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18 pages, 3002 KiB

Open AccessArticle

Geriatric Assessment of Older Patients Receiving Trabectedin in First-Line Treatment for Advanced Soft Tissue Sarcomas: The E-TRAB Study from The German Interdisciplinary Sarcoma Group (GISG-13)

by Bernd Kasper, Daniel Pink, Christian Rothermundt, Stephan Richter, Marinela Augustin, Attila Kollar, Annegret Kunitz, Wolfgang Eisterer, Verena Gaidzik, Thomas Brodowicz, Gerlinde Egerer, Peter Reichardt, Peter Hohenberger and Markus K. Schuler

Cancers 2024, 16(3), 558; https://doi.org/10.3390/cancers16030558 - 28 Jan 2024

Cited by 2 | Viewed by 1122

Abstract

E-TRAB was a non-interventional, prospective trial investigating the feasibility and predictive value of geriatric assessments (GA) in older STS patients treated with trabectedin as first-line therapy. Primary endpoints were overall survival (OS), quality of life and individual clinical benefit assessed by the patient-reported [...] Read more.

E-TRAB was a non-interventional, prospective trial investigating the feasibility and predictive value of geriatric assessments (GA) in older STS patients treated with trabectedin as first-line therapy. Primary endpoints were overall survival (OS), quality of life and individual clinical benefit assessed by the patient-reported outcome measures QLQ-C30 and PRO-CTCAE. Further, several GA tools were applied and correlated with clinical outcomes and treatment-related toxicities. The final analyses included 69 patients from 12 German-speaking sites. The median age of patients was 78 years (range: 55 to 88). Baseline data on PROs and GA identified a diverse population of older patients with respect to their global health status, although a large proportion of them suffered from limitations, required geriatric help and had a high risk of morbidity. The Cancer and Age Research Group (CARG) score classified 38%, 29% and 23% of the patients with low, intermediate and high risks for therapy-related side effects, respectively. Median OS was 11.2 months [95%CI: 5.6; 19.4]. The study confirmed that trabectedin as first-line treatment in older patients with STS has an acceptable and manageable safety profile. Potential prognostic factors for clinical outcome and therapy-related toxicity were identified among the GA tools. Long Timed Up and Go (TUG) showed a significant correlation to OS and early death, whereas a high CARG score (>9) was associated with an increase in unplanned hospitalizations and the incidence of toxicities grade ≥ 3. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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17 pages, 264 KiB

Open AccessArticle

Suicide after a Diagnosis of Cancer: Follow-Up of 1.4 Million Individuals, 2009–2019

by Irmina Maria Michalek, Florentino Luciano Caetano dos Santos, Urszula Wojciechowska and Joanna Didkowska

Cancers 2023, 15(17), 4315; https://doi.org/10.3390/cancers15174315 - 29 Aug 2023

Cited by 1 | Viewed by 1255

Abstract

Background: The study explores whether Polish cancer patients face elevated suicide risk, emphasizing the vital need to comprehend and mitigate their unique mental health struggles. Methods: We conducted a cohort study based on Polish National Cancer Registry data (diagnosis in 2009–2019). Age-, sex-, [...] Read more.

Background: The study explores whether Polish cancer patients face elevated suicide risk, emphasizing the vital need to comprehend and mitigate their unique mental health struggles. Methods: We conducted a cohort study based on Polish National Cancer Registry data (diagnosis in 2009–2019). Age-, sex-, and year-standardized mortality ratios (SMR) are presented with 95% confidence intervals (CIs) overall and by sex. Results: The study included 1.43 million individuals diagnosed with cancer. There were 830 suicide cases in this group. The overall SMR for suicide was 1.34 (95% CI 1.25–1.43). The highest risk of suicide death was observed in the first six months after diagnosis (SMR = 1.94, 1.69–2.21): cancers of the heart and pleura (19.15, 2.32–69.18), an unspecified site (3.99, 1.09–10.22), and the esophagus (3.34, 1.08–7.79). The highest overall risk of suicide after cancer diagnosis was observed in esophageal (2.94, 1.47–5.26), gastric (2.70, 2.00–3.57), cervical (2.20, 1.06–4.05), and head and neck cancers (2.06, 1.52–2.72). Conclusions: Patients with cancer face significantly higher suicide risk, peaking within six months post-diagnosis. Urgent integration of suicide risk screening and prevention into cancer care is crucial, supporting mental well-being and guiding proactive healthcare strategies. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

17 pages, 1500 KiB

Open AccessArticle

Racial/Ethnic Disparities in Prostate Cancer 5-Year Survival: The Role of Health-Care Access and Disease Severity

by Christiane J. El Khoury and Sean A. P. Clouston

Cancers 2023, 15(17), 4284; https://doi.org/10.3390/cancers15174284 - 27 Aug 2023

Cited by 1 | Viewed by 2430

Abstract

Introduction: Prostate cancer (PCa) exhibits one of the widest racial and socioeconomic disparities. PCa disparities have also been widely linked to location, as living in more deprived regions was associated with lower healthcare access and worse outcomes. This study aims to examine PCa [...] Read more.

