Total Cancer Research Articles

The Significance of Comprehensive Metabolic Phenotypes in Cancer Risk: A Japan Multi-Institutional Collaborative Cohort (J-MICC) Study.

The present study investigated the relationship between metabolic phenotypes and the risk of cancer in a Japanese population using the criteria of metabolic phenotypes based on an examination and those based on questionnaires. We used data from 25,357 subjects for examination-based analyses and those from 53,042 subjects for questionnaire-based analyses in the Japan Multi-Institutional Collaborative Cohort Study. Metabolic phenotypes were defined by classifying subjects according to their BMI (obesity: BMI ≥25 kg/m2; normal weight: BMI <25 kg/m2) and the number of metabolic abnormalities. Metabolic abnormalities were defined according to metabolic syndrome components of the Joint Interim Statement Criteria for examination-based analyses and self-reported histories of diabetes, dyslipidemia, and hypertension for questionnaire-based analyses. Cox proportional hazards regression analyses adjusted for potential confounders were performed for total and site-specific cancer incidence according to metabolic phenotypes. Metabolically unhealthy obesity (MUHO) was significantly associated with cancer incidence in both examination-based [HR (95% CI): 1.17 (1.01-1.36)] and questionnaire-based analyses [HR (95% CI): 1.15 (1.04-1.26)]. Regarding site-specific cancer in questionnaire-based analyses, metabolically healthy obesity and MUHO were associated with colorectum and liver cancers in all subjects and with breast cancer in female subjects. Subjects with a metabolically unhealthy normal weight had a higher risk of pancreatic cancer. Moreover, MUHO was associated with corpus uteri cancer in female subjects. This prospective cohort study suggests that metabolic phenotypes are important risk factors for total and some site-specific cancers in Japanese adults.

The effect of Covid deaths on premature mortality trends in Northern Dimension partnership countries

Abstract Background Potential Years Life Lost (PYLL) is an established method to measure, follow trends and compare disease burden within and between countries. Northern Dimension Partnership in Health and Social wellbeing (NDPHS) network was established in 2003 and includes the following countries: Estonia, Finland, Germany, Iceland, Latvia, Lithuania, Norway, Poland, Russia, and Sweden. Due to the Russian invasion to Ukraine, Russia is now excluded from the collaboration. Methods Premature mortality is defined as a death before the age of 70 years. PYLL-rates per 100,000 population are presented in six cause of deaths categories: total mortality, external causes, vascular diseases, cancers, alcohol-related deaths and suicides. Furthermore, 2021 data included deaths due to the Covid infection. Data were obtained from Eurostat and analyses are standardized to EU standard population. Results PYLL-rates declined from 2003 to 2017 in all countries and in most causes of death sub-groups. The total (all causes, all countries) PYLL-rate declined between 2003 and 2017 from 7072 to 5154 in men and from 3263 to 2532 in women. However, from 2017 to 2021 the total PYLL-rate increased to 5469 in men and 2623 in women. The increase was explained by Covid mortality. When Covid deaths were excluded, a minor decrease was observed also between 2017 and 2021. In 2021, total PYLL-rates vary largely between countries: from 2804 to 12,393 in men and from 1781 to 4460 in women. Differences between countries in Covid-related and other cause-specific PYLL-rates were also large. In all countries and causes of death sub-groups PYLL-rates were markedly higher in men compared to women. Conclusions The number of years lost due to premature preventable mortality have declined markedly in all NDPHS countries in the last two decades. Between 2017 and 2021, some increase was observed due to the Covid-related deaths. Differences between countries in premature mortality are still large. Key messages • The number of years lost due to premature preventable mortality have declined markedly in all NDPHS countries since 2003 but still, in 2021, differences between countries were large. • Covid-related deaths caused an increase in premature mortality between 2017 and 2021.

The association between empirical dietary inflammatory pattern and risk of cancer and cancer-specific mortality: a systematic review and meta-analysis of prospective cohort studies

