Cancer In World Research Articles

Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations and overall mortality among adults with colorectal cancer in a multiethnic cohort study.

29 Background: High adherence to AICR recommendations on diet, adiposity, and physical activity is associated with improved survival among adults with colorectal cancer (CRC). However, over 80% of participants in existing studies self-reported as non-Hispanic White (NHW). We studied the association between adherence to AICR recommendations and overall mortality among adults with CRC in a multiethnic cohort. Methods: This prospective analysis used data from the Multiethnic Cohort (MEC) study. The MEC is a racially/ ethnically diverse cohort of over 200,000 participants residing in Hawaii and Los Angeles. Lifestyle behaviors in the MEC were assessed by questionnaire at enrolment/Q1 (1993-1996) and periodically over follow-up. We included those with incident CRC before completing Q3 (2003-2008). Follow-up was from Q3 survey completion to December 2019. The main exposure was the standardized AICR score [0-7 points] at Q3. The primary outcome was overall mortality; CRC-specific mortality was secondary. We used multivariable Cox proportional hazards regression to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CIs). Results: There were 1127 adults diagnosed with CRC prior to Q3. Of these, 1079 (95.7%) had non-missing data on the AICR score and comprised our study population. Median (IQR) age at diagnosis was 69 (62-75); median (IQR) follow-up was 12.2 (0.1-16.4) years. There were 489 (45.3%) women. By self-reported race/ethnicity, there were: 153 (14.2%) Black/African Americans, 453 (42.0%) Japanese Americans, 79 (7.3%) Latinos, 165 (15.3%) Native Hawaiians, and 229 (21.2%) NHWs. Only 48 (4.4%) adults had high adherence (AICR≥5 points). Those in the highest category of AICR scores (AICR≥4.5) had statistically significant lower risk of overall mortality relative to those in the lowest category (AICR≤2.5) (HR: 0.64, 95% CI, 0.47-0.89). A similar (but non-statistically significant) association was observed with CRC-specific mortality [HR (high vs low): 0.70, 95% CI, 0.31-1.60]. Those who increased their score between Q1&Q3 had lower overall mortality (HR: 0.87, 95% CI,0.79 - 0.96). Similar trends were observed in stratified analysis by race/ethnicity; however, statistical power was limited. Conclusions: High adherence to AICR recommendations was associated with lower risk of overall mortality in this multiethnic population of adults with CRC. Efforts to increase adherence to AICR recommendations in this population are needed.

Factors associated with first-to-second-line attrition among patients with metastatic breast cancer in the real world.

Estimating patient attrition across lines of treatment (i.e. the probability that upon treatment failure the patient will not be able to receive a subsequent treatment) may be a valuable tool for optimizing treatment sequencing. We sought to describe the first-to-second-line attrition rate and factors associated with attrition in a real-world cohort of patients with metastatic breast cancer. The Gruppo Italiano Mammella (GIM)14/BIO-META (NCT02284581) is an ongoing, ambispective observational multicenter study enrolling patients with metastatic breast cancer receiving first-line therapy. In patients experiencing disease progression, attrition was defined as no further anticancer treatment and death within 6 months from the end of first-line therapy. The attrition rate from the first-to-second line was studied by descriptive analyses and univariate and multivariable logistic models were used to explore potentially predictive factors. From January 2000 to December 2021, 3109 patients with metastatic breast cancer were enrolled in the GIM14/BIO-META study. Among them, 2498 patients experienced first-line treatment failure. Overall, first-to-second line attrition was 9.0% (95% confidence interval 7.9% to 10.1%), with similar attrition for patients with hormone receptor-positive/HER2-negative (8.5%) and HER2-positive (7.1%) breast cancer. Patients with triple-negative disease experienced the highest attrition (13.0%). Age, menopausal status, disease-free interval from primary tumor diagnosis, type of metastatic spread, and tumor subtype independently predicted first-to-second-line attrition. These findings could inform treatment decisions and guide clinical research on treatment sequencing. For instance, patients with the lowest risk of attrition may be the ideal candidates for trials exploring de-escalated first-line regimens, followed by more aggressive treatments upon progression.

Resistance to Radiotherapy in Cancer.