Introduction: Prostate cancer (PCa) exhibits one of the widest racial and socioeconomic disparities. PCa disparities have also been widely linked to location, as living in more deprived regions was associated with lower healthcare access and worse outcomes. This study aims to examine PCa survival across various USA counties in function of different socioeconomic profiles and discuss the role of potential intermediary factors. Methods: The SEER database linked to county-level SES was utilized. Five-year PCa-specific survival using the Kaplan–Meier method was performed for five racial/ethnic categories in function of SES quintiles. Multilevel Cox proportional hazards regression was performed to assess the relationship between county-level SES and PCa survival. Multivariate regression analysis was performed to examine the role of healthcare utilization and severity. Results: A total of 239,613 PCa records were extracted, and 5-year PCa-specific survival was 94%. Overall, living in counties in the worst poverty/income quintile and the worst high-school level education increased PCa mortality by 38% and 33%, respectively, while the best bachelor’s-level education rates decreased mortality risk by 23%. Associations varied considerably upon racial/ethnic stratification. Multilevel analyses showed varying contributions of individual and area-level factors to survival within minorities. The relationship between SES and PCa survival appeared to be influenced by healthcare utilization and disease stage/grade. Discussion: Racial/ethnic categories responded differently under similar county-level SES and individual-level factors to the point where disparities reversed in Hispanic populations. The inclusion of healthcare utilization and severity factors may provide partial early support for their role as intermediaries. Healthcare access (insurance) might not necessarily be associated with better PCa survival through the performance of biopsy and or/surgery. County-level education plays an important role in PCa decision making as it might elucidate discussions of other non-invasive management options. Conclusions: The findings of this study demonstrate that interventions need to be tailored according to each group’s needs. This potentially informs the focus of public health efforts in terms of planning and prioritization. This study could also direct further research delving into pathways between area-level characteristics with PCa survival. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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12 pages, 1853 KiB

Open AccessArticle

Evaluation of Efficacy of ALK Inhibitors According to Body Mass Index in ALK Rearranged NSCLC Patients—A Retrospective Observational Study

by Marco Siringo, Gabriella Gentile, Salvatore Caponnetto, Isabella Sperduti, Daniele Santini, Enrico Cortesi and Alain Jonathan Gelibter

Cancers 2023, 15(13), 3422; https://doi.org/10.3390/cancers15133422 - 30 Jun 2023

Cited by 2 | Viewed by 2477

Abstract

No evidence exists as to whether body mass index (BMI) impairs clinical outcomes from ALK inhibitors (ALKi) in patients with ALK-rearranged non-small cell lung cancer (NSCLC). Retrospective data of patients affected by metastatic ALK-rearranged NSCLC treated with ALKi were collected. We divided patients [...] Read more.

No evidence exists as to whether body mass index (BMI) impairs clinical outcomes from ALK inhibitors (ALKi) in patients with ALK-rearranged non-small cell lung cancer (NSCLC). Retrospective data of patients affected by metastatic ALK-rearranged NSCLC treated with ALKi were collected. We divided patients into “low- BMI” (≤25 kg/m²) and “high- BMI” (>25 kg/m²) categories and correlated them with overall survival (OS) and progression-free survival (PFS). We included 40 patients treated with ALKi. We observed a 3-year OS of 81.5% in high-BMI vs. 49.6% in low-BMI categories (p = 0.049); the 3-year first-line PFS was superior in high-BMI vs. low-BMI patients (47% vs. 19%, p = 0.019). As expected, patients treated with Alectinib had a 55.6% 3-year PFS vs. 7.1% for others treated with ALKi (p = 0.025). High-BMI was associated with a 100% 3-year PFS rate vs. 25.4% in low-BMI Alectinib patients (p = 0.03). BMI was independently correlated with first-line PFS and OS at multivariate analysis with PS (HR 0.39, CI 95% 0.16–0.96, p = 0.042; HR 0.18, CI 95% 0.05–0.61, p = 0.006). High-BMI was associated with higher efficacy in ALK-rearranged patients. These results are particularly exciting for Alectinib and could be correlated to mechanisms that should be investigated in subsequent prospective studies. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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10 pages, 831 KiB

Open AccessArticle

Risk of Intraepithelial Neoplasia Grade 3 or Worse (CIN3+) among Women Examined by a 5-Type HPV mRNA Test during 2003 and 2004, Followed through 2015

by Amir Rad, Sveinung Wergeland Sørbye, Sweta Tiwari, Maja-Lisa Løchen and Finn Egil Skjeldestad

Cancers 2023, 15(12), 3106; https://doi.org/10.3390/cancers15123106 - 8 Jun 2023

Cited by 1 | Viewed by 2023

Abstract

Background: The study’s purpose was to evaluate the performance of a five-type HPV mRNA test to predict cervical intraepithelial neoplasia grade 3 or worse (CIN3+) during up to 12 years of follow-up. Methods: Overall, 19,153 women were recruited by gynecologists and general practitioners [...] Read more.

