Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study

An updated overview on hepatocellular carcinoma in patients with Metabolic dysfunction-Associated Steatotic Liver Disease: Trends, pathophysiology and risk-based surveillance

Hepatocellular carcinoma (HCC) is a relevant complication occurring in individuals with advanced Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD). Recent epidemiological data suggest an alarming increase in the HCC burden worldwide, with a relevant proportion attributable to MASLD (up to 38 %), either in cirrhotic or non-cirrhotic livers. In view of the changing landscape of metabolic syndrome as "silent pandemic", this narrative review aims to provide an updated picture of the burden of HCC in individuals with MASLD. In the complex pathophysiological pathways linking insulin resistance to MASLD and cardiometabolic syndrome, metabolic inflammation appears a relevant driver of systemic as well as organ-specific complications. Novel insights from the field of immunology, gut-derived liver damage, and association with extra-hepatic cancers will be discussed. Finally, strategies for risk-based HCC surveillance (circulating biomarkers, prognostic models and polygenic risk scores) will be provided and the potential impact of novel drug targeting fibrosing Metabolic dysfunction-Associated Steatohepatitis (MASH) on incident HCC will be discussed.

Temporal trends in disability adjusted life year and mortality for colorectal cancer attributable to a high red meat diet in China from 1990 to 2021: an analysis of the global burden of disease study 2021

BACKGROUND

High red meat consumption is a main modifiable risk factor for colorectal cancer mortality (CRC), but its attributable disease burden remains unclear in China. We aimed to analyze the temporal trends in CRC deaths and disability-adjusted life years (DALYs) attributable to high red meat consumption in China from 1990 to 2021 and to predict the disease burden in the next 15 years.

METHODS

Data was obtained from the Global Burden of Disease (GBD) 2021 study. The Joinpoint regression model was used to calculate the annual percentage change (APC) and the average annual percentage change (AAPC). In addition, the age-period-cohort (APC) model was employed to explore the effects of age, period, and cohort on CRC mortality. The autoregressive integrated moving average (ARIMA) model was utilized to predict the disease burden in 2022-2036. We also compared the CRC burden attributed to high red meat in China with 204 countries worldwide.

RESULTS

The results showed that the number of CRC deaths in China due to high red meat consumption increased nearly 2.5 times, from 17,608 (95% UI: -3 to 36,613) in 1990 to 43,580 (95% UI: -16 to 92,083) in 2021. Male CRC deaths exhibited a more pronounced increase, rising from 9,800 in 1990 to 27,600 in 2021. Additionally, the number of DALYs increased from 518,213 (95% UI: -105,107 to 1,074,174) in 1990 to 1,091,788 (95% UI: -509 to 2,295,779) in 2021. Joinpoint regression analysis confirmed that the AAPC in ASDR and ASMR was - 0.20 (95% CI: -0.40 ∼ 0.00) and - 0.30 (95% CI: -0.40 ~ -0.10). When age, period, and cohort effects were examined as the reference group, the risk of CRC was found to increase with age. However, women experienced a marked decline in both period and cohort effects compared to men.

CONCLUSIONS

Compared to global levels, the burden in China is heavier. In terms of mortality or DALY standardized rates, Chinese women show a similar downward trend to the overall trend, while Chinese men show a striking upward trend. This study provides valuable insights into enhancing CRC prevention and improving dietary patterns in China.

Lipid Profiles, Telomere Length, and the Risk of Malignant Tumors: A Mendelian Randomization and Mediation Analysis

Background/Objectives: The relationship between lipid profiles, telomere length (TL), and cancer risk remains unclear. Methods: This study employed two-sample Mendelian randomization (MR) with mediation analysis to investigate their causal relationships, examining lipid profiles as exposure, TL as mediator, and nine cancer types as outcomes. We conducted our analysis using two-stage least squares (2SLS) regression integrated with inverse variance weighted (IVW) methods to address potential endogeneity and strengthen our causal inference. Results: we found that unfavorable lipid profiles were causally linked to increased TL (p < 0.05). TL showed positive causal associations with lung and hematologic cancers (OR > 1, p < 0.05). Direct associations were observed between total and low-density lipoprotein (LDL) cholesterol and gastric cancer (OR < 1, p < 0.05), and between remnant cholesterol and colorectal cancer (OR > 1, p < 0.05). Mediation analysis revealed TL as a significant mediator in the pathway from lipid profiles to cancer development (p < 0.05). No horizontal pleiotropy was detected. Conclusions: Our findings suggest that lipid metabolism disorders may influence cancer development through telomere regulation, particularly in lung and hematologic cancers. This emphasizes the importance of lipid management in cancer prevention and treatment, especially for these cancer types.

Effectiveness of a Breast Cancer Educational Conference Targeting Healthcare Workers in Honduras

Purpose: Previous studies have demonstrated that many healthcare workers in low- and middle-income countries (LMICs) lack the appropriate training and knowledge to recognize and diagnose breast cancer at an early stage. As a result, women in LMICs are frequently diagnosed with late-stage breast cancer (Stage III/IV) with a poor prognosis. Materials and Methods: We hosted a 1-day breast cancer educational conference directed towards healthcare workers in Honduras. We conducted pre- and postcourse (1-2 months later) assessments that evaluated knowledge of screening, diagnosis, and treatment of breast cancer. Breast cancer specialists at the University of Minnesota and Honduras developed a 12-question assessment tool in Spanish. Results: A total of 157 people attended the course, and 86 completed the precourse knowledge assessment. The overall percentage of correct responses was 70% in the precourse assessment. Postcourse knowledge assessments were completed by 94 participants. The overall percentage of correct responses was 80% in the postcourse assessment and was significantly higher than precourse assessment scores (p < 0.0001). For the individual domains of screening, diagnosis, and treatment, the postcourse knowledge assessment scores were significantly improved as compared with the precourse scores (p < 0.0001). Conclusion: In this study, we found that a 1-day, in-person breast cancer educational course directed towards healthcare workers in Honduras resulted in improved breast cancer knowledge assessment scores. Future research and implementation strategies will include training healthcare workers throughout Honduras and determining the impact of these educational interventions on the late-stage presentation of breast cancer.

Global, regional, and national burden of acute lymphoblastic leukemia in children: Epidemiological trends analysis from 1990 to 2021

Children are the main susceptible group to acute lymphoblastic leukemia (ALL), and the lack of sufficient data has impeded a comprehensive understanding of its global impact. This study analyzed the annual numbers and rates of incidence, deaths, and disability-adjusted life years (DALYs) of childhood ALL from 1990 to 2021, disaggregated by age group, gender, and socio-demographic index (SDI) at the global, regional, and national levels, based on the 2021 Global Burden of Disease (GBD) database. Although global deaths and DALYs rates for childhood ALL showed declining trends, the incidence rate fluctuated. Incidence rates in high SDI regions were higher, but deaths and DALY rates were lower. Moreover, the burden in Sub-Saharan Africa and other low SDI countries was growing. The burden on boys has been higher than on girls in this period. This study underscored improving prevention and treatment measures are critical to control the persistent global burden of children ALL.

Disease burden of biliary tract cancer in 204 countries and territories, 1990-2021: A comprehensive demographic analysis of the Global Burden of Disease Study 2021

BACKGROUND

Biliary tract carcinomas (BTCs) are relatively rare but lethal primary malignant tumors derived from the biliary tract system. The burden of BTCs varies according to sex, age, region, and country, but limited attention has been paid to the burden of BTCs. We sought to explore the up-to-date data from the Global Burden of Disease Study (GBD) and expand findings by accessing the demographic features of BTC disease burden.

METHODS

Using the latest data from the GBD 2021, we evaluated and analyzed the distributions and patterns of BTC disease burden in various age groups, sexes, regions, and countries.

RESULTS

The number of incident cases, deaths, and disability-adjusted life-years (DALYs) tended to increase and peaked at 216,770 (95% uncertainty interval [UI]: 181,890-245,240), 171,960 (95% UI: 142,350-194,240), and 3,732,100 (95% UI: 3,102,900-4,317,000) person-years, respectively, in 2021. However, the average global age-standardized rates (ASRs) of incident cases, deaths, and DALYs shrunk by -11.46% (95% UI: -21.91 to 3.35%), -24.09% (95% UI: -33.19 to 16.88%), and -26.25% (95% UI: -35.53 to 18.36%), respectively, from 1990 to 2021. Meanwhile, the male/female ratio (male per 100 female) of incidence, deaths, and DALYs changed from 76.40, 75.41, and 74.72 to 86.89, 79.11, and 82.29, respectively. In 2021, the highest number of incident cases, deaths, and DALYs occurred in East Asia. The top three highest incidences, deaths, and DALYs were observed in China, India, and Japan, and the highest ASRs were observed in Chile in 2021. Analysis of the Human Development Index along with disease burden estimates of BTCs also suggests that the burden of the disease is related to the level of comprehensive development of the society.

CONCLUSION

This study provided a comprehensive comparison of differences in the burden of disease across populations and over time, and further presented evidence concerning the formulation of prevention and control policies and etiologic studies for BTCs and proposed logical hypotheses to investigate.