Radiation therapy or radiotherapy is a medical treatment that uses high doses of ionizing radiation to eliminate cancer cells and shrink tumors. It works by targeting the DNA within the tumor cells restricting their proliferation. Radiotherapy has been used for treating cancer for more than 100 years. Along with surgery and chemotherapy, it is one of the three main and most common approaches used in cancer therapy. Nowadays, radiotherapy has become a standard treatment option for a wide range of cancers around the world, including lung, breast, cervical, and colorectal cancers. Around 50% of all patients will require radiotherapy, 60% of whom are treated with curative intent. Moreover, it is commonly used for palliative treatment. Radiotherapy provides 5-year local control and overall survival benefit in 10.4% and 2.4% of all cancer patients, respectively. The highest local control benefit is reported for cervical (33%), head and neck (32%), and prostate (26%) cancers. But no benefit is observed in pancreas, ovary, liver, kidney, and colon cancers. Such relatively low efficiency is related to the development of radiation resistance, which results in cancer recurrence, metastatic dissemination, and poor prognosis. The identification of radioresistance biomarkers allows for improving the treatment outcome. These biomarkers mainly include proteins involved in metabolism and cell signaling pathways.

Meat consumption and racial/ethnic disparities in population-based study in the city Campinas, Brazil

The aim of the present study was to investigate meat consumption among adults residing in a city in the countryside of São Paulo, Campinas, according to ethnicity/skin color in two periods: 2008/2009 and 2014/2015, given the scarce literature on the subject. Thus, we sought to evaluate the association between race/color and consumption of meat, a food of great cultural value, based on the hypothesis that this demographic marker is relevant to explain food choices. A cross-sectional population-based study evaluating participants from the Health Survey of the City of Campinas (ISACAMP) was conducted in 2008/2009 and 2014/2015, with 2,354 and 1,606 individuals respectively, aged 20y or older. Food consumption data were collected using the 24-hour food recall method and meats were classified according to animal origin and type of processing. Linear regression models were run to assess the association between meat consumption and sociodemographic variables with a significance level of 5%. Lower total consumption of meat, red meat, beef and fish was found among individuals with self-declared black skin color compared to those with self-declared white skin color. Red meat consumption varied from 109.4g to 157.9g in 2008/2009 and from 102.1g to 125.1g in 2014/2015 between the groups, remaining above the recommendation in both periods. The World Cancer Research Fund recommends consuming between 50 and 71.4 g/day of red meat; thus, these findings reinforce the importance of studies that investigate the impact of ethnicity on food consumption, since racial disparities may be in the origin of the insufficient or excessive consumption of certain types of meat, and understanding the factors associated with the consumption of types of meat is relevant for the adoption of health actions aimed at adequate food intake.

Dietary-Lifestyle Patterns and Colorectal Cancer Risk: Global Cancer Update Programme (CUP Global) Systematic Literature Review.

While healthy dietary and lifestyle factors have been individually linked to lower colorectal cancer (CRC) risks, recommendations for whole diet-lifestyle patterns remained unestablished due to limited studies and inconsistent pattern definitions. This updated review synthesized literature on dietary-lifestyle patterns and CRC risk/mortality. PubMed and Embase were searched through 31 March 2023 for randomized controlled trials and prospective cohort studies examining adulthood dietary patterns combined with modifiable lifestyle factors such as adiposity, smoking, alcohol consumption, physical activity, and/or others. Patterns were categorized by derivation methods: a priori, a posteriori, and a hybrid combining both; and were then descriptively reviewed for the primary outcomes: CRC risk or mortality. The Global Cancer Update Programme Expert Committee and Expert Panel independently graded the evidence on the likelihood of causality using pre-defined grading criteria. Thirty-three observational studies were reviewed. 'Strong-probable' evidence was concluded for higher levels of alignment with the a priori-derived World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations score and lower CRC risk; and 'limited-suggestive' evidence for the American Cancer Society guidelines and Healthy Lifestyle Index with lower CRC risk (mainly due to concerns about risk of bias for confounding). A posteriori-derived patterns lack firm evidence (only one study). 'Strong-probable' evidence was concluded for higher levels of alignment with the Empirical Lifestyle Index for Hyperinsulinemia hybrid pattern and higher CRC risk. By cancer subsite, only the WCRF/AICR recommendations score showed 'strong-probable' evidence with lower colon cancer risk. All exposure-mortality pairs were graded 'limited-no conclusion'. The evidence for other pattern-outcome associations was graded as 'limited-no conclusion'. Adopting a healthy pattern of diet, maintaining a healthy weight, staying physically active, and embracing health-conscious habits, such as avoiding tobacco and moderating alcohol, are collectively associated with a lower CRC risk. Healthy lifestyle habits are key to primary CRC prevention.

