Endoscopy remains the most common modality by which screen-eligible adults are up-to-date with colorectal (CRC) screening. For the Area-Level Estimates of Cancer Screening (ALECS) study, we leveraged multi-payor claims data to generate small-area estimates of the prevalence of being up-to-date with colorectal cancer (CRC) screening among continuously insured screen-eligible adults in North Carolina (NC). First, we created bespoke small areas at the intersection of counties and ZIP codes, which enabled linkages with aggregated claims data using patients’ residential ZIP codes and counties. Using a 10-year lookback period, we then defined the cohort as near-continuously insured screen-eligible adults age 50–74, who did not have a prior diagnosis of CRC or a total colectomy as of December 2020. Statewide, from 2012 to 2020, 79.8–81.2
Cancer research registries are critical for ensuring representative participation in clinical trials. However, registries based primarily in hospitals may under-enroll women and other populations who experience structural, logistical, cultural, and informational barriers to care and research participation. Community-based organizations (CBOs) may help address this gap by developing registries that engage diverse populations of women at increased risk for and surviving with breast cancer more directly. The purpose of this study was to examine demographic, clinical, and organizational (i.e., engagement related) factors associated with women’s interest in joining a CBO-led breast cancer research registry to support clinical trial access and representation. Secondary analyses were conducted on repeated cross-sectional surveys (2022–2024) administered to women who contacted a national breast cancer-focused CBO for information and support (n=2,389). Measured variables included demographics, cancer risk, quality of life, patient navigation, empowerment, CBO care quality, social media use, and interest in registry participation; bivariate tests, ANOVAs, and MANCOVAs were used to assess associations. Nearly half of women expressed interest in joining the registry (46.2
Systemic inflammation drives cancer progression. We investigated the clinical utility of five routine complete blood count (CBC)-derived inflammatory biomarkers, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), monocyte–lymphocyte ratio (MLR), systemic inflammation response index (SIRI), and systemic immune-inflammation index (SII), in colorectal cancer (CRC) patients. We performed head-to-head case-control and prognostic analyses of five indices in 2305 CRC patients and 78,281 health‑screening controls, with replication in 1031 CRC patients. Analyses included propensity score matching, Cox regression, restricted cubic splines, and Harrell’s concordance index. Population reference intervals were derived, and cross‑population transferability was assessed using the National Health and Nutrition Examination Survey (NHANES). All indices were elevated in CRC patients and independently associated with survival. MLR retained diagnostic and prognostic significance in Stage I disease and was replicated. Dose–response trends were observed across quartiles, with non‑linear threshold effects for MLR and SIRI. Incremental prognostic gains beyond stage were modest. Reference intervals showed substantial overlap between CRC and healthy populations, limiting screening utility. NHANES comparison revealed non‑uniform transferability. CBC‑derived indices demonstrated reproducible diagnostic and prognostic relevance, with MLR particularly informative in early‑stage CRC. Reference intervals contextualise abnormality but should not be interpreted as CRC screening or treatment thresholds.