The Impact of Bevacizumab and miR200c on EMT and EGFR-TKI Resistance in EGFR-Mutant Lung Cancer Organoids

Objectives: This research aims to investigate the mechanisms of resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in non-small-cell lung cancer (NSCLC), particularly focusing on the role of the epithelial-mesenchymal transition (EMT) within the tumor microenvironment (TME). Materials and Methods: We employed an in vitro three-dimensional organoid model that mirrors the physiology of human lung cancer. These organoids consist of lung cancer cells harboring specific EGFR mutations, human mesenchymal stem cells, and human umbilical vein endothelial cells. We analyzed EMT and drug resistance markers, and evaluated the effects of the anti-angiogenic agent Bevacizumab and micro-RNA miR200c. Results: The study identified a significant link between EMT and EGFR-TKI resistance. Notable findings included a decrease in E-cadherin and an increase in Zinc Finger E-Box Binding Homeobox 1 (ZEB1), both of which influenced EMT and resistance to treatment. Bevacizumab showed promise in improving drug resistance and mitigating EMT, suggesting an involvement of the Vascular Endothelial Growth Factor (VEGF) cascade. Transfection with miR200c was associated with improved EMT and drug resistance, further highlighting the role of EMT in TKI resistance. Conclusions: Our research provides significant insights into the EMT-driven EGFR-TKI resistance in NSCLC and offers potential strategies to overcome resistance, including the use of Bevacizumab and miR200c. However, due to the limitations in organoid models in replicating precise human cancer TME and the potential influence of specific EGFR mutations, further in vivo studies and clinical trials are necessary for validation.

Analysis of Variants Induced by Combined Ex Vivo Irradiation and In Vivo Tumorigenesis Suggests a Role for the ZNF831 p.R1393Q Variant in Cutaneous Melanoma Development

UVR is known to be the most important environmental carcinogen for cutaneous melanoma. Whereas genomic analyses of melanoma tumors implicate a high rate of UV damage, the experimental induction and recovery of bona fide UV-signature changes have not been directly observed. To replicate recurrent UV variants from The Cancer Genome Atlas_SKCM specimens, we UV irradiated cultured immortalized human melanocytes and subjected them to in vivo tumorigenesis assays. Exome sequencing of the xenografted tumors revealed an increase in UV-signature mutations within the tumors and identified 48 induced variants that overlap with The Cancer Genome Atlas skin cutaneous melanoma UV-hotspot mutations. A UV-induced mutation, ZNF831 p.R1393Q, was correlated with a decreased survival (hazard ratio = 5.44, 95% confidence interval = 1.92-15.47, P = .0015) and was preferentially observed in melanomas compared with that in all The Cancer Genome Atlas tumors (P = 4.42 × 10-7). In addition, ZNF831 mRNA expression loss was strongly associated with decreased patient survival (hazard ratio = 2.14, 95% confidence interval = 1.62-2.83, P = 7.91 × 10-8), although the transcripts may arise from multiple cell types, including T cells. In multiple melanoma lines, overexpression of wild-type ZNF831 reduced spheroid growth, heightened apoptosis, and increased cell motility, with the ZNF831 p.R1393Q variant partially or wholly abolishing these functional phenotypes. We thus experimentally recovered a "functional UV-hotspot mutation" in ZNF831 that is altered in human melanoma specimens.

Transoral Laser Microsurgery and Transoral Robotic Surgery in Aging Patients: A State-of-The-Art Review

Purpose

In the present study, the findings related to the epidemiology, clinical presentation, and therapeutic outcomes of elderly patients treated with transoral laser microsurgery (TOLM) and transoral robotic surgery (TORS) for supraglottic laryngeal squamous cell carcinoma (LSCC) have been reviewed.

Methods

A PubMed, Cochrane Library, and Scopus literature search was conducted according to the PRISMA statements. Critical literature analysis was carried out considering the last advancement in TOLS and TORS, and their related surgical, functional, and survival outcomes.

Findings

The mean age of patients with supraglottic LSCCs has progressively increased in the past decades. The data on postoperative complications in elderly patients with LSCC are heterogeneous and contradictory. The thought of the age-related high risk of complications was based on open supraglottic laryngectomy (SGL), but not on TOLM and TORS findings, which do not support an age-related increase of most postoperative complications. The only complication that could be associated with age is aspiration. The adequate selection of patients undergoing TOLM or TORS, and the pre- to postoperative evaluation of swallowing function can prevent this risk. The OS of elderly patients treated with TOLM or TORS SGL could be lower compared to younger patients. However, the disease-free survival was not influenced by age, highlighting the role of comorbidities and intercurrent diseases in the presumed lower survival. The survival analysis could definitively consider the physiological age rather than the chronological age to investigate the impact of age on survival outcomes.

Conclusion

The current literature supports an important place of TOLM and TORS in managing cT1-T3 supraglottic LSCC. The preoperative geriatric, nutritional, and swallowing evaluations are important for ensuring an adequate selection of patients treated with TORS or TOLM SGL.

A latent profile analysis of spiritual well-being and their relation to perceived social support and hope in patients with early-stage lung cancer

PURPOSE

This study aimed to investigate the subtypes of spiritual well-being among patients with early-stage lung cancer, examine the characteristics of each subtype, and determine the relationship between spiritual well-being and perceived social support as well as hope within these subtypes.

METHODS

A sample of 418 patients with early-stage lung cancer from three hospitals in Hubei Province completed the general sociodemographic questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, the Perceived Social Support Scale, and the Herth Hope Index. Latent profile analysis (LPA) was used to identify the patterns of spiritual well-being in patients with early-stage lung cancer, and influencing factors of different patterns were identified by univariate analysis and multinomial logistic regression analysis.

RESULTS

Three latent classes were identified: the "low spiritual well-being" (C1, 33.97%), the "moderate spiritual well-being" (C2, 38.28%), and the "high spiritual well-being" (C3, 27.75%). Factors such as nationality, religion, annual household disposable income, perceived social support scores, and hope scores influenced the potential categories of spiritual well-being in patients with early-stage lung cancer.

CONCLUSIONS

The spiritual well-being of patients with early-stage lung cancer varies, necessitating customized spiritual care to meet the diverse needs of patients. Additionally, providing comprehensive social support and helping patients achieve positive states of spiritual well-being can promote better cancer treatment outcomes.

Predicting prognosis prior to the combination of atezolizumab and bevacizumab on unresectable HCC: Analysis and comparison of tumor heterogeneity at CT and Gd-EOB-DTPA hepatobiliary MR imaging

Since 2007, the combination of atezolizumab and bevacizumab, comprising an immune checkpoint inhibitor and a molecularly targeted agent, has become the first-line treatment for advanced hepatocellular carcinoma (HCC). Predicting prognosis prior to systemic chemotherapy remains a critical concern. This study included 84 advanced HCC patients who underwent enhanced computed tomography (CT) and Gd-EOB-DTPA magnetic resonance imaging (MRI) before the systemic therapy were included. In CT, the 2 radiologists measured mean CT Hounsfield unit (CTHU) value by drawing region of interest at the largest diameter of the tumor on arterial phage. The HU values were categorized into 5 groups: ≤ 0, 0 < HU ≤ 50, 50 < HU ≤ 100, 100 < HU ≤ 150, and HU > 150. The percentage of the entire tumor in each category was calculated. On MRI, hepatobiliary phase imaging features and relative enhancement ratio (RER) were also evaluated by 2 radiologists. Prognostic factors associated with progression-free survival were identified using statistical analysis. RER on HBP MRI correlated with prognosis in systemic chemotherapy. Conversely, other image features on HBP MRI and CT histogram provided consistent treatment effect.

Polyketides and alkaloids from the fungus Aspergillus Fumigatus YB4-17 and ent-Fumiquinazoline J induce apoptosis, paraptosis in human hepatoma HepG2 cells

Hepatocellular carcinoma (HCC) is one of the most common malignancies. The currently available clinical drugs for HCC frequently cause serious side effects and the treatment outcomes are unsatisfactory. It is urgent to develop effective drugs with high selectivity and low adverse effects for HCC. Metabolites produced by microorganisms have shown great potential in the development of therapeutic agents for HCC. In our study, the EtOAc extract of the strain Aspergillus fumigatus YB4-17 exhibited significant cytotoxicity towards the HCC HepG2 cells at 10 μg/mL. Various column chromatographic separations of the extract afforded seven polyketides (1-7), including a new diphenyl ether derivative (1), along with fourteen known alkaloids (8-21). The structure elucidation was conducted via NMR spectroscopic data and MS data analysis. The absolute configuration of compound 11 was confirmed by comparing experimental and calculated electronic circular dichroism spectrum for the first time. The biological evaluation of these metabolites revealed that compound 11 selectively inhibited the proliferation of HCC HepG2 cells with negligible toxicity to normal cells. Mechanism study indicated that compound 11 induced apoptosis and paraptosis in HepG2 cells, providing a novel therapeutic perspective for the treatment of hepatocellular carcinoma.

Trends in the Disease Burden and Risk Factors of Women's Cancers in China From 1990 to 2019

Objectives

To examine age-specific trends and risk factors in the burden of women's cancers (WCs) in China from 1990 to 2019 to inform strategies.

Methods

Data were sourced from the Global Burden of Disease 2019 and World Population Prospects 2019. Time trends, age differences, and key factors for breast, cervical, and ovarian cancers (BC, CC, and OC) were analyzed based on age-standardized incidence rate (ASIR) and disability-adjusted life years (DALYs) rate.

Results

ASIRs for BC and CC increased over the study period, with a slower growth rate for CC after 2005, likely due to targeted HPV prevention. OC showed the highest ASIR and DALY increases, indicating a growing concern. Peak ASIR for BC and CC was in women aged 50-55, while OC showed a higher burden in women aged 70-79. Lower DALYs in women born after 1985 suggest improved healthcare access.

Conclusion

This study highlights significant trends in cancer burden among Chinese women, driven by age and reproductive health policies. Future efforts should enhance screening, health literacy, and age-targeted risk reduction for specific cancer types.

Prognostic utility of the modified albumin-bilirubin score among patients undergoing curative-intent surgery for gallbladder cancer

BACKGROUND

Gallbladder cancer (GBC) has been associated with high rates of recurrence and dismal prognosis even after curative-intent resection. The prognostic utility of the modified albumin-bilirubin (mALBI) score among individuals undergoing curative-intent resection for GBC has not been determined.