Background: The study’s purpose was to evaluate the performance of a five-type HPV mRNA test to predict cervical intraepithelial neoplasia grade 3 or worse (CIN3+) during up to 12 years of follow-up. Methods: Overall, 19,153 women were recruited by gynecologists and general practitioners in different parts of Norway between 2003 and 2004. The study population comprised 9582 women of these women, aged 25–69 years with normal cytology and a valid five-type HPV mRNA test at baseline. Follow-up for CIN3+ through 2015 was conducted in the Norwegian Cervical Cancer Screening Programme. Results: The cumulative incidence of CIN3+ by baseline status for HPV mRNA-positive and mRNA-negative women were 20.8% and 1.1%, respectively (p < 0.001). Age did not affect the long-term ability of the HPV mRNA test to predict CIN3+ during follow-up. Conclusion: The low long-term risk of CIN3+ among HPV mRNA-negative women and the high long-term risk among HPV mRNA-positive women strengthen the evidence that the five-type HPV mRNA test is an appropriate screening test for women of all ages. Our findings suggest that women with a negative result may extend the screening interval up to 10 years. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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11 pages, 1031 KiB

Open AccessArticle

Rising Trend in the Prevalence of HPV-Driven Oropharyngeal Squamous Cell Carcinoma during 2000–2022 in Northeastern Italy: Implication for Using p16^INK4a as a Surrogate Marker for HPV-Driven Carcinogenesis

by Paolo Boscolo-Rizzo, Jerry Polesel, Annarosa Del Mistro, Elisabetta Fratta, Chiara Lazzarin, Anna Menegaldo, Valentina Lupato, Giuseppe Fanetti, Fabrizio Zanconati, Maria Guido, Vittorio Giacomarra, Enzo Emanuelli, Margherita Tofanelli and Giancarlo Tirelli

Cancers 2023, 15(9), 2643; https://doi.org/10.3390/cancers15092643 - 7 May 2023

Cited by 8 | Viewed by 2247

Abstract

Background: The prevalence and incidence of oropharyngeal squamous cell carcinomas (OPSCCs) driven by human papillomavirus (HPV) infection are increasing worldwide, being higher in high-income countries. However, data from Italy are scanty. p16^INK4a overexpression is the standard in determining HPV-driven carcinogenesis, but disease [...] Read more.

Background: The prevalence and incidence of oropharyngeal squamous cell carcinomas (OPSCCs) driven by human papillomavirus (HPV) infection are increasing worldwide, being higher in high-income countries. However, data from Italy are scanty. p16^INK4a overexpression is the standard in determining HPV-driven carcinogenesis, but disease prevalence impacts on its positive predictive value. Methods: This is a multicenter retrospective study enrolling 390 consecutive patients aged ≥18 years, diagnosed with pathologically confirmed OPSCC in Northeastern Italy between 2000 and 2022. High-risk HPV-DNA and p16^INK4a status were retrieved from medical records or evaluated in formalin-fixed paraffin-embedded specimens. A tumor was defined as HPV-driven when double positive for high-risk HPV-DNA and p16^INK4a overexpression. Results: Overall, 125 cases (32%) were HPV-driven, with a significant upward temporal trend from 12% in 2000–2006 to 50% in 2019–2022. The prevalence of HPV-driven cancer of the tonsil and base of the tongue increased up to 59%, whereas it remained below 10% in other subsites. Consequently, the p16^INK4a positive predictive value was 89% for the former and 29% for the latter. Conclusions: The prevalence of HPV-driven OPSCC continued to increase, even in the most recent period. When using p16^INK4a overexpression as a surrogate marker of transforming HPV infection, each institution should consider the subsite-specific prevalence rates of HPV-driven OPSCC as these significantly impact on its positive predictive value. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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13 pages, 882 KiB

Open AccessArticle

Association between Age at Helicobacter pylori Eradication and the Risk of Gastric Cancer Stratified by Family History of Gastric Cancer: A Nationwide Population-Based Study

by Yoon Suk Jung, Mai Thi Xuan Tran, Huiyeon Song, Boyoung Park and Chang Mo Moon

Cancers 2023, 15(5), 1604; https://doi.org/10.3390/cancers15051604 - 4 Mar 2023

Cited by 3 | Viewed by 2742

Abstract

Introduction: This study compares the risk of GC according to age at H. pylori eradication, stratified based on the presence of family history of GC using a population-based large cohort. Method: We analyzed individuals who underwent GC screening between 2013 and 2014 and [...] Read more.