Background/aimCurrent evidence indicates a correlation between the inflammatory potential of diet and the risk of cancer and cancer-specific mortality. This study aimed to assess the association between empirical dietary inflammatory pattern (EDIP), which has recently been designed based on the inflammatory potential of the diet, and the risk of cancer and cancer-specific mortality.MethodsA systematic literature search was conducted across the PubMed/Medline, Scopus, and Web of Science databases from January 2016 to March 2024. A random effects model was used to calculate the pooled effect size (ES) and 95% confidence intervals (95% CI). Heterogeneity between studies was assessed using the Cochran Q test and the I2 statistic.ResultsFrom the initial 229 records, 24 prospective cohort studies with 2,683,350 participants and 37,091 cancer incidence cases, as well as 20,819 cancer-specific mortality, were included in our study. Pooled results indicated a significant association between higher adherence to the EDIP and an increased risk of total cancer (ES: 1.10; 95% CI: 1.05–1.15; I2 = 41.1), colorectal cancer (ES: 1.19; 95% CI: 1.11–1.27; I2 = 41.1), and liver cancer (ES: 1.48; 95% CI: 1.14–1.94; I2 = 36.9). However, no significant association between increased adherence to the EDIP and an increased risk of ovarian or endometrial cancer was found. Furthermore, greater adherence to the EDIP was significantly associated with an increased risk of cancer-specific mortality (ES: 1.18; 95% CI: 1.05–1.33; I2 = 45.4).ConclusionOur results showed that a diet with higher inflammatory properties is associated with an increased risk of cancer and cancer-specific mortality.Systematic review registrationPROSPERO registration no. CRD42024496912.

Toxic metal accumulation, health risk, and distribution in road dust from the urban traffic-intensive environment.

Owing to increasing levels of potentially toxic metals in road dust, air pollutants suspended in the air, pose significant health risks due to rapid, unplanned urbanization and industrialization. This study investigated the pollution status and health risks of trace metals (i.e., Cr, Cd, Ni, Cu, and Pb) in road dust collected from 16 locations across six land-use categories in Eskişehir, Türkiye, including residential, roadside, traffic, tram stations, and car industrial areas. The analysis of trace metals revealed distinct types of urban pollution based on these functional areas. In areas with heavy traffic, high concentrations of the elements, especially Zn, Cr, and Ni, would indicate significant toxic metal pollution. The overall contamination was evaluated using three indices: enrichment factor (EF 0.45-65.75), geo-accumulation index (Igeo - 2.50-4.18), and pollution index (PI 0.27-27.22). Human health risks of potentially toxic trace metals in urban road dust were evaluated for children and adult groups based on hazardous index (HI) and total cancer risk (TCR). The health risk assessments revealed that children (mean HIchildren 8.62E - 01; TCRchildren 6.99E + 04) are more vulnerable to toxic metal exposure than adults (mean HIadults 1.01E - 01; TCRadults 3.01E + 04), with ingestion being the primary exposure route over dermal contact and inhalation. In conclusion, we have captured the interaction between road dust and health risks, especially for children.

Effectiveness of constructed wetland technology-treated industrial wastewater on the spinach (Spinacia oleracea) health risks and biochar efficiency.

In peri-urban areas, use of industrial wastewater for irrigation is a common practice. Industrial wastewater contains cadmium, chromium, lead, nickel, and other elements that deteriorate food quality and affect human health. Biochar has been proven to remediate heavy metal contaminated soil by reducing their mobility and bioavailability. A pot experiment was conducted to evaluate the efficiency of different levels of biochar on spinach growth with low heavy metal concentration and to minimize associated health issues. The experiment lasted two months and the treatments: Control (tap water), untreated and treated industrial wastewater and both in combination with biochar (0.5% and 1%) were applied in completely randomized design. Findings suggested that treated industrial wastewater with 1% biochar resulted in maximum plant height, shoot weight, chlorophyll contents (SPAD value), photosynthetic and transpiration rate. Biochar significantly reduced heavy metal mobility in soil due to its porous structure, high pH, higher CEC, and variety of surface functional groups. The cumulative hazard index (HI), hazard quotient, cancer risk, and total cancer risk (TCR) were calculated using method provided by US-EPA for each metal. All treatments had HI values of < 1, however applying 1% biochar significantly reduced the HI values to 2.00E-01 and 2.88E-01 in adults and children, respectively. TCR for all treatments was < 1, while treated industrial wastewater and biochar (1%) has significantly reduced to 1.55E-02 and 1.91E-03 for adults and children, respectively. Thus, it was determined that irrigation with industrial effluents caused toxicity in vegetables, which had a negative impact on human health. Biochar effectively mitigated metal toxicity in both soil and spinach plants that resulted in reduced health/cancer risk.

Cancer impact on lower-income patients in Malaysian public healthcare: An exploration of out-of-pocket expenses, productivity loss, and financial coping strategies.

