Introduction Cancer and cardiovascular disease (CVD) are leading causes of death among Texas residents. While advances in cancer treatment have increased survival, long-term survivors face elevated CVD risk. We examined temporal trends in cancer- and CVD-related incidence-based mortality (IBM) rates among Texas residents diagnosed with cancer by cancer stage, primary site, and county, and associations between the CVD-to-cancer IBM ratio and survival. Methods Using Texas Cancer Registry data, this retrospective cohort study calculated cancer- and CVD-related IBM rates overall and by stage and the five sites with the highest cancer- and CVD-related deaths, and assessed annual percentage change (APC) using Joinpoint regression. County-level heatmaps displayed cumulative IBM rates and CVD-to-cancer IBM ratios, defined as CVD-related IBM rate divided by cancer-related IBM rate, by these groupings. Weighted Pearson correlations with bootstrap standard errors examined associations between CVD-to-cancer IBM ratios and 1- and 5-year survival among patients diagnosed during 2010-2015, followed through 2020. Results In 2010-2019, cancer-related IBM rates declined (APC = -2.51%, 95% CI -3.02 to -2.01, p < 0.001), while CVD-related IBM rates increased (APC = +1.87%, 95% CI 0.81-2.93, p < 0.001). Cancer-related IBM rates decreased, and CVD-related IBM rates generally increased across localized, regional, and distant-stage groups. CVD-to-cancer IBM ratios were higher for high-survival cancers including prostate and breast cancers. Across stages (n=4), correlations between CVD-to-cancer IBM ratio and survival were r = 0.81 (1-year) and r = 0.86 (5-year); inferential statistics were unobtainable. Across sites (n=29), correlations were r = 0.86 (5-year; 95% CI 0.80-0.93, p < 0.001) and r = 0.81 (1-year; 95% CI 0.74-0.89, p < 0.001). Conclusions Cancer-related IBM rates declined while CVD-related IBM rates increased, especially in localized-stage, high-survival sites, and specific Texas counties. Incorporating cardiovascular risk assessment and prevention early in cancer care, focusing on underserved areas, may improve long-term survival.
Introduction Globally, cervical cancer is a public health problem, contributing to a substantial proportion of morbidity, disability, and mortality, particularly in low- and middle-income countries. Tracking the burden of the disease using the latest GBD 2023 estimates to provide updated national and subnational evidence is crucial for policy modification and for assessing the effectiveness and efficiency of integrated interventions for its prevention and control. Methods Cervical cancer data on prevalence, incidence, mortality, disability-adjusted life years, years of life lost, and years lived with disability were extracted from the 2023 GBD Study for 11 regional states and two chartered cities in Ethiopia, from 1990 to 2023. The Bayesian meta-regression, disease modeling, and causes-of-death ensemble modeling methods were used to calculate fatal and non-fatal health metric values over time. Results The GBD 2023 model estimated that the age-standardized prevalence rate was 487.84 cases per 100,000 females (95% UI: 241.24, 884.44), the incidence rate was 97.93 new cases per 100,000 females (95% UI: 54.16, 166.79), the mortality rate was 44.16 deaths per 100,000 females (95% UI: 25.84-73.59), the Disability-Adjusted Life Year (DALY) rate was 1782.25 DALYs per 100,000 females (95% UI: 1013.95-2909.85), the Years of Life Lost (YLL) rate was 1744.11 YLLs per 100,000 females (95% UI: 991.60-2842.40), and the Years Lived with Disability (YLD) rate was 38.13 YLDs per 100,000 females (95% UI: 17.98-67.81), with notably varied inter-age category rates. A significant difference was observed in the mortality rate of cervical cancer in 2023 in Addis Ababa and the Southwest. The risk factor for cervical cancer was unsafe sex. Conclusion Cervical cancer remains a significant public health problem in Ethiopia. The estimated age-standardized rates show increases, with notable sub-national differences. Mortality and years of life lost make up most of the burden, and unsafe sex is the primary risk factor, indicating late diagnosis and limited access to effective prevention and treatment services.
Introduction Health literacy is increasingly recognized as a critical determinant of cancer prevention, treatment adherence, and survivorship outcomes. In colorectal cancer (CRC), disparities in health literacy, particularly among ethnic minority and underserved populations, may contribute to reduced screening uptake, suboptimal treatment decisions, and poorer quality of life. Although numerous studies have examined the relationship between health literacy and CRC-related outcomes, the evidence remains fragmented across the CRC care continuum, including screening, treatment, survivorship, communication, and digital health. To address this gap, we conducted a scoping review to comprehensively characterize the current evidence regarding health literacy and CRC outcomes in vulnerable populations. Methods We conducted a scoping literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. PubMed was searched between January and March 2025 to identify peer-reviewed studies evaluating the influence of health literacy on CRC-related outcomes. Studies were included if they focused on CRC and assessed measurable associations between health literacy and outcomes related to screening, treatment adherence, survivorship, communication, financial toxicity, or patient-reported outcomes. Results Thirty-nine studies met inclusion criteria and were included in the review. Across diverse geographic and clinical settings, limited health literacy was consistently associated with lower CRC screening rates, reduced knowledge of screening guidelines, increased fatalistic beliefs, and greater perceived barriers to screening. Among CRC patients, low health literacy was linked to poorer treatment adherence, lower chemotherapy uptake, reduced health-related quality of life (HRQoL), and higher mortality risk, particularly among vulnerable populations. Conclusions This scoping review reinforces that health literacy is a significant and modifiable determinant of CRC outcomes and contributes to persistent disparities across the CRC care continuum. Standardized, culturally and linguistically responsive interventions targeting literacy gaps should be prioritized to improve equitable CRC prevention, treatment, and survivorship care.
Plain Language Summary Breast cancer is not a single disease. Each tumour carries its own set of genetic changes, and reading these changes can help doctors choose the most suitable treatment. A recent study from Ukraine used a modern genetic test to examine tumours from breast cancer patients — one of the first efforts of its kind in that country. It found that certain gene changes were common, especially one that tends to appear in slower-growing, more treatable tumours. In our letter responding to that study, we make one main point: finding a gene change is only the first step. What matters is turning that finding into a real decision about care. Several of the gene changes seen in the study affect the same biological “switch” inside cancer cells, and there are now approved medicines that act specifically on that switch. So these results are not just interesting numbers — for many patients they could point toward a targeted treatment. We also explain why this depends on careful laboratory work. The specialist who examines the tumour must describe each gene change precisely, make sure the test used is reliable, and check whether a change might also run in the family and need genetic counselling. When done carefully, genetic testing can move from simply listing gene changes to genuinely guiding treatment — including for patients in regions where such testing is still new.
The gut microbiota is a complex and dynamic ecosystem involved in the modulation of host immune responses. Accumulating evidence links gut microbial composition to the efficacy and toxicity of immune checkpoint inhibitors (ICIs), although most evidence supporting microbiota-based biomarkers remains observational. Higher baseline alpha-diversity has been associated with favorable outcomes in several cohorts, but these associations are not uniform, and individual taxonomic signatures show substantial inter-study variability. In this perspective, we discuss baseline microbiota profiling as a promising investigational approach to patient stratification in immuno-oncology. Despite its methodological limitations, 16S rRNA sequencing remains a scalable, reproducible, and clinically feasible approach compared with more complex techniques such as shotgun metagenomics. Standardization of sampling procedures, sequencing methodologies, and bioinformatic pipelines is essential for the reliable implementation of microbiota-based biomarkers in routine clinical care. Integrating gut microbiota assessment into pre-treatment evaluation may improve patient selection and support a more biologically informed approach to immunotherapy.