Introduction: This study compares the risk of GC according to age at H. pylori eradication, stratified based on the presence of family history of GC using a population-based large cohort. Method: We analyzed individuals who underwent GC screening between 2013 and 2014 and received H. pylori eradication therapy before screening. Results: Among 1,888,815 H. pylori-treated patients, 2610/294,706 and 9332/1,594,109 patients with and without a family history of GC, respectively, developed GC. After adjusting for confounders, including age at screening, the adjusted hazard ratios (95% confidence intervals) for GC comparison, 70–74, 65–69, 60–64, 55–59, 50–54, 45–49, and <45 years with ≥75 years at H. pylori eradication were 0.98 (0.79–1.21), 0.88 (0.74–1.05), 0.76 (0.59–0.99), 0.62 (0.44–0.88), 0.57 (0.36–0.90), 0.38 (0.22–0.66), and 0.34 (0.17–0.67), respectively, among patients with a family history of GC (p < 0.001) and 1.01 (0.91–1.13), 0.95 (0.86–1.04), 0.86 (0.75–0.98), 0.67 (0.56–0.81), 0.56 (0.44–0.71), 0.51 (0.38–0.68), and 0.33 (0.23–0.47), respectively, among patients without a family history of GC (p < 0.001). Conclusion: In patients with and without a family history of GC, young age at H. pylori eradication was significantly associated with a reduced risk of GC, suggesting that the early treatment of H. pylori infection can maximize GC prevention. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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20 pages, 6193 KiB

Open AccessArticle

Melanoma Mortality Trends in 28 European Countries: A Retrospective Analysis for the Years 1960–2020

by Paweł Koczkodaj, Urszula Sulkowska, Joanna Didkowska, Piotr Rutkowski and Marta Mańczuk

Cancers 2023, 15(5), 1514; https://doi.org/10.3390/cancers15051514 - 28 Feb 2023

Cited by 9 | Viewed by 2088

Abstract

Background: In 2020, in 27 European Union (EU) Member States, melanoma accounted for 4% of all new cancer cases and 1.3% of all cancer deaths, making melanoma the fifth most common malignancy and placing it in the 15 most frequent causes of cancer [...] Read more.

Background: In 2020, in 27 European Union (EU) Member States, melanoma accounted for 4% of all new cancer cases and 1.3% of all cancer deaths, making melanoma the fifth most common malignancy and placing it in the 15 most frequent causes of cancer deaths in the EU-27. The main aim of our study was to investigate melanoma mortality trends in 25 EU Member States and three non-EU countries (Norway, Russia, and Switzerland) in a broad time perspective (1960–2020) in a younger (45–74 years old) vs. older age group (75+). Methods: We identified melanoma deaths defined by ICD-10 codes C-43 for individuals aged 45–74 and 75+ years old between 1960–2020 in 25 EU Member States (excluding Iceland, Luxembourg, and Malta) and in 3 non-EU countries—Norway, Russia, and Switzerland. Age-standardized melanoma mortality rates (ASR) were computed using the direct age-standardization for Segi’s World Standard Population. To determine melanoma-mortality trends with 95% confidence intervals (CI), Joinpoint regression was applied. Our analysis used the Join-point Regression Program, version 4.3.1.0 (National Cancer Institute, Bethesda, MD, USA). Results: Regardless of the considered age groups, in all investigated countries, in general, melanoma standardized mortality rates were higher for men than women. Considering the age group 45–74, the highest number of countries was characterized by decreasing melanoma-mortality trends in both sexes—14 countries. Contrarily, the highest representation of countries in the age group 75+ was connected with increasing melanoma-mortality trends in both sexes—26 countries. Moreover, considering the older age group—75+—there was no country with a decreasing melanoma mortality in both sexes. Conclusions: Investigated melanoma-mortality trends vary in individual countries and age groups; however, a highly concerning phenomenon—increasing melanoma-mortality rates in both sexes—was observed in 7 countries for the younger age group and in as many as 26 countries for the older age group. There is a need for coordinated public-health actions to address this issue. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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15 pages, 313 KiB

Open AccessArticle

Addictions, Social Deprivation and Cessation Failure in Head and Neck Squamous Cell Carcinoma Survivors

by Lara Nokovitch, Yonjae Kim, Philippe Zrounba, Pierre-Eric Roux, Marc Poupart, Rabiha Giagnorio, Dominique Triviaux, Charles Maquet, Jennifer Thollin, Nathalie Arantes, Nathalie Thomas, Béatrice Fervers and Sophie Deneuve

Cancers 2023, 15(4), 1231; https://doi.org/10.3390/cancers15041231 - 15 Feb 2023

Cited by 2 | Viewed by 1753

Abstract

Aim: To evaluate the evolution of addictions (tobacco and alcohol) and social precarity in head and neck squamous cell carcinoma survivors when these factors are addressed from the time of diagnosis. Methods: Addictions and social precarity in patients with a new diagnosis of [...] Read more.