Cancer patients often grapple with substantial out-of-pocket (OOP) expenses and productivity loss, with the ramifications being particularly crucial for lower-income households. This study aims to estimate OOP costs incurred by cancer patients, assess their productivity loss, and analyse the financial coping mechanisms employed by individuals within the lower-income bracket. The study employed face-to-face interviews among cancer patients aged 40 years and above, currently undergoing treatment, and belonging to the lower-income group. Participants were recruited from six public cancer referral hospitals. OOP expenses, encompassing medical and non-medical costs, along with productivity loss, were measured. A generalized linear model was applied to identify potential OOP determinants. Additionally, the coping mechanisms employed by individuals to finance their cancer OOP expenses were also determined. Among the 430 participants recruited, predominantly female (63.5%), and aged 60 or older (53.9%). The annual mean total cancer costs per patient were US$ 2,398.28 (±2,168.74), including 15% for medical costs US$ 350.95 (±560.24), 34% for non-medical costs US$820.24 (±818.24), and 51% for productivity loss costs US$1,227.09 (±1,809.09). Transportation, nutritional supplements, outpatient treatment, and medical supplies were notable cost contributors to total OOP expenditures. Ethnicity (β = 1.44; 95%CI = 1.15-1.79), household income (β = 1.40; 95%CI = 1.10-1.78), annual outpatient visits (β = 1.00; 95%CI = 1.00-1.01), age (β = 0.74; 95%CI = 0.56-0.98), and employment status (β = 0.54; 95%CI = 0.72-1.34) were identified as significant predictors of OOP costs among cancer patients. Notably, 91% of participants relied on household salaries and savings, while 15% resorted to interest-free borrowing, 11% sold possessions, and 0.5% borrowed with interest to finance their expenses. This study offers crucial insights into the economic impact of cancer on individuals and their families, providing policymakers with valuable information to tackle challenges faced in their journey. Despite substantial public healthcare subsidies, the study revealed that cancer costs can remain a potential barrier to accessing essential treatment. Therefore, there is a need for reinforced system-level infrastructure to facilitate targeted financial navigation services.

Potentially Toxic Elements in Urban-Grown Lettuce: Effectiveness of Washing Procedures, Risk Assessment, and Isotopic Fingerprint

This study investigates the presence of potentially toxic elements (PTEs) in lettuce (Lactuca sativa L.) grown in urban gardens in a highly industrialized city in Brazil and evaluates the effectiveness of different washing methods in reducing contamination. Ten elements (arsenic (As), barium (Ba), cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), nickel (Ni), lead (Pb), vanadium (V), and zinc (Zn)) were analyzed for their concentration, and a health risk assessment was performed. The results showed that Pb concentrations in lettuce from gardens near the Capuava Petrochemical Complex reached 0.77 mg kg−1, exceeding both national and international safety limits. The most effective washing procedure involved the use of sodium hypochlorite, which reduced As by 46%, Pb by 48%, and V by 52%. However, elements such as Ba, Cd, Cr, and Ni showed limited reductions of less than 10% across all washing methods. Health risk assessments revealed a particular concern for children, with the total cancer risk (TCR) exceeding acceptable limits in some gardens. Isotopic analysis of Pb revealed that atmospheric pollution from gasoline emissions and industrial activities were the primary sources of contamination. The elevated levels of Pb, Cr, and As highlight the need for targeted health education in local communities, especially regarding the importance of proper washing techniques. Risk management strategies, including improved contamination control and public awareness, are crucial to minimize exposure to these harmful elements, particularly in vulnerable populations like children.

Traces of the past: assessing the impact of potentially toxic elements from an abandoned mine on groundwater and agricultural soil in San Luis Potosí, México.

The study was conducted in Cerritos, San Luis Potosí, México, near the Guaxcama mine, focused on environmental contamination (groundwater and agricultural soil) from antimony (Sb), arsenic (As), lead (Pb), cadmium (Cd), and mercury (Hg). In March 2022, 20 agricultural soil and 16 groundwater samples were collected near the historically cinnabar (HgS)- and arsenopyrite (FeAsS)-rich Guaxcama mine. Hydride generation atomic fluorescence spectrometry (HG-AFS) for As, cold vapor atomic fluorescence spectrometry (CV-AFS) for Hg, and inductively coupled plasma optical emission spectrometry (ICP-OES) for Cd, Pb, and Sb were used for the determinations of potentially toxic elements (PTEs). While concentrations of Cd, Hg, Pb, and Sb in groundwater were below detection limits, As levels exhibited a range from 40.9 ± 1.4 to 576.0 ± 1.0µg/L, exceeding permissible limits for drinking water (10µg/L). In agricultural soil, As was between 7.67 ± 0.16 and 24.1 ± 0.4µg/g, Hg ranged from 0.203 ± 0.018 to 2.33 ± 0.19µg/g, Cd from 2.53 ± 0.90 to 2.78 ± 0.01µg/g, and Pb from 11.7 ± 1.2 to 34.3 ± 4.1µg/g. Only one study area surpassed the Mexican As soil limit of 22µg/g. Sequential extraction (four-step BCR procedure) indicated significant As bioavailability in soil (fractions 1 and 2) ranging from 3.66 to 10.36%, heightening the risk of crop transfer, in contrast to the low bioavailability of Hg, showing that fractions 1, 2, and 3 were below the limit of quantification (LOQ). Crucial physicochemical parameters in soil, including nitrate levels, pH, and organic matter, were pivotal in understanding contamination dynamics. Principal component analysis highlighted the influence of elements like Fe and Ca on phytoavailable As, while Pb and Cd likely originated from a common source. Ecological risk assessments underscored the significant impact of pollution, primarily due to the concentrations of Cd and Hg. Non-cancer and cancer risks to residents through As poisoning via contaminated water ingestion also were found. The hazard index (HI) values varied between 4.0 and 82.2 for adults and children. The total incremental lifetime cancer risk (TILCAR) values for adults ranged from 7.75E - 04 to 1.06E - 02, whereas for children, the values were from 2.47E - 04 to 3.17E - 03.

