Barchuk A, Vignat J, Wiggins C
… +2 more, Bray F, Znaor A
J Natl Cancer Inst
· 2026 May · PMID 42097291
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Kidney cancer incidence varies substantially across world regions, influenced by risk factors and diagnostic intensity. Using CI5-XII, which includes high-quality data from 460 population-based cancer registries in 65 co...Kidney cancer incidence varies substantially across world regions, influenced by risk factors and diagnostic intensity. Using CI5-XII, which includes high-quality data from 460 population-based cancer registries in 65 countries (2013 to 2017), we analysed kidney cancer incidence (ICD-10 C64) across 533 populations. Age-standardised incidence rates (ASR) were calculated using the Segi-Doll World Standard. ASRs ranged from 0.5 to 29.5 per 100,000 in men and from 0.5 to 16.8 in women, with the highest rates observed in North America and Eastern Europe, particularly among American Indian/Alaska Native and Black individuals, and in Northwest Russia. The lowest rates were observed in Asian and African registries, as well as in Asian and Pacific Islander Individuals in the United States. Male-to-female ratios clustered around two. Further detailed analysis of possible determinants, including structural factors, is needed to explain the wide inter- and intra-regional variability in kidney cancer incidence.
Post LM, Hurwitz L, Fisher JA
… +3 more, Kaufman JD, Koutros S, Jones RR
J Natl Cancer Inst
· 2026 May · PMID 42097289
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BACKGROUND: Outdoor air pollution, including fine particulate matter (PM2.5), is an established carcinogen, yet few studies evaluate its associations with prostate cancer risk and findings are mixed. METHODS: We used spa...BACKGROUND: Outdoor air pollution, including fine particulate matter (PM2.5), is an established carcinogen, yet few studies evaluate its associations with prostate cancer risk and findings are mixed. METHODS: We used spatiotemporal prediction models to estimate annual average historical residential PM2.5 (1980 to 2017) and NO2 (1990 to 2017) concentrations for N = 289,299 men aged ≥50 years in the NIH-AARP Diet and Health Study, enrolled from six states and two metro areas in 1995 to 1996, followed through 2018. We used Cox regression to estimate hazard ratios and 95% confidence intervals (HR [CI]) of associations between 5-year average PM2.5 and NO2 and incident prostate cancer, overall and by tumor aggressiveness (ie, advanced [n = 5,791], high-grade [ie, Gleason score ≥8, n = 5,793], fatal [n = 3,057]). We evaluated interactions with hypothesized effect modifiers. RESULTS: Historical PM2.5 and NO2 concentrations were not associated with prostate cancer risk overall (PM2.5 HR10-year lag per 5 µg/m3=1.00 [0.98-1.02], NO2 HR10-year lag per 10 ppb = 1.00 [0.98-1.01]). Some positive trends were observed for aggressive disease (eg, high-grade PM2.5 HR10-year lag=1.03 [0.99-1.09], advanced: NO2 HR10-year lag=1.04 [0.99-1.08]). Stratified analyses also showed stronger associations for aggressive disease among Hispanic men (eg, high-grade: NO2 HR = 1.25 [1.05-1.48], pint=0.01). Heterogeneity was also evident by urbanicity (high-grade: pint=0.01, PM2.5 and NO2) and state (advanced: pint=0.05, NO2), potentially reflecting air pollution mixture heterogeneity. CONCLUSIONS: In this large U.S. cohort, historical residential PM2.5 or NO2 concentrations were not associated with prostate cancer risk overall; however, risk was elevated in some subgroups and for aggressive outcomes. Future evaluation of air pollution mixture components may clarify observed subgroup differences.