Current Review on Nanophytomedicines in the Treatment of Oral Cancer: Recent Trends and Treatment Prospects.

Cancer is one of the major life-threatening diseases in the world and oral cancer is the 8th most common type of deadly cancers in Asian countries. Despite many causes, tobacco is the main causative agent as 90% of oral cancer cases were due to daily consumption of tobacco and its products. The major drawback of the conventional therapies for oral cancer including chemotherapy, surgery and radiotherapy or combination of these is the dose limiting toxicity. Developments in technology and research led to new innovative discoveries in cancer treatments. In the past few decades, increased attention has been given to researches in alternative cancer treatment strategies using plants and plant products. Recently many anticancer drugs from natural products or phytochemicals were approved internationally. Due to the low bioavailability and poor solubility of phytochemicals, various research works on nano-carrier based drug delivery systems were exploited in the recent past to make them as promising anticancer agents. In the current review, an overview of oral cancer and its treatment, risk factors, missing links of conventional therapies, contribution of nanotechnology in cancer treatment and research on phytochemical based drug treatment and different polymeric nanoparticles were discussed briefly. The future prospects for the use of various types of polymeric nanoparticles applied in the diagnosis and treatment of oral cancer were also mentioned. The major concern of this review is to give the reader a better understanding on various types of treatment for oral cancer.

The Impact of Chemical Composition of Processed Foods on Human Health in Bangladesh

Processed foods have become a staple in the diet of many Bangladeshis due to urbanization and changing lifestyles. However, their chemical composition raises significant public health concerns. Investigating chemical composition of processed food consumption in Bangladesh and evaluating its relationship to dietary quality are the goals of this study. This study applies data from a nationwide household food budget survey to a classification of foods based on the kind, degree, and purpose of food processing. Foods are divided into three categories: chemical composition of processed food (Group 3), processed culinary components (Group 2), and unprocessed or slightly processed foods (Group 1). The population was selected from Dhaka city in Bangladesh. The result of this study is the average per capita energy availability from food purchases was 8908 (SE 81) kJ/d (2129 (SE 19) kcal/d). Chemical composition of processed foods accounted for more than 61.7 percent of dietary energy (Group 3), compared to 25.6 percent from Group 1 and 12.7 percent from Group 2. The total diet included less fiber than advised and surpassed WHO upper limits for fat, saturated fat, free sugars, and sodium density. Additionally, it surpassed the World Cancer Research Fund/American Institute for Cancer Research's average energy density goal. When combined, Group 3 products are higher in fat, sugar, salt, and energy density than Group 1 and Group 2 products alone. According to the current analysis, any significant dietary change would need consuming significantly fewer chemical composition of processed food and a greater number of meals and dishes made with minimally processed foods and processed culinary components.

Exposure to Drinking Water Trihalomethanes and Risk of Cancer: A Systematic Review of the Epidemiologic Evidence and Dose-Response Meta-Analysis.

Chlorination is a widespread method for drinking water disinfection that has the drawback of introducing potentially carcinogenic chemical by-products to drinking water. We systematically evaluated the epidemiologic evidence of exposure to trihalomethane (THM) disinfection by-products and risk of cancer. We conducted a systematic review and meta-analysis of epidemiologic studies that assessed the association of exposure to residential concentrations of THMs with risk of cancer in adults. A protocol was preregistered in PROSPERO (CRD42023435491). PubMed, Embase, Web of Science, and Cochrane were searched for publications up to April 2024. Study selection and risk of bias appraisal using the National Toxicology Program Office of Health Assessment and Translation (NTP OHAT) tool was done in duplicate. Summary risk estimates were assessed using random effects meta-analysis and one-stage dose-response meta-analysis. The literature search resulted in 2,022 records, of which 29 publications assessing 14 different cancers were eligible for inclusion. Summary relative risks (RRs) were estimated for bladder cancer and colorectal cancer based on 5,860 and 9,262 cases and 84,371 and 90,272 participants, respectively. The summary RR of bladder cancer for the highest exposed compared with the lowest was 1.33 (95% CI: 1.04, 1.71), and in the dose-response analysis, RRs were statistically significant above THM concentrations of . For colorectal cancer, the summary RR was 1.15 (95% CI: 1.07, 1.24). According to the World Cancer Research Fund criteria, we found limited-suggestive evidence that THM in drinking water increases the risk of bladder and colorectal cancer at levels below current regulatory limits in the US and EU, indicating that these fail to protect against cancer in the general population. https://doi.org/10.1289/EHP14505.