Associations between polychlorinated biphenyls and cancer risk among type 2 diabetes: The modifying effects of lifestyle

A growing percentage of diabetes-related deaths has been attributed to cancer, with environmental factors playing important contributions. Thus, we studied the potential relationship between endocrine disruptors polychlorinated biphenyls (PCBs) and cancer risk in diabetes. We aimed to evaluate the association between serum seven indicator-PCB (PCB-28/52/101/118/138/153/180) levels and incident cancer, and further explore the possible modifying role of lifestyle. A total of 2806 type 2 diabetes mellitus (T2DM) cases were included from the Dongfeng-Tongji cohort at the baseline in 2008 and tracked until December 2018, and 320 incident cancers were identified during about 10-year follow-up. Cox proportional hazards models and competing risk regression models were used to reveal associations of baseline concentrations of PCBs with total cancer and specific cancer, respectively. Lifestyle score was determined by body mass index, waist circumference, physical activity, smoking, alcohol drinking, and diet. Each interquartile range (IQR) increment of non-dioxin-like PCBs (NDL-PCBs) generated an 8%–30% increase in cancer incidence. Individuals in the highest quartile for PCB-52, PCB-101, PCB-138, and lowly chlorinated PCBs had 1.44- to 1.68-fold higher cancer risk compared to those in the lowest quartile. Restricted cubic spline analyses and the quantile g-computation model showed similar results. Significant interactions were found between PCBs and fasting blood glucose or simplified insulin resistance assessment indicators. NDL-PCBs were positively and significantly associated with gastrointestinal cancer and respiratory cancer, especially with liver cancer, colorectal cancer, and lung cancer. Higher PCBs showed a significant increase in total cancer risk among participants with an unhealthy lifestyle, however, no associations were observed in those with a relatively healthy lifestyle (Pinteraction < 0.05). Our findings indicated an increased cancer risk associated with NDL-PCBs, highlighted the role of a healthy lifestyle in potentially reducing adverse impact, and provided preliminary data for environmental and public health interventions to alleviate the risk of cancer among diabetes.

Distribution patterns, health hazards, and multivariate assessment of contamination sources of As, Pb, Ni, Zn, and Fe in agricultural soils

Soil heavy metal contamination is a worldwide environmental concern that presents considerable risks to ecosystems, agricultural progress, and human health. This study aims to evaluate the potential environmental and health hazards linked to the presence of arsenic (As), lead (Pb), nickel (Ni), zinc (Zn), and iron (Fe) in agricultural soil in Al Majma’ah governorate, Saudi Arabia. The contamination factor (CF), pollutant load index (PLI), chronic daily intake (CDI), hazard index (HI), and total lifetime cancer risk (LCR) were calculated for 34 soil samples. The results from the CF and PLI analysis demonstrate that the examined soil has a low contamination factor and is free from heavy metal pollution. The average CDI values for adults and children exhibited the following descending order: Fe > Zn > Cu > Pb > As. The highest HI values observed in adults ranged from 0.0375 (Fe) to 0.00019 (Zn), but in children, the range was from 0.3497 (Fe) to 0.0018 (Zn). The hazard index values for heavy metal(loid)s (HMs) in the Al Majma’ah area were all below 1.0, suggesting that residents in the area are not exposed to a significant non-carcinogenic risk. The LCR values ranged from 8.37E−06 to 7.80E-05 for As in both adults and children, and from 7.50E−08 to 6.98E-07 for Pb. The findings indicated a level of risk that was deemed acceptable or tolerable, without any significant adverse health effects

Quality of life and interpersonal support among adult patients with cancer undergoing chemotherapy at an academic cancer institute.

