program including supplemental funding from the Cancer Cures Moonshot Initiative. No commercial support was obtained. Brian Befano was supported by NCI/ NIH under Grant T32CA09168.

Anticancer Potential of β-Carboline Alkaloids: An Updated Mechanistic Overview.

his comprehensive review is designed to evaluate the anticancer properties of β-carbolines derived from medicinal plants, with the ultimate goal of assessing their suitability and potential in cancer treatment, management, and prevention. An exhaustive literature survey was conducted on a wide array of β-carbolines including, but not limited to, harmaline, harmine, harmicine, harman, harmol, harmalol, pinoline, tetrahydroharmine, tryptoline, cordysinin C, cordysinin D, norharmane, and perlolyrine. Various analytical techniques were employed to identify and screen these compounds, followed by a detailed analysis of their anticancer mechanisms. Natural β-carbolines such as harmaline and harmine have shown promising inhibitory effects on the growth of cancer cells, as evidenced by multiple in vitro and in vivo studies. Synthetically derived β-carbolines also displayed noteworthy anticancer, neuroprotective, and cognitive-enhancing effects. The current body of research emphasizes the potential of β-carbolines as a unique source of bioactive compounds for cancer treatment. The diverse range of β-carbolines derived from medicinal plants can offer valuable insights into the development of new therapeutic strategies for cancer management and prevention.

Role of vitamins A, C, D, E in cancer prevention and therapy: therapeutic potentials and mechanisms of action.

Cancer, a leading global cause of mortality, arises from intricate interactions between genetic and environmental factors, fueling uncontrolled cell growth. Amidst existing treatment limitations, vitamins have emerged as promising candidates for cancer prevention and treatment. This review focuses on Vitamins A, C, E, and D because of their protective activity against various types of cancer. They are essential as human metabolic coenzymes. Through a critical exploration of preclinical and clinical studies via PubMed and Google Scholar, the impact of these vitamins on cancer therapy was analyzed, unraveling their complicated mechanisms of action. Interestingly, vitamins impact immune function, antioxidant defense, inflammation, and epigenetic regulation, potentially enhancing outcomes by influencing cell behavior and countering stress and DNA damage. Encouraging clinical trial results have been observed; however, further well-controlled studies are imperative to validate their effectiveness, determine optimal dosages, and formulate comprehensive cancer prevention and treatment strategies. Personalized supplementation strategies, informed by medical expertise, are pivotal for optimal outcomes in both clinical and preclinical contexts. Nevertheless, conclusive evidence regarding the efficacy of vitamins in cancer prevention and treatment is still pending, urging further research and exploration in this compelling area of study.

Cancer cell membrane proteins-encapsulated nanovaccine enhances cancer immunotherapy and prevention by provoking antigen-specific cellular immunity via the dendritic cell-targeted delivery

Cancer nanovaccines offer a promising strategy for fighting against tumors, however, the engineering of cancer nanovaccines that can be easily fabricated with tanglesome cancer cell-derived antigens and elicit an adequately strong tumor-specific cellular immunity remains challenging. Herein, metal-phenolic networks (MPNs) are used as an antigen delivery platform to prepare the mannose-modified MPNs nanovaccine loaded with ovalbumin (OVA) and the immunoadjuvant CpG oligodeoxynucleotide (MMOC) through the facile self-assembly. When the model antigen OVA is substituted with cancer cell membrane proteins (CCMPs), the nanovaccine is called MMCC. MMOC markedly activates dendritic cells (DCs) via the mannose-mediated endocytosis and efficiently promotes the antigen cross-presentation, thus inspiring a robust antigen-specific CD8+ T cell response as well as immune memory effect in vivo. Consequently, MMOC exhibits admirable therapeutic and preventive results on E.G7-OVA tumors. Moreover, the combination use of MMCC with anti-PD1 significantly inhibits the growth of 4T1 tumors by strengthening the cellular immunity and decreasing the proportion of regulatory T cells (Tregs). The survival rate of 4T1 tumor-bearing mice in the prophylaxis assay is maintained at 100 % by MMCC over 42 days. Altogether, this study affords a universal and effective nanovaccine preparation strategy for cancer immunotherapy and prevention.

Systemic and Local Strategies for Primary Prevention of Breast Cancer.

One in eight women will develop breast cancer in the US. For women with moderate (15-20%) to average (12.5%) risk of breast cancer, there are few options available for risk reduction. For high-risk (>20%) women, such as BRCA mutation carriers, primary prevention strategies are limited to evidence-based surgical removal of breasts and/or ovaries and anti-estrogen treatment. Despite their effectiveness in risk reduction, not many high-risk individuals opt for surgical or hormonal interventions due to severe side effects and potentially life-changing outcomes as key deterrents. Thus, better communication about the benefits of existing strategies and the development of new strategies with minimal side effects are needed to offer women adequate risk-reducing interventions. We extensively review and discuss innovative investigational strategies for primary prevention. Most of these investigational strategies are at the pre-clinical stage, but some are already being evaluated in clinical trials and others are expected to lead to first-in-human clinical trials within 5 years. Likely, these strategies would be initially tested in high-risk individuals but may be applicable to lower-risk women, if shown to decrease risk at a similar rate to existing strategies, but with minimal side effects.