Clinical features and prognosis analysis of stage III/IV patients with lung cancer after treatment with toripalimab: A real-world retrospective.

Toripalimab is the first antitumor programmed cell death protein 1 (PD-1) antibody approved in China. For better patient management, it is important to understand the real-world outcomes of toripalimab in treating patients with lung cancer in the real world outside of clinical trials to improve patient care. We retrospectively examined the clinical data of 80 patients with lung cancer who received the PD-1 inhibitor (toripalimab). The Chi-square test was performed to identify clinical factors associated with the advancement of the disease. Multivariate Cox regression analysis was used to screen prognostic variables linked to real-world progression-free survival (PFS) and overall survival (OS). OS and PFS were calculated using the Kaplan-Meier method, and the comparisons were determined using the log-rank test, and continuous and categorical variables were explained using median and percentage, respectively. The median OS of the estimated 80 patients was 15.85 months (95% confidence interval [CI]: 14.103-17.949 months), and the estimated PFS was 5.650 months (95% CI: 7.226-11.264 months). The longer OS and PFS correlate with the patient's staging and number of treatment lines. The PD-1 drug gave stage III patients a significantly longer PFS and OS compared to stage IV patients (PFS: 14.65 vs. 6.68, P = 0.004; OS: 21.1 vs. 13.7, P = 0.003). First- or second-line immunotherapy patients have significantly longer PFS and OS than third- or fourth-line (PFS: 6.4 vs. 3.6, P = 0.009; OS: 20.0 vs. 10.5, P = 0.003). In patients with stage IV (n = 60) with extensive metastasis, the site of metastasis is mostly 1-3 sites after receiving toripalimab. The duration of PD-1 inhibitor OS in progressive patients (n = 56) was significantly prolonged (P = 0.038). For patients with lung cancer, toripalimab can considerably extend PFS and OS in the first or second line and in stage III. PD-1 inhibitors are administered to patients with stage IV extensively metastatic lung cancer, which indicates an oligometastatic progression pattern, primarily in 1-3 locations, who are treated with PD-1 inhibitors. Continuing toripalimab beyond disease progression significantly prolonged OS.

Plant-based dietary patterns and ultra-processed food consumption: a cross-sectional analysis of the UK Biobank

Dietary shift towards more plant-based options is increasingly popular, but the quantity of ultra-processed foods (UPFs) they contain is largely unknown. This study assessed the level of UPF and minimally processed food consumption among regular and low red meat eaters, flexitarians, pescatarians, vegetarians and vegans in a large dataset of United Kingdom (UK) adults. This is a cross-sectional analysis of the UK Biobank participants recruited between December 19, 2006, and October 1, 2010. Responses to food frequency questions were used to identify diet types for vegans (never eating any animal-based foods); vegetarians (never eating meat/fish); pescatarians (never eating meat); flexitarians (consumed fish/meat under twice a week); low red meat eaters (consumed fish/poultry more than once a week but red/processed meat under twice a week); and regular red meat eaters (consumed red/processed meat more than once a week). Consumption of all food and drinks collected in 24-h recalls between April 29, 2009, and June 28, 2012, were categorised using the Nova classification. The primary outcomes are the consumption of UPFs and minimally processed foods, expressed as a percentage of daily food intake (grams/day). Multivariable linear regression assessed the mean percentage point difference in UPF and minimally processed food consumption between diet types. This study included 199,502 UK Biobank participants (mean age 58.2 [standard deviation 7.9] years; 55.1% women). The mean UPF consumption was 24.2%, 21.9%, 22.0%, 20.4%, 23.8%, and 22.7% among 75,091 regular red meat eaters, 70,144 low red meat eaters, 45,057 flexitarians, 4932 pescatarians, 4119 vegetarians and 159 vegans, respectively. The adjusted results suggested that compared with regular red meat eaters, UPF consumption was 1.3 percentage points higher among vegetarians (95% confidence interval [CI]: 0.9, 1.7) and lower among low red meat eaters (-1.3, 95% CI:-1.4,-1.1), flexitarians (-0.8, 95% CI:-1.0,-0.7), and pescatarians (-1.6, 95% CI:-1.9,-1.2). The UPF consumption in vegans were not significantly different from regular red meat eaters (1.2 percentage points, 95% CI:-0.7, 3.2). Minimally processed food consumption was higher in all other types of diet than regular red meat eaters, with an adjusted percentage point difference ranged from 0.4 (95% CI: 0.005, 0.9) for vegetarians to 3.2 (95% CI: 1.0, 5.5) for vegans compared with regular red meat eaters. This UK-based study found higher UPF consumption in vegetarian diets and lower in diets with a modest amount of meat or fish. It is important that policies which encourage the urgently needed transition to more sustainable dietary patterns also promote rebalancing diets towards minimally processed foods. National Institute for Health and Care Research (NIHR) School for Public Health Research, World Cancer Research Fund.

