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Mukhopadhyay D, Cocco P, Orrù S, Cherchi R, De Matteis S. The role of MicroRNAs as early biomarkers of asbestos-related lung cancer: A systematic review and meta-analysis. Pulmonology 2025; 31:2416792. [PMID: 38402124 DOI: 10.1016/j.pulmoe.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Asbestos is still the leading cause of occupational cancer mortality worldwide. Asbestos-related lung cancer (LC) and malignant pleural mesothelioma (MPM) prognosis is still poor especially at advanced stage, so early diagnosis biomarkers are needed. MicroRNAs (miRNAs) have been proposed as potential early diagnostic biomarkers of asbestos-related LC and MPM. AIM To evaluate the role of miRNAs as diagnostic and prognostic biomarkers of asbestos-related LC and MPM by performing a literature systematic review and meta-analysis. METHODS MEDLINE, EMBASE via Ovid, PUBMED and Cochrane library databases were systematically searched up to April 2023 to identify relevant articles. A grey literature search was also conducted using the Google Scholar platform. MeSH and free text terms for 'asbestos', 'occupational exposure', 'lung cancer', 'mesothelioma' and 'miRNAs' were used to search the literature. Our systematic review protocol was registered in the PROSPERO database. Study quality was assessed via the Newcastle-Ottawa Scale. RESULTS From the search, 331 articles were retrieved, and, after applying our selection criteria, and exclusion of one study for poor quality, 27 studies were included in the review. Most of the studies were hospital-based case-control, conducted in Europe, and evaluated MPM among men only. MiRNAs expression was measured mainly in plasma or serum. MiR-126, miR-132-3p, and miR-103a-3p were the most promising diagnostic biomarkers for MPM, and we estimated a pooled area under the curve (AUC) of 85 %, 73 %, and 50 %, respectively. In relation to MPM prognosis, miR-197‑3p resulted associated with increased survival time. MiR-126, alone and combined with miR-222, was confirmed associated also to LC diagnosis, together with miR-1254 and miR-574-5p; no miRNA was found associated to LC prognosis. CONCLUSION Based on our systematic literature review there is suggestive evidence that the expression of specific miRNAs in the blood serum or plasma are associated with asbestos-related LC and MPM diagnosis and prognosis. Further large longitudinal studies are urgently needed to validate these findings and elucidate the underlying mechanisms given the potential important implications for patients' survival.
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Affiliation(s)
- D Mukhopadhyay
- Molecular and Translational Medicine, Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Cagliari, Italy
| | - P Cocco
- Centre for Occupational and Environmental Health, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, United Kingdom
| | - S Orrù
- Operative Unit of Medical Genetics, Health Agency of Sardinia, Hospital Binaghi, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Cagliari, Italy
| | - R Cherchi
- Operative Unit of Thoracic Surgery, Hospital G. Brotzu, Cagliari, Italy
| | - S De Matteis
- Department of Health Sciences, University of Milan, Milan, Italy
- NHLI, Imperial College London, United Knigdom
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Chen X, Zhong M, Chen C, Huang L, Zhang K, Wu X. Multivariable prediction of returning to work among early-onset colorectal cancer survivors in China: A two-year follow-up. Asia Pac J Oncol Nurs 2025; 12:100637. [PMID: 39990168 PMCID: PMC11843046 DOI: 10.1016/j.apjon.2024.100637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 12/04/2024] [Indexed: 02/25/2025] Open
Abstract
Objective The number of early-onset colorectal cancer survivors (EOCRCs) is increasing. The primary aim of rehabilitation after battling cancer is to enable patients to return to work, as they constitute a significant contributor to societal productivity. A predictive model was developed to identify priority populations requiring intervention and refine responses to increase their capacity to return to work after undergoing treatment for EOCRC. Methods The baseline information was collected before patients were discharged at the end of their treatment course. The data of patients who returned to work were collected at 1 and 2 years after discharge. A predictive variable model was developed via binary logistic regression. The TRIPOD checklist was used. Results At 1 year, 64.7% of the EOCRC survivors had returned to work. Male sex, education, return to work self efficacy, re-entry readiness and social support increased the possibility of returning to work; higher levels of self-perceived fatigue and lower levels of family care decreased the possibility of returning to work within the 1-year model. At 2 years, 72.8% of the EOCRC survivors had returned to work. In the 2-year model, education, self-transcendence, return to work self efficacy, re-entry readiness and occupational environment increased the possibility of returning to work; self-perceived fatigue and psychosocial adjustment decreased the possibility of returning to work. Conclusions The results of this study can guide early assessment and intervention for EOCRC survivors, to facilitate their return to work.
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Affiliation(s)
- Xiaojun Chen
- School of Economics and Management, Beijing University of Posts and Telecommunications, Institution I, Beijing, China
- Band of Guiyang Co., Ltd, Institution II, Guiyang, China
| | - Mengjiao Zhong
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Institution III, Guangzhou, China
| | - Chunyan Chen
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Institution III, Guangzhou, China
| | - Lingyao Huang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Institution III, Guangzhou, China
| | - Kun Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Institution IV, Shandong, China
| | - Xiaodan Wu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Institution III, Guangzhou, China
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Institution V, Macao SAR, China
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Subelack J, Morant R, Blum M, Eichenberger A, Geissler A, Ehlig D. Risk factors for interval breast cancer: insights from a decade of a mammography screening program. Breast Cancer Res Treat 2025; 211:23-33. [PMID: 39934544 DOI: 10.1007/s10549-025-07619-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Accepted: 01/14/2025] [Indexed: 02/13/2025]
Abstract
PURPOSE Breast cancer remains a major global health issue, with mammography screening programs (MSPs) being critical for early detection to improve survival. Interval breast cancers (IBC) are an important quality criterion and have been linked with increased mortality. We aimed to identify risk factors for IBC diagnoses, based on MSP data. METHODS In this retrospective cohort study, we merged data from the Swiss MSP "donna" with data from cancer registries from 2010 to 2019 to categorize cases as IBC or screen-detected breast cancer (SBC). We compared the incidence, tumor characteristics, and survival proportions of women with IBC versus SBC. We used a multivariable Poisson regression with robust errors to identify risk factors for IBC diagnoses. RESULTS We identified 1134 breast cancer cases, specifically 251 IBC and 883 SBC. The 7-year survival proportions significantly deviated with 92.9% for women with IBC and 96.4% for women with SBC (p < 0.05). Women with IBC are diagnosed with significantly higher tumor stages (p < 0.05) and have a worse tumor biology in multiple dimensions e.g. larger tumor size or more often triple negative (p < 0.05). Higher breast density (BI-RADS d risk ratio (RR): 3.293), certain age groups (55-59 years RR: 1.345), and a family breast cancer history (RR: 1.299) were identified as significant (p < 0.05) risk factors for IBC diagnoses. CONCLUSIONS Women with IBC had lower overall survival proportions than women with SBC, possibly due to higher stages at diagnosis. Increased breast density and a positive family history of breast cancer could encourage MSPs to personalize their screening process (e.g. additional diagnostics).
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Affiliation(s)
- Jonas Subelack
- Chair of Health Economics, Policy and Management, School of Medicine, University of St.Gallen, St. Jakobstr. 21, 9000, St.Gallen, Switzerland.
| | - Rudolf Morant
- Cancer League of Eastern Switzerland, St.Gallen, Switzerland
| | - Marcel Blum
- Chair of Health Economics, Policy and Management, School of Medicine, University of St.Gallen, St. Jakobstr. 21, 9000, St.Gallen, Switzerland
- Cancer League of Eastern Switzerland, St.Gallen, Switzerland
| | | | - Alexander Geissler
- Chair of Health Economics, Policy and Management, School of Medicine, University of St.Gallen, St. Jakobstr. 21, 9000, St.Gallen, Switzerland
| | - David Ehlig
- Chair of Health Economics, Policy and Management, School of Medicine, University of St.Gallen, St. Jakobstr. 21, 9000, St.Gallen, Switzerland
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Tobias J, Heinl S, Dendinovic K, Ramić A, Schmid A, Daniel C, Wiedermann U. The benefits of Lactiplantibacillus plantarum: From immunomodulator to vaccine vector. Immunol Lett 2025; 272:106971. [PMID: 39765312 DOI: 10.1016/j.imlet.2025.106971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2024] [Revised: 12/23/2024] [Accepted: 01/02/2025] [Indexed: 01/12/2025]
Abstract
Probiotics have been increasingly recognized for positively influencing many aspects of human health. Lactiplantibacillus plantarum (L. plantarum), a non-pathogenic bacterium, previously known as Lactobacillus plantarum, is one of the lactic acid bacteria commonly used in fermentation. The probiotic properties of L. plantarum have highlighted its health benefits to humans when consumed in adequate amounts. L. plantarum strains primarily enter the body orally and alter intestinal microflora and modulate the immune responses in their host; thereby benefiting human health. Furthermore, the use of L. plantarum as vaccine vectors delivering mucosal antigens has been shown to be a promising strategy. These aspects, from Immunomodulation to vaccine delivery by L. plantarum in preclinical settings, are highlighted in this review. Along these lines, construction of a recombinant L. plantarum strain expressing a B cell multi-peptide, as a future vaccine to modulate immunity and confer anti-tumor effect by targeting Her-2/neu-overexpressing cancers in local and distal sites, is also presented and discussed.
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Affiliation(s)
- Joshua Tobias
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
| | - Stefan Heinl
- Institute of Molecular Biotechnology, Department of Biotechnology, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Kristina Dendinovic
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ajša Ramić
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Anna Schmid
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Catherine Daniel
- Univ. Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL Center for Infection and Immunity of Lille, F-59000 Lille, France
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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Pei W, Li J, Lei S, Nie S, Liu L. Burden of major cancers in China attributable to modifiable risk factors: Predictions from 2012 to 2035. Int J Cancer 2025; 156:1369-1379. [PMID: 39503513 DOI: 10.1002/ijc.35233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 09/23/2024] [Accepted: 10/02/2024] [Indexed: 11/08/2024]
Abstract
The cancer burden continues to escalate in China. This study was designed to quantify the burden of deaths attributable to modifiable risk factors for major cancers in China from 2012 to 2035, and to provide evidence-based recommendations for cancer management. Using nationally representative data on risk factors and cancer mortality, a comparative risk assessment approach was employed to calculate the temporal trend of population-attributable fractions (PAFs) for 15 modifiable risk factors associated with major cancers in China. The PAF for modifiable risk factors decreased from 64.5% (95% uncertainty interval [UI]: 46.2%-75.3%) in 2012 to 59.3% (95% UI: 40.6%-71.2%) in 2035. Attributable deaths increased from 1,309,990 (95% UI: 938,217-1,529,170) in 2012 to 1,313,418 (95% UI: 898,411-1,577,189) in 2035, while attributable disability-adjusted life years (DALYs) rose from 28,488,120 (95% UI: 20,471,859-33,308,237) to 33,017,705 (95% UI: 22,730,814-39,564,735). Between 2012 and 2035, the top three risk factors contributing to cancer burden shifted from smoking, insufficient fruit intake and particulate matter <2.5 μm in diameter (PM2.5) exposure to smoking, physical inactivity, and inadequate fruit intake. Controlling modifiable risk factors at recommended levels by 2020 could have prevented around 890,000 deaths and 2.2 million DALYs by 2035. The proportion of cancer burden due to modifiable risk factors is projected to decrease, but the absolute number continues to rise. Adhering to an optimal lifestyle could prevent ~40% of cancer deaths by 2035. Key modifiable risk factors including smoking, physical inactivity, and insufficient intake of fruits require high attention.
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Affiliation(s)
- Wei Pei
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jia Li
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Shengxi Lei
- Wuhan Britain-China School, Wuhan, People's Republic of China
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Li Liu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
- Hubei Provincial Clinical Research Center for Colorectal Cancer, Wuhan, People's Republic of China
- Wuhan Clinical Research Center for Colorectal Cancer, Wuhan, People's Republic of China
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Wang C, Ren J, Wang X. Comment On "Development and Validation of a Predictive Score for Preoperative Detection of Lymphovascular Invasion in Rectal Cancer". J Surg Oncol 2025. [PMID: 40152820 DOI: 10.1002/jso.28115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2025] [Accepted: 01/29/2025] [Indexed: 03/29/2025]
Affiliation(s)
- Chun Wang
- Medical School of Nantong University, Nantong University, Nantong, China
- Department of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Jing Ren
- Medical School of Nantong University, Nantong University, Nantong, China
- Department of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Xudong Wang
- Department of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong, China
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Minozzi S, La Rosa GRM, Salis F, Camposeragna A, Saulle R, Leggio L, Agabio R. Combined pharmacological and psychosocial interventions for alcohol use disorder. Cochrane Database Syst Rev 2025; 3:CD015673. [PMID: 40110869 PMCID: PMC11924338 DOI: 10.1002/14651858.cd015673.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2025]
Abstract
BACKGROUND Alcohol use disorder (AUD) is a mental disorder characterised by a strong desire to consume alcohol and impaired control of alcohol use, with devastating consequences. Many people with AUD do not respond to psychosocial or pharmacological interventions when these are provided alone. Combining these interventions may improve the response to treatment, though evidence remains limited. OBJECTIVES To assess the effects of combined pharmacological and psychosocial interventions for the treatment of AUD in adults. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, three other databases, and two trials registers in November 2023, without language restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing combined pharmacological and psychosocial interventions versus pharmacological or psychosocial interventions alone, or no intervention/treatment as usual (TAU), in adults with AUD. Our primary outcomes were continuous abstinent participants, frequency of use (measured as heavy drinkers, percentages of abstinent days, heavy-drinking days), amount of use (number of drinks per drinking day), adverse events, serious adverse events, dropouts from treatment, and dropouts due to adverse events. DATA COLLECTION AND ANALYSIS We assessed risk of bias using Cochrane's RoB 1 tool, performed random-effects meta-analyses, and evaluated the certainty of evidence according to the GRADE approach. MAIN RESULTS We included 21 RCTs (4746 participants). The most studied pharmacological and psychosocial interventions were naltrexone (81.0%) and cognitive behavioural therapy (66.7%), respectively. Most participants were men (74%), aged about 44 years, with AUD, without comorbid mental disorders or other substance use disorders; 15 RCTs detoxified participants before treatment. We judged 28.5% of the studies as at low risk of bias for random sequence generation, allocation concealment, performance bias for objective and subjective outcomes, and detection bias for subjective outcomes; all studies were at low risk of detection bias for objective outcomes; 85.7% of studies were at low risk of attrition bias; 14.2% of studies were at low risk of reporting bias. 1) Compared to psychosocial intervention alone, combined pharmacological and psychosocial interventions probably reduce the number of heavy drinkers (above the clinically meaningful threshold (MID) of 2%; absolute difference (AD) -10%, 95% confidence interval (CI) -18% to -2%; risk ratio (RR) 0.86, 95% CI 0.76 to 0.97; 8 studies, 1609 participants; moderate-certainty evidence). They may increase continuous abstinent participants (MID 5%; AD 5%, 95% CI 1% to 11%; RR 1.17, 95% CI 1.02 to 1.34; 6 studies, 1184 participants; low-certainty evidence). They probably have little to no effect on: • the rate of abstinent days (MID 8%; mean difference (MD) 4.16, 95% CI 1.24 to 7.08; 10 studies, 2227 participants); • serious adverse events (MID 1%; AD -2%, 95% CI -3% to 0%; RR 0.20, 95% CI 0.03 to 1.12; 4 studies; 524 participants); • dropouts from treatment (MID 10%; AD -3%, 95% CI -5% to 0%; RR 0.89, 95% CI 0.79 to 1.01; 15 studies, 3021 participants); and • dropouts due to adverse events (MID 5%; AD 2%, 95% CI 0% to 5%; RR 1.91, 95% CI 1.04 to 3.52; 8 studies, 1572 participants) (all moderate-certainty evidence). They may have little to no effect on: • heavy-drinking days (MID 5%; MD -3.49, 95% CI -8.68 to 1.70; 4 studies, 470 participants); • number of drinks per drinking day (MID 1 drink; MD -0.57, 95% CI -1.16 to 0.01; 7 studies, 805 participants); and • adverse events (MID 30%; AD 17%, 95% CI -5% to 46%; RR 1.25, 95% CI 0.93 to 1.68; 4 studies, 508 participants) (all low-certainty evidence). 2) Compared to pharmacological intervention alone, combined pharmacological and psychosocial interventions may have little to no effect on: • the rate of abstinent days (MID 8%; MD -1.18, 95% CI -4.42 to 2.07; 2 studies, 1158 participants); and • dropouts from treatment (MID 10%; AD 1%, 95% CI -10 to 14%; RR 0.98, 95% CI 0.65 to 1.47; 3 studies, 1246 participants) (all low-certainty evidence). We are uncertain about their effect on: • continuous abstinent participants (MID 5%; AD 3%, 95% CI -5% to 18%; RR 1.22, 95% CI 0.62 to 2.40; 1 study, 241 participants); • the number of heavy drinkers (MID 2%; AD 2%, 95% CI -4% to 8%; RR 1.03, 95% CI 0.94 to 1.12; 1 study, 917 participants); • the number of drinks per drinking day (MID 1 drink; MD -2.40, 95% CI -3.98 to -0.82; 1 study, 241 participants); and • dropouts due to adverse events (MID 5%; AD -1%, 95% CI -3% to 6%; RR 0.61, 95% CI 0.14 to 2.72; 2 studies, 1165 participants) (all very low-certainty evidence). 3) We are uncertain about the effect of combined pharmacological and psychosocial interventions, when compared to TAU, on: • the number of heavy drinkers (MID 2%; AD -5%, 95% CI -13% to 2%; RR 0.93, 95% CI 0.83 to 1.03; 1 study, 616 participants); • the rate of abstinent days (MID 8%; MD 3.43, 95% CI -1.32 to 8.18; 1 study, 616 participants); • dropouts from treatment (MID 10%; AD 0%, 95% CI -10% to 15%; RR 0.98, 95% CI 0.58 to 1.65; 2 studies, 696 participants); and • dropouts due to adverse events (MID 5%; AD 3%, 95% CI 0% to 15%; RR 2.97, 95% CI 0.70 to 12.67; 1 study, 616 participants) (all very low-certainty evidence). The certainty of evidence ranged from moderate to very low, downgraded mainly due to risk of bias and imprecision. AUTHORS' CONCLUSIONS As implications for practice, our findings indicate that adding pharmacological to psychosocial interventions is safe and helps people with AUD recover. These conclusions are based on low- to moderate-certainty evidence. Given the few studies and very low-certainty evidence, any benefits of adding psychosocial to pharmacological interventions or comparing the combined intervention to TAU are less clear. As implications for research, further studies should investigate the effects of the combined intervention compared to pharmacotherapy or TAU.