J Natl Cancer Inst
· 2026 May · PMID 42097285
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Artificial Intelligence (AI) is rapidly transforming cancer care by enabling healthcare teams to make more accurate diagnoses, predict responses to therapy, improve outcomes, and deliver truly personalized treatment. As...Artificial Intelligence (AI) is rapidly transforming cancer care by enabling healthcare teams to make more accurate diagnoses, predict responses to therapy, improve outcomes, and deliver truly personalized treatment. As AI-based tools become increasingly embedded in diagnostic workflows and clinical decision-making, it is essential to understand their potential and limitations to ensure safe and effective adoption. Here, we provide an accessible primer on the integration of AI into cancer diagnosis and treatment response, aimed at oncologists, pathologists, clinical researchers, and healthcare technologists. This primer focuses primarily on AI applications in digital pathology, liquid biopsy, and clinical decision support, while acknowledging related advances in radiology, genomics, and EHR-based analytics. We begin with an introduction to core AI concepts and then examine how AI-driven technologies are becoming an integral part of cancer diagnosis through digital pathology, medical imaging, and liquid biopsy. We further explore AI's expanding role in supporting the cancer care team through a patient's treatment journey, from prognostication and therapy selection through real-time treatment monitoring. Real-world applications and practical implementation strategies are presented, alongside a discussion of the ethical, regulatory, and reproducibility challenges that must be addressed. By providing a structured overview of both the technological advances and the real-world implementation challenges, this commentary aims to engage a broad audience, from oncologists and pathologists to data scientists and policy makers, in navigating the evolving role of AI in cancer care and guiding its responsible integration into clinical practice.
BACKGROUND: (Z)-endoxifen is the tamoxifen metabolite that possesses the highest affinity to the estrogen receptor and is evolving as an alternative to tamoxifen. Mammographic breast density (MBD) change has been shown t...BACKGROUND: (Z)-endoxifen is the tamoxifen metabolite that possesses the highest affinity to the estrogen receptor and is evolving as an alternative to tamoxifen. Mammographic breast density (MBD) change has been shown to be a proxy for tamoxifen therapy response. The objective was to measure the effect of 2 different doses of (Z)-endoxifen on MBD, safety, and side effects in healthy women. METHODS: Healthy premenopausal women included in the national Swedish screening program in Stockholm were invited to KARISMA Endoxifen, a proof of principle, dose determining, double-blinded, randomized, placebo-controlled trial. Women were randomly assigned to placebo or 1 or 2 mg of (Z)-endoxifen daily for 6 months. RESULTS: In all, 240 women were randomly assigned. There was a significant relative change in MBD in both (Z)-endoxifen arms compared to placebo: -19.3% (95% confidence interval [CI] = -6.15% to -32.4%) in the 1 mg arm and -26.5% (95% CI = -14.1% to -38.9%) in the 2 mg arm. The number of participants discontinuing because of adverse events related to the investigational medicinal product was 4 (placebo), 5 (1 mg), and 11 (2 mg), respectively. Participants on 2 mg of (Z)-endoxifen reported significantly higher scores of vasomotor symptoms, compared with placebo. No clinically significant changes in hematological safety tests or vital signs were noted. CONCLUSION: Both 1 and 2 mg of (Z)-endoxifen significantly reduced MBD to a degree comparable to the established 20 mg dose of tamoxifen. The 1 mg dosage of (Z)-endoxifen indicated superior tolerability. Future studies are necessary to confirm impact on breast cancer incidence. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05068388.
BACKGROUND: Adaptive designs (ADs) are increasingly employed to improve trial efficiency; however, their benefits over fixed designs in late-phase oncology trials remain underexplored. We aimed to determine whether ADs i...BACKGROUND: Adaptive designs (ADs) are increasingly employed to improve trial efficiency; however, their benefits over fixed designs in late-phase oncology trials remain underexplored. We aimed to determine whether ADs in phase III cancer trials are associated with primary completion time and primary endpoint success compared with fixed designs. METHODS: This cross-sectional study analyzed phase III randomized lung and breast cancer trials initiated between 2000 and 2020 using Aggregate Analysis of ClinicalTrials.gov database (static version downloaded April 15, 2025). Eligible trials had time-to-event primary endpoints and were completed or terminated. Trials were classified as adaptive or non-adaptive based on pre-planned design modifications. Associations between trial design and primary completion time were examined using Kaplan-Meier curves and multivariable cause-specific Cox regression, while primary endpoint success via multivariable logistic regression. RESULTS: Of 421 eligible trials, 210 employed ADs. Adoption of ADs increased over time, with group-sequential designs being most common adaptive approach. ADs showed earlier primary completion, but no significant association was observed after multivariable adjustment. Adaptive trials had higher hazards of early stopping for efficacy or futility and lower hazards of administrative termination. Among 396 trials with available results, 163 achieved primary endpoint success. Adaptive trials had higher odds of success than non-adaptive trials (66.26% vs 33.74%; odds ratio: 2.363, 95% confidence interval: 1.491 to 3.778; P<.001). CONCLUSION: ADs were associated with higher primary endpoint success but not shorter primary completion time. Given high failure rates in late-phase oncology, ADs may improve efficiency primarily by facilitating data-driven decisions rather than accelerating trial timelines.