Adherence to the Cancer Prevention Recommendations from World Cancer Research Fund/American Institute for Cancer Research After Cancer Diagnosis on Mortality in South Korea.

The World Cancer Research Fund/American Institute for Cancer Research recommends following the recommendations for cancer prevention even after cancer diagnosis. To provide evidence on the potential benefits of adherence on improved survival, we investigated the effects of post-diagnostic adherence to the recommendations regarding diet, physical activity, and body weight on all-cause mortality among Korean cancer survivors. Among the total number of cancer survivors (n = 173,195) recruited from 2004 to 2013 for the Health Examinees study, 5485 were selected for the analyses and classified by tertiles according to the adherence score. The Cox proportional hazards model was used to estimate the adjusted hazard ratios (HR) and their 95% confidence intervals (CI) of the adherence groups on all-cause mortality. Although no clear association was observed overall during a mean follow-up of 10.1 (standard deviation = 3.0) years, reduced mortality was observed for the middle (HR = 0.74 [95% CI = 0.51-1.08]) and highest adherent group (0.66 [0.43-0.99]) in comparison to the lowest adherent group among long-term survivors (>5 years after cancer diagnosis). Among the cancer prevention recommendation items, "be physically active" and "limit consumption of fast foods" were inversely associated with mortality. Adhering to the WCRF/AICR cancer prevention recommendations may help improve the prognosis of long-term cancer survivors.

RETRACTED: Kokkinopoulou et al. Associations Between Christian Orthodox Church Fasting and Adherence to the World Cancer Research Fund's Cancer Prevention Recommendations. Nutrients 2022, 14, 1383.

The Nutrients Editorial Office retracts the article "Associations between Christian Orthodox Church Fasting and Adherence to the World Cancer Research Fund's Cancer Prevention Recommendations" [...].

Investigating High-risk Factors, Precise Diagnosis, and Treatment of Castration- Resistant Prostate Cancer (CRPC).

The treatment of metastatic castration-resistant prostate cancer (mCRPC) in the actual world currently presents difficulties. In light of this, it is crucial to investigate high-risk factors for the progression of advanced prostate cancer and to identify methods for delaying the onset of CRPC. This study aimed to explore the high-risk factors that impact the progression of prostate cancer and emphasize the significance of precise diagnosis and treatment based on etiological classification in the clinical management of castration-resistant prostate cancer. A retrospective analysis was conducted on 277 newly diagnosed cases of PCa treated with endocrine therapy. A follow-up was done on prostate-specific antigen (PSA) levels and testosterone. Additionally, a prospective analysis was performed on the clinical data of 60 patients with CRPC. Following the principle of "4W1H", 30 patients were included in the precision treatment group for a second biopsy and related tests, while another 30 patients were included in the conventional treatment group. The therapeutic effect and prognosis of the two groups were observed. Distant metastasis (HR = 1.879, 95% CI: 1.311 ~ 2.694, P = 0.001), PSA nadir > 0.2 ng/mL (HR = 1.843, 95% CI: 1.338 ~ 2.540, P = 0.001), testosterone nadir > 20 ng/dL (HR = 1.403, 95% CI: 1.035 ~ 1.904, P = 0.029), and time to testosterone nadir > 6 months (HR = 1.919, 95% CI: 1.364 ~ 2.701, P = 0.001) were risk factors for the progression to CRPC. Patients in the CRPC group were treated with precision therapy and conventional therapy based on their molecular subtyping. The precision treatment group showed a significantly prolonged median PSA progression-free survival compared to the conventional treatment group (16.0 months vs. 13.0 months, P=0.025). The median radiographic progression-free survival was also significantly extended in the precision treatment group compared to the conventional treatment group (21.0 months vs. 16.0 months, P=0.042). Patients with prostate cancer diagnosed with distant metastasis at initial presentation require early intervention. Close monitoring of PSA and serum testosterone changes is necessary during the process of endocrine therapy. After entering the CRPC stage, the etiological classification precision treatment can improve the therapeutic effect and improve the prognosis of patients.