METHODS

Patients who underwent radical resection for GBC between 2000 and 2022 were identified from an international, multi-institutional database. Preoperative albumin and bilirubin levels were used to calculate the mALBI score. The relationship among mALBI score, overall survival (OS), and recurrence-free survival (RFS) was examined.

RESULTS

Among 269 patients who underwent radical resection for GBC, 161 (59.9%) had mALBI grade 1, 48 (17.8%) had grade 2a, 47 (17.5%) had grade 2b, and 13 (4.8%) had mALBI grade 3. After surgery, compared with patients with a low mALBI grade (grade 1/2a), individuals with a high mALBI grade (grade 2b/3) had worse 5-year OS (54.4% vs 19.2%, respectively; P < .001) and RFS (42.0% vs 17.8%, respectively; P < .001). On multivariable analysis, after controlling for relevant clinicopathologic variables, individuals with a high mALBI score remained independently associated with higher risks of death and recurrence (OS: hazard ratio [HR], 2.38 [95% CI, 1.50-3.79]; RFS: HR, 2.12 [95% CI 1.41-3.20]) versus patients with a low mALBI score after curative-intent resection for GBC. Of note, mALBI score was associated with incrementally worse survival within T2, T3, and N+ categories, whereas classic American Joint Committee on Cancer subclassifications failed to distinguish patients with long-term survival.

CONCLUSION

The mALBI score presents a simple, objective measure of hepatic functional reserve and may be a useful prognostic tool for patients undergoing curative-intent resection for GBC.

Early multi-cancer detection through deep learning: An anomaly detection approach using Variational Autoencoder

Cancer is a disease that causes many deaths worldwide. The treatment of cancer is first and foremost a matter of detection, a treatment that is most effective when the disease is detected at an early stage. With the evolution of technology, several computer-aided diagnosis tools have been developed around cancer; several image-based cancer detection methods have been developed too. However, cancer detection faces many difficulties related to early detection which is crucial for patient survival rate. To detect cancer early, scientists have been using transcriptomic data. However, this presents some challenges such as unlabeled data, a large amount of data, and image-based techniques that only focus on one type of cancer. The purpose of this work is to develop a deep learning model that can effectively detect as soon as possible, specifically in the early stages, any type of cancer as an anomaly in transcriptomic data. This model must have the ability to act independently and not be restricted to any specific type of cancer. To achieve this goal, we modeled a deep neural network (a Variational Autoencoder) and then defined an algorithm for detecting anomalies in the output of the Variational Autoencoder. The Variational Autoencoder consists of an encoder and a decoder with a hidden layer. With the TCGA and GTEx data, we were able to train the model for six types of cancer using the Adam optimizer with decay learning for training, and a two-component loss function. As a result, we obtained the lowest value of accuracy 0.950, and the lowest value of recall 0.830. This research leads us to the design of a deep learning model for the detection of cancer as an anomaly in transcriptomic data.

The molecular features of lung cancer stem cells in dedifferentiation process-driven epigenetic alterations

Cancer stem cells (CSCs) may be dedifferentiated somatic cells following oncogenic processes, representing a subpopulation of cells able to promote tumor growth with their capacities for proliferation and self-renewal, inducing lineage heterogeneity, which may be a main cause of resistance to therapies. It has been shown that the "less differentiated process" may have an impact on tumor plasticity, particularly when non-CSCs may dedifferentiate and become CSC-like. Bidirectional interconversion between CSCs and non-CSCs has been reported in other solid tumors, where the inflammatory stroma promotes cell reprogramming by enhancing Wnt signaling through nuclear factor kappa B activation in association with intracellular signaling, which may induce cells' pluripotency, the oncogenic transformation can be considered another important aspect in the acquisition of "new" development programs with oncogenic features. During cell reprogramming, mutations represent an initial step toward dedifferentiation, in which tumor cells switch from a partially or terminally differentiated stage to a less differentiated stage that is mainly manifested by re-entry into the cell cycle, acquisition of a stem cell-like phenotype, and expression of stem cell markers. This phenomenon typically shows up as a change in the form, function, and pattern of gene and protein expression, and more specifically, in CSCs. This review would highlight the main epigenetic alterations, major signaling pathways and driver mutations in which CSCs, in tumors and specifically, in lung cancer, could be involved, acting as key elements in the differentiation/dedifferentiation process. This would highlight the main molecular mechanisms which need to be considered for more tailored therapies.

Targeting PADI2 as a potential therapeutic strategy against metastasis in oral cancer via suppressing EMT-mediated migration and invasion and CCL3/5-induced angiogenesis

Oral squamous cell carcinoma (OSCC) is a prevalent and aggressive malignancy, with metastasis being the leading cause of death in patients. Unfortunately, therapeutic options for metastatic OSCC remain limited. Peptidylarginine deiminases (PADI) are implicated in various tumorigenesis and metastasis processes across multiple cancers. However, the role of PADI2, a type of PADI, in OSCC is not well understood. This study aimed to explore the impact of PADI2 on epithelial-mesenchymal transition (EMT), angiogenesis, and OSCC metastasis. The effect of PADI2 on EMT was evaluated using cell lines by Western blot analysis with shRNA targeting PADI2. In addition, the selective PADI2 inhibitor AFM32a was used to assess the effect of PADI2 on cancer metastasis and angiogenesis in animal models. Our findings indicated that PADI2 expression correlated with EMT changes, and PADI2 knockdown reversed these changes, reducing cell proliferation, cell migration, and invasion. PADI2 inhibition also diminished tube formation in HUVECs and decreased secretion of angiogenesis-related chemokines CCL3, CCL5 and CCL20. In a mouse model, AFM32a markedly reduced lung metastasis and production of CCL3 and CCL5. Our in vitro and in vivo studies suggested inhibiting PADI2 could prevent OSCC metastasis by impeding EMT and angiogenesis via AKT/mTOR signaling pathway. These results highlight PADI2 as a potential therapeutic target for combating OSCC metastasis.

Zebrafish: A smart tool for heart disease research

The increasing prevalence of heart disease poses a significant threat to human survival and safety. However, the current treatments available for heart disease are quite limited. Therefore, it is important to utilize suitable animal models that can accurately simulate the physiological characteristics of heart disease. This would help improve our understanding of this disease and aid in the development of new treatment methods and drugs. Zebrafish heart not only exhibits similarities to mammalian hearts, but they also share ~70% of homologous genes with humans. Utilizing zebrafish as an alternative to expensive and time-consuming mammalian models offers numerous advantages. Zebrafish models can be easily established and maintained, and compound screening and genetic methods allow for the development of various economical and easily controlled zebrafish and zebrafish embryonic heart disease models in a short period of time. Consequently, zebrafish have become a powerful tool for exploring the pathological mechanisms of heart disease and identifying new effective genes. In this review, we summarize recent studies on different zebrafish models of heart disease. We also describe the techniques and protocols used to develop zebrafish models of myocardial infarction, heart failure, and congenital heart disease, including surgical procedures, forward and reverse genetics, and drug and combination screening. This review aims to promote the utilization of zebrafish models in investigating diverse pathological mechanisms of heart disease, enhancing our knowledge and comprehension of heart disease, and offering novel insights and objectives for exploring the prevention and treatment of heart disease.

Integration of observational and causal evidence for the association between adiposity and 17 gastrointestinal outcomes: An umbrella review and meta-analysis

We systematically reviewed observational and Mendelian randomization (MR) articles that evaluated the association between obesity and 17 gastrointestinal (GI) diseases to integrate causal and observational evidence. A total of 594 observational studies from 26 systematic reviews and meta-analyses and nine MR articles were included. For every 5 kg/m2 increase in body mass index (BMI), there was an increased risk of GI diseases ranging from 2% for rectal cancer (relative risk [RR]: 1.02, 95% confidence interval [CI]: 1.01 to 1.03) to 63% for gallbladder disease (RR: 1.63, 95% CI: 1.50 to 1.77). MR articles indicated that risks of developing GI diseases elevated with each 1 standard deviation increase in genetically predicted BMI, ranging from 11% for Crohn's disease to 189% for nonalcoholic fatty liver disease. Moreover, upper GI conditions were less susceptible, whereas hepatobiliary organs were more vulnerable to increased adiposity. Among the associations between obesity and the 17 GI conditions, causal relationships were inferred from only approximately half (10/17, 59%). This study reveals a substantial gap between observational and causal evidence, indicating that a combined approach is necessary to effectively inform public health policies and guide epidemiological research on obesity and GI diseases.

Trends in age-specific incidence, mortality, and DALYs of female breast cancer from 1990 to 2021

Objectives

Breast cancer is a leading cause of morbidity and mortality among women worldwide. This study aims to analyze the trends in breast cancer incidence, mortality, and disability-adjusted life years (DALYs) across different age groups from 1990 to 2021, and to project the mortality rate for the next decade.

Methods

Global breast cancer data were analyzed, focusing on three distinct age groups: 15-49 years, 50-69 years, and 70+ years. Joinpoint regression analysis was used to identify periods of significant changes in cancer rate trends (joinpoints). Age-specific annual percent changes (APC) and average annual percent changes (AAPC) were calculated to identify trends over time. Additionally, an autoregressive integrated moving average (ARIMA) model was employed to forecast future mortality rates.