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Affiliation(s)
- Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Francesco Salis
- Department of Biomedical Sciences, Section of Neurosciences and Clinical Pharmacology, University of Cagliari, Monserrato (Cagliari), Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Rosella Saulle
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Baltimore, Maryland, USA
| | - Roberta Agabio
- Department of Biomedical Sciences, Section of Neurosciences and Clinical Pharmacology, University of Cagliari, Monserrato (Cagliari), Italy
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Yean AW, Leong E, King OS, Mohamad Z. Breast cancer treatment modalities, treatment delays, and survival in Brunei Darussalam. BMC Cancer 2025; 25:510. [PMID: 40114099 PMCID: PMC11924827 DOI: 10.1186/s12885-025-13861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 03/04/2025] [Indexed: 03/22/2025] Open
Abstract
INTRODUCTION Breast cancer remains a leading cause of cancer-related mortality globally. This study aims to examine the demographic variables and effects of different treatment modalities and treatment delays on overall and relative survival rates of breast cancer patients in Brunei Darussalam. METHODS This retrospective study analysed data from the Brunei Darussalam Cancer Registry on breast cancer cases diagnosed and treated between 2013 and 2022. Statistical analyses included descriptive statistics to characterise the study population, Kaplan-Meier estimates to compare survival curves of different groups, Log rank tests to determine significant differences in survival rates among groups, and Cox Proportional Hazard (PH) models to estimate hazard ratios (HRs) and identify predictors of survival outcomes. Overall survival (OS) and relative survival (RS) rates were calculated. RESULTS Out of the 431 women treated for breast cancer, the majority were diagnosed at the regional stage (45.7%), with 39.0% at the localised stage. Over half (55.4%) of the diagnoses occurred in women aged 40 to 59, while about a quarter (25.5%) were in the 60-69 age group. Surgery was the most common first-line treatment modality (55.9%), with a median time to treatment of 37 days, followed by chemotherapy (30.6%). More than half of the patients (62.9%) were treated within 60 days of diagnosis. Treatment varied by age and cancer stage, with younger patients more likely to undergo surgery and older patients more likely to receive chemotherapy or hormonal therapy. Survival rates were high for patients receiving only surgery (5-year RS: 98.7%, OS: 92.3%), and significant survival differences were found for cancer stage and treatment delay, with a HR of 2.5 for delays over 60 days. Multivariate analysis showed that patients with distant stage cancer had a significantly higher risk of death (HR = 15.3) compared to localised stage. CONCLUSION This study highlights the impact of treatment modalities and delays on breast cancer survival in Brunei Darussalam, emphasising the need for timely treatment to improve survival rates. Our findings suggest that ensuring breast cancer treatment initiation within two months post-diagnosis may enhance patient outcomes, supporting potential policy targets for timely access to care.
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Affiliation(s)
- Ang Woan Yean
- Faculty of Science, Universiti Brunei Darussalam, Jln Tungku Link, Bandar Seri Begawan, Brunei Darussalam
| | - Elvynna Leong
- Faculty of Science, Universiti Brunei Darussalam, Jln Tungku Link, Bandar Seri Begawan, Brunei Darussalam.
| | - Ong Sok King
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jln Tungku Link, Bandar Seri Begawan, Brunei Darussalam
- Department of Policy and Planning, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam
| | - Zulkhairi Mohamad
- The Brunei Cancer Centre, Jerudong Park Medical Centre, Jerudong, Bandar Seri Begawan, Brunei Darussalam
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Mehnert-Theuerkauf A, Oksbjerg Dalton S, Johansen C. Cancer survivorship and functional health: what we need to address in an aging cancer population. Acta Oncol 2025; 64:458-461. [PMID: 40105724 DOI: 10.2340/1651-226x.2025.43076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2025] [Accepted: 03/01/2025] [Indexed: 03/20/2025]
Affiliation(s)
- Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig, Germany.
| | - Susanne Oksbjerg Dalton
- Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark Institute of Clinical Medicine, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
| | - Christoffer Johansen
- Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark; Institute of Clinical Medicine, Faculty of Health, Copenhagen University, Copenhagen, Denmark; Department of Oncology, CASTLE, Copenhagen University Hospital, Copenhagen, Denmark
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Caturano A, Erul E, Nilo R, Nilo D, Russo V, Rinaldi L, Acierno C, Gemelli M, Ricotta R, Sasso FC, Giordano A, Conte C, Ürün Y. Insulin resistance and cancer: molecular links and clinical perspectives. Mol Cell Biochem 2025:10.1007/s11010-025-05245-8. [PMID: 40089612 DOI: 10.1007/s11010-025-05245-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Accepted: 02/23/2025] [Indexed: 03/17/2025]
Abstract
The association between insulin resistance (IR), type 2 diabetes mellitus (T2DM), and cancer is increasingly recognized and poses an escalating global health challenge, as the incidence of these conditions continues to rise. Studies indicate that individuals with T2DM have a 10-20% increased risk of developing various solid tumors, including colorectal, breast, pancreatic, and liver cancers. The relative risk (RR) varies depending on cancer type, with pancreatic and liver cancers showing a particularly strong association (RR 2.0-2.5), while colorectal and breast cancers demonstrate a moderate increase (RR 1.2-1.5). Understanding these epidemiological trends is crucial for developing integrated management strategies. Given the global rise in T2DM and cancer cases, exploring the complex relationship between these conditions is critical. IR contributes to hyperglycemia, chronic inflammation, and altered lipid metabolism. Together, these factors create a pro-tumorigenic environment conducive to cancer development and progression. In individuals with IR, hyperinsulinemia triggers the insulin-insulin-like growth factor (IGF1R) signaling pathway, activating cancer-associated pathways such as mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase (PIK3CA), which promote cell proliferation and survival, thereby supporting tumor growth. Both IR and T2DM are linked to increased morbidity and mortality in patients with cancer. By providing an in-depth analysis of the molecular links between insulin resistance and cancer, this review offers valuable insights into the role of metabolic dysfunction in tumor progression. Addressing insulin resistance as a co-morbidity may open new avenues for risk assessment, early intervention, and the development of integrated treatment strategies to improve patient outcomes.
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Affiliation(s)
- Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
| | - Enes Erul
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, 06620, Turkey
| | - Roberto Nilo
- Data Collection G-STeP Research Core Facility, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
| | - Davide Nilo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Vincenzo Russo
- Department of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA, 19122, USA
- Division of Cardiology, Department of Medical Translational Sciences, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Luca Rinaldi
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, 86100, Campobasso, Italy
| | - Carlo Acierno
- Azienda Ospedaliera Regionale San Carlo, 85100, Potenza, Italy
| | - Maria Gemelli
- Medical Oncology Unit, IRCCS MultiMedica, Milan, Italy
| | | | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Antonio Giordano
- Department of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA, 19122, USA
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166, Rome, Italy
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099, Milan, Italy
| | - Yüksel Ürün
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, 06620, Turkey.
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11
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Elmadani M, Mokaya PO, Omer AAA, Kiptulon EK, Klara S, Orsolya M. Cancer burden in Europe: a systematic analysis of the GLOBOCAN database (2022). BMC Cancer 2025; 25:447. [PMID: 40075331 PMCID: PMC11905646 DOI: 10.1186/s12885-025-13862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 03/04/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND Cancer remains a significant public health challenge in Europe, with substantial regional disparities in incidence, mortality, and access to healthcare. This study analyses cancer patterns across Eastern, Northern, Southern, and Western Europe in 2022, highlighting key public health implications and gaps in prevention and treatment. METHODS Using data from GLOBOCAN 2022, this study assessed total new cancer cases, age-standardized incidence and mortality rates (ASRs) per 100,000, and cumulative cancer risk at age 75. The top three cancers by sex and region were also analysed to identify trends and disparities. RESULTS In 2022, Europe recorded 4,471,422 new cancer cases (ASR 280 per 100,000), with a cumulative risk of 27.9% by age 75. Males accounted for 2,359,303 cases (ASR 319.6, cumulative risk 31.9%), while females had 2,112,119 cases (ASR 253.4, cumulative risk 24.7%). Northern and Western Europe had the highest incidence rates, with Denmark leading at 374.7 per 100,000 (cumulative risk 34.9%), likely due to advanced screening and healthcare. Conversely, Eastern Europe had the highest mortality, with 1,091,871 deaths (ASR 135.3), reflecting late diagnoses and limited access of treatment. Hungary exhibited the highest mortality rate (ASR 143.7, cumulative risk 15.8%), followed by Poland (ASR 133.1). Prostate and breast cancers were the most common in males and females, respectively. Lung cancer, despite a lower incidence (ASR 24.7), had the highest mortality (ASR 17.7), while pancreatic cancer showed high fatality (ASR 6.3, mortality ASR 5.6). Thyroid cancer had a relatively high incidence (ASR 7.5) but low mortality (ASR 0.21). CONCLUSIONS Significant regional disparities in cancer burden underscore the need for targeted public health strategies. Expanding cancer screening programs, strengthening smoking cessation and HPV vaccination efforts, and improving healthcare accessibility particularly in Eastern Europe are critical to reducing mortality and enhancing early detection. Differences in mortality-to-incidence ratios also highlight the role of healthcare infrastructure and timely interventions. Future research should explore the socioeconomic and environmental determinants driving these disparities to inform evidence-based cancer control policies across Europe.
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Affiliation(s)
- Mohammed Elmadani
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pecs, Vorosmarty Mihaly Street 4, Pecs, 7621, Hungary.
- Jamhuriya Research Center, Jamhuriya University of Science and Technology, Mogadishu, Somalia.
- Department of Epidemiology, Faculty of Public Health, University of El Imam El Mahdi, Kosti, Sudan.
| | - Peter Onchuru Mokaya
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pecs, Vorosmarty Mihaly Street 4, Pecs, 7621, Hungary
| | - Ahmed A A Omer
- Institute of Clinical Pharmacy, University of Szeged, Szeged, Hungary
| | - Evans Kasmai Kiptulon
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pecs, Vorosmarty Mihaly Street 4, Pecs, 7621, Hungary
| | - Simon Klara
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pecs, Vorosmarty Mihaly Street 4, Pecs, 7621, Hungary
| | - Mate Orsolya
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pecs, Vorosmarty Mihaly Street 4, Pecs, 7621, Hungary
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12
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George S, Saju H, Jaikumar T, Raj R, Nisarga R, Sontakke S, Sangshetti J, Paul MK, Arote RB. Deciphering a crosstalk between biological cues and multifunctional nanocarriers in lung cancer therapy. Int J Pharm 2025; 674:125395. [PMID: 40064384 DOI: 10.1016/j.ijpharm.2025.125395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 02/08/2025] [Accepted: 02/21/2025] [Indexed: 03/17/2025]
Abstract
In recent years, the utilization of nanocarriers has significantly broadened across a diverse spectrum of biomedical applications. However, the clinical translation of these tiny carriers is limited and encounters hurdles, particularly in the intricate landscape of the tumor microenvironment. Lung cancer poses unique hurdles for nanocarrier design. Multiple physiological barriers hinder the efficient drug delivery to the lungs, such as the complex anatomy of the lung, the presence of mucus, immune responses, and rapid clearance mechanisms. Overcoming these obstacles necessitates a targeted approach that minimizes off-target effects while effectively penetrating nanoparticles/cargo into specific lung tissues or cells. Furthermore, understanding the cellular uptake mechanisms of these nano carriers is also essential. This knowledge aids in developing nanocarriers that efficiently enter cells and transfer their payload for the most effective therapeutic outcome. Hence, a thorough understanding of biological cues becomes crucial in designing multifunctional nanocarriers tailored for treating lung cancer. This review explores the essential biological cues critical for developing a flexible nanocarrier specifically intended to treat lung cancer. Additionally, it discusses advancements in nanotheranostics in lung cancer.
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Affiliation(s)
- Sharon George
- Centre for Nano and Material Sciences, Jain (Deemed to be) University, Jain Global Campus, Bangalore, Karnataka 562112, India
| | - Hendry Saju
- Centre for Nano and Material Sciences, Jain (Deemed to be) University, Jain Global Campus, Bangalore, Karnataka 562112, India
| | - Tharun Jaikumar
- Centre for Nano and Material Sciences, Jain (Deemed to be) University, Jain Global Campus, Bangalore, Karnataka 562112, India
| | - Reshma Raj
- Centre for Nano and Material Sciences, Jain (Deemed to be) University, Jain Global Campus, Bangalore, Karnataka 562112, India
| | - R Nisarga
- Centre for Nano and Material Sciences, Jain (Deemed to be) University, Jain Global Campus, Bangalore, Karnataka 562112, India
| | - Samruddhi Sontakke
- Centre for Nano and Material Sciences, Jain (Deemed to be) University, Jain Global Campus, Bangalore, Karnataka 562112, India
| | - Jaiprakash Sangshetti
- Y. B. Chavan College of Pharmacy, Dr. Rafiq Zakaria Campus, Rauza Baugh, Aurangabad 431001, India
| | - Manash K Paul
- Department of Radiation Biology and Toxicology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal 576104, India; Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), 90095 CA, USA.
| | - Rohidas B Arote
- Centre for Nano and Material Sciences, Jain (Deemed to be) University, Jain Global Campus, Bangalore, Karnataka 562112, India; Dental Research Institute, School of Dentistry, Seoul National University, Gwanak-ku, Seoul 08826, Republic of Korea.