Development, Content Validity and Usability of a Self-Assessment Instrument for the Lifestyle of Breast Cancer Survivors in Brazil.

Breast cancer is the most common cancer among women globally, and it negatively impacts diet and quality of life, increasing the risk of recurrence. Adhering to World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) lifestyle guidelines, such as healthy eating habits and nutritional status, can help in primary and secondary cancer prevention. However, no questionnaire was found for self-assessment of these guidelines for the Brazilian population. The aim of this study is to carry out content validity, pilot, and usability testing of the self-administered digital instrument "PrevCancer" assessing adherence to the WCRF/AICR recommendations in Brazilian female breast cancer survivors. We conducted a psychometric study that involved the development of an instrument based on WCRF/AICR recommendations. Assessment of content validity involved the Content Validity Index (CVI) based on expert assessments (n = 7). The pilot study involved the System Usability Scale (SUS) after applying the developed instrument (n = 65) and anthropometric assessment for convergent validity by female participants (n = 55). The final usability test consisted of evaluating the satisfaction with the instrument of women with breast cancer (n = 14). The "PrevCancer" instrument demonstrated good content (CVI = 1.0) as well as good usability and acceptability in the pilot study (mean SUS score = 88.1). The convergent validity stage demonstrated positive associations between the PrevCancer parameters and anthropometric parameters (p < 0.001). In the final usability study (mean SUS score = 90.3), participants' receptivity to the instrument was excellent. The PrevCancer instrument had valid content and great usability by the target population, proving to be a useful tool for future cancer research.

Spiral shaped highly sensitive rectangular PCF-based cancer cells detector in terahertz regime

Abstract The increasing fatality rate of cancer in the modern world has become a global concern. To address this issue, early detection of cancer cells in human blood is essential. In this article, a rectangular spiral shaped photonic crystal fiber has been proposed for sensing cancer cells in terahertz regime. The proposed PCF based sensor features a square shaped core surrounded by rectangular air holes of different sizes in a spiral manner. Finite element method based COMSOL Multiphysics software has been used for the design and analysis of the model. The model is sensitive to refractive index variation for the identification of cancer cells. The values of effective refractive index, effective mode area, relative sensitivity, non-linearity, and confinement loss are obtained for MCF-7, MDA-MB-231, Jurkat, HeLa, Basal and PC-12. The PCF based sensor resulted in excellent results of relative sensitivity and Confinement loss as good as 99.377% and 8.59 × 10−12 dBm−1 respectively. Furthermore, the present PCF based sensor model is fabrication feasible, and we hope that it can be utilized at industrial level for biosensing applications in terahertz waveguide regime.

Quality of life and adherence to healthy lifestyle factors among breast cancer survivors in Cyprus

Abstract Breast cancer is a prevalent disease for women globally, with rising survival rates highlighting the need to address the breast cancer survivors’ (BCS) quality of Life (QoL). Furthermore, adherence to a healthy lifestyle is associated with decreased mortality in BCS. Mapping the Lifestyle Medicine pillars and the World Cancer Research Fund/American Institute for Cancer Research recommendations identifies 7 healthy lifestyle components: weight management, physical activity, healthy eating, restorative sleep, avoidance of risky substances, positive social connections and stress management. This study examines adherence to these healthy lifestyle components and QoL among BCS. A cross-sectional study conducted in 2022-23 recruited primary adult BCS from the Bank of Cyprus Oncology Centre. Participants completed a survey assessing self-reported QoL and adherence to the aforementioned 7 healthy lifestyle components, through validated questionnaires. Out of 349 BCS approached, 272 were included in the final analysis. Mean age and time since main treatment completion were 51 (SD: 7.4) and 3.6 (SD: 2.5) years respectively. Amongst study participants 58% were classified as bad sleepers, 53.3% were overweight or obese, 23% were stressed, 78% reported to have moderate/high physical activity, and 60% adhered to the Mediterranean diet. Regarding substance use, 16% were current smokers, and 18% were hazardous drinkers. Median score for social support was 75 (IQR: 53-97; max score=100) and for QoL was 67 (IQR: 50-97; max score:100). BCS in Cyprus generally exhibit moderate adherence to the Mediterranean diet, engage in fairly active lifestyles and enjoy high levels of social support and QoL. On the other hand, a substantial proportion smoke or drink, are overweight or obese, are stressed and have poor sleep quality. Targeted interventions to increase the adherence of breast cancer survivors to the 7 healthy lifestyle components are required. Key messages • Overall variability exists in the adherence to healthy lifestyle components among BCS in Cyprus. • This population can benefit from intervention targeting sleep, stress and weight management.