370 Background: The National Cancer Institute (NCI) defines quality of life (QOL) as “overall enjoyment of life.” Increasingly, cancer treatments like chemotherapy are focused on not only increasing survival time but on maintaining and/or improving QOL. Interpersonal support has been shown to have an impact on QOL. Assessment of both can help focus efforts to improve quality of care for cancer patients. Methods: This study enrolled patients from the Lifespan Cancer Institute at The Miriam Hospital (TMH) in Rhode Island who were adults 18+ and on chemotherapy infusion treatment with an active cancer diagnosis. Patients were randomly selected for an in-person interview during scheduled chemotherapy infusion appointments from February 9 to April 26, 2024. We collected patient demographics and study staff administered the 16-item Quality of Life Scale (QOLS) and 12-item Interpersonal Support Evaluation List (ISEL). Results: Of 432 total eligible cancer patients at TMH, 96 (22%) completed the prospective survey. The average (SD) age was 68.4 years old (10.3). The majority of patients were male (51%), Caucasian (80%), married (65%), on Medicare (62%), diagnosed in 2023 or 2024 (59%), and the most common cancers were gastrointestinal (30%), genitourinary (24%), and breast (17%). Overall, patients demonstrate mostly high satisfaction in certain QOL and interpersonal support domains with variation across others. Over 80% of patients are “delighted” or “pleased” with their material comforts, close family and friends, entertainment, and independence. However, approximately 50% of patients report a mixed or worse level of satisfaction with their health, participation in organizations/public affairs, and active recreation and varying levels of satisfaction with other QOL domains. Over 60% of patients report the highest level of perceived interpersonal support across all domains (appraisal, belonging, tangible) with indication of stronger appraisal support compared to belonging and tangible. Conclusions: Our results indicate a strong satisfaction among patients with their close interpersonal networks rather than external affairs or activities. Satisfaction with health and active recreation among chemotherapy patients is much more variable. These findings suggest possible benefits of wellness and health maintenance programs during treatment. Lowest areas of interpersonal support indicate a need to build more comprehensive support resources for tangible tasks like moving, assisting with chores, or other physical activities and building support groups to increase belonging. Opportunities to build community among chemotherapy patients or utilize clinical social workers will likely improve satisfaction in many of the more low and variable QOL and interpersonal support domains, particularly for patients navigating a new or first-ever cancer diagnosis.

Long-term outcomes of intraoperative chemotherapy with 5-FU for colorectal cancer patients receiving curative resection (IOCCRC): a randomized, multicenter, prospective, phase III trial.

We aimed to compare combined intraoperative chemotherapy and surgical resection with curative surgical resection alone in colorectal cancer patients. We performed a multicenter, open-label, randomized, phase III trial. All eligible patients were randomized and assigned to intraoperative chemotherapy and curative surgical resection or curative surgical resection alone (1:1). Survival actualization after long-term follow-up was performed in patients analyzed on an intention-to-treat basis. From January 2011 to January 2016, 696 colorectal cancer patients were enrolled and randomly assigned to intraoperative chemotherapy and radical surgical resection (n=341) or curative surgical resection alone (n=344). Intraoperative chemotherapy with surgical resection showed no significant survival benefit over surgical resection alone in colorectal cancer patients (3-year DFS: 91.1% vs. 90.0%, P=0.328; 3-year OS: 94.4% vs. 95.9%, P=0.756). However, colon cancer patients benefitted from intraoperative chemotherapy, with a relative 4% reduction in liver and peritoneal metastasis (HR=0.336, 95% CI: 0.148-0.759, P=0.015) and a 6.5% improvement in 3-year DFS (HR=0.579, 95% CI: 0.353-0.949, P=0.032). Meanwhile, patients with colon cancer and abnormal pretreatment CEA levels achieved significant survival benefits from intraoperative chemotherapy (DFS: HR=0.464, 95% CI: 0.233-0.921, P=0.029 and OS: (HR=0.476, 95% CI: 0.223-1.017, P=0.049). Intraoperative chemotherapy showed no significant extra prognostic benefit in total colorectal cancer patients who underwent radical surgical resection; however, in colon cancer patients with abnormal pretreatment serum CEA levels (> 5ng/ml), intraoperative chemotherapy could improve long-term survival.

Human and environmental risk assessment and plausible sources of toxic heavy metals at beach placers in southeast Sri Lanka

Beach placers are typically rich in heavy minerals, which are crucial for a wide range of industrial applications. This study investigates the human and environmental risks posed by toxic heavy metals (As, Pb, Zn, Cu, Cr, Fe, V and Mn) in beach placers of southeastern Sri Lanka using 42 X-ray fluorescence data. Risk indicators (EF, Igeo, CF and PLI) indicate the polluted nature of the placers. Correlation analysis (correlation matrix and HCA) identified pollution sources as heavy mineral-rich rocks, agricultural fertilizers, pesticides and municipal wastes. The environmental impact caused by toxic metals is less in placers. The highest non-carcinogenic risks (HI) resulted by Cr (1.69E+00), V (4.29E+00) and Fe (2.06E+00) to children. The total cancer risk of As and Cr in placers is unacceptable (children: 2.60E-04, 2.48E-03, and adults: 3.14E-05, 2.87E-04, respectively). Different strategies are introduced to mitigate the identified risks in source areas and the coastal environment.