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13
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Kim Y. The effects of smoking, alcohol consumption, obesity, and physical inactivity on healthcare costs: a longitudinal cohort study. BMC Public Health 2025; 25:873. [PMID: 40045251 PMCID: PMC11881326 DOI: 10.1186/s12889-025-22133-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 02/27/2025] [Indexed: 03/09/2025] Open
Abstract
BACKGROUND Research indicates major risk factors including smoking, alcohol consumption, obesity and physical inactivity contribute significantly to global disease burden and healthcare costs. However, these studies have challenges, such as increased bias and uncertainty arising from use of population attributable fractions (PAF) and the issue of reverse causality in cross-sectional data. This study aims to evaluate the long-term healthcare costs associated with these behaviors using a longitudinal cohort. METHODS This longitudinal cohort study used the Korean National Health Insurance Service-National Sample Cohort database (NHIS-NSC 2.0), covering 2002-2019. The cohort included individuals aged 40-69 years who underwent health examinations in 2002-2004 and had no pre-existing risk factor-related diseases. Cumulative healthcare costs during 2010-2019 were analyzed using a generalized linear model with log-link function and gamma distribution, adjusted for other health behaviors and sociodemographic factors. RESULTS Smoking, alcohol consumption, obesity, and physical inactivity significantly increased healthcare costs for both sexes. Male current smokers incurred 13.8% higher costs than never-smokers, while female smokers spent 18.6% more. Former smokers had lower costs than current smokers, with reductions of 9.9% for males and 13.2% for females. Almost daily alcohol consumption raised costs by 21.4% for males and 31.8% for females. Costs varied by BMI categories, with severe obesity increasing expenditures by 26.9% for males and 46.5% for females compared to normal weight. Overweight status showed contrasting effects between sexes, with a 3.4% decrease in healthcare costs for males but a 7.6% increase for females. Exercising 1-4 times weekly reduced costs by 7.6% for males and 7.4% for females compared to non-exercisers. CONCLUSIONS The study underscores the economic impact of health risk behaviors and supports the need for targeted public health interventions. The findings highlight the importance of targeted interventions for high-risk groups for reducing healthcare costs.
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Affiliation(s)
- Younhee Kim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, South Korea.
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14
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Su D, Cui Y, He C, Yin P, Bai R, Zhu J, Lam JST, Zhang J, Yan R, Zheng X, Wu J, Zhao D, Wang A, Zhou M, Feng T. Projections for prevalence of Parkinson's disease and its driving factors in 195 countries and territories to 2050: modelling study of Global Burden of Disease Study 2021. BMJ 2025; 388:e080952. [PMID: 40044233 PMCID: PMC11881235 DOI: 10.1136/bmj-2024-080952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2025] [Indexed: 03/09/2025]
Abstract
OBJECTIVE To predict the global, regional, and national prevalence of Parkinson's disease by age, sex, year, and Socio-demographic Index to 2050 and quantify the factors driving changes in Parkinson's disease cases. DESIGN Modelling study. DATA SOURCE Global Burden of Disease Study 2021. MAIN OUTCOME MEASURES Prevalent number, all age prevalence and age standardised prevalence of Parkinson's disease in 2050, and average annual percentage change of prevalence from 2021 to 2050; contribution of population ageing, population growth, and changes in prevalence to the growth in Parkinson's disease cases; population attributable fractions for modifiable factors. RESULTS 25.2 (95% uncertainty interval 21.7 to 30.1) million people were projected to be living with Parkinson's disease worldwide in 2050, representing a 112% (95% uncertainty interval 71% to 152%) increase from 2021. Population ageing (89%) was predicted to be the primary contributor to the growth in cases from 2021 to 2050, followed by population growth (20%) and changes in prevalence (3%). The prevalence of Parkinson's disease was forecasted to be 267 (230 to 320) cases per 100 000 in 2050, indicating a significant increase of 76% (56% to 125%) from 2021, whereas the age standardised prevalence was predicted to be 216 (168 to 281) per 100 000, with an increase of 55% (50% to 60%) from 2021. Countries in the middle fifth of Socio-demographic Index were projected to have the highest percentage increase in the all age prevalence (144%, 87% to 183%) and age standardised prevalence (91%, 82% to 101%) of Parkinson's disease between 2021 and 2050. Among Global Burden of Disease regions, East Asia (10.9 (9.0 to 13.3) million) was projected to have the highest number of Parkinson's disease cases in 2050, with western Sub-Saharan Africa (292%, 266% to 362%) experiencing the most significant increase from 2021. The ≥80 years age group was projected to have the greatest increase in the number of Parkinson's disease cases (196%, 143% to 235%) from 2021 to 2050. The male-to-female ratios of age standardised prevalence of Parkinson's disease were projected to increase from 1.46 in 2021 to 1.64 in 2050 globally. CONCLUSIONS By 2050 Parkinson's disease will have become a greater public health challenge for patients, their families, care givers, communities, and society. The upward trend is expected to be more pronounced among countries with middle Socio-demographic Index, in the Global Burden of Disease East Asia region, and among men. This projection could serve as an aid in promoting health research, informing policy decisions, and allocating resources.
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Affiliation(s)
- Dongning Su
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yusha Cui
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chengzhang He
- GYENNO Science Co, Ltd, Shenzhen, China
- Hust-GYENNO CNS Intelligent Digital Medicine Technology Center, Wuhan, China
| | - Peng Yin
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, Beijing, China
| | - Ruhai Bai
- Evidence-Based Research Center of Social Science and Health, School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
| | - Jinqiao Zhu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Joyce S T Lam
- Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Junjiao Zhang
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Rui Yan
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoqing Zheng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiayi Wu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dong Zhao
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Anxin Wang
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
| | - Maigeng Zhou
- The National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Xicheng District, Beijing, China
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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15
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Santos TDS, Gonçalves CDA, da Cunha CP, Milhomem JP, da Silva KM, da Costa BT, Piantolo RG, Fernandes RJC, da Silva YM, Guimarães RM. Temporal trend of breast cancer burden among younger and older Brazilian women, 1990-2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2025; 28:e250006. [PMID: 40053004 PMCID: PMC11884820 DOI: 10.1590/1980-549720250006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 12/13/2024] [Accepted: 12/16/2024] [Indexed: 03/10/2025] Open
Abstract
OBJECTIVE To analyze the temporal trend of the burden of breast cancer in Brazilian women under 40 years of age compared to the age group over 40 years of age, between 1996 and 2019. METHODS An ecological time trend study was conducted in Brazil between 1996 and 2019 using data from the Global Burden of Disease (GBD) study. The segmented regression method (Joinpoint Regression) was applied to analyze rates among women under and over 40 years of age. To capture differences in the level and trend of mortality and DALYs, the rate ratio was calculated for the two groups on a year-by-year basis. RESULTS Regarding DALY, an average annual decline of 0.7% (95%CI -0.8 to -0.5, p<0.01) was observed among women over 40 years old, while an annual increase of 1.0% (95%CI 0.9 to 1.1, p<0.001) was noted for women up to 40 years old. For mortality, the decline among older women was 0.3% per year (95%CI -0.4 to -0.2, p<0.001), and the increase among young women was 0.8% per year (95%CI 0.7 to 1.0, p<0.001). The average rate ratio for DAILY was 5.2, while for mortality, the average rate ratio was 8.1. CONCLUSION the analysis reinforces the idea that the magnitude and trend of breast cancer mortality among young women is a health issue requiring attention from health decision-makers. This diagnosis underscores the importance of initiating discussions on the need to review population screening criteria, incorporating clinical prediction rules.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Raphael Mendonça Guimarães
- Universidade Estácio de Sá, School of Medicine – Rio de Janeiro (RJ), Brazil
- Oswaldo Cruz Foundation, National School of Public Health – Rio de Janeiro (RJ), Brazil
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16
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Lim WH. Breast Cancer and Levonorgestrel-Releasing Intrauterine Systems. JAMA 2025:2831021. [PMID: 40029699 DOI: 10.1001/jama.2024.27807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2025]
Affiliation(s)
- Wei How Lim
- Graduate School of Medicine, University of Wollongong, New South Wales, Australia
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17
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Zhu Z, Yuan J, Fu L, Zhang W, Liu S, Liu Y. Mortality of Head and Neck Cancer in China From 1990 to 2019: A Secondary Data Analysis. Cancer Rep (Hoboken) 2025; 8:e70116. [PMID: 40071521 PMCID: PMC11897804 DOI: 10.1002/cnr2.70116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Revised: 11/28/2024] [Accepted: 12/24/2024] [Indexed: 03/15/2025] Open
Abstract
BACKGROUND The rising global incidence of head and neck cancer imposes a growing burden on health systems. However, comprehensive analysis of mortality trends, particularly age, period, and cohort effects, remains limited. OBJECTIVE This study aims to evaluate head and neck cancer mortality trends in China from 1990 to 2019, with a focus on age, period, and cohort effects. METHODS A secondary data analysis was conducted using data from the Global Burden of Disease Study, focusing on the Chinese population aged 20 years and older. The cancers examined included those of the lip-oral cavity, nasopharynx, other pharynx, larynx, and thyroid. Mortality data, including death numbers and age-standardized rates, were analyzed using joinpoint regression and age-period-cohort analysis to identify trends. RESULTS The study revealed that from 1990 to 2019, the age-standardized mortality rate for head and neck cancer in China decreased more significantly than the global average. Although the overall trend in China showed a decrease, there were sporadic increases, especially among males. In contrast, females exhibited a more consistent decline. The age-period-cohort analysis demonstrated increasing mortality with age, decreasing mortality over successive periods, and fluctuating cohort effects, with a marked decrease for cohorts born after 1930. CONCLUSION Overall, the mortality rate for head and neck cancer in China is declining, with age being a significant risk factor for mortality, and earlier-born cohorts facing higher risks. Continuous monitoring is essential to understand the impact of evolving clinical practice guidelines on the mortality of head and neck cancer.
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Affiliation(s)
- Zhengxin Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Jiasheng Yuan
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Li Fu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Wanqing Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Songtao Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
| | - Yuehui Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital, Jiangxi Medical CollegeNanchang UniversityNanchangJiangxiChina
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18
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Silva DBD, Pianovski MAD, Carvalho Filho NPD. Environmental pollution and cancer. J Pediatr (Rio J) 2025; 101 Suppl 1:S18-S26. [PMID: 39488336 DOI: 10.1016/j.jped.2024.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 09/20/2024] [Accepted: 09/20/2024] [Indexed: 11/04/2024] Open
Abstract
OBJECTIVE To identify and describe pollutants with carcinogenic potential that contaminate indoor and outdoor air, food and soil. DATA SOURCE The descriptors environmental pollutants, occupational cancer, prevention and soil pollutants were used to conduct the research for literature review. Articles published from 2003 to 2024 in the electronic databases Pubmed Medline, Lilacs and Scielo, in Portuguese and English, were included. SUMMARY OF FINDINGS There are multiple sources of pollution in the external and internal environments, including motor vehicles, industrial facilities, smoke from tobacco products, agricultural activities, fires and domestic combustion devices. The most important pollutants related to chemical substances include all forms of asbestos, benzene, exhaust gases from gasoline engines, food and water contaminants, such as arsenic and inorganic arsenic compounds, in addition to persistent organic pollutants, such as dioxins. The use of fossil fuels and biomass for domestic heating are also important sources of pollution. The carcinogenic potential of pollutants varies according to the sources of pollution, climate conditions and the region's topography. CONCLUSIONS Global environmental pollution is an international public health problem with multiple health effects. Many environmental pollutants are proven to be carcinogenic to adults, while few causes have been scientifically established for children. Pollution is mainly caused by uncontrolled urbanization and industrialization. Preventing environmental exposure to carcinogenic pollutants requires both government regulation and community action and commitment.
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Affiliation(s)
- Denise Bousfield da Silva
- Departamento de Pediatria, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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Xiong J, Li Y, Li J, Zhao C. A Linkage Between 25-Hydroxyvitamin D and Post-Stroke Cognitive Impairment, as Well as the Duration of Hospitalization After a Stroke. J Eval Clin Pract 2025; 31:e70039. [PMID: 40099417 DOI: 10.1111/jep.70039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 01/13/2025] [Accepted: 02/09/2025] [Indexed: 03/19/2025]
Abstract
AIMS A variety of complications can arise following a stroke, with post-stroke cognitive impairment (PSCI) being a prevalent consequence. The objective of the research was to explore the relationship between 25(OH)D levels, PSCI, and the duration of hospitalization. METHODS Serum concentrations of 25(OH)D were measured within the first 24 h of hospital admission. Cognitive impairment in stroke patients was assessed using the Mini-Mental State Examination (MMSE). Functional independence was evaluated on the day of discharge using the Barthel Index (BI). Additionally, the duration of hospitalization for each patient was recorded. Data analysis was performed using SPSS statistical software. RESULTS An observation revealed that levels of 25(OH)D were comparatively reduced in stroke people who suffered from cognitive impairment as opposed to individuals without such impairment (p = 0.022). Patients with cognitive impairment following a stroke demonstrated reduced BI scores (p < 0.001) and longer durations of hospitalization (p = 0.002) in contrast to patients without cognitive impairment. Upon comparing groups with different concentrations of 25(OH)D, it was observed that individuals with low concentrations had longer hospitalization durations (p = 0.03) and higher NIHSS scores (p = 0.003) than those with high concentrations of 25(OH)D. Furthermore, binary logistic regression analysis indicated that a 25(OH)D level of < 25 nmol/L was a significant risk factor for cognitive impairment following a stroke. CONCLUSIONS The study indicated a potential linkage between reduced levels of 25(OH)D and an escalated susceptibility to cognitive impairment following a stroke. Furthermore, individuals with lower concentrations of 25(OH)D generally experienced longer hospital stays.
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Affiliation(s)
- Jianrong Xiong
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
- Department of Rehabilitation Medicine, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Jinhua, Zhejiang, P.R. China
| | - Yongxiang Li
- Department of Rehabilitation Medicine, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Jinhua, Zhejiang, P.R. China
| | - Jinhui Li
- Department of Chinese Medicine & Rehabilitation, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chenliang Zhao
- Department of Critical Care Medicine, Heyou Hospital, Shunde District, Foshan City, Guangdong, P.R. China
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20
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Potter LN, Jones DR, Schlechter CR, Lam CY, Nahum-Shani I, Fagundes CP, Wetter DW. Momentary predictors of tobacco lapse among African Americans during a quit attempt. Addict Behav 2025; 162:108231. [PMID: 39693676 PMCID: PMC11731177 DOI: 10.1016/j.addbeh.2024.108231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 11/21/2024] [Accepted: 12/10/2024] [Indexed: 12/20/2024]
Abstract
BACKGROUND AND AIMS African American smokers are less likely to successfully quit and experience a greater burden of tobacco-related health outcomes than White individuals. There is a profound need to understand factors that impact tobacco cessation among African Americans who are undergoing a quit attempt. This study aimed to examine the within- and between-person associations of risk factors (motivation, self-efficacy, urge, positive affect, negative affect, smoking expectancies, and cigarette availability) with lapse. DESIGN AND SETTING Observational study in the Houston, TX area that used ecological momentary assessment (EMA) to collect data for 10 days following a smoking quit attempt. Multilevel modeling was used to test associations between risk factors and lapse. PARTICIPANTS N = 211 African American adults, 51 % female, and ages 18-74. MEASUREMENTS EMA was used to assess risk factors (motivation, self-efficacy, urge, positive affect, negative affect, smoking expectancies, and cigarette availability) and lapse. FINDINGS At the within-person level, moments characterized by greater urge, smoking expectancies, and cigarette availability were associated with greater risk of lapse in daily life. At the between-person level, those who had lower motivation and self-efficacy and greater urge, smoking expectancies, and cigarette availability were more likely to lapse in daily life. CONCLUSIONS The current study addresses important theoretical underpinnings regarding the dynamic nature of predictors of lapse. Although some predictors (urge, smoking expectancies, cigarette availability) did have a significant effect with lapse in expected directions, between person effects may be increasingly important in this population, and additional momentary predictors should be explored in future research.