Aim: To evaluate the evolution of addictions (tobacco and alcohol) and social precarity in head and neck squamous cell carcinoma survivors when these factors are addressed from the time of diagnosis. Methods: Addictions and social precarity in patients with a new diagnosis of HNSCC were assessed through the EPICES score, the Fagerström score, and the CAGE questionnaire. When identified as precarious/dependent, patients were referred to relevant addiction/social services. Results: One hundred and eighty-two patients were included. At the time of diagnosis, an active tobacco consumption was associated with alcohol drinking (Fisher’s exact test, p < 0.001). Active smokers were more socially deprived (mean EPICES score = mES = 36.2 [±22.1]) than former smokers (mES = 22.8 [±17.8]) and never smokers (mES = 18.9 [±14.5]; Kruskal-Wallis, p < 0.001). The EPICES score was correlated to the Fagerström score (Kruskal-Wallis, p < 0.001). Active drinkers (mES = 34.1 [±21.9]) and former drinkers (mES = 32.7 [±21]) were more likely to be socially deprived than those who never drank (mES = 20.8 [±17.1]; Krukal-Wallis, p < 0.001). A Fagerström score improvement at one year was associated to a CAGE score improvement (Fisher’s exact test, p < 0.001). Tobacco and alcohol consumption were more than halved one year after treatment. Patients who continued to smoke one year after diagnosis were significantly more likely to continue to drink (Fisher’s exact test, p < 0.001) and had a significantly higher initial EPICES score (Kruskal-Wallis, p < 0.001). Conclusions: At one year, addictions and social deprivation tend to improve when taken care of from the diagnosis. The most dependent patients and those with multiple frailties are at highest risk of cessation failure. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

12 pages, 1652 KiB

Open AccessArticle

Trends in Overall Survival among Patients Treated for Sarcoma at a Large Tertiary Cancer Center between 1986 and 2014

by Erik Stricker, Damon R. Reed, Matthew B. Schabath, Pagna Sok, Michael E. Scheurer and Philip J. Lupo

Cancers 2023, 15(2), 514; https://doi.org/10.3390/cancers15020514 - 14 Jan 2023

Cited by 3 | Viewed by 2127

Abstract

Sarcomas are relatively rare malignancies accounting for about 1% of all cancer diagnoses. Studies on sarcomas comprising large cohorts covering extended time periods are lacking. Therefore, this study aimed to evaluate the impact of demographic, behavioral, and clinical characteristics on overall survival (OS) [...] Read more.

Sarcomas are relatively rare malignancies accounting for about 1% of all cancer diagnoses. Studies on sarcomas comprising large cohorts covering extended time periods are lacking. Therefore, this study aimed to evaluate the impact of demographic, behavioral, and clinical characteristics on overall survival (OS) among individuals diagnosed with soft tissue sarcoma (STS) or bone sarcoma at the Moffitt Cancer Center between 1986 and 2014. Unadjusted and multivariable Cox proportional hazard regression (CPHR) models were constructed to generate hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate associations between a range of demographic, behavioral, and clinical characteristics, and OS. Additionally, Kaplan–Meier survival curves, associated log-rank statistics, and adjusted CPHR models were generated by time periods based on the year of first contact (1986–1994, 1995–1999, 2000–2005, 2006–2010, 2011–2014) to evaluate for temporal differences in OS. Of the 2570 patients, 2037 were diagnosed with STS, whereas 533 were diagnosed with bone sarcoma. At the time of analysis, 50% of the population were alive. In multivariable analyses, we observed poorer survival for patients ≥ 40 years of age (HR = 1.54, 95% CI = 1.34–1.78), current smokers (HR = 1.18, 95% CI = 1.01–1.37), patients with metastasis (HR = 2.19, 95% CI = 1.95–2.47), and patients not receiving first-line surgery treatment (HR = 2.11, 95% CI = 1.82–2.45). We discovered limited improvements in OS over time among individuals diagnosed with STS or bone sarcomas with the exception of gastrointestinal stromal tumors (GIST), which showed a significant improvement in OS across time periods (p = 0.0034). Overall, we identified well-established characteristics associated with OS (e.g., metastasis) in addition to factors (e.g., smoking status) not previously reported to impact OS. Improvements in survival over time have been relatively modest, suggesting the need for improved therapeutic options, especially for those diagnosed with less frequent sarcomas. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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13 pages, 2389 KiB

Open AccessArticle

Changing Patterns in Cancer Mortality from 1987 to 2020 in China

by Binbin Su, Panliang Zhong, Yundong Xuan, Junqing Xie, Yu Wu, Chen Chen, Yihao Zhao, Xinran Shen and Xiaoying Zheng

Cancers 2023, 15(2), 476; https://doi.org/10.3390/cancers15020476 - 12 Jan 2023

Cited by 9 | Viewed by 4255

Abstract

Background: China has the highest number of new cancer cases and deaths worldwide, posing huge health and economic burdens to society and affected families. This study comprehensively analyzed secular trends of national cancer mortality statistics to inform future prevention and intervention programs in [...] Read more.