The association of diabetes mellitus and routinely collected patient-reported outcomes in patients with cancer. A real-world cohort study.

Current studies have indicated that diabetes mellitus (DM) is highly prevalent in patients with cancer, but there is little research on consequences on the well-being of patients during cancer treatment. This analysis evaluates the relationship between DM and patient-reported outcomes (PRO) in patients with cancer, using a large and well-characterized cohort. This study utilized the Total Cancer Care protocol at the University of Utah Huntsman Cancer Institute. For this analysis, we integrated data from electronic health records, the Huntsman Cancer Registry, and routinely collected PRO questionnaires. We assessed the association between DM in patients with cancer and PRO scores for anxiety, depression, fatigue, pain interference, and physical function using multiple linear regression and t-tests. The final cohort comprised 3512 patients with cancer, with a mean age of 57.8 years at cancer diagnosis. Of all patients, 49.1% (n = 1724) were female, with 82.0% (n = 2879) patients reporting PROs at least at one time point. Compared with patients who responded, nonresponders were more often female (p = 0.0035), less frequently non-Hispanic White (p = 0.0058), and had a higher BMI (p = 0.0759). Patients with cancer and diabetes had worse PRO scores for anxiety (p = 0.0003), depression (p < 0.0001), fatigue (p < 0.0001), pain interference (p < 0.0001), and physical function (p < 0.0001) compared to patients with cancer without diabetes. Significant associations between diabetes and PRO scores were observed for anxiety (β ± SE: 1.27 ± 0.48; p = 0.0076), depression (β ± SE: 1.46 ± 0.45; p = 0.0011), fatigue (β ± SE: 2.11 ± 0.52; p < 0.0001), pain interference (β ± SE: 1.42 ± 0.50; p = 0.0046), and physical function (β ± SE: -2.74 ± 0.48; p < 0.0001). The results of this study suggest that patients with cancer and diabetes may be at greater risk for anxiety, depression, fatigue, higher pain interference, and reduced physical function. Strengthening diabetes management is imperative to address the negative impact of diabetes on PROs. In particular, this may be true for patients with skin, breast, prostate, and kidney cancer.

Heavy Metal Distributions of Macroalgal Species From the Mersin Inner Bay, Türkiye

The bio-accumulation of heavy metals in macroalgae poses significant risks to marine ecosystems and human health. In this study, heavy metal distributions of macroalgae and potential health risk assessment in the Mersin inner Bay were determined from macroalgae (Stypopodium schimperi, Padina pavonica, Laurencia obtusa, Dictyota sp., Sargassum vulgare, Jania rubens, Halopithys sp., Osmundea sp., Halopithys incurve, Ulva intestinalis, Entromorpha flexuosa, Ulva linza) samples collected between February and September 2021. The levels of heavy metals were found as 1.24-5.93 g/kg for aluminum, 0.61-5.26 g/kg for iron, 1.17-7.61 mg/kg for cobalt, 0.03-0.21 mg/kg for cadmium, 4.26-43.10 mg/kg for chromium, 0.28-437.52 mg/kg for cupper, 17.90-139.08 mg/kg for manganese, 2.78-79.25 mg/kg for nickel, 0.75-3.49 mg/kg for lead and 1.71-70.34 mg/kg for zinc, respectively. The potential risk assessment of macroalgal species using the calculated total cancer risk (TCR) suggested high carcinogenic risk from the carcinogenic chromium, copper and nickel (TCR&gt;1.00E-04).

Occurrence, sources and risk assessment of 12 dioxin-like polychlorinated biphenyls (DL-PCBs) in sediments from the Soummam River protected area, Algeria: A potential threat to the Mediterranean Sea

The levels, the sources and the potential risks associated with twelve dioxin-like PCBs were investigated in the sediments of the Soummam River in northeastern Algeria. Total dl-PCBs concentrations ranged from 3.64 ng/g to 9.38 ng/g with PCB 118 and PCB 105 being the predominant congeners. Principal component analysis suggested that commercial mixtures and municipal waste incineration could be responsible for the presence of PCBs in the region. TEQ values ranged from 12.93 pg/g to 60.98 pg/g indicating adverse effects on aquatic organisms. Moreover, cancer risk assessed via Total Lifetime Cancer Risk (TLCR) suggested that for all the stations, the risk was low but not negligible. Additionally, the non-cancer risk was significant at half of the stations for children but negligible for adults at all the stations. Consequently, measures must be taken by local authorities to protect the environment and the human health.