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Affiliation(s)
- Lindsey N Potter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute, University of Utah, United States; Department of Population Health Sciences, University of Utah, United States.
| | - Dusti R Jones
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute, University of Utah, United States; Department of Population Health Sciences, University of Utah, United States
| | - Chelsey R Schlechter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute, University of Utah, United States; Department of Population Health Sciences, University of Utah, United States
| | - Cho Y Lam
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute, University of Utah, United States; Department of Population Health Sciences, University of Utah, United States
| | - Inbal Nahum-Shani
- Institute for Social Research, University of Michigan, United States; Center for Methodologies for Adapting and Personalizing Prevention, Treatment, and Recovery Services for SUD and HIV (MAPS Center), University of Michigan, United States
| | | | - David W Wetter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute, University of Utah, United States; Department of Population Health Sciences, University of Utah, United States
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21
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Wang J, Liu F, Heng J, Li G. Identification of EXO1 as a potential biomarker associated with prognosis and tumor immune microenvironment for specific human cancers. Mamm Genome 2025; 36:262-279. [PMID: 39718579 DOI: 10.1007/s00335-024-10092-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Accepted: 12/11/2024] [Indexed: 12/25/2024]
Abstract
Exonuclease 1 (EXO1) is an evolutionarily conserved exonuclease, which have function on maintaining genomic stability. Elevated expression of EXO1 has been reported in certain cancers. However, a comprehensive pan-cancer analysis of EXO1 is still lacking and its role in human cancer development remains poorly understood. This study aims to investigate the genetic alterations and expression perturbations of EXO1 and evaluate its potential clinical relevance in different cancer types. By employing powerful bioinformatics tools and utilizing data sourced from The Cancer Genome Atlas and the Genotype-Tissue Expression datasets, a comprehensive pan-cancer analysis of EXO1 was conducted, including an examination of gene expression, alterations in genetics, DNA methylation patterns, survival outcomes, clinical traits, immune features, and functional enrichment analysis. EXO1 was found to be highly expressed across 20 tumor types, including lung adenocarcinoma, lung squamous cell carcinoma, and breast invasive carcinoma. The expression levels of EXO1 are frequently associated with later clinical stages and unfavorable outcomes. Genetic alterations in EXO1 were predominantly found to be amplified in a pan-cancer context. A total of 131 missense mutations, 24 truncation mutations, 1 in-frame mutation, 6 splice site mutations, and 1 fusion mutation were identified. Interestingly, a significant co-occurrence of alterations in EXO1 with other ten gene alterations were identified. The expression of EXO1 in multiple tumors showed a significant correlation with tumor mutational burden, microsatellite instability, and genes related to immunological checkpoints. In most types of cancer, a strong correlation exists between the expression of EXO1 and the infiltration of CD4+ Th2 cells, memory CD4+ T cells, myeloid-derived suppressor cells, and common lymphoid progenitors. Analysis of 150 genes related to EXO1 demonstrate an enrichment in processes such as cell cycle regulation, DNA damage repair, and relevant signaling pathways, suggesting a possible mechanism through which EXO1 may facilitate tumor development. This study offers a deep insight into the role of EXO1 in different types of human cancers, indicating that EXO1 could act as an important prognostic biomarker and a therapeutic target for certain types of cancer.
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Affiliation(s)
- Jingyun Wang
- Department of Obstetrics and Gynecology, Hunan Provincial People's Hospital (The First-Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Fen Liu
- Department of Obstetrics and Gynecology, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University (The First Hospital of Changsha), Changsha, China
| | - Jianfu Heng
- Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, China
| | - Guoli Li
- Department of Nephrology and Laboratory of Kidney Disease, Hunan Provincial People's Hospital (The First-Affiliated Hospital of Hunan Normal University), No. 61# Jiefang West Road, Changsha, 410005, Hunan, China.
- Hunan Clinical Research Center for Chronic Kidney Disease, Changsha, China.
- Hunan Engineering Research Center for Kidney Disease Prevention and Rehabilitation, Changsha, China.
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22
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Gong M, Xia T, Chen Z, Zhu Y. Comparison analysis of the burden and attributable risk factors of early-onset and late-onset colorectal cancer in China from 1990 to 2019. Eur J Cancer Prev 2025; 34:140-150. [PMID: 39150077 DOI: 10.1097/cej.0000000000000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
OBJECTIVES The project intended to analyze the impact of burden and related risk factors of late-onset colorectal cancer (LOCRC) and early-onset colorectal cancer (EOCRC) in China, thus offering essential references for optimizing prevention and control strategies. METHOD Global Burden of Disease Study was employed to describe burden changes of EOCRC and LOCRC in China during 1990-2019, containing the numbers of incidence, deaths, prevalence, and disability-adjusted life years (DALYs), and to compare attributable deaths and DALYs risk factors in varying age and sex segments. RESULTS The numbers and corresponding crude rates of incidence, deaths, prevalence, and DALYs of EOCRC and LOCRC in China during 1990-2019 demonstrated an upward trend across all age categories, with males being dramatically predominant. Overall, over time, the impact of a low-calcium diet and a low-fiber diet on mortality and DALY rates decreased, while the impact of other risk factors increased. In terms of gender, the risk factors affecting males changed greatly, with smoking, inadequate milk intake, and the low whole-grain diet being the main factors in 2019, while in 1990, the main factors were the low-calcium diet, smoking, and inadequate milk intake. CONCLUSION The burden of colorectal cancer in China is concerning. Patients grouped by diagnostic age exhibit different characteristics, indicating the need for high-quality research in the future to achieve personalized medicine tailored to different population characteristics.
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Affiliation(s)
| | - Tian Xia
- Department of Colorectal Surgery
| | | | - Yuanyuan Zhu
- Department of Oncology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
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23
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Sundbøll J, Veres K, Troelsen FS, Würtz M, Bøtker HE, Sørensen HT. Myocardial infarction and short- or long-term risk of a subsequent cancer diagnosis: a Danish Nationwide Cohort Study. J Thromb Haemost 2025; 23:1023-1033. [PMID: 39701292 DOI: 10.1016/j.jtha.2024.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Revised: 11/05/2024] [Accepted: 12/05/2024] [Indexed: 12/21/2024]
Abstract
BACKGROUND Growing evidence suggests that myocardial infarction (MI) may be a marker of cancer risk, but many aspects of this relation are poorly understood. OBJECTIVES To examine the short- and long-term risk of incident cancer in patients presenting with MI. METHODS Using nationwide population-based Danish health registries, we identified all patients with a first-time diagnosis of MI (1995-2021) and followed them for up to 28 years for any subsequent diagnosis of cancer. We computed risks and standardized incidence ratios with 95% CIs as the observed number of cancers relative to the expected number based on national cancer incidence rates by sex, age, and calendar year. RESULTS Among 185 065 patients diagnosed with MI, we observed 25 315 subsequent cancers. The risk of any cancer was 2.4% after 1 year of follow-up, increasing to 25.8% after 28 years, taking the competing risks of death into account. During the first year of follow-up, the standardized incidence ratio of any cancer was 1.67 (95% CI, 1.62-1.73). The standardized incidence ratio remained moderately elevated during 2 to 5 years (1.03; 95% CI, 1.01-1.05) and beyond 5 years (1.07; 95% CI, 1.05-1.09). The strongest associations were found for hematological as well as obesity- and smoking-related cancers during the first year of follow-up, whereas primarily, the risk of smoking-related cancers remained elevated throughout the entire follow-up period. CONCLUSION MI was associated with subsequent risk of cancer, driven by hematologic, obesity-, and smoking-related cancers in the short term and smoking-related cancers in the long term.
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Affiliation(s)
- Jens Sundbøll
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark; Department of Cardiology, Regional Hospital Gødstrup, Herning, Denmark.
| | - Katalin Veres
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Frederikke S Troelsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Morten Würtz
- Department of Cardiology, Regional Hospital Gødstrup, Herning, Denmark
| | - Hans Erik Bøtker
- Department of Clinical Medicine, Cardiology and Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus University, Aarhus, Denmark; Center for Population Medicine, Aarhus University Hospital, and Aarhus University, Aarhus, Denmark
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24
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Xin S, Wen M, Tian Y, Dong H, Wan Z, Jiang S, Meng F, Xiong Y, Han Y. Impact of histopathological subtypes on invasive lung adenocarcinoma: from epidemiology to tumour microenvironment to therapeutic strategies. World J Surg Oncol 2025; 23:66. [PMID: 40016762 PMCID: PMC11866629 DOI: 10.1186/s12957-025-03701-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Accepted: 02/02/2025] [Indexed: 03/01/2025] Open
Abstract
Lung adenocarcinoma is the most prevalent type of lung cancer, with invasive lung adenocarcinoma being the most common subtype. Screening and early treatment of high-risk individuals have improved survival; however, significant differences in prognosis still exist among patients at the same stage, especially in the early stages. Invasive lung adenocarcinoma has different histological morphologies and biological characteristics that can distinguish its prognosis. Notably, several studies have found that the pathological subtypes of invasive lung adenocarcinoma are closely associated with clinical treatment. This review summarised the distribution of various pathological subtypes of invasive lung adenocarcinoma in the population and their relationship with sex, smoking, imaging features, and other histological characteristics. We comprehensively analysed the genetic characteristics and biomarkers of the different pathological subtypes of invasive lung adenocarcinoma. Understanding the interaction between the pathological subtypes of invasive lung adenocarcinoma and the tumour microenvironment helps to reveal new therapeutic targets for lung adenocarcinoma. We also extensively reviewed the prognosis of various pathological subtypes and their effects on selecting surgical methods and adjuvant therapy and explored future treatment strategies.
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Affiliation(s)
- Shaowei Xin
- Department of Thoracic Surgery, Air Force Medical Center, Fourth Military Medical University, Beijing, China
- Department of Thoracic Surgery, 962 Hospital of the Joint Logistics Support Force, Harbin, China
| | - Miaomiao Wen
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yahui Tian
- Department of Thoracic Surgery, Air Force Medical Center, Fourth Military Medical University, Beijing, China
| | - Honghong Dong
- Department of Thoracic Surgery, Air Force Medical Center, Fourth Military Medical University, Beijing, China
| | - Zitong Wan
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
- College of Life Sciences, Northwestern University, Xi'an, 710069, China
| | - Suxin Jiang
- Department of Thoracic Surgery, Air Force Medical Center, Fourth Military Medical University, Beijing, China
| | - Fancheng Meng
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yanlu Xiong
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
- Innovation Center for Advanced Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
- Department of Thoracic Surgery, First Medical Center, Chinese PLA General Hospital and PLA Medical School, Beijing, China.
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Baqiao District, Shaanxi, , Xi'an, 710038, China.
| | - Yong Han
- Department of Thoracic Surgery, Air Force Medical Center, Fourth Military Medical University, Beijing, China.
- Department of Thoracic Surgery, Air Force Medical Center, Fourth Military Medical University, 30 Fucheng Road, Haidian District, Shaanxi, , Beijing, 100142, China.
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25
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Alwashmi ASS, Khan NU, Chen T. Risk-benefits assessment of tamoxifen or raloxifene as chemoprevention for risk reduction of breast cancer among BRCA1 and BRCA2 carriers: a meta-analysis. Sci Rep 2025; 15:6796. [PMID: 40000769 PMCID: PMC11861701 DOI: 10.1038/s41598-025-89915-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Accepted: 02/10/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Breast cancer is a major global health burden, with hereditary factors such as BRCA1/2 mutations significantly increasing the lifetime risk. This meta-analysis aimed to evaluate the outcomes of selective estrogen receptor modulators (SERMs), tamoxifen, and raloxifene as chemopreventive agents for breast cancer risk reduction in BRCA1/2 mutation carriers. METHODS A meta-analysis was conducted according to the PRISMA guidelines. PubMed, Cochrane Library, and MEDLINE databases were searched for relevant studies published between 2000 and 2024. Case-control studies and observational cohort studies examining the use of tamoxifen/raloxifene in BRCA1/2 carriers were included. Data on the incidence and risk ratios of breast cancer were also extracted. Quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was performed using Review Manager (version 5.4.0). RESULTS Nine studies (13,676 women) were included. Two studies had low risk, and the remaining seven studies had moderate risk, as assessed by the NOS checklist. Pooled analysis showed tamoxifen/raloxifene decreased breast cancer risk compared to controls (RR 0.80, 95% CI 0.72-0.88, p = 0.04). The risk ratio of breast cancer incidence among BRCA1/2 carriers was reduced after tamoxifen use (RR 1.82, 95% CI 1.48-2.23, p < 0.00001). Subgroup analysis revealed reduced breast cancer risk with SERM use in both BRCA1 (RR 1.51, 95% CI 1.48-1.51) and BRCA2 carriers (RR 1.48, 95% CI 1.40-1.58). The heterogeneity ranged from 51 to 85%, representing high significance and variation in true effect sizes underlying the different included studies. Whereas the heterogeneity among subgroups BRCA1 and BRCA2 was 98%, and the difference was 0%, showing no difference in response to SERM for risk reduction of breast cancer. CONCLUSION This meta-analysis provides evidence that tamoxifen and raloxifene significantly reduce the breast cancer risk in women with BRCA1/2 mutations. Chemoprevention efficacy was similar for both BRCA1 and BRCA2 carriers. Further research is needed to validate these findings and to optimize their use in high-risk populations.
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Affiliation(s)
- Ameen S S Alwashmi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Qassim, 51452, Saudi Arabia
| | - Najeeb Ullah Khan
- Institute of Biotechnology & Genetic Engineering (Health Division), The University of Agriculture, Peshawar, 25130, Pakistan.
| | - Tianhui Chen
- Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou, 310022, Zhejiang, China.
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Winterstein JT, Abels J, Kuehn A, Carl N, Wies C, Brinker TJ. AI-generated cancer prevention influencers can target risk groups on social media at low cost. Eur J Cancer 2025; 217:115251. [PMID: 39842364 DOI: 10.1016/j.ejca.2025.115251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2024] [Revised: 01/10/2025] [Accepted: 01/16/2025] [Indexed: 01/24/2025]
Abstract
BACKGROUND This study explores the potential of Artificial Intelligence (AI)-generated social media influencers to disseminate cancer prevention messages. Utilizing a Generative AI (GenAI) application, we created a virtual persona, "Wanda", to promote cancer awareness on Instagram. METHODS We created five posts, addressing the five most modifiable risk factors for cancer: tobacco consumption, unhealthy diet, sun exposure, alcohol consumption, and Human Papillomavirus (HPV) infection. To amplify the campaign's reach, posts were boosted using a custom-targeted as well as an automated advertisement algorithm. An overall budget of €100 was equally distributed between the two algorithms. Campaign performance was assessed based on the number of users reached and the age distribution of the audience. RESULTS The campaign achieved a total of 9902 recognitions, with a cost-efficiency analysis revealing an average expenditure of €0.013 per reach. The most economical intervention achieved a cost of only €0.006 per reach. In comparing the two advertisement strategies, we observed similar overall reach but noted differences in the age demographics of the audience. CONCLUSION Our findings underscore the potential of combining generative AI with strategically targeted advertisement to promote cancer prevention messages effectively, with minimal time and financial investment. We discuss chances presented by GenAI applications in health communication, their implication, and the impact of parasocial relationships on content perception. This study highlights the potential of AI-driven influencers as scalable tools for digital health communication.