Background: China has the highest number of new cancer cases and deaths worldwide, posing huge health and economic burdens to society and affected families. This study comprehensively analyzed secular trends of national cancer mortality statistics to inform future prevention and intervention programs in China. Methods: The annual estimate of overall cancer mortality and its major subtypes were derived from the National Health Commission (NHC). Joinpoint analysis was used to detect changes in trends, and we used age-period-cohort modeling to estimate cohort and period effects in Cancers between 1987 and 2020. Net drift (overall annual percentage change), local drift (annual percentage change in each age group), longitudinal age curves (expected longitudinal age-specific rate), and period (cohort) relative risks were calculated. Results: The age-standardized cancer mortality in urban China has shown a steady downward trend but has not decreased significantly in rural areas. Almost all cancer deaths in urban areas have shown a downward trend, except for colorectal cancer in men. Decreasing mortality from cancers in rural of the stomach, esophagus, liver, leukemia, and nasopharynx was observed, while lung, colorectal cancer female breast, and cervical cancer mortality increased. Birth cohort risks peaked in the cohorts born around 1920–1930 and tended to decline in successive cohorts for most cancers except for leukemia, lung cancer in rural, and breast and cervical cancer in females, whose relative risks were rising in the very recent cohorts. In addition, mortality rates for almost all types of cancer in older Chinese show an upward trend. Conclusions: Although the age-standardized overall cancer mortality rate has declined, and the urban-rural gap narrowed, the absolute cancer cases kept increasing due to the growing elderly population in China. The rising mortality related to lung, colorectal, female breast, and cervical cancer should receive higher priority in managing cancer burden and calls for targeted public health actions to reverse the trend. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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10 pages, 247 KiB

Open AccessArticle

Actual and Potential Role of Primary Care Physicians in Cancer Prevention

by Marta Mańczuk, Irena Przepiórka, Magdalena Cedzyńska, Krzysztof Przewoźniak, Elwira Gliwska, Agata Ciuba, Joanna Didkowska and Paweł Koczkodaj

Cancers 2023, 15(2), 427; https://doi.org/10.3390/cancers15020427 - 9 Jan 2023

Cited by 4 | Viewed by 2164

Abstract

Although the role of primary care in cancer prevention has been proven, its assumptions are still insufficiently implemented and the actual rates of cancer prevention advice delivery remain low. Our study aimed to identify the actual and potential role of primary care physicians [...] Read more.

Although the role of primary care in cancer prevention has been proven, its assumptions are still insufficiently implemented and the actual rates of cancer prevention advice delivery remain low. Our study aimed to identify the actual and potential role of primary care physicians (PCPs) in the cancer prevention area. Design of the study is a cross-sectional one, based on a survey of 450 PCPs who took part in a nationwide educational project in Poland. Only 30% of PCPs provide cancer prevention advice routinely in their practice, whereas 70% do that only sometimes. PCPs’ actual role in cancer prevention is highly unexploited. They inquire routinely about the patient’s smoking history (71.1%), breast cancer screening program (43.7%), cervical cancer screening (41.1%), patient’s alcohol consumption (34%), patient’s physical activity levels (32.3%), body mass index (29.6%), the patient’s eating habits (28%) and patient’s potential for sun/UV-Ray exposure (5.7%). The potential role of PCPs in cancer prevention is still underestimated and underutilized. Action should be taken to raise awareness and understanding that PCPs can provide cancer prevention advice. Since lack of time is the main obstacle to providing cancer prevention advice routinely, systemic means must be undertaken to enable PCPs to utilize their unquestionable role in cancer prevention. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

10 pages, 1309 KiB

Open AccessArticle

An Ecologic Study of the Association between 1,3-Dichloropropene and Pancreatic Cancer

by Gerald McGwin, Jr. and Russell L Griffin

Cancers 2023, 15(1), 150; https://doi.org/10.3390/cancers15010150 - 27 Dec 2022

Cited by 4 | Viewed by 1752

Abstract

Background: 1,3-Dichloropropene (1,3-D) is a soil fumigant that is used to protect fruit, vegetable, field, tree, and vine crops from nematode infestation and soil borne diseases. It is a commonly use pesticide, is applied by either direct injection into the soil or drip [...] Read more.

Background: 1,3-Dichloropropene (1,3-D) is a soil fumigant that is used to protect fruit, vegetable, field, tree, and vine crops from nematode infestation and soil borne diseases. It is a commonly use pesticide, is applied by either direct injection into the soil or drip irrigation and is highlight volatile. Though currently classified as “Suggestive Evidence of Carcinogenic Potential”, the literature in animal-based studies has inconsistent results and there is limited research among a human population with one study only among the California population. The purpose of the current analysis is to conduct a state-level analysis of the association between 1,3-D and pancreatic cancer mortality. Methods: Data for this ecological study were derived from death certificate data (for pancreatic mortality) from 1999 to 2020 and United States Geologic Survey National Water-Quality Assessment project for years 1992–2016 (1,3-D use). A negative binomial regression adjusted for selected lifestyle risk factors of pancreatic cancer (i.e., obesity, alcohol use, and smoking prevalence) estimated rate ratios (RRs) and associated 95% confidence intervals (CIs)for the association between 1,3-D quartiles and pancreatic cancer mortality rate. Models lagged in five-year increments to account for the induction period of pancreatic cancer. Results: Overall, there was no association between 1,3-D quartile and pancreatic cancer mortality rate; however, limiting the analyses to states reporting 1,3-D use for at least 20 years, the highest quartile of 1,3-D use was associated with an 11% increase in the pancreatic cancer mortality rate in the five-year lagged model (RR 1.11, 95% CI 1.06–1.16). This association was consistent across the other lag periods. Conclusions: Accounting for lifestyle factors associated with pancreatic cancer risk, there is a significantly increase rate of pancreatic cancer mortality among states that have the highest quartile of 1,3-D use and have been using 1,3-D for a long-term period. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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18 pages, 4337 KiB