Results

The overall incidence of breast cancer increased significantly with an AAPC of 1.6% from 1990 to 2021. The highest increase was observed in the 15-49 years age group (AAPC: 1.3%), while the 70+ years age group showed the lowest increase (AAPC: 0.2%). Mortality rates exhibited a complex pattern, with a modest overall increase (AAPC: 0.8%), a slight increase in the 15-49 years age group (AAPC: 0.4%), and decreases in both 50 and 69 years (AAPC: -0.4%) and 70+ years age groups (AAPC: -0.3%). DALY rates increased slightly overall (AAPC: 0.7%), primarily driven by the 15-49 years age group (AAPC: 0.4%), while the older age groups showed a declining trend (AAPC: -0.4%).

Conclusion

Incidence rates are rising across all age groups, with the highest increase observed among younger women (15-49 years). In contrast, older age groups (50 + years) are experiencing improvements in mortality and DALYs. These findings underscore the need for targeted public health interventions, enhanced screening practices, and ongoing advancements in breast cancer treatment to address the evolving burden of this disease across different age groups.

Non-used cryopreserved sperm among oncological patients: extra-long-term follow-up and analysis

PURPOSE

To investigate factors influencing long-term utilization and disposal patterns of cryopreserved semen straws in oncological patients.

METHODS

This retrospective study included all men who cryopreserved semen due to cancer between October 1993 and December 2021. To assess non-used cryopreserved sperm straws, we investigated the following parameters: cryopreserved semen and usage for fertility treatments versus disposal, summarized by total non-used cases. A Kaplan-Meier curve was used to describe last usage and disposal requests over a 15-year analysis. A Log-rank test was applied to compare between age and paternal status categories.

RESULTS

The cohort consisted of 445 patients. Of these, 55 patients utilized thawed semen for fertility treatments, and 65 opted for disposals, leaving 325 patients who neither used nor disposed of their cryopreserved straws. Our findings revealed a distinct pattern based on age, with the youngest age group (< 25 years) exhibiting significantly lower utilization and disposal rates compared to older patient groups. Additionally, men without children exhibited significantly fewer disposal requests compared to fathers. The median cryopreserved straws were 10 (interquartile range, 6 to 17), while the median used straws were only 2 (interquartile range, 2 to 6).

DISCUSSION

Our study brings attention to the additional and needless burden of preservation from both patient and preserved straw perspectives. Implementing a policy based on a cost-effective approach, incorporating time and straw limits, and considering demographic characteristics, could enhance efficiency and necessitate patient consent before preservation.

Spatial Transcriptomics Unravel the Tissue Complexity of Oral Pathogenesis

Spatial transcriptomics (ST) is a cutting-edge methodology that enables the simultaneous profiling of global gene expression and spatial information within histological tissue sections. Traditional transcriptomic methods lack the spatial resolution required to sufficiently examine the complex interrelationships between cellular regions in diseased and healthy tissue states. We review the general workflows for ST, from specimen processing to ST data analysis and interpretations of the ST dataset using visualizations and cell deconvolution approaches. We show how recent studies used ST to explore the development or pathogenesis of specific craniofacial regions, including the cranium, palate, salivary glands, tongue, floor of mouth, oropharynx, and periodontium. Analyses of cranial suture patency and palatal fusion during development using ST identified spatial patterns of bone morphogenetic protein in sutures and osteogenic differentiation pathways in the palate, in addition to the discovery of several genes expressed at critical locations during craniofacial development. ST of salivary glands from patients with Sjögren's disease revealed co-localization of autoimmune antigens with ductal cells and a subpopulation of acinar cells that was specifically depleted by the dysregulated autoimmune response. ST of head and neck lesions, such as premalignant leukoplakia progressing to established oral squamous cell carcinomas, oral cancers with perineural invasions, and oropharyngeal lesions associated with HPV infection spatially profiled the complex tumor microenvironment, showing functionally important gene signatures of tumor cell differentiation, invasion, and nontumor cell dysregulation within patient biopsies. ST also enabled the localization of periodontal disease-associated gene expression signatures within gingival tissues, including genes involved in inflammation, and the discovery of a fibroblast subtype mediating the transition between innate and adaptive immune responses in periodontitis. The increased use of ST, especially in conjunction with single-cell analyses, promises to improve our understandings of craniofacial development and pathogenesis at unprecedented tissue-level resolution in both space and time.

The efficacy and safety of CDK4/6 inhibitors combined with endocrine therapy versus endocrine therapy alone in the adjuvant treatment of patients with high-risk invasive HR+/HER2-early breast cancer: A comprehensive updated meta-analysis of randomized clinical trials

BACKGROUND

This paper aimed to evaluate the effectiveness of incorporating CDK 4/6 inhibitors (CDK4/6i) into ET for the adjuvant treatment of HR + HER2-resected early-stage breast cancer (ESBC) patients, employing meta-analysis.

METHODS

In this paper, we compiled randomized clinical trials focusing on CDK4/6i used in the adjuvant treatment of high-risk invasive HR-positive and HER2-ESBC patients. A meta-analysis was performed in line with the PRISMA guidelines.

RESULTS

We identified four clinical trials that met our inclusion criteria and were published between 2020 and 2024. These trials involved a combined sample size of 17,749 patients diagnosed with breast cancer. The data obtained from the pooled analysis revealed a remarkable beneficial trend in terms of invasive disease-free survival (iDFS) for the use of ET in combination with CDK4/6i compared to the group receiving ET alone (HR = 0.81, 95 % CI: 0.67-0.98, p = 0.03). Of note, CDK4/6 inhibitors demonstrated a notably beneficial effect in both grade 2 (HR = 0.69, 95 % CI: 0.59-0.81, p < 0.001) and grade 3 (HR = 0.76, 95 % CI: 0.65-0.89, p < 0.001). Significant improvements were noted in terms of distant relapse-free survival (dRFS) in the groups treated with abemaciclib and ribociclib (HR = 0.65, 95 % CI: 0.56-0.76, p < 0.001; HR = 0.72, 95 % CI: 0.58-0.89, p = 0.003, respectively). CDK4/6i didn't yield a statistically significant difference in overall survival (OS) (HR = 0.96, 95 % CI: 0.77-1.19, p = 0.69). The use of CDK4/6i with ET was associated with an increased risk of adverse events, particularly anemia and neutropenia, compared with ET alone (OR = 9.12, 95 % CI = 5.04-16.48, p < 0.001).

CONCLUSION

The findings of this paper demonstrate a significant improvement in iDFS when ET is combined with CDK4/6i, compared to ET alone. Specifically, treatments with abemaciclib and ribociclib showed notable enhancements in dRFS.

Neurotoxicity of the antineoplastic drugs: "Doxorubicin" as an example

There is an increased prevalence of cancer, and chemotherapy is widely and routinely utilized to manage the majority of cancers; however, administration of chemotherapeutic drugs has faced limitations concerning the "off-target" cytotoxicity. Chemobrain and impairment of neurocognitive functions have been observed in a significant fraction of cancer patients or survivors and reduce their life quality; this could be ascribed to the ability of chemotherapeutic drugs to alter the structure and function of the brain. Doxorubicin (DOX), an FDA-approved chemotherapeutic drug with therapeutic effectiveness, is commonly used to treat several carcinomas clinically. DOX-triggered neurotoxicity is the most serious adverse reaction after DOX-induced cardiotoxicity which greatly limits its clinical application. DOX-induced neurotoxicity is a net of multiple mechanisms that have been verified in pre-clinical and clinical studies, such as oxidative stress, neuroinflammation, mitochondrial disruption, apoptosis, autophagy, disruption of neurotransmitters, and impairment of neurogenesis. There is a massive need for developing novel therapeutics for both cancer and DOX-associated neurotoxicity; therefore investigating the implicated mechanisms of DOX-induced chemobrain will reveal multi-targets for novel curative strategies. Recently, various neuroprotective mechanisms were employed to mitigate DOX-mediated neurotoxicity. For this purpose, therapeutic interventions using pharmacological compounds were developed to protect healthy "off-target" tissues from DOX-induced toxicity. In addition, nanoplatforms were used to enable target delivery of DOX; to prevent its deposition in non-cancerous tissues. The aim of the current review is to provide some reference value for the future management of DOX-induced neurotoxicity and to summarize the underlying mechanisms of DOX-mediated neurotoxicity and the potential therapeutic interventions.

Fungal disease incidence and prevalence in Iraq - Preliminary estimates

BACKGROUND

The surveillance of serious and superficial skin fungal infections in Iraq has not been conducted. Limited information exists on their incidence and prevalence.

OBJECTIVES

This study aimed to analyze, compute and estimate the prevalence and burden of fungal infections, as no previous data is available and no studies has been attempted in Iraq.

METHODS

In the present study the data were collected and reviewed from published data on epidemiology of fungal infections nationally, internationally, from unpublished postgraduate master and PhD theses, hospital records and private clinic records. External sources of data from other countries were used for diseases which lacked sufficient local data.

RESULTS

We estimated 985,628 annual serious infections comprising of 2.26 % of the total population. When including superficial fungal infections group of the skin, this rises to 2,075,113 infections at 4.76 % of the total population. The most common serious and skin infections were recurrent Candida vaginitis, fungal rhinosinusitis and tinea capitis comprising 61.5 %, 21.8 %, and 22.4 % of all infections although the total incidence of superficial fungal infections was also high at 1,071,485. Respiratory fungal disease is also common comprising 14.0 % of infections. We predicted the following annual burden per 100,000; oral candidiasis at 247.9, esophageal candidiasis at 6.04, candidemia at 5.0, Candida peritonitis at 0.75, recurrent Candida vaginitis at 5461, allergic bronchopulmonary aspergillosis at 35, severe asthma with fungal sensitisation at 46, invasive aspergillosis at 7.9, chronic pulmonary aspergillosis at 11.7, chronic fungal rhinosinusitis at 496, mucormycosis at 0.99, fungal keratitis at 14.0, and total dermatophytosis at 1631, the most severe being tinea capitis at 366. Many of these estimates were made with data sourced from other nations, so additional data from Iraq is required to validate or modify these estimates.