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Affiliation(s)
- Jana T Winterstein
- Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany; Medical Faculty, University Heidelberg, Heidelberg, Germany
| | - Julia Abels
- Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Arlene Kuehn
- Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicolas Carl
- Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Christoph Wies
- Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany; Medical Faculty, University Heidelberg, Heidelberg, Germany
| | - Titus J Brinker
- Division of Digital Prevention, Diagnostics and Therapy Guidance, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Hou Y, Shao W, Wang Y, Yang H, Shao R, Lu Z. Association between cardiovascular health, cancer and its prognosis: A prospective cohort study. Public Health 2025; 242:1-6. [PMID: 39993354 DOI: 10.1016/j.puhe.2025.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 12/06/2024] [Accepted: 02/19/2025] [Indexed: 02/26/2025]
Abstract
OBJECTIVES Whether cardiovascular health (CVH) contributes to a reduced risk of cancer incidence and improves cancer prognosis remains unclear. This study aimed to evaluate the associations between CVH and risks of incident cancer and its subsequent CVD development and mortality. STUDY DESIGN Prospective cohort study. METHODS This study obtained data from the UK Biobank study. CVH was assessed based on Life's Essential 8 (LE8) metrics. The primary outcome was incident cancer, which was defined using ICD-10 code C00-C97, excluding nonmelanoma skin cancer. The hazard ratio and 95 % confidence intervals between CVH and risk of incident cancer and risk of CVD and death after diagnosis of cancer were assessed using multistate Markov and Cox proportional hazards regression models. CVD includes coronary heart disease, atrial fibrillation, heart failure and stroke. The median follow-up period was 12.7 years, and follow-up ended on December 1, 2022. RESULTS In total, 218,587 participants were eligible for analysis. During the follow-up, 27,603 (12.6 %) participants experienced incident cancer, 26,630 (12.2 %) experienced incident CVD and 12,399 (5.7 %) died. In fully-adjusted multi-state models, increased CVH scores were significantly associated with a reduced risk of incident cancer (HR per 10-point increment of CVH scores: 0.98, 95 % CI: 0.96-0.99), incident CVD (0.90, 0.89-0.91), and death (0.84, 0.81-0.87). Higher CVH scores were also associated with lower risks of incident CVD (0.90, 0.86-0.94) and death (0.89, 0.87-0.92) among cancer survivors. Notably, participants with a high Townsend deprivation index demonstrated the strongest associations of CVH with cancer and its prognosis, compared to those with low or intermediate levels of the index (P-for-interaction <0.05). CONCLUSIONS CVH is notably associated with the reduced risk of cancer and its subsequent development of CVD and death, which is more evident among participants with lower socioeconomic status. Our results highlight the potential of promoting LE8 adherence for primary and secondary prevention of cancer.
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Affiliation(s)
- Yabing Hou
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Department of Medical Information Technology and Management, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Weihao Shao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yueqing Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Ruitai Shao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zuolin Lu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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28
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He M, Gu R, Huang X, Zhao A, Tian S, Zheng Y. Global burden of colorectal cancer attributable to metabolic risks from 1990 to 2021, with projections of mortality to 2035. Int J Colorectal Dis 2025; 40:46. [PMID: 39969585 PMCID: PMC11839689 DOI: 10.1007/s00384-025-04817-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2025] [Indexed: 02/20/2025]
Abstract
BACKGROUND The global burden of colorectal cancer (CRC) attributable to metabolic risk factors is increasing. It is crucial to analyze the global epidemiological patterns of CRC attributable to metabolic risk factors and predict future trends. METHODS Detailed data on CRC mortality and disability-adjusted life years (DALYs) attributable to metabolic risk factors were extracted for this study using data from the Global Burden of Diseases (GBD) 2021 study to assess the burden of CRC from 1990 to 2021 by global, regional, national, and sociodemographic index (SDI) regions and quantify the time trend using the estimated annual percentage change (EAPC). Bayesian age-period-cohort (BAPC) models projected the global mortality from 2022 to 2035. RESULTS The global number of CRC deaths due to metabolic risk factors increased from 70,916 in 1990 to 172,993 in 2021, a 2.4-fold increase. CRC mortality and DALYs attributable to high body mass index (BMI) and fasting plasma glucose (FPG) increased significantly at the global level from 1990 to 2021. In 2021, the GBD regions with the highest CRC age-standardized mortality rate (ASMR) due to high BMI and high FPG were in Central Europe. The ASMR of CRC attributable to high BMI and high FPG among males is expected to increase from 2022 to 2035. CONCLUSION CRC mortality and DALYs attributable to metabolic factors are increasing. Reducing the burden of CRC due to high BMI and FPG levels is critically needed.
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Affiliation(s)
- Maolang He
- Department of Gastroenterology, The First Affiliated Hospital of Shihezi University, Shihezi, 832008, China
| | - Ruru Gu
- Department of Gastroenterology, The First Affiliated Hospital of Shihezi University, Shihezi, 832008, China
| | - Xin Huang
- School of Medicine, Shihezi University, Shihezi, 832002, China
| | - Aifang Zhao
- School of Medicine, Shihezi University, Shihezi, 832002, China
| | - Shuxin Tian
- Department of Gastroenterology, The First Affiliated Hospital of Shihezi University, Shihezi, 832008, China.
| | - Yong Zheng
- Department of Gastroenterology, The First Affiliated Hospital of Shihezi University, Shihezi, 832008, China.
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Farì R, Besutti G, Pattacini P, Ligabue G, Piroli F, Mantovani F, Navazio A, Larocca M, Pinto C, Giorgi Rossi P, Tarantini L. The role of imaging in defining cardiovascular risk to help cancer patient management: a scoping review. Insights Imaging 2025; 16:37. [PMID: 39961941 PMCID: PMC11832977 DOI: 10.1186/s13244-025-01907-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 01/13/2025] [Indexed: 02/20/2025] Open
Abstract
OBJECTIVE This scoping review explores the potential role of cancer-staging chest CT scans in assessing cardiovascular (CV) risk in cancer patients. It aims to evaluate: (1) the correlation between non-gated chest CT and the conventional Agatston score from cardiac CT; (2) the association between coronary calcium scores from non-gated chest CT and CV risk in non-oncological patients; (3) the link between coronary calcium assessed by non-gated chest CT and CV events or endothelial damage in cancer patients. METHODS Three different searches were performed on PubMed, according to the three steps described above. Both original articles and systematic reviews were included. RESULTS Many studies in the literature have found a strong correlation between coronary calcium scores from non-gated chest CTs and the conventional Agatston scores from gated cardiac CTs. Various methodologies, including Agatston scoring, ordinal scoring, and the "extent" and "length" methods, have been successfully adapted for use with non-gated chest CTs. Studies show that non-gated scans, even those using iodinated contrast, can accurately assess coronary calcification and predict CV risk, with correlations as high as r = 0.94 when compared to cardiac CTs. In oncological settings, studies demonstrated a significant link between coronary calcium levels on non-gated chest CTs and higher CV risk, including MACE and overall mortality. CONCLUSIONS Radiological assessment of coronary calcium on non-gated CT scans shows potential for improving CV risk prediction. CRITICAL RELEVANCE STATEMENT Non-gated chest CT scans can detect endothelial damage in cancer patients, highlighting the need for standardized radiological practices to assess CV risks during routine oncological follow-up, thereby enhancing radiology's role in comprehensive cancer care. KEY POINTS Cancer therapies improve outcomes but increase cardiovascular risk, requiring balanced management. Coronary calcification on non-gated CT correlates with Agatston scores, predicting cardiovascular risk. Routinely performed CTs predict cardiovascular risk, optimizing the management of cancer patients.
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Affiliation(s)
- Roberto Farì
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Giulia Besutti
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Pierpaolo Pattacini
- Radiology Unit, Department of Diagnostic Imaging and Laboratory Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Guido Ligabue
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Piroli
- Cardiology Unit, Department of Specialized Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Mantovani
- Cardiology Unit, Department of Specialized Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandro Navazio
- Cardiology Unit, Department of Specialized Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mario Larocca
- Oncology Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Carmine Pinto
- Oncology Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Luigi Tarantini
- Cardiology Unit, Department of Specialized Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Ghanem AS, Faludi EV, Bata R, Mezei E, Hadar V, Móré M, Tóth Á, Nagy AC. Cancer prevalence and its determinants in Hungary: Analyzing data from the 2009, 2014, and 2019 European Health Interview Surveys. PLoS One 2025; 20:e0315689. [PMID: 39946492 PMCID: PMC11825095 DOI: 10.1371/journal.pone.0315689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 11/29/2024] [Indexed: 02/17/2025] Open
Abstract
Background and aim Hungary has the fifth highest cancer incidence rate in the European Union, with an age-standardized rate (ASR) of 336.7 per 100,000 according to GLOBOCAN 2022. Additionally, Hungary holds the highest cancer mortality rate in the EU, with an ASR of 148.1 per 100,000. This study aimed to investigate the sociodemographic, lifestyle, and chronic disease-related factors affecting cancer prevalence in the Hungarian population. Materials and methods Data from the 2009, 2014, and 2019 installments of the European Health Interview Survey conducted in Hungary were pooled, resulting in a representative sample of 16,480 individuals. Weighted multiple logistic regression models were used to analyze the data, with goodness of fit assessed using the Hosmer-Lemeshow test. The best-fitting models were further evaluated using ROC analysis to calculate the Area Under the Curve (AUC) to assess discriminative ability. Results Urban residency was associated with higher cancer odds in 2014 (OR 1.85 [CI: 1.08-3.16]) and the pooled data (OR 1.44 [CI: 1.08-1.9]). Employed individuals had lower odds of cancer (2014: OR 0.34 [CI: 0.16-0.74]; pooled: OR 0.64 [CI: 0.45-0.92]). Among comorbid conditions, peptic ulcer (2009: OR 1.74 [CI: 1.13-2.69]; 2019: OR 3.2 [CI: 1.58-6.47]; pooled: OR 1.83 [CI: 1.31-2.54]) and chronic liver disease (2009: OR 3.52 [CI: 1.73-7.17]; pooled: OR 2.5 [CI: 1.4-4.47]) were significantly associated with higher cancer odds. Reporting bad health was linked to increased cancer risk (2009: OR 2.92 [CI: 1.87-4.58]; 2014: OR 5.52 [CI: 3.23-9.45]; 2019: OR 2.23 [CI: 1.26-3.95]). Conclusion Comorbid conditions such as peptic ulcer and chronic liver disease significantly increase cancer risk in Hungary. Urban residents require targeted preventive measures, and unemployment should be addressed. Early detection through appropriate screening and effective management of comorbid conditions are essential to prevent escalation and reduce overall cancer prevalence.
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Affiliation(s)
- Amr Sayed Ghanem
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Eszter Vargáné Faludi
- Department of Integrative Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Róbert Bata
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Emese Mezei
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Vanessza Hadar
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Marianna Móré
- Institute of Social and Sociological Sciences, Faculty of Health Sciences, University of Debrecen, Nyíregyháza, Hungary
| | - Ágnes Tóth
- Department of Integrative Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Attila Csaba Nagy
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
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Du H, Wang X, Wang K, Ai Q, Shen J, Zhu R, Wu J. Identifying invasiveness to aid lung adenocarcinoma diagnosis using deep learning and pathomics. Sci Rep 2025; 15:4913. [PMID: 39929860 PMCID: PMC11810995 DOI: 10.1038/s41598-025-87094-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2024] [Accepted: 01/16/2025] [Indexed: 02/13/2025] Open
Abstract
Most classification efforts for primary subtypes of lung adenocarcinoma (LUAD) have not yet been integrated into clinical practice. This study explores the feasibility of combining deep learning and pathomics to identify tumor invasiveness in LUAD patients, highlighting its potential clinical value in assisting junior and intermediate pathologists. We retrospectively analyzed whole slide image (WSI) data from 289 patients with surgically resected ground-glass nodules (GGNs). First, three ResNet deep learning models were used to identify tumor regions. Second, features from the best-performing model were extracted to build pathomics using machine learning classifiers. Third, the accuracy of pathomics in predicting tumor invasiveness was compared with junior and intermediate pathologists' diagnoses. Performance was evaluated using the area under receiver operator characteristic curve (AUC). On the test cohort, ResNet18 achieved the highest AUC (0.956) and sensitivity (0.832) in identifying tumor areas, with an accuracy of 0.904; Random Forest provided high accuracy and AUC values of 0.814 and 0.807 in assessing tumor invasiveness. Pathology assistance improved diagnostic accuracy for junior and intermediate pathologists, with AUC values increasing from 0.547 to 0.759 and 0.656 to 0.769. This study suggests that deep learning and pathomics can enhance diagnostic accuracy, offering valuable support to pathologists.
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Affiliation(s)
- Hai Du
- Department of Radiology, Ordos Central Hospital, Ordos Inner Mongolia, China
| | - Xiulin Wang
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
- Dalian Innovation Institute of Stem Cell and Precision Medicine, Dalian, Liaoning, China
| | - Kaifeng Wang
- Fujian Medical University, Fuzhou, Fujian, China
| | - Qi Ai
- Department of Radiology, Affiliated Xinhua Hospital of Dalian University, Dalian, Liaoning, China
| | - Jing Shen
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Ruiping Zhu
- Department of Pathology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China.
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Qiao Z, Xiong J, Zhang S, Chen L, Wang J, Chen R. A comparative analysis of global and Chinese trends in the burden of kidney cancer from 1990 to 2021. Sci Rep 2025; 15:4558. [PMID: 39915578 PMCID: PMC11802867 DOI: 10.1038/s41598-025-88682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 01/30/2025] [Indexed: 02/09/2025] Open
Abstract
Kidney cancer, a prevalent malignant tumor in the urinary system, poses a significant disease burden and remains a crucial public health concern. Utilizing GBD(Global Burden of Disease)2021 data, our study examined the standardized incidence, mortality, prevalence, and DALYs(Disability Adjusted Life Years) rate of renal cancer. We calculated the [1-MIR(Mortality to Incidence Ratio)] value to assess treatment outcomes and survival rates, employed a joinpoint regression model to determine the AAPC(Average Annual Percentage Change), and conducted comparative and longitudinal analyses between China and global trends. The SII(Slope Index of Inequality) and the CI(Concentration Index) were used to assess the DALYs inequality caused by kidney cancer, and the SDI(Socio-demographic Index) was used as the basis for the ranking. Through the joinpoint regression model, we calculated the AAPC and conducted a comprehensive analysis of the disease burden of kidney cancer, evaluating its current status and changing trends. From 1990 to 2021, the age-standardized incidence rate, age-standardized mortality rate, age-standardized prevalence rate, and age-standardized DALYs rate of kidney cancer in China were lower than those the global average. However, the growth rate in China was significantly faster than the global average. The age-standardized incidence rate and prevalence rate of kidney cancer in males showed a greater increase compared to females, both in China and globally. Additionally, the age-standardized rate of kidney cancer in males was notably higher than in females, particularly among middle-aged males. The (1-MIR) of renal cancer increased from 0.36 to 0.62 in China and from 0.49 to 0.58 globally. Overall, the treatment effect of renal cancer has shown some successful outcomes. The SII decreased from 53.47 to 50.19, and the CI decreased from 0.342 to 0.289. The health inequality level of kidney cancer was significant but alleviated. From 1990 to 2021, there was a noticeable increase in the global incidence of kidney cancer. Specifically, the standardized incidence and prevalence of kidney cancer in the Chinese population saw a more rapid rise compared to the global average. Additionally, the disease burden of kidney cancer remained significantly higher in males than in females.
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Affiliation(s)
- Zhongli Qiao
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, China
| | - Jun Xiong
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, China.
| | - Shenyu Zhang
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, China
| | - Lin Chen
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, China
| | - Jialin Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, China
| | - Runze Chen
- School of Public Health, Hangzhou Normal University, Hangzhou, 311121, China
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Liu FY, Liu X, Ding DN, Liu SX, Xu J, Zhao YX, Wang YH, Han FJ. Optimizing the Future: A Game Theory to Tumor Therapeutic Strategies. Biol Proced Online 2025; 27:6. [PMID: 39915726 PMCID: PMC11800618 DOI: 10.1186/s12575-025-00264-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Accepted: 01/20/2025] [Indexed: 02/11/2025] Open
Abstract
BACKGROUND Cancer poses significant economic and societal burdens on countries in the coming decades. During chemotherapy, patients frequently encounter adverse reactions. Recent research has revealed that Chinese medicine plays a crucial role in mitigating the side effects of chemotherapy. Therefore, in this article, we propose that the cancer treatment process can be likened to an unequal game. To refine treatment strategies, we suggest employing the Steinberg model to incorporate Chinese medicine into the chemotherapy regimen for tumor treatment. RESULTS We found that when malignant tumors exhibit vigorous proliferation, doctors should administer Chinese medicine in conjunction with chemotherapy drugs, continuously optimizing the therapeutic effect of the Chinese medicine. Upon reaching a specific threshold in the treatment effect of the Chinese medicine, doctors may appropriately augment the dosage of chemotherapy drugs, building upon the initial regimen. Conversely, in cases where the proliferation ability of malignant tumors is weak, the dosage of chemotherapy and the adjuvant therapy with Chinese medicine should be kept in a relatively balanced state. Once the effect of the Chinese medicine attains a particular threshold, the dosage of chemotherapy can be concurrently increased to achieve a superior therapeutic result. CONCLUSIONS From a game theory perspective, doctors can devise strategies to minimize drug toxicity and improve tumor treatment outcomes by coordinating the use of chemotherapy drugs with appropriate adjustments to Chinese medicine therapy methods.