Abstract A062: Glycemic control and risk of total and advanced prostate cancer in Veterans with diabetes: analysis of disparities by race/ethnicity

Abstract Introduction Access to quality healthcare is considered a key driver in the multifactorial process giving rise to racial inequities in two of the most common complex diseases in adult men in the US - prostate cancer and diabetes. Whether inequities in diabetes treatment and outcomes, and/or related metabolic and hormone signaling pathways contribute to racial differences in prostate cancer outcomes in an equal access setting is unknown. Our objective is to determine if associations between glycemic control assessed by routine clinically measured hemoglobin A1c (A1c), among men with diabetes and risk of total and advanced prostate are similar in Black and White men receiving care from the Veterans Health Administration (VHA). Methods We used clinical data from the VHA to construct a longitudinal cohort of male Veterans &amp;gt;=45 years of age with diagnosed diabetes free of any cancer from 01/01/2010 to 12/31/2019. We classified men with total prostate cancer if the date of prostate cancer diagnosis preceded any other cancer diagnosis. Advanced prostate cancer was classified as prostate cancer diagnosis with Gleason score &amp;gt;=8, or PSA &amp;gt;=100 ng/mL, or metastasis, or death from prostate cancer. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for time-updated annual mean A1c (&amp;lt;7% [ref]; 7-8%; &amp;gt;8%) and total and advanced prostate cancer risk adjusted for age; marital status; rurality, smoking; annual primary care visits; service-connected disability; comorbidities; statin use; and oral diabetes medication use for non-Hispanic Black (NHB) and non-Hispanic White (NHW) men separately. Results Among 736,964 Veterans with diabetes, we observed 31,330 prostate cancer events including 6,779 advanced prostate cancers. For NHW men, poor glycemic control (A1c &amp;gt;8%) and moderate control (A1c 7-8%) were associated with a 19% (HR=0.81; 95%CI=0.78-0.84) and 8% lower risk (HR=0.92; 95%CI=0.89-95) of total prostate cancer incidence (p-trend&amp;lt;0.001). Among NHB men, inverse associations were attenuated for poor (HR=0.90; 95% CI=0.86-0.95) and moderate (HR=1.01; 95% CI=0.96-1.06) glycemic control and total prostate cancer risk (p-trend &amp;lt;0.001). For advanced prostate cancer, associations were inverse for poor (HR=0.90; 95% CI=0.83-0.97) and moderate glycemic control (HR=0.90; 95% CI=0.84-0.97) and advanced prostate cancer risk in NHW men, while non-statistically significant associations were observed in NHB men with poor HR=1.06; 95%CI=0.96-1.18) and moderate glycemic control (HR=1.04; 95%CI=0.94-1.16). Conclusion In the largest equal access healthcare system in the US, inverse associations for glycemic control and risk of total and advanced prostate cancer varied by race/ethnicity with stronger inverse associations observed in NHW men compared to NHB men. Whether the racial differences in diabetes treatment and care contribute to the observed disparities in total and advanced prostate cancer risk could inform precision public health efforts aimed at reducing inequities in both diabetes and prostate cancer outcomes. Citation Format: Michael T. Marrone, Kinfe G. Bishu, Neal Axon, Hermes Florez, Robert L. Grubb, Mulugeta Gebregziabher. Glycemic control and risk of total and advanced prostate cancer in Veterans with diabetes: analysis of disparities by race/ethnicity [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A062.

Abstract C166: Overall survival and mutational landscape comparison between Appalachian and non-Appalachian patients with ovarian cancer - An Oncology Research Information Network (ORIEN) analysis