Cancers attributable to diet in Italy.

Cancer burden can be reduced by controlling modifiable risk factors, including diet. We provided an evidence-based assessment of cancer cases and deaths attributable to diet in Italy in 2020. We considered dietary factor-cancer type pairs for which the World Cancer Research Fund/American Institute for Cancer Research - Continuous Update Project reported either 'convincing' or 'probable' evidence of causal association. Relative risks were retrieved from recent meta-analyses and dietary intakes (around 2005) from a national food consumption survey. Sex-specific population attributable fractions (PAFs) were computed by comparing the distribution of dietary intakes in the Italian population against counterfactual scenarios based on dietary recommendations. Using data from national cancer and mortality registries in 2020, we estimated the number of attributable cancer cases and deaths, assuming ~15-year lag period. Unhealthy diet accounted for 6.3% (95% CI: 2.5%-9.9%) of all cancer cases in men and 4.5% (95% CI: 1.7%-7.4%) in women. PAFs of colorectal cancer were 10.5% and 7.0% for any intake of processed meat, 3.3% and 2.0% for high red meat, 4.8% and 4.3% for low dairy products, and 7.9% and 9.0% for low fiber intakes in men and women, respectively. PAFs for low intake of non-starchy vegetables and fruit ranged from 0.8% to 16.5% in men and 0.6%-17.8% in women for cancers of the aerodigestive tract. The estimated cancer burden associated with unfavorable dietary habits in Italy is considerable, but appears lower than for other high-income countries, reflecting the typically Mediterranean diet.

Trastuzumab Deruxtecan in Human Epidermal Growth Factor Receptor 2-Positive Metastatic Gastric Cancer in a Real-World Setting: A Nationwide Cohort Study.

Trastuzumab deruxtecan (T-DXd) has been approved for human epidermal growth factor receptor 2-positive locally advanced or metastatic gastric and gastroesophageal junction (HER2+ mG/GEJ) cancer since July 2022 in France, through an accelerated approval. The aim of this study was to evaluate its real-world use. We characterized T-DXd users treated for HER2+ mG/GEJ cancer using data from the French National Health Insurance database. The cohort included 196 patients, mostly men (78.1%), with a median age of 65 years. Median overall survival reached 7.7 months (95% CI: 6.2-9.0). Patients treated with T-DXd for HER2+ mG/GEJ cancer in the real world showed lower outcomes than those in pivotal clinical trials, consistent with previous reports on accelerated approvals.

Who, what, where, when, and how: IPOS legacy and future directions

Abstract The International Psycho-Oncology Society (IPOS) has played a pivotal role in the integration and advancement of psychosocial care within oncology. Cancer diagnosis is just one of many stressors for patients, but those with mental health disorders, especially depression or anxiety, struggle disproportionately. Despite evidence for empirically supported psychological treatments and supportive care initiatives, the global visibility of psychosocial oncology is low in countries having the greatest need. Forecasts of cancer incidence and mortality suggest that more than two-thirds of the world's cancers will occur in low-income and middle-income/resource countries (LMRCs) within the next 15 years. Having multiple economic, institutional, and governmental/political barriers, LMRCs have not benefited from extensive research and psychosocial care integration seen in higher resource countries. But importantly, IPOS can leverage its global position and network to lead and support the inclusion of psychosocial care into national LMRC cancer plans and facilitate within-country research development and mentorship. The future requires awareness and leadership to build a global psychosocial infrastructure to improve quality of life for all affected individuals.

MA04.04 Treatment Patterns and Survival of Screen-Detected Lung Cancer in the Real World Versus the National Lung Screening Trial

MA04.04 Treatment Patterns and Survival of Screen-Detected Lung Cancer in the Real World Versus the National Lung Screening Trial