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Affiliation(s)
- Fang-Yuan Liu
- Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Xin Liu
- Harbin Institute of Technology, Harbin, 150001, China
| | - Dan-Ni Ding
- Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Shao-Xuan Liu
- Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Jing Xu
- Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Yu-Xin Zhao
- Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Yan-Hong Wang
- First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
| | - Feng-Juan Han
- First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
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Massari S, Bauleo L, Gariazzo C, Michelozzi P, Bardi LD, Zengarini N, Maio S, Stafoggia M, Davoli M, Viegi G, Cesaroni G, Marinaccio A. Cancer mortality and sectors of employment: a cohort study in Italy. BMC Public Health 2025; 25:458. [PMID: 39910412 PMCID: PMC11796278 DOI: 10.1186/s12889-025-21328-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 01/03/2025] [Indexed: 02/07/2025] Open
Abstract
BACKGROUND Cancer is a multifactorial disease. The large impact of occupational exposure on the burden of cancer continues to be a paramount public health concern that deserves more attention. The study aims to evaluate cancer-specific mortality risk in relation to sectors of employment. METHODS We used a cohort from the Rome Longitudinal Study (ROL) and linked it with the National Social Insurance Agency (INPS) database to obtain working histories. We considered the longest duration of employment in a sector as a proxy of exposure, and insurance activities as the reference category. A Cox regression adjusted model was used to examine the associations between cancer-specific causes of death and the sector of employment in men and women. A similar analysis was performed considering the length of employment (≤ 10 years versus ≥ 10 years). RESULTS The study population comprised 910,559 (52% of the total population of the cohort after linkage with INPS) 30 + yr employees (53% men and 47% women) followed for a total period of approximately 7 million years. The outcomes confirmed some well-known associations (e.g. lung and pleura in construction, pleura in paper and printing, and lung in wood and leather) and suggested possible high-risk sectors that have not yet been thoroughly investigated. In men we observed an increased mortality risk for stomach cancer in the printing and paper industry (HR = 1.69, 95% CI:1.11-2.57) as well as for stomach and lung cancer in cleaning activities (HR = 1.98, 95% CI:1.13-3.49 and HR = 1.55, 95% CI:1.22-1.98, respectively). Among women, there was an elevated mortality risk in the cleaning industry for all malignant cancers (HR = 1.15, 95% CI:1.03-1.29), liver cancer (HR = 1.94, 95% CI:1.08-3.48) and cancer of the lympho-hematopoietic tissue (HR = 1.65, 95% CI:1.09-2.50). CONCLUSIONS The results showed an increased risk of cancer death in some traditional industrial sectors compared to the reference category of insurance activities such as construction and wood and leather products and limited evidence in sectors like cleaning, accommodation and food services and hairdressing. The adopted method proved to be effective in monitoring occupational risks and activating proper prevention initiatives and further insights.
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Affiliation(s)
- Stefania Massari
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene - Italian National Institute for Insurance against Accidents at Work (Inail), Via Stefano Gradi 55, Rome, 00143, Italy.
| | - Lisa Bauleo
- Department of Environment and Health, Italian National Institute of Health, Rome, Italy
| | - Claudio Gariazzo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene - Italian National Institute for Insurance against Accidents at Work (Inail), Via Stefano Gradi 55, Rome, 00143, Italy
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Luca Dei Bardi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
- Department of Statistical Sciences, Sapienza University of Rome, Rome, 00185, Italy
- Helsinki Institute for Demography and Population Health, University of Helsinki, Helsinki, Finland
- Max Planck, University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland
| | | | - Sara Maio
- Institute of Clinical Physiology, National Research Council (CNR), Pisa, 56124, Italy
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Giovanni Viegi
- Institute of Clinical Physiology, National Research Council (CNR), Pisa, 56124, Italy
- Institute of Translational Pharmacology, National Research Council (CNR), Palermo, 90146, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene - Italian National Institute for Insurance against Accidents at Work (Inail), Via Stefano Gradi 55, Rome, 00143, Italy
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Liang M, Zhang Z, Wu L, Chen M, Tan S, Huang J. Evolving prognostic paradigms in lung adenocarcinoma with brain metastases: a web-based predictive model enhanced by machine learning. Discov Oncol 2025; 16:117. [PMID: 39904937 PMCID: PMC11794753 DOI: 10.1007/s12672-025-01854-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 01/24/2025] [Indexed: 02/06/2025] Open
Abstract
INTRODUCTION Patients with lung adenocarcinoma (LUAD) who develop brain metastases (BM) face significantly poor prognoses. A well-crafted prognostic model could greatly assist clinicians in patient counseling and in devising tailored therapeutic strategies. METHODS The study cohort comprised LUAD patients with BM identified from the surveillance, epidemiology, and end results database between 2000 and 2018. We pinpointed independent prognostic features for overall survival (OS) using Lasso regression analyses. Predictive models were built using Random Forest, XGBoost, Decision Trees, and Artificial Neural Networks, with their performance evaluated via metrics including the area under the receiver operating characteristic curve (AUC), calibration plots, brier score, and decision curve analysis (DCA). RESULTS We extracted a total of 9121 eligible patients from the database, identifying eleven clinical parameters that significantly influenced OS prognostication. The XGBoost model exhibited superior discriminative power, achieving AUC values of 0.829 and 0.827 for 1- and 2-year survival, respectively, in the training cohort, and 0.816 and 0.809 in the validation cohort. In comparison to other models, the XGBoost model excelled in both training and validation phases, as demonstrated by substantial differences in AUC, DCA, calibration, and Brier score. This model has been made accessible via a web-based platform. CONCLUSIONS This study has developed an XGBoost-based machine learning model with an accompanying web-based application, providing a novel resource for clinicians to support personalized decision-making and enhance treatment outcomes for LUAD patients with BM.
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Affiliation(s)
- Min Liang
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, Maoming, China
| | - Zhiwen Zhang
- Emergency Department, Maoming People's Hospital, Maoming, China
| | - Langming Wu
- Department of Science and Education, Maoming People's Hospital, Maoming, China
| | - Mafeng Chen
- Department of Otolaryngology, Maoming People's Hospital, Maoming, China
| | - Shifan Tan
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, Maoming, China.
| | - Jian Huang
- Department of Thoracic Surgery, Maoming People's Hospital, Maoming, China.
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Liu Y, Li L, Chen Z, Ren S, He R, Liang Y, Tan Y, Shao X, Chen S, Chen X, Tang J, Liao Y. Relationship between parental smoking and adolescent smoking: gender differences and mediation of resilience. BMC Public Health 2025; 25:434. [PMID: 39901135 PMCID: PMC11792306 DOI: 10.1186/s12889-025-21457-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/14/2025] [Indexed: 02/05/2025] Open
Abstract
BACKGROUND Though the relationship between parental smoking and adolescent smoking has been established, gender differences, and mediation of resilience in this relationship are poorly understood. This research aims to investigate the prevalence of adolescent smoking, and to understand how consequences may differ for boys and girls, as well as to explore what role resilience played in this relationship. METHODS Through the school-based cross-sectional survey, a total of 65,898 adolescents were involved in this study, and information were collected by self-reported questionnaire. Participants' smoking status and their parental smoking status were collected by self-made questionnaire, and resilience was assessed by the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). The multivariate logistic regression was conducted to explore the relationship between parental smoking and adolescent smoking. After that, the path analysis was applied to explore the mediation of resilience in this relationship. RESULTS Of all participants, the rate of self-report current smoking and biologically verified smoking was 1.4% and 2.0%, respectively. Both self-reported and biologically verified prevalence of smoking among boys were higher than that in girls. There were gender differences in the impact of parental smoking on adolescent smoking: mother smoking had a negative effect on adolescent smoking, and resilience could mitigate this negative effect. Father smoking had no association with girl smoking, while father smoking was positively associated with boy smoking, and resilience was mediated in this association. CONCLUSIONS Our findings suggested smoking prevention in adolescents can be done differently for different genders. Besides, results indicated resilience was important in preventing adolescent smoking. Furthermore, parents quitting smoking can play an important role in preventing adolescent smoking to a certain extent.
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Affiliation(s)
- Yi Liu
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
- Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China, Chengdu, China
| | - Ling Li
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Zhangming Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Silan Ren
- Department of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China
| | - Ruini He
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Yudiao Liang
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Youguo Tan
- Department of Psychiatry, Zigong Mental Health Center, Zigong, Sichuan, China
| | - Xu Shao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Shanshan Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Xiaogang Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China.
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Semprini J, Saulsberry L, Olopade OI. Socioeconomic and Geographic Differences in Mammography Trends Following the 2009 USPSTF Policy Update. JAMA Netw Open 2025; 8:e2458141. [PMID: 39908017 PMCID: PMC11800017 DOI: 10.1001/jamanetworkopen.2024.58141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Accepted: 11/29/2024] [Indexed: 02/06/2025] Open
Abstract
Importance In 2024, the US Preventive Services Task Force (USPSTF) reversed a 2009 policy recommending only females aged 50 to 74 years complete a biennial mammogram. Understanding whether females facing heterogeneous breast cancer risks responded to the 2009 guidance may illuminate how they may respond to the latest policy update. Objective To evaluate whether the 2009 policy was associated with changes in mammography screening in females no longer recommended to complete a biennial mammogram and whether these changes varied by factors associated with breast cancer risk. Design, Setting, and Participants The difference-in-differences design compared biennial mammogram trends in the exposed groups (aged 40-49 and ≥75 years) with trends of the unexposed groups (aged 50-64 and 65-74 years), before and after the 2009 update. Population-based, repeated cross-sectional survey data came from the Behavioral Risk Factor Surveillance System (BRFSS) biennial cancer screening module (2000-2018). The sample was restricted to females between ages 40 and 84 years. Data were analyzed from March 1 to June 30, 2024. Main Outcomes and Measures The outcome was a binary variable indicating whether the respondent reported a mammogram in the past 2 years (biennial). After 2009, females aged 40 to 49 and 75 or older years were exposed to the policy update, as a complete biennial mammogram was recommended. Subgroup analyses included race and ethnicity, educational level, household income, smoking history, current binge drinking status, and state of residence. Results The sample included 1 594 834 females; 75% reported a biennial mammogram. In those aged 40 to 49 years, the USPSTF update was associated with a 1.1 percentage-point (95% CI, -1.8% to -0.3 percentage points) decrease in the probability of a biennial mammogram, with the largest decreases in the non-Hispanic Black population (-3.0 percentage points; 95% CI, -5.5% to -0.5 percentage points). In the aged 75 years or older group, the USPSTF update was associated with a 4.8 percentage-point decrease (95% CI, -6.3% to -3.5 percentage points) in the probability of a biennial mammogram, with significant heterogeneity by race and ethnicity, binge drinking status, and state residence. Conclusions and Relevance In this study, socioeconomic factors were associated with differences in how females responded to the 2009 USPSTF mammography recommendation. Whether the 2024 update considered such differences is unclear. These findings suggest that including risk assessment into future USPSTF policy updates may improve adoption of risk-reducing interventions and shorten the time to diagnosis and treatment for high-risk patients.
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Affiliation(s)
- Jason Semprini
- Department of Public Health, Des Moines University College of Health Sciences, West Des Moines, Iowa
| | - Loren Saulsberry
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois
| | - Olufunmilayo I. Olopade
- Section of Hematology/Oncology, Department of Medicine, University of Chicago Medicine Comprehensive Cancer Center, Chicago, Illinois
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Danpanichkul P, Suparan K, Auttapracha T, Tothanarungroj P, Kongarin S, Rakwong K, Tan DJH, Sukphutanan B, Muthiah MD, Tung D, Luo J, Morishita A, Tan EY, Takahashi H, Mousa OY, Lui RN, Noureddin M, Kim D, Harnois DM, Yang JD, Roberts LR, Wallace MB, Wijarnpreecha K. Early-Onset Gastrointestinal Cancers and Metabolic Risk Factors: Global Trends From the Global Burden of Disease Study 2021. Mayo Clin Proc 2025. [DOI: 10.1016/j.mayocp.2024.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2025]
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Danpanichkul P, Suparan K, Chaiyakunapruk N, Auttapracha T, Kongarin S, Wattanachayakul P, Ramadoss V, Suenghataiphorn T, Sukphutanan B, Pang Y, Lui RN, Yang JD, Noureddin M, Díaz LA, Liangpunsakul S, Arab JP, Wijarnpreecha K. Alcohol-related liver and extrahepatic malignancies: burden of disease and socioeconomic disparities in 2019. Eur J Gastroenterol Hepatol 2025; 37:198-206. [PMID: 39589794 DOI: 10.1097/meg.0000000000002882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2024]
Abstract
BACKGROUND Alcohol is linked to various cancers. While many studies have focused on developed countries, the burden of alcohol-related cancers in developing countries remains underexplored. METHODS We analyzed data from the Global Burden of Disease Study (2000-2019) to assess mortality and disability-adjusted life years (DALYs) from alcohol-related cancers in low and low-to-middle sociodemographic index (SDI) countries. RESULTS In 2019, there were 494 730 mortality from alcohol-related cancer. Low and low-middle SDI countries contributed over 15% of global mortality of alcohol-related cancer. Among multiple types of cancer, other pharyngeal cancers in these countries accounted for over 30% of global mortality of alcohol-related cancer. Primary liver cancer exhibited the highest mortality ( n = 16 090) in low and low-middle SDI countries. While deaths and DALYs rates from alcohol-related cancers decreased globally between 2000 and 2019, the related burden increased in low and low-middle SDI countries with a rise in all types of alcohol-related cancers, except for primary liver cancer. The most rapidly growing mortality rates in low SDI were from other pharyngeal cancers (+2.25%), whereas in low-middle SDI countries, colorectal cancer evidenced the highest increase (+2.76%). CONCLUSION The burden from alcohol-related cancer has risen in countries with low and low-to-middle SDI, especially other pharyngeal cancers and colorectal cancer. Policymakers should focus on improving alcohol-related policies as well as screening availability to tackle the associated burden of cancer in resource-constrained countries. However, the difficulty in isolating the impact of alcohol due to limited data on other confounders necessitates caution in interpreting these findings.