Open AccessArticle

Incidence of Hereditary Gastric Cancer May Be Much Higher than Reported

by Paula Baraúna de Assumpção, Paulo Pimentel de Assumpção, Fabiano Cordeiro Moreira, Ândrea Ribeiro-dos-Santos, Amanda F. Vidal, Leandro Magalhães, André Salim Khayat, André Maurício Ribeiro-dos-Santos, Giovanna C. Cavalcante, Adenilson Leão Pereira, Inácio Medeiros, Sandro José de Souza, Rommel Mario Rodríguez Burbano, Jorge Estefano Santana de Souza and Sidney Emanuel Batista Dos Santos

Cancers 2022, 14(24), 6125; https://doi.org/10.3390/cancers14246125 - 12 Dec 2022

Cited by 1 | Viewed by 2048

Abstract

Hereditary gastric cancers (HGCs) are supposed to be rare and difficult to identify. Nonetheless, many cases of young patients with gastric cancer (GC) fulfill the clinical criteria for considering this diagnosis but do not present the defined pathogenic mutations necessary to meet a [...] Read more.

Hereditary gastric cancers (HGCs) are supposed to be rare and difficult to identify. Nonetheless, many cases of young patients with gastric cancer (GC) fulfill the clinical criteria for considering this diagnosis but do not present the defined pathogenic mutations necessary to meet a formal diagnosis of HGC. Moreover, GC in young people is a challenging medical situation due to the usual aggressiveness of such cases and the potential risk for their relatives when related to a germline variant. Aiming to identify additional germline alterations that might contribute to the early onset of GC, a complete exome sequence of blood samples from 95 GC patients under 50 and 94 blood samples from non-cancer patients was performed and compared in this study. The number of identified germline mutations in GC patients was found to be much higher than that from individuals without a cancer diagnosis. Specifically, the number of high functional impact mutations, including those affecting genes involved in medical diseases, cancer hallmark genes, and DNA replication and repair processes, was much higher, strengthening the hypothesis of the potential causal role of such mutations in hereditary cancers. Conversely, classically related HGC mutations were not found and the number of mutations in genes in the CDH1 pathway was not found to be relevant among the young GC patients, reinforcing the hypothesis that existing alternative germline contributions favor the early onset of GC. The LILRB1 gene variants, absent in the world’s cancer datasets but present in high frequencies among the studied GC patients, may represent essential cancer variants specific to the Amerindian ancestry’s contributions. Identifying non-reported GC variants, potentially originating from under-studied populations, may pave the way for additional discoveries and translations to clinical interventions for GC management. The newly proposed approaches may reduce the discrepancy between clinically suspected and molecularly proven hereditary GC and shed light on similar inconsistencies among other cancer types. Additionally, the results of this study may support the development of new blood tests for evaluating cancer risk that can be used in clinical practice, helping physicians make decisions about strategies for surveillance and risk-reduction interventions. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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10 pages, 802 KiB

Open AccessArticle

The Association between Infectious Mononucleosis and Cancer: A Cohort Study of 24,190 Outpatients in Germany

by Christoph Roderburg, Sarah Krieg, Andreas Krieg, Tom Luedde, Karel Kostev and Sven H. Loosen

Cancers 2022, 14(23), 5837; https://doi.org/10.3390/cancers14235837 - 26 Nov 2022

Cited by 7 | Viewed by 2695

Abstract

Background: Cancer represents one of the leading causes of death worldwide. Besides genetic risk factors and non-communicable diseases, chronic infections including Epstein–Barr virus (EBV) infection have been identified as promotors of cancer. In the present manuscript, we evaluated the association between infectious mononucleosis, [...] Read more.

