Low muscle mass (LMM) is a risk factor for adverse health outcomes, but its prognostic relevance in cancer remains insufficiently studied. We investigated the independent and combined effects of LMM and obesity on mortality in cancer patients. This cohort study included 635,867 cancer patients. LMM was defined as the lowest quartile on the appendicular skeletal muscle mass index (ASMI). Obesity was defined as body mass index ≥25 kg/m2 and abdominal obesity as waist circumference ≥90 cm (males) and ≥85 cm (females). Patients were classified into four groups based on muscle mass and obesity status. Cox proportional hazards models calculated adjusted hazard ratios (HRs) and 95
Examine rural–urban disparities in prostate-specific antigen (PSA) testing and participation in shared decision-making (SDM) following the 2018 USPSTF guidelines. We analyzed data from the 2019, 2021, and 2023 cycles of the National Health Interview Survey including men ≥55 years, excluding those with a history of prostate cancer or missing data. We tested three outcomes: (1) ever received a PSA test; (2) past 12-month PSA testing; and (3) participation in SDM (assessed in 2019 only). The main exposure was rural–urban classification of respondents’ residence. There were 15,393 eligible respondents. After adjusting for sampling weights and the complex sampling design, 18
Digital health is expanding the range of delivery options available for cancer prevention and may support the development of integrated in-person, digital, and hybrid models. This commentary proposes a framework for cancer prevention delivery across modalities. It argues that the expansion of virtual platforms for cancer-related psychosocial and behavioral interventions may be redefining prevention pathways rather than merely adding digital options. It highlights the possible redistribution of some interventions, such as human papillomavirus vaccination and hepatitis B vaccination, toward in-person services, while cancer-related psychosocial interventions such as cancer prevention-related education can increasingly be delivered through digital platforms, which may improve access and continuity for some populations, although benefits depend on digital access, program design, and implementation context. It also raises concerns about fragmentation, equity, and implementation.
The incidence of hepatocellular carcinoma (HCC) has increased in the United States. Historically, HCC rates are higher among males than females and among racial and ethnic minorities compared with non-Hispanic White (NHW) individuals. However, HCC incidence patterns have changed over time. We examined how sex and race/ethnicity-specific incidence rate ratios (IRR) for HCC have evolved. Age-adjusted HCC incidence rates were calculated using the Surveillance Epidemiology and End Results (SEER) 12 Program. Trends in sex- and race/ethnicity-specific IRRs were evaluated overall and by age group (< 50 vs. ≥50 years). IRRs were calculated as the ratio of age-adjusted rates for each comparison group to the reference group (male-to-female; racial/ethnic group-to-NHW), allowing assessment of relative disparities independent of absolute incidence. From 1992 to 2022, 68,023 HCC cases were identified. Incidence increased through the early 2010s before stabilizing and declining after 2015. HCC incidence remained higher among males than females; however, the male-to-female IRR declined from 3.29 to 3.11, with the most pronounced decline among adults aged <50 years. The non-Hispanic Asian/Pacific Islander (NHAPI)-to-NHW IRR declined from 5.86 to 1.87, while non-Hispanic Black (NHB)-to-NHW and Hispanic-to-NHW IRRs declined more modestly. Age-stratified analyses showed more pronounced declines in some relative disparities among younger adults, although several estimates were not statistically significant. Sex- and race/ethnicity-specific relative disparities in HCC incidence narrowed over three decades. These findings indicate attenuation of relative disparities, while substantial differences in absolute HCC incidence persisted across demographic groups.
Delays from diagnosis to first treatment are a persistent challenge in Mexico. Retrospective observational cohort at the National Cancer Institute (INCAN), Mexico City (November 2017–December 2021). Women with first-time breast cancer and complete dates for diagnosis and treatment start were included. Primary outcome was diagnosis-to-treatment interval (DTI) in days; timeliness was defined as initiation ≤ 30 days. Bivariate tests and multivariable logistic regression were used (two-sided α = .05). We included 425 women. Median DTI was 18 days (IQR 14–24) among timely cases and 42 days (IQR 35–55) among delayed cases. By care period, median DTI was 28 days pre-pandemic and 23.5 days during the pandemic; the proportion initiating ≤ 30 days was similar (58.7 vs 61.9
The impact of cancer extends beyond clinical outcomes, often disrupting interpersonal relationships and living situations. Although these social factors are important for survivorship, little is known about how marital status, residential urbanicity, and income change over time for cancer patients. Using SEER 17, we obtained data from 457,058 adults diagnosed with multiple primary cancers from 2000 to 2021 and evaluated changes in marital status, urbanicity, and household income between the first and last recorded diagnoses. Analyses were stratified by follow-up interval (short: 2–5, long: > 5 years). Marital status change was evaluated among patients who were married at the first cancer diagnosis (n = 255,939), and changes in urbanicity and household income were evaluated as secondary analyses among patients who remained married from first to last diagnosis (n = 214,956). Logistic regressions adjusted for demographic and clinical factors were used to estimate odds ratios and 95