CONCLUSION

Recurrent Candida vaginitis, fungal rhinosinusitis, and tinea capitis are considered to be the most frequent fungal diseases present in Iraq.

Cannabis Use and Head and Neck Cancer

Importance

Cannabis is the most commonly used illicit substance worldwide. Whether cannabis use is associated with head and neck cancer (HNC) is unclear.

Objective

To assess the clinical association between cannabis use and HNC.

Design, Setting, and Participants

This large multicenter cohort study used clinical records from a database that included 20 years of data (through April 2024) from 64 health care organizations. A database was searched for medical records for US adults with and without cannabis-related disorder who had recorded outpatient hospital clinic visits and no prior history of HNC. Propensity score matching was performed for demographic characteristics, alcohol-related disorders, and tobacco use. Subsequently, relative risks (RRs) were calculated to explore risk of HNC, including HNC subsites. This analysis was repeated among those younger than 60 years and 60 years or older.

Exposure

Cannabis-related disorder.

Main Outcomes and Measures

Diagnosis of HNC and any HNC subsite.

Results

The cannabis-related disorder cohort included 116 076 individuals (51 646 women [44.5%]) with a mean (SD) age of 46.4 (16.8) years. The non-cannabis-related disorder cohort included 3 985 286 individuals (2 173 684 women [54.5%]) with a mean (SD) age of 60.8 (20.6) years. The rate of new HNC diagnosis in all sites was higher in the cannabis-related disorder cohort. After matching (n = 115 865 per group), patients with cannabis-related disorder had a higher risk of any HNC (RR, 3.49; 95% CI, 2.78-4.39) than those without HNC. A site-specific analysis yielded that those with cannabis-related disorder had a higher risk of oral (RR, 2.51; 95% CI, 1.81-3.47), oropharyngeal (RR, 4.90; 95% CI, 2.99-8.02), and laryngeal (RR, 8.39; 95% CI, 4.72-14.90) cancer. Results were consistent when stratifying by older and younger age group.

Conclusions and Relevance

This cohort study highlights an association between cannabis-related disorder and the development of HNC in adult patients. Given the limitations of the database, future research should examine the mechanism of this association and analyze dose response with strong controls to further support evidence of cannabis use as a risk factor for HNCs.

The Risk Information and Skin-cancer Education for Undergraduate Prevention (RISE-UP) Study: Protocol for a Trial of Personalized Sun Protection Interventions for Skin Cancer Prevention among Undergraduate Students

BACKGROUND

Addressing the increasing incidence of skin cancer among young adults is a priority. The objective of the Risk Information and Skin-cancer Education for Undergraduate Prevention (RISE-UP) study is to identify personalized intervention components to prevent sunburn, a clinically significant outcome highly associated with skin cancer, in college students.

METHODS

Guided by the Elaboration Likelihood Model, the study will use Multiphase Optimization Strategy (MOST) methodology to test three intervention components (ultraviolet photography, MC1R genetic testing, and action planning) each with two levels (yes v. no) in a full-factorial experiment to evaluate unique and combined effects of these components to improve outcomes over the longer-term, with seasonally timed follow-up. At-risk University of Utah students (N = 528) will be recruited. Eligibility criteria include self-reported sunburn or tanning in the past year, or not utilizing recommended sun protection. After baseline assessment, participants will be randomized to intervention group, stratified by sex. Assessments will be completed at (1) Baseline; (2) Intervention; (3) 1 month after intervention; (4) 4 months after intervention (the end of the first summer); and (5) 15 months after intervention (the end of the second summer). The primary outcome will be participants' self-reported number of sunburns. Secondary outcomes will include self-reported sun protection and tanning behaviors and, in a randomly selected subgroup, an objective measure of ultraviolet radiation (UVR) exposure.

CONCLUSION

The RISE-UP study will determine the efficacy of different combinations of personalized skin cancer preventative interventions for young adults and determine the optimal combination of intervention components to prevent skin cancer.

CLINICAL TRIAL REGISTRATION

NCT05634252.

Immunotherapy for Head and Neck Squamous Cell Carcinoma: Present and Future Approaches and Challenges

Despite significant progress and improving outcomes in the management of head and neck squamous cell carcinoma (HNSCC), there are few effective treatment options for patients with recurrent or metastatic head and neck squamous cell carcinoma. The advent of immune checkpoint inhibitors has changed the treatment algorithm of head and neck squamous cell carcinoma and are approved in the frontline setting for recurrent and metastatic (R/M) head and neck squamous cell carcinomas. Although promising for some patients, most patients with R/M HNSCC do not derive clinical benefit from currently approved checkpoint inhibitors. Many studies are underway to identify the patient population that would benefit the most from immunotherapy as well as postimmunotherapy treatment failures, including novel combinations of immunomodulatory therapies. In this review, we summarize the clinical development of all major clinical trials of immunotherapy in HNSCC.

RNA splicing variants of the novel long non-coding RNA, CyKILR, possess divergent biological functions in non-small cell lung cancer

The CDKN2A gene, responsible for encoding the tumor suppressors p16(INK4A) and p14(ARF), is frequently inactivated in non-small cell lung cancer (NSCLC). Herein, an uncharacterized long non-coding RNA (lncRNA) (ENSG00000267053) on chromosome 19p13.12 was found to be overexpressed in NSCLC cells with an active, wild-type CDKN2A gene. This lncRNA, named Cy clin-Dependent K inase I nhibitor 2A-regulated l nc R NA (CyKILR), also correlated with an active WT STK11 gene, which encodes the tumor suppressor, Liver kinase B1. CyKILR displayed two splice variants, CyKILRa (exon 3 included) and CyKILRb (exon 3 excluded), which are cooperatively regulated by CDKN2A and STK11 as knockdown of both tumor suppressor genes was required to induce a significant loss of exon 3 inclusion in mature CyKILR RNA. CyKILRa localized to the nucleus, and its downregulation using antisense RNA oligonucleotides enhanced cellular proliferation, migration, clonogenic survival, and tumor incidence. In contrast, CyKILRb localized to the cytoplasm, and its downregulation using siRNA reduced cell proliferation, migration, clonogenic survival, and tumor incidence. Transcriptomics analyses revealed enhancement of apoptotic pathways with concomitant suppression of key cell cycle pathways by CyKILRa demonstrating its tumor-suppressive role. CyKILRb inhibited tumor suppressor microRNAs indicating an oncogenic nature. These findings elucidate the intricate roles of lncRNAs in cell signaling and tumorigenesis.

Upfront Surgery vs. Endoscopic Stenting Bridge to Minimally Invasive Surgery for Treatment of Obstructive Left Colon Cancer: Analysis of Surgical and Oncological Outcomes

BACKGROUND

Left colon cancer obstruction treatment is a debated topic in the literature. Stent placement is effective as a bridge-to-surgery strategy, but there are some concerns about the oncological safety for the reported higher risk of local and peritoneal recurrence. This study aims to compare the surgical and oncological outcomes of patients treated with stent followed by elective surgery with those treated with primary resection.

METHODS

This is a retrospective observational study. We included patients of both sexes, ≥18 years old, with a histological diagnosis of intestinal adenocarcinoma, and admitted to our hospital for left colon cancer obstruction demonstrated by CT scan without metastasis or perforation. They were treated through primary resection (PR) or stent placement followed by elective surgery (SR). The two groups were compared for general characteristics, surgical outcomes, and oncological outcomes (metastasis and local recurrence) at 30 days, 90 days, 1 year, and 3 years. Post-operative quality of life (QoL) was also investigated.

RESULTS

The SR group showed a shorter hospital stay, a lower post-operative mortality, a lower stoma rate at 1 year, and a higher number of minimally invasive procedures. Oncological outcomes were not different compared to the PR group. The SR group demonstrated better QoL in two out of six items on the EQ-5D-5L test.

CONCLUSIONS

Stent placement as a bridge-to-surgery strategy is feasible and provides better surgical outcomes in terms of post-operative complications, surgical approach, stoma rate, and QoL. Oncological outcomes were not reported differently, but further studies should be conducted to better evaluate this aspect.

Image-Guided Radiation Therapy Is Equally Effective for Basal and Squamous Cell Carcinoma

Non-melanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are highly prevalent and a significant cause of morbidity. Image-guided superficial radiation therapy (IGSRT) uses integrated high-resolution dermal ultrasound to improve lesion visualization, but it is unknown whether efficacy varies by histology. This large retrospective cohort study was conducted to determine the effect of tumor histology on freedom from recurrence in 20,069 biopsy-proven NMSC lesions treated with IGSRT, including 9928 BCCs (49.5%), 5294 SCCs (26.4%), 4648 SCCIS cases (23.2%), and 199 lesions with ≥2 NMSCs (1.0%). Freedom from recurrence at 2, 4, and 6 years was 99.60%, 99.45%, and 99.45% in BCC; 99.58%, 99.49%, and 99.49% in SCC; and 99.96%, 99.80%, and 99.80% in SCCIS. Freedom from recurrence at 2, 4, and 6 years following IGSRT did not differ significantly comparing BCC vs. non-BCC or SCC vs. non-SCC but were slightly lower among SCCIS vs. non-SCCIS (p = 0.002). There were no significant differences in freedom from recurrence when stratifying lesions by histologic subtype. This study demonstrates that there is no significant effect of histology on freedom from recurrence in IGSRT-treated NMSC except in SCCIS. These findings support IGSRT as a first-line therapeutic option for NMSC regardless of histology.