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Affiliation(s)
- Pojsakorn Danpanichkul
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Kanokphong Suparan
- Immunology Unit, Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA
| | | | | | | | - Vijay Ramadoss
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore, Singapore
| | | | | | - Yanfang Pang
- Affiliated Hospital of Youjiang Medical University for Nationalities
- National Immunological Laboratory of Traditional Chinese Medicine
- Center for Medical Laboratory Science, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Rashid N Lui
- Department of Clinical Oncology, and Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Institute of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ju Dong Yang
- Karsh Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Mazen Noureddin
- Houston Research Institute and Houston Methodist Hospital, Houston, Texas, USA
| | - Luis Antonio Díaz
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
| | - Suthat Liangpunsakul
- Division of Gastroenterology and Hepatology, Department of Medicine
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine
- Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
| | - Juan Pablo Arab
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine
- Department of Internal Medicine, Banner University Medical Center
- BIO5 Institute, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
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Li Y, Huang Y, Huang H, Wei T, Zhang A, Xing L, Yin X, Li H, Ren G, Li F. Global, regional, and national burden of male breast cancer in 204 countries and territories: a systematic analysis from the global burden of disease study, 1990-2021. EClinicalMedicine 2025; 80:103027. [PMID: 39831130 PMCID: PMC11741047 DOI: 10.1016/j.eclinm.2024.103027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Revised: 12/09/2024] [Accepted: 12/12/2024] [Indexed: 01/03/2025] Open
Abstract
Background Male breast cancer (MBC) is a rare malignancy that has been under-investigated, with limited global epidemiological research dedicated to it. A comprehensive estimate of the global, regional, and national burden of MBC is valuable for policy planning. This study aims to evaluate the burden of MBC across 204 countries and territories. Methods MBC data were collected from the 2021 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates spanning from 1990 to 2021. The global incidence, prevalence, deaths, and disability-adjusted life-years (DALYs) attributed to MBC, as well as corresponding age-standardized rates, were calculated. Temporal trends, projections of incidence and mortality to 2050, lifetime risk, and risk factors of MBC were also estimated according to regions and countries. Findings In 2021, there were 38,827 (95% uncertainty interval [UI], 24,650-47,846) new cases, 320,459 (95% UI, 220,533-384,317) prevalent cases, 13,274 (95% UI, 9074-16,240) deaths, and 380,917 (95% UI, 252,922-476,417) DALYs attributed to MBC worldwide, with the highest disease burden observed in the Eastern Sub-Saharan Africa region. From 1990 to 2021, the age-standardized incidence and mortality rates of MBC significantly increased, but they are projected to decrease over the next 30 years. High-middle Socio-demographic Index (SDI) quintile had the highest lifetime risk of developing MBC, while the low SDI quintile had the highest lifetime risk of dying from MBC. Dietary risk and alcohol use were identified as important risk factors for MBC deaths and DALYs globally. Interpretation The global burden of MBC significantly increased from 1990 to 2021, with notable geographic disparities. Efforts aimed at MBC prevention and control strategies should take into account the inequities in its global distribution. Funding This study was supported by the National Natural Science Foundation of China (grant numbers 82372996 and 82202913) and the Chongqing Natural Science Foundation (grant number CSTB2023NSCQ-MSX0480).
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Affiliation(s)
- Yunhai Li
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Ying Huang
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Hongbo Huang
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Tingting Wei
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Aijie Zhang
- Health Management Center, University-Town Hospital Affiliated to Chongqing Medical University, Chongqing, China
| | - Lei Xing
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xuedong Yin
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Hongyuan Li
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Guosheng Ren
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fan Li
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
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Li H, Bao Y, He J, Yu H, Tian C, Zhou X, Liang C, Liu S. Chitosan-based dihydromyricetin composite hydrogel demonstrating sustained release and exceptional antibacterial activity. Int J Biol Macromol 2025; 291:139128. [PMID: 39725105 DOI: 10.1016/j.ijbiomac.2024.139128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 12/06/2024] [Accepted: 12/22/2024] [Indexed: 12/28/2024]
Abstract
Plant-derived antibacterial agents are increasingly pivotal in mitigating the escalating threat posed by pathogenic microorganisms. Dihydromyricetin (DMY), a plant bioactive compound prevalent in Ampelopsis grossedentata, exhibits remarkable antibacterial properties. However, its poor solubility in water significantly hinders its application in antibacterial therapies, necessitating the exploration of suitable carriers for the loading and sustained release of DMY. In this study, a chitosan-based hydrogel was rapidly synthesized at 25 °C using carboxymethyl chitosan and sodium alginate as precursors, and then utilized for the encapsulation of DMY. The as-prepared hydrogel was characterized using scanning electron microscopy, Fourier-transform infrared spectroscopy, and thermogravimetric analysis, indicating its favorable swelling properties, injectability, transparency, and self-healing capabilities. Antibacterial assays demonstrated that both surface and internal of the hydrogel exhibited over 99 % inhibition against both Pseudomonas aeruginosa and Staphylococcus aureus when the DMY loading concentration reached 0.4 mg/mL. Furthermore, drug release studies demonstrated that the hydrogel effectively sustained the release of DMY for up to 130 h, irrespective of the acidic or alkaline aqueous solutions, as well as in phosphate-buffered saline. These findings provide novel insights and references for the synergistic antibacterial application of plant-derived agents in conjunction with hydrogels.
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Affiliation(s)
- Huanhuan Li
- Key Laboratory of Hunan Forest Products and Chemical Industry Engineering, National and Local United Engineering Laboratory of Integrative Utilization of Eucommia ulmoides, Jishou University, Zhangjiajie 427000, China; College of Chemistry and Chemical Engineering, Jishou University, Jishou 416000, China
| | - Yunhui Bao
- Key Laboratory of Hunan Forest Products and Chemical Industry Engineering, National and Local United Engineering Laboratory of Integrative Utilization of Eucommia ulmoides, Jishou University, Zhangjiajie 427000, China; Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, International Innovation Center for Forest Chemicals and Materials, College of Materials Science and Engineering, Nanjing Forestry University, Nanjing 210037, China
| | - Jian He
- Key Laboratory of Hunan Forest Products and Chemical Industry Engineering, National and Local United Engineering Laboratory of Integrative Utilization of Eucommia ulmoides, Jishou University, Zhangjiajie 427000, China; College of Chemistry and Chemical Engineering, Jishou University, Jishou 416000, China
| | - Huazhong Yu
- Key Laboratory of Hunan Forest Products and Chemical Industry Engineering, National and Local United Engineering Laboratory of Integrative Utilization of Eucommia ulmoides, Jishou University, Zhangjiajie 427000, China; College of Chemistry and Chemical Engineering, Jishou University, Jishou 416000, China
| | - Chunlian Tian
- Key Laboratory of Hunan Forest Products and Chemical Industry Engineering, National and Local United Engineering Laboratory of Integrative Utilization of Eucommia ulmoides, Jishou University, Zhangjiajie 427000, China
| | - Xianwu Zhou
- Key Laboratory of Hunan Forest Products and Chemical Industry Engineering, National and Local United Engineering Laboratory of Integrative Utilization of Eucommia ulmoides, Jishou University, Zhangjiajie 427000, China; College of Chemistry and Chemical Engineering, Jishou University, Jishou 416000, China
| | - Chengwei Liang
- Key Laboratory of Hunan Forest Products and Chemical Industry Engineering, National and Local United Engineering Laboratory of Integrative Utilization of Eucommia ulmoides, Jishou University, Zhangjiajie 427000, China; College of Chemistry and Chemical Engineering, Jishou University, Jishou 416000, China
| | - Shima Liu
- Key Laboratory of Hunan Forest Products and Chemical Industry Engineering, National and Local United Engineering Laboratory of Integrative Utilization of Eucommia ulmoides, Jishou University, Zhangjiajie 427000, China; College of Chemistry and Chemical Engineering, Jishou University, Jishou 416000, China.
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Diao X, Guo C, Jin Y, Li B, Gao X, Du X, Chen Z, Jo M, Zeng Y, Ding C, Liu W, Guo J, Li S, Qiu H. Cancer situation in China: an analysis based on the global epidemiological data released in 2024. Cancer Commun (Lond) 2025; 45:178-197. [PMID: 39659114 PMCID: PMC11833671 DOI: 10.1002/cac2.12627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 10/26/2024] [Accepted: 10/31/2024] [Indexed: 12/12/2024] Open
Abstract
BACKGROUND Cancer remains a major cause of mortality and a significant economic burden in China. Exploring the disparities in cancer patterns and control strategies between China and developed countries may offer valuable insights for policy formulation and enhance cancer management efforts. This study examined the incidence, mortality, and disability-adjusted life year (DALY) burden of cancer in China, and compared these metrics with those observed in the United States (US) and the United Kingdom (UK). METHODS Data on cancer incidence, mortality, and DALYs for China, the US, and the UK were sourced from the GLOBOCAN 2022 online database and the Global Burden of Disease 2021 study (GBD 2021). We utilized Joinpoint regression models to analyze trends in cancer incidence and mortality across these countries, calculating annual percent changes (APCs) and determining the optimal joinpoints. RESULTS In 2022, China recorded around 4,824,703 new cancer cases and 2,574,176 cancer-related deaths, contributing to 71,037,170 DALYs. China exhibited a lower cancer incidence rate compared to the US and the UK. Although cancer-related mortality in China is slightly lower than that in the UK, it is significantly higher than that in the US. Additionally, China experienced significantly higher DALY rates compared to both the US and UK. The cancer landscape in China was also undergoing significant changes, with a rapid rise in the incidence and burden of lung, colorectal, breast, cervical, and prostate cancers. Meanwhile, the incidence and burden of stomach cancer continued to decline. Although the incidence of liver and esophageal cancers was decreasing, the burden of liver cancer was increasing, while the burden of esophageal cancer remained largely unchanged. CONCLUSIONS The cancer profile of China is shifting from that of a developing country to one more typical of a developed country. The ongoing population aging and the rise in unhealthy lifestyles are expected to further escalate the cancer burden in China. Consequently, it is crucial for Chinese authorities to revise the national cancer control program, drawing on successful strategies from developed countries, while also accounting for the regional diversity in cancer types across China.
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Affiliation(s)
- Xiayao Diao
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Chao Guo
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Yukai Jin
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Bowen Li
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Xuehan Gao
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Xin Du
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Zhenchong Chen
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Minju Jo
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Yi Zeng
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Chao Ding
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Wenwu Liu
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Jianrong Guo
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
| | - Shanqing Li
- Department of Thoracic SurgeryPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingP. R. China
| | - Haibo Qiu
- Department of Gastric SurgeryState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat‐sen University Cancer CenterGuangzhouGuangdongP. R. China
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O'Brien P, Gleeson D, Kuntsche E, Room R. A chance for countries to support Ireland's world-leading cancer warning labels for alcohol containers. Drug Alcohol Rev 2025; 44:385-388. [PMID: 39556443 DOI: 10.1111/dar.13977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 10/24/2024] [Accepted: 10/24/2024] [Indexed: 11/19/2024]
Abstract
Ireland has regulated for all packaged alcohol products to include a health warning that states that 'there is a link between alcohol and fatal cancers'. This warning is being opposed in the World Trade Organization by 12 member states who are raising that the warning is an unnecessary barrier to trade. The World Health Organization is supporting Ireland. Countries should not oppose Ireland's warning which is defensible from legal and public health perspectives.
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Affiliation(s)
| | - Deborah Gleeson
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Birolim MM, Souza SCS, Rodrigues R, da Silva DF, Martínez‐Vizcaíno V, Mesas AE. The Association Between Physical Activity and Uterine Leiomyoma and Its Symptoms: A Systematic Review and Meta-Analysis. Health Sci Rep 2025; 8:e70487. [PMID: 39995801 PMCID: PMC11847712 DOI: 10.1002/hsr2.70487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 01/17/2025] [Accepted: 02/07/2025] [Indexed: 02/26/2025] Open
Abstract
Background and Aims Although many studies have focused on the impact of physical activity on hormone-mediated tumors, its effect on uterine leiomyomas (UL) remains unclear. This systematic review synthesizes the scientific evidence on the role of physical activity in the occurrence and symptomatology of UL while putting forward a research agenda. Methods The PubMed, Scopus, Web of Science, SciELO, and Cochrane Library databases were searched for studies published up to January 10, 2025. The Newcastle‒Ottawa Scale was used to assess study quality, and the GRADE tool was used to determine evidence certainty. Dear-Simonian and Laird random effects models were used to estimate the pooled odds ratio (OR) and 95% confidence interval (CI) of the association between physical activity and UL. The PRISMA guidelines were followed. Results Fifteen studies were included (three cross-sectional, 6 case-control, and 6 cohort studies), of which 11 were considered in the meta-analysis. The difference between women who did and did not regularly practice physical activity (OR = 0.93; 95% CI: 0.82, 1.05; I 2 = 77.6%, n = 8 studies) in the likelihood of having UL did not meet conventional levels of statistical significance. Moreover, those women who engaged in more intense physical activity were less likely to have UL (OR = 0.86; 95% CI: 0.75, 0.99; I 2 = 80.5%, n = 5 studies) than those who engaged in less intense physical activity. Conclusion Increased physical activity is associated with a slight decrease in the risk of UL and may provide relief from associated symptoms. Since current evidence is still limited to supporting specific physical activity recommendations, a research agenda is proposed for future studies on this subject. PROSPERO Registration CRD42021247505.
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Affiliation(s)
- Marcela Maria Birolim
- Department of MedicineUniversidade Estadual do Centro OesteGuarapuavaParanáBrazil
- Postgraduate Program in Health PromotionCentro Universitario GuairacáGuarapuavaParanáBrazil
| | | | - Renne Rodrigues
- Postgraduate Program in Public HealthUniversidade Estadual de LondrinaLondrinaParanáBrazil
- Epidemiology Nucleus of Medical GraduationUniversidade Federal da Fronteira SulChapecóBrazil
| | | | - Vicente Martínez‐Vizcaíno
- Health and Social Research CenterUniversidad de Castilla‐La ManchaCuencaSpain
- Facultad de Ciencias de la SaludUniversidad Autónoma de ChileTalcaChile
| | - Arthur Eumann Mesas
- Health and Social Research CenterUniversidad de Castilla‐La ManchaCuencaSpain
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Liu K, Iyer HS, Lu Y, Laden F, Song M, Roscoe C. Neighborhood socioeconomic disparities in cancer incidence following a hypothetical intervention to increase residential greenspace cover in the UK Biobank cohort. ENVIRONMENTAL RESEARCH 2025; 266:120387. [PMID: 39566677 DOI: 10.1016/j.envres.2024.120387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 11/14/2024] [Accepted: 11/16/2024] [Indexed: 11/22/2024]
Abstract
BACKGROUND Higher greenspace exposure has been associated with lower risk of certain cancers. However, few studies have evaluated potential benefits of increasing population-level exposure to greenspace on cancer disparities. We estimated the impact of a hypothetical intervention to increase residential greenspace cover on neighborhood socioeconomic disparities in total, breast, colorectal, lung, and prostate cancer incidence. METHODS Our study included 411,787 cancer-free UK Biobank participants. Percentage of greenspace around baseline residential addresses (300m, 1000m distance buffers) was derived by combining domestic gardens and greenspace cover from the Generalized Land Use Database. We categorized neighborhood socioeconomic deprivation using the Index of Multiple Deprivation (2010). We estimated hazard ratios (HR) and 95% confidence intervals (CI) of each cancer associated with greenspace, adjusting for sociodemographic and lifestyle factors. We additionally adjusted for air pollution in supplementary analyses as we a-priori hypothesized that it was on the causal pathway between greenspace and cancer. Further, we used parametric g-computation to calculate the standardized 10-year risk of each cancer, comparing the least to most socioeconomically disadvantaged participants, both without any hypothetical greenspace intervention and under a hypothetical intervention to increase residential greenspace cover to a favorable threshold (75th percentile amongst the least socioeconomically deprived participants). RESULTS We documented 40,519 incident cases of cancer over 4,210,008 person-years follow-up. An interquartile range increase in greenspace cover within 300m was associated with lower incidence of total (HR 0.98; 95% CI 0.97, 1.00) and lung (HR 0.96; 95% CI 0.92, 0.99) cancer, and was suggestively associated with lower prostate and breast cancer incidence, but not colorectal cancer. Additional adjustment for fine particulate matter air pollution (PM2.5) weakened lung cancer associations but strengthened breast and prostate cancer associations (e.g., greenspace 1000m breast cancer HR 0.94; 95% CI 0.89 0.99; 1000m prostate cancer HR 0.91; 95% CI 0.86, 0.95). The hypothetical intervention to increase greenspace (300m) resulted in 1.3 fewer total cancer cases per 1000 (95% CI 1.0, 1.6) in the most compared to least deprived group, a 23% reduction in the socioeconomic disparity gap. DISCUSSION Higher residential greenspace cover was associated with lower total and lung cancer incidence, and suggestively associated with lower breast and prostate cancer incidence. Policies to increase residential greenspace cover may reduce the risk of certain cancers, particularly among socioeconomically disadvantaged groups.
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Affiliation(s)
- Kuangyu Liu
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Hari S Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Yujia Lu
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mingyang Song
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Division of Gastroenterology, Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Charlotte Roscoe
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Division of Population Sciences, Dana Faber Cancer Institute, Boston, MA, USA; Oregon Health and Science University-Portland State University (OHSU-PSU) School of Public Health, Portland, OR, USA.