Multi-cancer detection (MCD) tests represent a promising innovation in early cancer detection, yet public awareness of these technologies remains limited. Engagement with cancer-related information may play a key role in shaping awareness of emerging screening tools. This study used data from the 2024 Health Information National Trends Survey (HINTS 7) (n = 6,145) to examine the association between self-reported cancer information seeking (ever sought cancer information vs. never sought cancer information) and awareness of multi-cancer detection (MCD) tests (heard of MCD tests vs. not heard of MCD tests) among U.S. adults. Survey-weighted logistic regression models were estimated to assess this association, adjusting for age, sex, race/ethnicity, educational attainment, family history of cancer, and health insurance coverage. Average marginal effects (AMEs) and predicted probabilities were estimated to facilitate interpretation. Sensitivity analyses excluded respondents with a personal history of cancer. Overall, 16.7
This study examines whether lung cancer risk is influenced by block-level greenness, controlling for age, sex, race/ethnicity, area deprivation index (ADI), and walkability in older adults, and whether age, sex, race/ethnicity, ADI, or walkability plays a moderating role in this relationship. Data from US Medicare beneficiaries aged 65 years and older were included for the years 2011 and 2016. Beneficiaries included in this study received a lung cancer diagnosis for the first time between 2012 and 2016. All resided in Miami-Dade County, Florida (Mage = 74.31 ± 6.95, 58.69
The purpose of this study is to describe the 2022 cancer burden by sex and age group globally, as well as by world region. We utilized GLOBOCAN 2022 estimates to quantify overall and cancer-specific incidence and mortality using counts and age-standardized rates (ASRs; per 100,000) simultaneously stratified by sex and age bands (0–14, 15–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80 + years), globally and by world region. In 2022, an estimated 18.7 million cases (excluding nonmelanoma skin cancer) and 9.7 million cancer-related deaths occurred globally, of which 51 and 56
The European Code of Cancer Practice (ECCP) is a patient-centred framework for good clinical cancer practice, to improve outcomes for all of Europe’s patients [1]. Given challenges with applications to rural regions, the study aimed to explore the barriers and facilitators to implementing the ECCP in a rural, coastal, and urban context. We conducted semi-structured individual and group interviews with nine acute cancer professionals; nine non-clinical professionals; and four people with lived experience of cancer. Interviews were analysed using reflexive thematic analysis, underpinned by a constructivist approach. Three themes were developed across all groups. 1) ‘Fragmented communication pathways limits access’ to information-sharing between services, and about support and research, linked to workforce challenges. 2) ‘Geographic and infrastructural disparities between urban, rural, and coastal areas’ highlight barriers to accessing and delivering care, including transport issues, alongside place-specific facilitators to wellbeing. 3) ‘Unmet needs for living well during and after treatment’ denotes financial, work-related, and psychological challenges through treatment and survivorship. These barriers transcended across all ECCP domains. Workforce challenges that limit information-sharing about support and research, and gaps in post-treatment support, must be addressed to meet the ECCP aim to ensure equitable cancer care across geographical locations.
To identify barriers and facilitators for survey completion in the VOICES of Black Women (VOICES) study and to determine which communication methods encouraged survey completion. In 2023, the American Cancer Society piloted VOICES, an online study to better understand cancer and other health conditions among Black women. Approximately 2/3 of the 243 women who registered and consented did not complete the baseline survey (n = 140). In 2024, we sequentially employed four methods of communication to contact non-responders: email, mailed postcard, text message, and phone. At each touchpoint, we requested participants answer three questions about why they had not completed the survey. Thirty women (22
Although red meat and processed meat are well-established risk factors of colorectal cancer (CRC), the mechanisms underlying this association are less clear. Heme iron, abundant in red and processed meats, is one plausible etiologic factor. In addition, calcium, a well-established independent protective factor against CRC, may prevent heme-induced colorectal carcinogenesis by binding to heme iron in the gut. We prospectively examined the association between heme iron and CRC risk and whether these associations differed by calcium intake in the Nurses’ Health Study, Nurses’ Health Study II and Health Professionals Follow-Up Study. We used Cox proportional hazards regression analyses to calculate cohort-specific hazard ratios (HRs) and pooled results using a fixed-effect model. We analyzed data from 211,851 participants and documented 2983 incident CRC cases during up to 36 years of follow-up. Comparing the highest to lowest quintile, the pooled multivariable HRs (95
Residential segregation is recognized as an upstream driver of poor health, yet few studies have evaluated its impact on breast cancer incidence at a local level. We examined associations of neighborhood residential segregation with breast cancer (BC) incidence in the Multiethnic Cohort Study (MEC). Measures of Index of Concentration at the Extremes were developed to assess residential segregation by income, education, race and ethnicity, and racialized income. A prospective study (1993–1996 through December 2019) was conducted to examine associations of these measures and breast cancer incidence for 101,785 African American, Japanese American, Latina, Native Hawaiian, and White female participants in the MEC, aged 45–75 years at baseline and residing in California and Hawai‘i. Multivariable Cox regression was conducted to evaluate the associations of several residential segregation measures with breast cancer incidence (cases = 7,381) adjusting for demographic, lifestyle, and reproductive factors. In California, BC risk was higher for females residing in neighborhoods with the highest compared to lowest concentration of privilege by income segregation (quintile 5 [Q5] vs. Q1: hazard ratio [HR] 1.12, 95