Correlation between environmental DEET exposure and the mortality rate of cancer survivors: a large-sample cross-sectional investigation

BACKGROUND

N, N-Diethyl-meta-toluamide (DEET) is the predominant active ingredient found in insect repellents utilized by consumers. Exposure to DEET has been associated with notable risks to human health. Nonetheless, there is a scarcity of extensive cohort studies investigating the precise correlation between DEET exposure and mortality rates among cancer survivors. The objective of this study is to thoroughly evaluate the connection between DEET exposure and mortality rates in cancer survivors.

METHODS

This study employed individual samples obtained from the National Health and Nutrition Examination Survey (NHANES). Utilizing data from NHANES spanning 2007 to 2016, this study incorporated a cohort of 5,859 cancer survivors for subsequent analysis, following the exclusion of incomplete datasets. Through subgroup analysis, the research examined the impact of quartile levels of 3-diethyl-carbamoyl benzoic acid (DCBA), the primary metabolite of DEET, on cancer survivors across various subgroups within the broader population. Furthermore, the research utilized a multivariable Cox proportional hazards regression model and Kaplan-Meier (KM) curves to investigate the relationship between 3-diethyl-carbamoyl benzoic acid (DCBA), a principal metabolite of DEET, and mortality rates in individuals who have survived cancer.

RESULTS

The study identified an association between specific quartiles of DCBA concentration and a decreased risk of all-cause mortality among cancer survivors, specifically in the second (Q2: 0.665-1.95) and third quartiles (Q3: 1.95-6.845). Furthermore, a significant correlation was observed between the third quartile and cancer-specific mortality (Q3: 1.95-6.845), as well as between the second quartile and non-cancer mortality (Q2: 0.665-1.95). The quartiles of DCBA concentration exhibit a statistically significant correlation with total deaths (P < 0.001), cancer-specific deaths (P = 0.009), and non-cancer deaths (P < 0.001) among cancer survivors. The correlation between DCBA and reduced mortality risk in cancer survivors is particularly notable among females and individuals of non-Hispanic Black descent.

CONCLUSION

The detection of DCBA in the urine of adult cancer survivors is strongly associated with increased mortality risks, particularly among females and non-Hispanic Black individuals, warranting further investigation and targeted interventions.

Vitamin D receptor polymorphisms and associated miRNAs in the development of breast cancer in African American women

Breast cancer (BCa) is a prevalent form of cancer in women, exhibiting varying rates and distribution across different ethnic groups. Among these groups, African American (AA) women have the highest incidence of BCa and the lowest levels of Vitamin D (VD). Numerous studies have explored the connection between variations in the VDR gene and BCa risk, particularly in different populations, but research on the AA population remains limited. Epigenetic modifications, including specific microRNAs (miRNAs), can influence gene expression without altering the genetic code and have been implicated in cancer initiation and progression. Our hypothesis suggests that VDR gene variations may increase BCa risk in AA women and that changes in miRNA expression profiles could contribute to BCa development. Using data from the 1000 Genome Project, we identified five VDR gene variants with significant frequency differences between AA and European-American (EA) populations. We genotyped 404 African American BCa cases and controls for five variants using TaqMan® assays. SNPstats assessed their association with BCa risk. The rs1544410 variant's recessive model (A/A) showed a decreased BCa risk in AA (odds ratio 0.33, 95% CI: 0.15-0.73, p-value 0.0041). Conversely, the rs2853563 variant's recessive model (A/A) was linked to an increased BCa risk (odds ratio 4.04, 95% CI: 1.49-10.95, p-value 0.0022). We investigated miRNA expression influenced by VD in HCC1806 Triple-Negative Breast Cancer (TNBC) cell lines with the A/A allele for rs2853563. nCounter® Nanostring technology assessed miRNA profiles after calcitriol treatment. Our results indicated that calcitriol treatment led to reduced expression of six miRNAs, four of which are associated with tumor suppression in the presence of the AA genotype in TNBC cell lines. These findings suggest that specific VDR genotypes could have a potential effect on the miRNAs expression which could potentially serve as markers for cell proliferation in TNBC.

Influence of Cytokine Genetic Polymorphisms in Helicobacter pylori-Associated Gastric Inflammation According to Sex in South Korea

Background/Aims

: The relationship between genetic polymorphisms and gastric inflammation remains unclear. This study aimed to evaluate the impact of genetic polymorphisms on Helicobacter pylori (HP)-associated gastritis according to sex.

Methods

: Two hundred thirty-two male and 404 female subjects with current HP infection were prospectively enrolled. The genotyping of IL-1B-511 C/T, IL-1RN variable number of tandem repeats, IL-6-572 G/C, IL-8-251 A/T, IL-8-781 C/T, IL-10-1082 G/A, IL-10-592 C/A, TNF-A-308 G/A, and transforming growth factor (TGF)-B-509 C/T, was determined by polymerase chain reaction-restriction fragment length polymorphism. The degree of monocyte or neutrophil infiltration, atrophic gastritis, and intestinal metaplasia was evaluated using the updated Sydney system.

Results

: Among the male subjects, moderate/severe atrophic gastritis of the corpus was higher in IL-1B-511 CC carriers than in CT and TT carriers independent of age, alcohol consumption, and HP virulence factors (26.9% vs 10.4%; adjusted hazard ratio [HR], 4.377; 95% confidence interval, 1.387 to 13.814). In females, IL-8-251 AA carriers were independently and significantly associated with moderate/severe atrophic gastritis of the corpus compared with that in AT and TT carriers (21.4% vs 6.0%, adjusted HR=3.799). In males, the IL-8-251 TT genotype was associated with moderate/severe intestinal metaplasia of the corpus compared with the AT and AA genotypes (13.4% vs 5.6%, adjusted HR=3.128), while the IL-10-592 CA and CC genotypes were associated with moderate/severe monocyte infiltration of the antrum compared with AA genotype (83.6% vs 71.8%, adjusted HR=2.227).

Conclusions

: Genetic polymorphisms in cytokines play different roles in HP-associated gastritis according to sex.

Discovery of IRAK1/4/pan-FLT3 Kinase Inhibitors as Treatments for Acute Myeloid Leukemia

We report the discovery of an imidazopyridine series of IRAK1/4/pan-FLT3 kinase inhibitors. Optimization of this series has produced compound 31 which displays potent and selective inhibition of IRAK1, IRAK4, FLT3, and all mutant forms of FLT3, as well as good in vitro ADME and pharmacokinetic properties. In a mouse xenograft model of AML, 31 produces survival prolongation equal to that of Gilteritinib, the leading marketed FLT3 inhibitor currently used to treat AML.

Body mass index and breast cancer risk in premenopausal and postmenopausal East Asian women: a pooled analysis of 13 cohort studies

BACKGROUND

It has been suggested that the association between body mass index and breast cancer risk differs between Asian women and Western women. We aimed to assess the associations between body mass index and breast cancer incidence in East Asian women.

METHODS

Pooled analyses were performed using individual participant data of 319,189 women from 13 cohort studies in Japan, Korea, and China. Participants' height and weight were obtained by measurement or self-reports at cohort baseline. Breast cancer was defined as code C50.0-C50.9 according to the International Classification. Using a Cox proportional hazards model, hazard ratios of breast cancer were estimated for each body mass index category, with the reference group set as the group with a body mass index of 21 to < 23 kg/m2. The hazard ratio for a 5 kg/m2 increase in body mass index was also calculated.

RESULTS

During a mean 16.6 years of follow-up, 4819 women developed breast cancer. Similar to Westerners, a steady increase in breast cancer risk with increasing body mass index was observed in postmenopausal women, but the slope of the risk increase appeared to slow at a body mass index of 26-28 kg/m2. In premenopausal women, the inverse association seen in Westerners was not observed. The risk of developing breast cancer after 50 years of age increased slightly with increasing body mass index, which was more pronounced in the older birth cohort. There was no significant association between body mass index and the risk of developing breast cancer before 50 years of age, but the risk estimates changed from positive to negative as the birth cohort got younger.

CONCLUSIONS

In East Asia, the role of body mass index in breast cancer in premenopausal women may be changing along with the increase in obesity and breast cancer. The increased risk of postmenopausal breast cancer with a higher body mass index was as robust as that of Western women.

Comparative analysis of the expression of р16, PD-L1 in squamous cell carcinoma of the oropharynx and CUP syndrome