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Dadgar I, Norström T, Ramstedt M. Is there a link between per capita alcohol consumption and cancer mortality? Drug Alcohol Rev 2025; 44:411-423. [PMID: 39667722 DOI: 10.1111/dar.13984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 11/06/2024] [Accepted: 11/11/2024] [Indexed: 12/14/2024]
Abstract
INTRODUCTION A growing body of evidence has established alcohol consumption as a causative factor in an increasing array of cancer types, thereby positioning it as a leading global risk factor for cancer. Surprisingly, there is a scarcity of studies examining the extent to which shifts in population drinking affect cancer mortality, despite the substantial public health implications. This paper aims to: (i) estimate the impact of changes in per capita alcohol consumption on both overall cancer mortality rates and specific types of alcohol-related cancer; and (ii) assess whether the association between cancer and population alcohol consumption is influenced by a country's drinking patterns. METHODS We used time-series data for 19 high-income countries spanning the period 1960-2018. Cigarette sales and GDP per capita were included as control variables. The data were analysed using first-difference modelling. The World Health Organization drinking patterns score was used to evaluate a country's drinking pattern. RESULTS Our findings revealed that a 1 L per capita increase in alcohol consumption was associated with a 0.9% rise in total cancer mortality among women and a 1.1% increase among men. Notably, among men, the association was more pronounced for cancers with strong evidence of alcohol's effect and for prostate cancer. For women, the alcohol effect was statistically significant for breast cancer. Generally, the estimated alcohol effects were elevated in the country group with more harmful drinking patterns. DISCUSSION AND CONCLUSIONS Our results indicate that lowering per capita alcohol consumption is likely to reduce cancer mortality.
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Affiliation(s)
- Iman Dadgar
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
- Center for Educational Leadership and Excellence, Stockholm School of Economics, Stockholm, Sweden
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Thor Norström
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - Mats Ramstedt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Olivo M, Darlington-Bernard A, Salque C, Fraticelli L, Ricard E, Carrouel F, Darlington E. The Explo'Santé mixed methods protocol: an interventional research school health promotion project in France. Arch Public Health 2025; 83:26. [PMID: 39881400 PMCID: PMC11780862 DOI: 10.1186/s13690-024-01487-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 12/22/2024] [Indexed: 01/31/2025] Open
Abstract
BACKGROUND According to WHO, "noncommunicable diseases (NCDs) kill 41 million people" annually, as the primary cause of death globally. WHO's Global Action Plan for the prevention and control of NCDs 2013-2020 (extended) tackles this issue and its implications regarding inequalities between countries and populations. Based on combined behavioural, environmental and policy approaches, health promotion aims to reduce health inequities and address health determinants through 3 strategies: education, prevention and protection. It is a well-known fact that long-term efficiency in health promotion, that is to say the promotion of health and well-being, involves interventions and programmes which target / involve children [1]. As a focal point in communities and a key environment for children, school is an important setting to implement health promotion programmes, especially integrated approaches and interventions targeting Life Skills (LS). Indeed, LS contribute to health and well-being, particularly for pupils. This article presents the research protocol of a French integrated school-based health promotion interventional research programme which intends to support the health promoting schools (HPS) approach in France: Explo'Santé. It results from a partnership between the University of Lyon and the French League against Cancer. METHODS Explo'Santé is an observational study based on a mixed methods research design, which aims to evaluate the effects of a health promotion programme, to elicit its implementation process and identify contextual factors. This 3-year, complex programme targets primary school pupils aged 8 to 10. It incorporates health education sessions, to develop pupils' LS and health literacy (HL), and to promote healthy environments. Teachers and French League prevention officers are trained to support skill development and programme sustainability. Data collection includes quantitative data via questionnaires, to assess programme impact on approximately 700 pupils, as well as 36 teachers, and 6 prevention officers, as well as qualitative data collected via focus groups with pupils, and interviews with teachers, parents, prevention officers, and school heads, to understand the barriers and promoting factors to the implementation of the programme, the differences in process and effects in different contexts, and its potential for sustainability. DISCUSSION Explo'Santé was designed to contribute to school-based health promotion strategies, by including key players, promoting partnerships, targeting multiple levels of impact and effect, and to ensure every step is research-based and informed. Finally, this study aims to identify the elements which would enable Explo'Santé to become a model in France and internationally.
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Affiliation(s)
- Matteo Olivo
- Laboratory Health Systemic Process (P2S), Research Unit, UR4129, University Claude Bernard Lyon 1, University of Lyon, 11 rue Guillaume Paradin, Lyon, 69008, France.
- Laboratory ECLLA, Jean Monnet University of Saint-Etienne, University of Lyon, 33 rue du 11 novembre, Saint-Etienne, 42023, France.
| | - Adeline Darlington-Bernard
- Laboratory Health Systemic Process (P2S), Research Unit, UR4129, University Claude Bernard Lyon 1, University of Lyon, 11 rue Guillaume Paradin, Lyon, 69008, France.
| | - Corélie Salque
- Laboratory Health Systemic Process (P2S), Research Unit, UR4129, University Claude Bernard Lyon 1, University of Lyon, 11 rue Guillaume Paradin, Lyon, 69008, France
| | - Laurie Fraticelli
- Laboratory Health Systemic Process (P2S), Research Unit, UR4129, University Claude Bernard Lyon 1, University of Lyon, 11 rue Guillaume Paradin, Lyon, 69008, France
| | - Emmanuel Ricard
- French League against Cancer, 14 rue Corvisart, Paris, 75013, France
| | - Florence Carrouel
- Laboratory Health Systemic Process (P2S), Research Unit, UR4129, University Claude Bernard Lyon 1, University of Lyon, 11 rue Guillaume Paradin, Lyon, 69008, France
| | - Emily Darlington
- Laboratory Health Systemic Process (P2S), Research Unit, UR4129, University Claude Bernard Lyon 1, University of Lyon, 11 rue Guillaume Paradin, Lyon, 69008, France
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Cui Z, Suo C, Zhao Y, Wang S, Zhao M, Chen R, Lu L, Zhang T, Chen X. Spatiotemporal Correlation Analysis for the Incidence of Esophageal and Gastric Cancer From 2010 to 2019: Ecological Study. JMIR Cancer 2025; 11:e66655. [PMID: 39885591 PMCID: PMC11798535 DOI: 10.2196/66655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 12/15/2024] [Accepted: 12/16/2024] [Indexed: 02/01/2025] Open
Abstract
Background Esophageal and gastric cancer were among the top 10 most common cancers worldwide. In addition, sex-specific differences were observed in the incidence. Due to their anatomic proximity, the 2 cancers have both different but also shared risk factors and epidemiological features. Exploring the potential correlated incidence pattern of them, holds significant importance in providing clues in the etiology and preventive strategies. Objective This study aims to explore the spatiotemporal correlation between the incidence patterns of esophageal and gastric cancer in 204 countries and territories from 2010 to 2019 so that prevention and control strategies can be more effective. Methods The data of esophageal and gastric cancer were sourced from the Global Burden of Disease (GBD). Spatial autocorrelation analysis using Moran I in ArcGIS 10.8 (Esri) was performed to determine spatial clustering of each cancer incidence. We classified different risk areas based on the risk ratio (RR) of the 2 cancers in various countries to the global, and the correlation between their RR was evaluated using Pearson correlation coefficient. Temporal trends were quantified by calculating the average annual percent change (AAPC), and the correlation between the temporal trends of both cancers was evaluated using Pearson correlation coefficients. Results In 2019, among 204 countries and territories, the age-standardized incidence rates (ASIR) of esophageal cancer ranged from 0.91 (95% CI 0.65-1.58) to 24.53 (95% CI 18.74-32.51), and the ASIR of gastric cancer ranged from 3.28 (95% CI 2.67-3.91) to 43.70 (95% CI 34.29-55.10). Malawi was identified as the highest risk for esophageal cancer (male RR=3.27; female RR=5.19) and low risk for gastric cancer (male RR=0.21; female RR=0.23) in both sexes. Spatial autocorrelation analysis revealed significant spatial clustering of the incidence for both cancers (Moran I>0.20 and P<.001). A positive correlation between the risk of esophageal and gastric cancer was observed in males (r=0.25, P<.001). The ASIR of both cancers showed a decreasing trend globally. The ASIR for esophageal and gastric cancer showed an AAPC of -1.43 (95% CI -1.58 to -1.27) and -1.76 (95% CI -2.08 to -1.43) in males, and -1.93 (95% CI -2.11 to -1.75) and -1.79 (95% CI -2.13 to -1.46) in females. In addition, a positive correlation between the temporal trends in ASIR for both cancers was observed at the global level across sexes (male r=0.98; female r=0.98). Conclusions Our study shows that there was a significant spatial clustering of the incidence for esophageal and gastric cancer and a positive correlation between the risk of both cancers across countries was observed in males. In addition, a codescending incidence trend between both cancers was observed at the global level.
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Affiliation(s)
- Zixuan Cui
- Department of Epidemiology, School of Public Health, Fudan University, Dongan Road 130, Shanghai, 200032, China, 86 15618218427
| | - Chen Suo
- Department of Epidemiology, School of Public Health, Fudan University, Dongan Road 130, Shanghai, 200032, China, 86 15618218427
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Jiangsu, China
| | - Yidan Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Dongan Road 130, Shanghai, 200032, China, 86 15618218427
| | - Shuo Wang
- Department of Epidemiology, School of Public Health, Fudan University, Dongan Road 130, Shanghai, 200032, China, 86 15618218427
| | - Ming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Dongan Road 130, Shanghai, 200032, China, 86 15618218427
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
| | - Ruilin Chen
- Department of Epidemiology, School of Public Health, Fudan University, Dongan Road 130, Shanghai, 200032, China, 86 15618218427
| | - Linyao Lu
- Fudan University Taizhou Institute of Health Sciences, Jiangsu, China
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Tiejun Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Dongan Road 130, Shanghai, 200032, China, 86 15618218427
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Jiangsu, China
- Yiwu Research Institute of Fudan University, Zhejiang, China
| | - Xingdong Chen
- Fudan University Taizhou Institute of Health Sciences, Jiangsu, China
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Zhangjiang Fudan International Innovation Center, Shanghai, China
- Yiwu Research Institute of Fudan University, Zhejiang, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Shanghai, China
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Li J, Guo K, Qiu J, Xue S, Pi L, Li X, Huang G, Xie Z, Zhou Z. Epidemiological status, development trends, and risk factors of disability-adjusted life years due to diabetic kidney disease: A systematic analysis of Global Burden of Disease Study 2021. Chin Med J (Engl) 2025; 138:00029330-990000000-01412. [PMID: 39863522 PMCID: PMC11882292 DOI: 10.1097/cm9.0000000000003428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND Approximately 40% of individuals with diabetes worldwide are at risk of developing diabetic kidney disease (DKD), which is not only the leading cause of kidney failure, but also significantly increases the risk of cardiovascular disease, causing significant societal health and financial burdens. This study aimed to describe the burden of DKD and explore its cross-country epidemiological status, predict development trends, and assess its risk factors and sociodemographic transitions. METHODS Based on the Global Burden of Diseases (GBD) Study 2021, data on DKD due to type 1 diabetes (DKD-T1DM) and type 2 diabetes (DKD-T2DM) were analyzed by sex, age, year, and location. Numbers and age-standardized rates were used to compare the disease burden between DKD-T1DM and DKD-T2DM among locations. Decomposition analysis was used to assess the potential drivers. Locally weighted scatter plot smoothing and Frontier analysis were used to estimate sociodemographic transitions of DKD disability-adjusted life years (DALYs). RESULTS The DALYs due to DKD increased markedly from 1990 to 2021, with a 74.0% (from 2,228,000 to 3,876,000) and 173.6% (from 4,123,000 to 11,279,000) increase for DKD-T1DM and DKD-T2DM, respectively. In 2030, the estimated DALYs for DKD-T1DM surpassed 4.4 million, with that of DKD-T2DM exceeding 14.6 million. Notably, middle-sociodemographic index (SDI) quintile was responsible for the most significant DALYs. Decomposition analysis revealed that population growth and aging were major drivers for the increased DKD DALYs in most GBD regions. Interestingly, the most pronounced effect of positive DALYs change from 1990 to 2021 was presented in high-SDI quintile, while in low-SDI quintile, DALYs for DKD-T1DM and DKD-T2DM presented a decreasing trend over the past years. Frontiers analysis revealed that there was a negative association between SDI quintiles and age-standardized DALY rates (ASDRs) in DKD-T1DM and DKD-T2DM. Countries with middle-SDI shouldered disproportionately high DKD burden. Kidney dysfunction (nearly 100% for DKD-T1DM and DKD-T2DM), high fasting plasma glucose (70.8% for DKD-T1DM and 87.4% for DKD-T2DM), and non-optimal temperatures (low and high, 5.0% for DKD-T1DM and 5.1% for DKD-T2DM) were common risk factors for age-standardized DALYs in T1DM-DKD and T2DM-DKD. There were other specific risk factors for DKD-T2DM such as high body mass index (38.2%), high systolic blood pressure (10.2%), dietary risks (17.8%), low physical activity (6.2%), lead exposure (1.2%), and other environmental risks. CONCLUSIONS DKD markedly increased and varied significantly across regions, contributing to a substantial disease burden, especially in middle-SDI countries. The rise in DKD is primarily driven by population growth, aging, and key risk factors such as high fasting plasma glucose and kidney dysfunction, with projections suggesting continued escalation of the burden by 2030.
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Affiliation(s)
- Jiaqi Li
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Keyu Guo
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Junlin Qiu
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Song Xue
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
- Department of Nephrology, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi 330006, China
| | - Linhua Pi
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Xia Li
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Gan Huang
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Zhiguo Xie
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Zhiguang Zhou
- Department of Metabolism and Endocrinology, National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
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Lai J, Li X, Liu W, Liufu Q, Zhong C. Global, regional and national burdens of occupational injuries, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Inj Prev 2025; 31:52-59. [PMID: 38789248 DOI: 10.1136/ip-2023-045149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/29/2024] [Indexed: 05/26/2024]
Abstract
OBJECTIVES Occupational injuries pose a significant challenge to global health and development. This study aimed to quantify the international and regional burdens of occupational injuries from 1990 to 2019, stratified by specific causes. METHODS We analysed global trends in deaths, disability-adjusted life years (DALYs), age-standardised mortality rates (ASMR) and age-standardised DALY rates (ASDR) related to occupational injuries. Specific injuries, including animal contact, drowning, mechanical forces, falls, fire, heat, hot substances, foreign bodies, poisoning and road injuries, were evaluated. Age-stratified and regional analyses were also performed. RESULTS Globally, the number of deaths, DALYs, ASMR and ASDR related to occupational injuries declined from 1990 to 2019. The middle Socio-demographic Index (SDI) region exhibited the highest burden, whereas the high SDI region showed the least burden. China and India had the highest occupational injury-related death rates in 2019. Males, particularly those aged 25-44 years, were found to be more vulnerable. Road injuries were the leading cause of death in all age groups. Compared with 1990, mortality numbers and rates decreased significantly by 2019, with the highest burdens experienced in East Asia, South Asia and Southeast Asia. CONCLUSION The global decline in occupational injuries is promising; however, certain regions and demographics remain disproportionately affected. Targeted interventions in high-burden areas are crucial to further reduce the impact of occupational injuries.
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Affiliation(s)
- Jianqiang Lai
- Department of Orthopedic Surgery, Gaozhou People's Hospital, Gaozhou, China
| | - Xianmin Li
- Department of Orthopedic Surgery, Gaozhou People's Hospital, Gaozhou, China
| | - Wei Liu
- Department of Orthopedic Surgery, Gaozhou People's Hospital, Gaozhou, China
| | - Qian Liufu
- Department of Orthopedic Surgery, Gaozhou People's Hospital, Gaozhou, China
| | - Chengfan Zhong
- Department of Orthopedic Surgery, Gaozhou People's Hospital, Gaozhou, China
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