Cervical screening in Australia is currently accessed through a healthcare provider, typically a general practitioner in primary care. We aimed to assess the real-world availability of and access to cervical screening services, including self-collection. Cross-sectional study was conducted using a secret shopper methodology with a standardized telephone script that emulated real-life calls. A random sample of Australian general practices, from each State/Territory (contacted November 2024-February 2025). Of the 310 general practices, 72 (23 χ_7^2 =15·774, P = ·013), ranging from 60 to 100
Observational studies examining the association between vitamin D and head and neck cancer (HNC) have reported conflicting results. We conducted a two-sample MR study to investigate the causal association between genetically predicted serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of HNC and its major subtypes: oral cavity, laryngeal, hypopharyngeal, and HPV-negative oropharyngeal cancers. Genetic instruments were selected from GWAS of 441,291 individuals (UK Biobank). Cancer outcomes were obtained from the HEADSpAcE consortium. Multiple sclerosis (MS) was analyzed as a positive control. We identified 115 independent genetic instruments for serum 25(OH)D. Causal estimates were primarily derived using inverse variance weighted (IVW) MR, supported by MR-Egger, weighted median, and mode-based methods. Extensive sensitivity analyses assessed heterogeneity, pleiotropy, and directionality. We identified 115 independent genetic instruments for serum 25(OH)D levels, which explained 5.12
Lung cancer is the leading cause of cancer death in the United States and disproportionately affects Black adults. Lung cancer screening (LCS) remains narrowly focused on cigarette smoking, often excluding other tobacco use, and low provider referral rates continue to limit screening uptake. Addressing these gaps is critical to advancing screening equity. We surveyed 100 Black adults (aged 50 + years) with a 20 + year history of tobacco use who either currently used or had quit within the past 15 years. The survey assessed tobacco use characteristics, cessation intentions, tobacco product harm perceptions, LCS-related quit motivations, and LCS knowledge and beliefs. We compared characteristics, beliefs, and experiences by LCS status (56
Early-onset colorectal cancer (EOCRC, < 50 years) is rising in the United States, whereas late-onset CRC (LOCRC, ≥ 50 years) is declining. Fewer studies have examined association between risk factors and age at colorectal (CRC) diagnosis by race. Hence, we investigated whether associations between lifestyle and clinical risk factors and age at CRC diagnosis differed by race. Retrospective study conducted between 2010 and 2023 using data from a tertiary medical center in Alabama. Exposure included lifestyle factors—smoking status, and body mass index; clinical factors—type 2 diabetes (T2D), hypertension, and hyperlipidemia. Outcome was age at CRC diagnosis categorized as LOCRC and EOCRC. Multivariable logistic regression was used to examine association between lifestyle and clinical risk factors with age at CRC diagnosis after controlling for race, sex, and marital status. Race-stratified analyses were conducted. Among 3,209 CRC patients, 54.1
The purpose of the study was to elucidate life-course and current exercise levels among women aged 50–69 who participated in BreastScreen Norway during the period from 2006 to 2015, and to estimate the risk of breast cancer based on exercise trajectory classes and current exercise level. Self-reported data from 325,953 women were utilized for descriptive and exploratory analyses. Retrospective information about exercise levels at ages 15–19, 20–29, 30–39, and 40–49 was used to establish exercise trajectory classes, while reported exercise at ages 50–69 was considered as current activity. Hazard Ratios (HR) with 95
Purpose Physical activity may play a supportive role in cancer survivorship. However, evidence on the association between post-diagnosis physical activity and mortality among women with gynecological cancer remains limited and inconsistent.Methods We conducted a systematic review of the literature published between 1949 and January 2026. Eligible observational studies were identified, and random-effects meta-analyses were performed to estimate pooled hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between post-diagnosis physical activity and all-cause mortality among women diagnosed with gynecological cancer.Results A total of ten eligible studies on endometrial, ovarian, and cervical cancer were included, collectively reporting 3,867 deaths. High levels of post-diagnosis physical activity, compared with low levels, were associated with lower mortality (HR: 0.65; 95% CI 0.54-0.78). This inverse relationship was evident in both endometrial and ovarian cancer survivors (endometrial cancer: HR: 0.60; 95% CI 0.43-0.83; ovarian cancer: HR: 0.71; 95% CI 0.58-0.86). Medium levels of physical activity tended to be inversely associated with mortality (HR: 0.88; 95% CI 0.76-1.02).Conclusion Higher levels of physical activity after a gynecological cancer diagnosis were associated with improved survival. The results suggest that physical activity may represent a modifiable lifestyle factor with the potential to improve long-term outcomes among gynecological cancer survivors.Implications for cancer survivors This supports the potential value of integrating physical activity into survivorship care, although further high-quality prospective studies are needed to strengthen causal inference.