Introduction. metastases in the absence of a primary tumor (cancer of unknown primary (Cup) syndrome) are diagnosed in 2–4 % of malignant tumor cases. This pathology is characterized by early metastatic dissemination, weak response to conventional chemotherapy, and aggressive progression. The use of checkpoint inhibitors targeting programmed cell death protein 1 (pD-1) and its ligand (pD-L1) has shown good results in treatment of various cancers including oropharyngeal squamous cell carcinoma (OpSCC). In Cup syndrome, the effectiveness of checkpoint inhibitors is rarely investigated, and pD-L1 expression is often not measured.Aim. To compare the frequency of p16 and pD-L1 hyperexpression in OpSCC and Cup syndrome, and to analyze dependency of survival rates on the level of expression of p16, the most important prognostic marker.Materials and methods. The study included 121 patients (59 with OpSCC and 62 with Cup syndrome) who received medical treatment in the multidisciplinary medical Center “medical City” (Tyumen) and Chelyabinsk Oncological Center of Oncology and Nuclear medicine between 2019 and 2023. Immunohistochemical examination was performed using the vENTANA Benchmark gX with primary antibodies against pD-L1 (clone Sp263, uSA) and р16 (uS Biological, uSA). Statistical analysis of the data was performed using SpSS 26 software. Long-term treatment outcomes were evaluated using 1-, 3-, 5-year survival rates and median survival. Overall survival was analyzed using the kaplan-meier method. Statistical significance of the differences was evaluated using the Cox model.Results. The studied groups did not differ by sex (p = 0.472), age (р = 0.640), and N stage (р = 0.262). patient age in the whole population varied between 42 and 81 years (median age 61.89 ± 11.9 years; mean age 60.81 ± 9.8 years). pD-L1 expression rate was higher in Cup syndrome at 92 % compared to 73 % in OpSCC (statistically significant difference; р = 0.01). Analysis of the association of ORSCC and Cup syndrome with human papilloma virus showed statistically significant difference in p16 hyperexpression: patients with OpSCC had p16-positive status more frequently (53 % of cases) while patients with Cup syndrome mostly had p16-negative status (73 % of cases). mean life expectancy of patients with OpSCC and p16-positive status was 62.65 months (95 % confidence interval 54.98–70.31), minimal observation period was 12 months, maximal was 70 months. mean life expectancy of patients with Cup syndrome and positive p16 status was 66.22 months (95 % confidence interval 56.35–76.10), minimal observation period was 12 months, maximal was 70 months. No statistically significant differences in survival rates of patients with OpSCC and Cup syndrome were found (р = 0.999).Conclusion. The study showed higher pD-L1 expression in patients with Cup syndrome compared to patients with OpSCC: 92 and 73 %, respectively (р = 0.01). The obtained results highlight the importance of routine pD-L1 expression evaluation in patients with Cup syndrome. The frequency of p16 hyperexpression was higher in OpSCC compared to Cup syndrome: 53 % versus 27 % (р = 0.02) which agrees with the worldwide epidemiological data: among all malignant neoplasms of the head and neck, Hpv infection is most common in OpSCC. Therefore, it serves as an important sign of hidden oropharyngeal cancer in Cup syndrome.

Global burden and cross-country inequalities in diseases associated with high body mass index from 1990 to 2019: Result from the Global Burden of Disease Study 2019

BACKGROUND

High body mass index (BMI) has gradually become an increased risk factor for the global burden of diseases (GBD). As the disease burden and the number of elders globally increase, it is crucial for policymakers to realise the associations between high BMI and disease burden worldwide in a timely manner and to develop effective interventions for different countries and ages.

METHODS

We used the GBD 2019 database to analyse the deaths and disability-adjusted life-years (DALYs) in the disease burden associated with high BMI and indicated the health inequality at the global, regional, and national levels. We applied the slope index of inequality and concentration index, two standard metrics of absolute and relative gradient inequality recommended by the World Health Organization (WHO), to quantify the distributive inequalities in the burden of diseases associated with high BMI. These rates were reported per 100 000 population as crude incidence rates, death rates, and DALYs rates. All the estimates were generated with a 95% uncertainty interval (UIs).

RESULTS

Globally, we revealed that an estimated age-standardised mortality rate associated with high BMI is 6.26 million (95% UIs = 3.99, 8.91). The age-standardised DALYs rate is 19.32 million (95% UIs = 12.77, 26.40), and the global population attributable fraction was 9% (95% UIs = 5, 12) in 2019. The largest number of high-BMI-related deaths in women mainly concentrated in the age group of 65-79 years, whereas the largest number in men was in the age group of 60-69 years. The age-standardised DALYs rate of diseases associated with high BMI was larger in the high-middle and middle socio-demographic index (SDI) (population attributable fraction (PAF) = 11 and PAF = 9) regions than those with high SDI (PAF = 1) and low SDI (PAF = 5) regions.

CONCLUSIONS

In this study, our results showed that the disease burden of global deaths and DALYs associated with high BMI has substantially increased between 1990-2019. Furthermore, we demonstrated that countries with higher SDI development levels shoulders higher burden of diseases associated with high BMI. Future policies to prevent and reduce the burden should be developed and implemented based on country-specific development status.

Epidemiology of malignant brain tumors in Genova, Italy. 1993-2017

We present an updated analysis on the incidence of primary brain tumors in the Metropolitan Area of Genova, the capital of the northwestern Italian region Liguria.The number of cases and incidence rates for all malignant brain tumors, glioblastoma, malignant brain tumors other than glioblastoma, and brain tumors not otherwise specified were calculated for each of seven three-year and one-eighth four-year periods in which the quarter century 1993-2017 was divided. The rates were age-adjusted (AAR) using the 2013 European standard population, presented per 100,000 person-years and the average percentage change over the three-year period was calculated.The number of cases of all malignant brain tumors and glioblastoma was higher in males than in females in each three-year period and in the entire quarter century 1993-2017. During the latter, the average three-year percentage change in AARs for all brain tumors was minimal [0.6 (95% C.I. = -1.0/2.1) %] while for glioblastoma there was a change of 5.3 (95% C.I. = -0.4/11.3) %. The partially concurrent decline in the incidence rates of malignant brain tumors other than glioblastoma or not otherwise specified suggests that the observed increase in the incidence rate of glioblastoma during 1993-2017 may have been at least partially linked to the improvement during the same period in sensitivity and specificity of the diagnosis of glioblastoma, depleting the reservoirs of other malignant or unspecified brain tumors. Research into possibly increased environmental risk factors (e.g., population exposure to ionizing radiation) for glioblastoma in Genova remains warranted.

Skimmed milk intake reduces the risk of ER- breast cancer: a Mendelian randomization analysis

BACKGROUND

In prior observational investigations, it has been demonstrated that the consumption of milk is associated with the incidence of breast cancer (BC). Despite the existence of a two-sample Mendelian randomization (MR) that suggests a causal relationship between milk intake and breast cancer risk, the outcomes still lack a definitive conclusion. This ambiguity may be attributed to variables such as the variety of milk ingested, estrogen levels, the specific type of BC, and potential confounding factors. Therefore, our principal objective is to establish the causal association between the consumption of skimmed milk and full cream milk and the risk of different types of BC through the utilization of two-sample and two-step MR analyses.

METHODS

In this study, we analyzed single nucleotide polymorphisms associated with skimmed and full-cream milk consumption in a cohort of 360,806 individuals from European populations through genome-wide association studies. We conducted a two-sample MR analysis using three different methods: inverse variance weighting (IVW) was used as the main analysis, and MR-Egger and Weighted median were used as supplementary analyses to IVW. We also performed sensitivity analysis, which included leave-one-out analysis, Cochran's Q test to detect heterogeneity, and MR-Egger intercept analysis to detect potential biases caused by pleiotropy. We used two-step MR analysis to evaluate potential mediators of associations.

RESULTS

In the two-sample MR analysis, IVW analysis suggests a potential inverse causal relationship between skimmed milk and BC [OR 0.34, 95% CI (0.12-1.00), P = 0.05]. Subgroup analysis revealed that skimmed milk reduces the risk of estrogen receptor-negative (ER-) breast cancer [OR 0.18, 95% CI (0.04-0.90), P = 0.04], but not estrogen receptor-positive (ER+) breast cancer [OR 0.42, 95% CI (0.15-1.22), P = 0.11]. MR Egger reached similar results, that is, skimmed milk reduces the risk of ER- breast cancer [OR 0.006, 95% CI (0.00-0.70), P = 0.04], but not BC [OR 0.16, 95% CI (0.01-4.66), P = 0.30] and ER+ breast cancer [OR 0.50, 95% CI (0.02-12.61), P = 0.65]. Additionally, we found no causal relationship between full cream milk and BC (P > 0.05). In two-step MR analysis, we found evidence for a mediating role of BMI in the relationship between skimmed milk intake and ER-breast cancer risk.

CONCLUSION

Our findings strengthen the evidence for a protective effect of skimmed milk consumption on ER-breast cancer risk. Further two-step MR analyses suggest that this protective effect may partly result from body mass index (BMI). There is no evidence that full cream milk consumption affects the risk of BC.

Gastric cancer and brain metastasis: A systematic review and meta‑analysis

Gastric cancer (GC) constitutes one of the most wide-ranging cancers, with brain metastasis (BM) being a markedly uncommon and unfavorable outcome. The present meta-analysis evaluated the relationship between no-surgical treatment vs. additional surgical BM resection on the patient's quality of life and potential survival using electronic databases, including PubMed (1980-April 2024), Medline (1980-April 2024), Cochrane Library, and EMBASE (1980-April 2024). After a literature search, six articles were included in the final study pool. The number of patients with BM and conservative treatment was 289 (80.05%) compared with those that underwent an additional surgical resection 72 (19.95%). The mean age was 59.2 years, and the males were 195 (73.8%) of 264 available from five studies. The findings of the present meta-analysis revealed that the curative effect of BM tumor resection on patients with GC undergoing additional treatment with stereotactic radiosurgery, whole-brain radiotherapy or chemotherapy was favorable for their survival.

Climate change, climate disasters and oncology care: a descriptive global survey of oncology healthcare professionals

PURPOSE

Climate disasters and climate change have implications for healthcare globally. As the number and intensity of climate disasters increase, it is important to understand the effects on healthcare. We conducted a global survey of oncology healthcare providers to identify awareness, experiences, and educational needs related to climate change.

METHODS

An existing climate and health survey was adapted to oncology. This IRB- approved, 30-item survey measured demographics, climate disaster awareness, effects on cancer care and educational needs. Healthcare professionals employed in oncology settings (practice, research, or academic) were eligible. The survey was disseminated via social media and professional organizations. Descriptive statistics were computed using SPSS.

RESULTS

154 responses from 26 countries were received from nurses (56%), physicians (19%), and other healthcare professionals (25%). Common climate change-related events impacting oncology care were extreme heat (63.8%) and heavy rains (52.2%). Respondents reported their workplace has a disaster plan for climate-related weather events (50.4%) or has taken steps to prepare for a climate-related weather event (48.5%). Respondents were aware that the planet has warmed significantly (98.7%), that healthcare contributes to greenhouse gas emissions (98.6%) and reported wanting to learn more about how climate change affects cancer care (88.3%). Preferred educational modalities include webinars (69%), e-learning (55%), journal articles (48.3%), conferences (46.3%) and podcasts (38.9%).