Abstract Objectives: Few studies have examined the mutational landscape in ovarian cancers, and none have focused on the Appalachian region which has a higher incidence of ovarian cancer, higher rates of poverty, and limited access to care compared to non-Appalachian region. Women with ovarian cancer enrolled in the Total Cancer Care prospective cohort study were evaluated to compare overall survival, mutational landscape, and immune cell composition between subjects in Appalachian and Non-Appalachian regions. Methods: Clinical and genomic data are available for 627 ovarian cancer patients with varying histology, including 66 from Appalachian Kentucky. MutSigCV was used to identify significantly mutated genes. CIBERSORTx was used to estimate the immune cell composition based on RNA sequencing data. Fisher’s exact test was used to compare clinical and genomic characteristics, Cox regression analysis was used to compare survival, and Wilcoxon rank-sum was used to compare immune cell composition. Results: Appalachian women with ovarian cancer were more likely to be older at time of diagnosis (64 years vs 58 years, p= 0.003), have a higher BMI (28.8 vs 26.9 kg/m2, p= 0.045), and be diagnosed at the highest pathologic grade (Grade III, 90.3% vs 84.8%, p=0.023) than non-Appalachian residents. A higher proportion of Appalachian residents were diagnosed at advanced stage III/IV (85.9% vs 75.4%, p= 0.128). In univariate survival analysis, those residing in Appalachian areas had poorer survival than the non-Appalachian residents (HR1.92, 95% CI 1.25-2.94, p=0.0022). Appalachian status remained significantly associated with worse survival after adjusting for age, BMI and stage at diagnosis (HR 1.72, 95% CI 1.04-2.86, p=0.036). There was no significant difference between cohorts on histology of ovarian carcinomas. Multiple genes were significantly different between the two populations. The Appalachian cohort had more frequent PRF1 (8.3% vs 1.9%, p=0.013), MECOM (6.7% vs 1.3%, p=0.018), and ITGAV mutations (6.7% vs 1.5%, p=0.026). RECQL4, EZR, SRGAP3, USP6 were also significantly more frequent in Appalachian residents. LRP1B was the only gene significantly associated with non-Appalachian status (9.4% vs 1.7%, p= 0.047). When analyzing immune cell composition by Appalachian status, Appalachian residency was significantly associated with higher levels of activated dendritic cells. Non-Appalachian residents had non-significantly higher levels of M2 macrophages. Conclusion: Women with ovarian cancer residing in Appalachia are older at time of diagnosis, have a higher BMI, and are diagnosed at higher pathologic grade compared to non- Appalachian residents. Even after controlling for age, stage and BMI, Appalachian residence remained significantly associated with worse survival. Multiple mutations associated with oncogenesis were significantly over-represented in the Appalachian cohort, which may contribute to excess mortality in the region. Citation Format: Allison L. Swiecki-Sikora, Jinge Liu, Michelle Churchman, Jinpeng Liu, Dava Piecoro, Taylor A. Rives, Julia Nagle, Eugenia Girda, Aliza Leiser, Sheri Holmen, Jennifer Doherty, Jing-Yi Chern, Robert Wenham, Bodour Salhia, Marilyn Huang, Stephen Edge, Laura L. Holman, Abdul Rafeh Naqash, Bradley Corr, Bryan Schneider, Chi Wang, Charles S. Dietrich, Jill M. Kolesar. Overall survival and mutational landscape comparison between Appalachian and non-Appalachian patients with ovarian cancer - An Oncology Research Information Network (ORIEN) analysis [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C166.

Performance of the National Cancer Screening Program for Gastric Cancer in Korea

In Korea, the National Cancer Screening Program for Gastric Cancer (NCSP-GC) was implemented in 1999 to reduce the mortality associated with gastric cancer, the most common cancer in Korea until 2018. In 2021, approximately 7.76 million screening endoscopies were performed as part of the NCSP-GC, including 10664 participants (37.2% of the total gastric cancer cases in 2021; 10909 of the 29361 cases) with histologically confirmed gastric cancer, according to data from the Korean National Health Insurance Service. The endoscopic screening component of the NCSP-GC has contributed to the early detection of gastric cancer and the reduction of its mortality. This review evaluates the performance and limitations of the endoscopic screening component of the NCSP-GC and discusses strategies to overcome limitations.

Wildfire-related PM2.5 and cause-specific cancer mortality

Wildfires have devastating effects on society and public health. However, little evidence from population-based cohort has been performed to analyze the relationship of wildfire-related PM2.5, an important component of wildfire smoke, with cancer-specific mortality. We aimed to explore this relationship and identify vulnerable populations in UK with lower levels of wildfire-related PM2.5 exposure. The study consisted of 492394 participants (age: 38–73 years) recruited by UK Biobank during 2004–2010. The cumulative wildfire-related PM2.5 within 10 kilometers of residence over three years was used as exposure, which was assessed by chemical transport and machine learning models. A time-varying Cox regression was utilized to explore the relationship of exposure with diverse cancer-specific mortality outcomes. Subgroup analyses of a range of potential modifiers were performed. Each 10 μg/m3 increment of 3-year cumulative exposure was related to a 0.4 % greater risk of total cancer (95 %CI: 1.001–1.007), a 1.1 % greater risk of lung cancer (95 %CI: 1.004–1.018), and a 2.7 % greater risk of lip, oral cavity and pharynx (LOP) cancer (95 %CI: 1.005–1.049). Higher vulnerability in the wildfire-related PM2.5-lung cancer relationship was found among participants being retired than those with other employment status. Even lower levels of exposure to PM2.5 from wildfires were related to elevated mortality risks for cancer from total, lung, LOP, highlighting the importance of wildfire prevention and control. Further investigations are warranted to enrich and extend existing knowledge in this field.