Helicobacter Pylori Prevalence in Colorectal Polyps: Increased Risk of Neoplastic Transformation

Aim: The aim of this study was to investigate the prevalence of Helicobacter pylori (H. Pylori) in colorectal polyps and whether this infection differs according to neoplastic and dysplastic polyp types. Materials and Methods: A total of 593 patients (mean age 59.5±12.0), 279 females and 314 males, who underwent colonoscopy and endoscopy at Erzurum Training and Research Hospital were included in the study. The patients were grouped into two groups with endoscopic findings. These groups are patients with colorectal polyps (n=330) and those with normal colonoscopy results (n=263). The presence of H. Pylori infection was diagnosed with endoscopic biopsy. Hematological parameters were analyzed. Results: H. Pylori positivity was detected at a rate of 59.1% in patients with colorectal polyps, while this rate was found to be 21.3% in the normal colonoscopy group (p<0.001). In patients with H. Pylori-positive colorectal polyps, 92.3% of the polyps were neoplastic polyps, and 7.7% were non-neoplastic polyps. The frequency of dysplasia was 66.2% in the H. Pylori positive group and 24.4% in the H. Pylori negative group. H. Pylori positivity increases the risk of neoplastic polyps by 3.2 times (OR=3.2, CI=1.6-6.4, p<0.001) and dysplasia by six times (OR=6.0, CI=3.6-9.8, p<0.001). Conclusion: Our study demonstrated that H. Pylori infection is strongly associated with colorectal polyps, especially neoplastic and dysplastic polyps. The findings suggest that H. Pylori infection might be a possible risk factor for the colorectal cancer development and that H. Pylori eradication can be considered in cancer prevention strategies.

The Role of Gut Microbiota in Modulating Cancer Therapy Efficacy

Gut microbiota substantially impacts pathogenic and normal immune responses and is associated with common chronic diseases. Moreover, it has a considerable effect on the efficacy of cancer therapy. Variant gut microbiota is linked with immune checkpoint inhibitors, chemo drugs, and radiotherapy resistance. Therefore, a comprehensive interpretation of the interactions between microbiota and cancer therapies is required to encourage researchers to develop new cancer prevention strategies and weaken the consequences of the different cancer therapies. This review discusses the modulating role of gut microbiota that impacts the efficacy of cancer therapies and focuses on its influence on each treatment method, in addition to delivering an overview of the gut microbiota’s role and forming relationships between bacteria, inflammation, and cancer therapies. Highlighting the mechanism of action of probiotics, antibiotics, fecal microbiota transplantation, and prebiotics promotes cancer therapies’ efficacy. Consequently, this makes the gut microbiota essential as a new adjunct augmenting the cancer therapeutic response.

Variability in Breast Density Estimation and Its Impact on Breast Cancer Risk Assessment.

Breast density is an independent risk factor for breast cancer, although variability exists in measurements. This study sought to evaluate the agreement between radiologists and automated breast density assessment software and assess the impact of breast density measures on breast cancer risk estimates using the Breast Cancer Surveillance Consortium (BCSC) model (v.2). A retrospective database search identified women who had undergone mammography between December 2021 and June 2022. The Breast Imaging Reporting and Data System (BI-RADS) breast composition index assigned by a radiologist (R) was recorded and analyzed using three commercially available software programs (S1, S2, and S3). The agreement rate and Cohen's kappa (κ) were used to evaluate inter-rater agreements concerning breast density measures. The 5-year risk of invasive breast cancer in women was calculated using the BCSC model (v.2) with breast density inputs from various density estimation methods. Absolute differences in risk between various density measurements were evaluated. Overall, 1,949 women (mean age, 53.2 years) were included. The inter-rater agreement between R, S1, and S2 was 75.0-75.6%, while that between S3 and the others was 60.2%-63.3%. Kappa was substantial between R, S1, and S2 (0.66-0.68), and moderate (0.49-0.50) between S3 and the others. S3 placed fewer women in mammographic density d (14.9%) than R, S1, and S2 (40.5%-44.0%). In BCSC risk assessment (v.2), S3 assessed fewer women with a high 5-year risk of invasive breast cancer than the other methods, resulting in an absolute difference of 0% between R, S1, and S2 in 75.0%-75.6% of cases, whereas the difference between S3 and the other methods occurs in 60.2%-63.3% of cases. Breast density assessment using various methods showed moderate-to-substantial agreement, potentially affecting risk assessments. Precise and consistent breast density measurements may lead to personalized and effective strategies for breast cancer prevention.