CONCLUSIONS

This global survey is the first to identify the awareness, experiences, and educational needs of oncology healthcare professionals related to climate change and climate disasters. Healthcare providers are positioned to take leadership roles related to climate and health.

The risk stratification and predictive performance of a new combined polygenic risk score for hepatocellular carcinoma

BACKGROUND

Recent genome-wide association studies (GWASs) in liver diseases have generated some polygenic risk scores (PRSs), but their predictive effectiveness on hepatocellular carcinoma (HCC) risk assessment remains unclear.

METHODS

Here, we constructed a novel combined polygenic risk score and evaluated its increment to the well-established risk model. We used 15 HCC-associated genetic loci from two PRSs and FinnGen GWAS data to calculate a PRS-combined score and to fit the related PRS model in the UK Biobank cohort (N = 436,162). The PRS-combined score was further assessed for risk stratification for HCC integrating with the recommended clinical risk scores.

RESULTS

The PRS-combined model achieved a better AUC (0.657) than that of PRS-HFC (0.637) and PRS-cirrhosis (0.645). The top 20% of the PRS-combined distribution had a 3.25 increased risk of HCC vs. the middle decile (45-55%). At the population level, the addition of PRS-combined to the CLivD score significantly increased the C-statistic (from 0.716 to 0.746) and provided a remarkable improvement in reclassification (NRI = 0.088) at the 10-year risk threshold of 0.2%. In clinic, additional assessment of PRS-combined would reclassify 34,647 intermediate-risk participants as high genetic risk, corresponding to an increase of 63.92% (62/97) of the HCC events classified at high risk using the Fibrosis-4 alone.

CONCLUSIONS

The PRS may enhance HCC risk prediction effectiveness in the general population and refine risk stratification of the conventional clinical indicator.

Double-Hit Diffuse Large B-Cell Lymphoma in AIDS

Diffuse large B-cell lymphoma (DLBCL) is the most common type of immunoblastic lymphoma associated with AIDS, with the stomach being the most frequent extranodal site of involvement. Despite the widespread use of combined antiretroviral therapy (cART), the incidence of systemic lymphomas remains relatively high. These lymphomas often present in the early stages of AIDS as high-grade malignancies. We report the case of a man in his early 30s who initially presented with chronic cough and weight loss, diagnosed with pulmonary tuberculosis and found to be HIV-positive. Within a few months, he returned with persistent abdominal pain and progressive weight loss. Imaging revealed a gastric ulcer, and biopsy confirmed the diagnosis of DLBCL. Although cART is now available and started early upon an HIV diagnosis, vigilant surveillance, early diagnosis, and prompt initiation of chemotherapy are critical for achieving an adequate response and remission.

Identification of key markers for the stages of nonalcoholic fatty liver disease: An integrated bioinformatics analysis and experimental validation

BACKGROUND

The identification of biomarkers for the early diagnosis of nonalcoholic fatty liver disease (NAFLD) is urgently needed. Here, we aimed to identify NAFLD biomarkers in the early stages of steatosis (SS) and nonalcoholic steatohepatitis (NASH) based on differential gene expression from bioinformatics data.

METHODS

A meta-analysis was performed from transcriptomic databases retrieved from public repositories containing data from biopsies of patients at various stages of NAFLD development. The status of the selected molecules was validated in the serum of patients with NAFLD by ELISA.

RESULTS

We identified 121 differentially expressed genes (DEGs) associated with SS and 402 associated with NASH. Gene Ontology (GO) enrichment revealed that the altered genes were primarily associated with dysfunction of primary cellular processes, and pathway analyses were mainly related to cholesterol metabolism. We identified ACSS2, PCSK9, and CYP7A1 as candidate biomarkers for SS and ANGPTL3, CD36, CYP51A1, FASN, FAS, FDFT1, and LSS as candidate biomarkers for NASH.

CONCLUSIONS

By experimental validation of bioinformatics data from patients with NAFLD, we identified promising biomarkers for detecting SS and NASH that might be useful for screening and diagnosing early NAFLD stages in humans.

Global, regional, and national burden of bladder cancer, 1990-2019: an age-period-cohort analysis based on the Global Burden of Disease 2019 study

OBJECTIVES

Bladder cancer is a common malignancy worldwide, with substantial morbidity and mortality. This study aimed to assess the global, regional, and national burden of bladder cancer from 1990 to 2019 using data from the Global Burden of Disease (GBD) 2019 study and to analyze the trends using an age-period-cohort (APC) model.

STUDY DESIGN

In this cross-sectional study, secondary analyses were conducted to assess the burden of bladder cancer using data from GBD 2019.

METHODS

Bladder cancer prevalence, incidence, mortality, disability-adjusted life years (DALYs), and their age-standardized rates (ASRs) were obtained from the GBD 2019 study. The estimated annual percentage changes (EAPCs) were calculated to quantify the trends in ASRs. An APC analysis was performed to distinguish the effects of age, period, and cohort on the observed temporal trends.

RESULTS

The global prevalence of bladder cancer increased substantially from 1990 to 2019, reaching 2,869,046.4 cases (95% UI: 2,614,200.3-3,114,474.4) in 2019. The age-standardized prevalence rate rose from 20.9 per 100,000 population in 1990 to 37.1 per 100,000 population in 2019, with an EAPC of 1.97 (95% CI: 1.93-2.01). The global burden of bladder cancer, as measured by DALYs, increased from 48.0 per 100,000 population in 1990 to 56.8 per 100,000 population in 2019, with an EAPC of 0.47 (95% CI: 0.4-0.53), demonstrating the growing impact of this disease on population health.

CONCLUSIONS

This study demonstrates a significant increase in prevalence, incidence, mortality, and DALYs, with substantial variations across sociodemographic index (SDI) quintiles and GBD regions. The findings emphasize the need for concerted efforts at the global, regional, and national levels to reduce the burden of bladder cancer through primary prevention, early detection, and improved access to treatment services.

Association of MASLD with the risk of extrahepatic cancers: A systematic review and meta-analysis of 18 cohort studies

BACKGROUND

Numerous recent studies have explored the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and the risk of various extrahepatic cancers. However, the conclusions were inconclusive. The aim of this study was to clarify this relationship by conducting a robust meta-analysis.

METHODS

Systematic searches were conducted on PubMed, Embase and Web of Science databases to identify relevant cohort studies published prior to February 2024. Hazard ratios (HRs) and their corresponding 95% confidence intervals (95% CIs) were combined using a random-effects model in this meta-analysis.

RESULTS

Eighteen cohort studies (approximately 16.7 million participants) were finally included in this meta-analysis. MASLD was linked to a higher risk of extrahepatic cancers, such as gastric (n = 10, HR = 1.47, 95% CI: 1.07-2.01), colorectal (n = 13, HR = 1.33, 95% CI: 1.16-1.53), pancreatic (n = 8, HR = 1.41, 95% CI: 1.11-1.79), biliary tract (n = 5, HR = 1.27, 95% CI: 1.18-1.37), thyroid (n = 6, HR = 1.46, 95% CI: 1.02-2.09), urinary system (n = 10, HR = 1.45, 95% CI: 1.25-1.69), breast (n = 11, HR = 1.17, 95% CI: 1.08-1.26) and female genital organ cancers (n = 10, HR = 1.36, 95% CI: 1.11-1.66). However, there was no statistically significant association between MASLD and the risk of head and neck (n = 6, HR = 1.03, 95% CI: 99-1.07), oesophageal (n = 9, HR = 1.26, 95% CI: 0.86-1.86), lung (n = 9, HR = 1.01, 95% CI: 0.92-1.10), prostate (n = 9, HR = 1.06, 95% CI: 0.94-1.19) or small intestine cancer (n = 2, HR = 1.75, 95% CI: 1.00-3.06).

CONCLUSIONS

This latest large-scale meta-analysis indicated that MASLD was associated with an increased risk of various extrahepatic cancers, such as gastric, colorectal, pancreatic, biliary duct, thyroid, urinary system, breast, skin and female genital cancers. Further research is needed to investigate the mechanisms underlying these associations.

Comparison of the effects of nursing and peer education on quality of life and resilience in patients with multiple sclerosis: A randomized clinical trial

Background

Multiple sclerosis (MS) is a prevalent disease of the central nervous system that often leads to diminished resilience and quality of life in affected individuals. This study aims to compare the effects of nursing and peer education on improving the quality of life and resilience in patients with multiple sclerosis.

Materials and methods

This three-group clinical trial study was conducted before and after interventions at the MS Society in Hamedan, Iran. In this study, 120 patients with MS were randomly selected and assigned to three groups: nurse education, peer education, and control. Quality of life and resilience questionnaires were self-reported before and two months after the completion of the intervention. The educational sessions were conducted over five meetings, each lasting between 45 and 60 min, held every two days. Group one received education led by nurses, while group two participated in peer-led education sessions.

Results

The results indicated that before the intervention, there were no significant statistical differences in demographic variables, resilience, and quality of life among the three groups (p > 0.05). However, after the intervention, both the peer and nurse groups showed a significant increase in quality of life and resilience compared to the control group (p < 0.05). Nevertheless, no differences were observed between the nurse and peer groups regarding these variables (p > 0.05).

Conclusions

Both nursing and peer education methods had an equal impact on enhancing the resilience and quality of life of patients with MS. It is recommended that peer support be utilized to empower MS patients, especially in contexts where there is a shortage of nurses.