Background: Cancer represents one of the leading causes of death worldwide. Besides genetic risk factors and non-communicable diseases, chronic infections including Epstein–Barr virus (EBV) infection have been identified as promotors of cancer. In the present manuscript, we evaluated the association between infectious mononucleosis, the clinical manifestation of EBV infection, and cancer development in a real-word cohort of outpatients in Germany. Methods: We used the Disease Analyzer database (IQVIA) and matched a total of 12,095 patients with infectious mononucleosis to a cohort of individuals without infectious mononucleosis based on age, sex, index year, and annual patient consultation frequency between 2000 and 2018. Results: Patients diagnosed with infectious mononucleosis had a cancer incidence of 5.3 cases per 1000 person years versus 4.4 cases per 1000 person years for patients without infectious mononucleosis. In multivariable regression models, infectious mononucleosis showed a trend towards a higher incidence of cancer in general in the age group > 50 years (incidence rate ratio (IRR): 1.32; 95% CI: 1.04–1.67) and among men (IRR: 1.36; 95% CI: 1.07–1.72). Infectious mononucleosis was significantly associated with an increased incidence of tumors of the hematopoietic and lymphoid tissues (IRR: 1.75; 95% CI: 1.22–2.50) and showed a strong trend towards an association with prostate cancer (IRR: 3.09; 95% CI: 1.23–7.76). Conclusion: Infectious mononucleosis is associated with an increased incidence of certain cancer types. The present data from a large real-world cohort support the evidence on a role of EBV in the development of different malignancies and could trigger research efforts to further elucidate its precise involvement in the carcinogenic process. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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Review

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14 pages, 1706 KiB

Open AccessReview

Developing Cardio-Oncology Programs in the New Era: Beyond Ventricular Dysfunction Due to Cancer Treatments

by Alexandra Pons-Riverola, Herminio Morillas, Javier Berdejo, Sonia Pernas, Helena Pomares, Leyre Asiain, Alberto Garay, Adela Fernandez-Ortega, Ana Carla Oliveira, Evelyn Martínez, Santiago Jiménez-Marrero, Elena Pina, Eduard Fort, Raúl Ramos, Lídia Alcoberro, Encarnación Hidalgo, Maite Antonio-Rebollo, Laia Alcober, Cristina Enjuanes Grau, Josep Comín-Colet and Pedro Moliner Show full author list Hide full author list

Cancers 2023, 15(24), 5885; https://doi.org/10.3390/cancers15245885 - 18 Dec 2023

Cited by 5 | Viewed by 1709

Abstract

Cardiovascular disease is a common problem in cancer patients that is becoming more widely recognized. This may be a consequence of prior cardiovascular risk factors but could also be secondary to the anticancer treatments. With the goal of offering a multidisciplinary approach to [...] Read more.

Cardiovascular disease is a common problem in cancer patients that is becoming more widely recognized. This may be a consequence of prior cardiovascular risk factors but could also be secondary to the anticancer treatments. With the goal of offering a multidisciplinary approach to guaranteeing optimal cancer therapy and the early detection of related cardiac diseases, and in light of the recent ESC Cardio-Oncology Guideline recommendations, we developed a Cardio-Oncology unit devoted to the prevention and management of these specific complications. This document brings together important aspects to consider for the development and organization of a Cardio-Oncology program through our own experience and the current evidence. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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15 pages, 1938 KiB

Open AccessEditor’s ChoiceReview

Sex Differences in the Efficacy of Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Meta-Analysis

by Guillermo Suay, Juan-Carlos Garcia-Cañaveras, Francisco Aparisi, Agustin Lahoz and Oscar Juan-Vidal

Cancers 2023, 15(18), 4433; https://doi.org/10.3390/cancers15184433 - 6 Sep 2023

Cited by 7 | Viewed by 1986

Abstract

Non-small cell lung cancer (NSCLC) is one of the world’s leading causes of morbidity and mortality. ICIs alone or combined with chemotherapy have become the standard first-line treatment of metastatic NSCLC. The impressive results obtained have stimulated our interest in applying these therapies [...] Read more.

Non-small cell lung cancer (NSCLC) is one of the world’s leading causes of morbidity and mortality. ICIs alone or combined with chemotherapy have become the standard first-line treatment of metastatic NSCLC. The impressive results obtained have stimulated our interest in applying these therapies in early disease stage treatments, as neoadjuvant immunotherapy has shown promising results. Among many of the factors that may influence responses, the role played by sex is attracting increased interest and needs to be addressed. Here, we aim to first review the state of the art regarding neoadjuvant ICIs, whether they are administered in monotherapy or in combination with chemotherapy at stages IB-IIIA, particularly at stage IIIA, before analyzing whether sex may influence responses. To this end, a meta-analysis of publicly available data comparing male and female major pathological responses (MPR) and pathological complete responses (pCR) was performed. In our meta-analysis, MPR was found to be significantly higher in females than in males, with an odds ratio (OR) of 1.82 (95% CI 1.13–2.93; p = 0.01), while pCR showed a trend to be more favorable in females than in males, but the OR of 1.62 was not statistically significant (95% CI 0.97–2.75; p = 0.08). Overall, our results showed that sex should be systematically considered in future clinical trials settings in order to establish the optimal treatment sequence. Full article

(This article belongs to the Special Issue Feature Paper in Section “Cancer Epidemiology and Prevention” in 2022–2023)

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