Joly F, Anota A, Chabaud S
… +31 more, Cropet C, Priou F, Harter P, Pignata S, Palacio I, Petru E, Kobayashi H, Vergote I, Parma G, Mäenpää J, Raymond E, Ataseven B, Pisano C, Lainez N, Tsibulak I, Yonemori K, Vuylsteke P, Lapresa MT, Mirza MR, Bouchaert P, Buderath P, Lorusso D, Herrero A, Eberst L, Burges A, Scambia G, Ortega E, Guillemet C, Pujade-Lauraine E, Kurtz JE, Ray-Coquard I
BACKGROUND: We analyzed health-related quality of life (HRQoL) and time until definitive HRQoL deterioration (TUDD) for patients with newly diagnosed advanced ovarian cancer receiving olaparib plus bevacizumab or placebo...BACKGROUND: We analyzed health-related quality of life (HRQoL) and time until definitive HRQoL deterioration (TUDD) for patients with newly diagnosed advanced ovarian cancer receiving olaparib plus bevacizumab or placebo plus bevacizumab in PAOLA-1. METHODS: HRQoL and TUDD, prespecified secondary endpoints, were assessed by EORTC Core Quality of Life Questionnaire (QLQ-C30) and Ovarian Cancer module (QLQ-OV28) at baseline and then every 12 weeks for 2 years. HRQoL and TUDD by homologous recombination deficiency (HRD) status and effect of progression on HRQoL were post hoc analyses. RESULTS: 806 patients were randomized (olaparib plus bevacizumab n = 537; placebo plus bevacizumab n = 269). There were no clinically meaningful between-group differences in adjusted mean global change from baseline in QLQ-C30 or QLQ-OV28 domains overall (between-group difference in QLQ-C30 Global Heath Status (GHS) score [95% CI] 1.65 [-0.27, 3.56]) or in the HRD-positive subgroup (1.23 [-1.25, 3.71]). TUDD estimates of QLQ-C30 GHS scores did not differ between treatment arms in the modified intention-to-treat population (hazard ratio [HR]=0.88; 95% CI = 0.72, 1.07) and favored olaparib plus bevacizumab vs placebo plus bevacizumab in the HRD-positive subgroup (HR = 0.70; 95% CI = 0.52, 0.93). Analyses of patients (103/465 [22.2%]) following disease progression showed clinically meaningful deterioration in QLQ-C30 emotional and social scores. CONCLUSION: Adding maintenance olaparib to bevacizumab showed no clinically meaningful detrimental effect on global HRQoL either overall or in the HRD-positive subgroup. ClinicalTrials.gov ID: NCT02477644.
Wang SE, Viallon V, Biessy C
… +28 more, O'Mara T, Kyrgiou M, Ellis LB, Crosbie EJ, Baker-Rand H, Yarmolinsky J, Keski-Rahkonen P, Johansson M, Fournier A, Canonico M, Naudin S, Turzanski Fortner R, Le Cornet C, Schulze M, Crous-Bou M, Sánchez MJ, Aizpurua A, Cabrera Castro N, Guevara M, Masala G, Tumino R, Giraudo MT, Panico C, Travis RC, Gunter MJ, Rinaldi S, Dashti SG, Dossus L
BACKGROUND: Obesity may increase endometrial cancer risk through pathways involving chronic inflammation, insulin resistance, and altered sex hormone levels. METHODS: Within the European Prospective Investigation into Ca...BACKGROUND: Obesity may increase endometrial cancer risk through pathways involving chronic inflammation, insulin resistance, and altered sex hormone levels. METHODS: Within the European Prospective Investigation into Cancer and Nutrition cohort, we investigated these mediating pathways using pre-diagnostic circulating biomarkers measured in 337 matched case-control pairs with postmenopausal measurements and 196 pairs with premenopausal measurements. We estimated the natural indirect effect (NIE) of obesity [body mass index (BMI) ≥30 kg/m2 vs < 25 kg/m2] on endometrial cancer risk: (1) for each biomarker separately, (2) for all biomarkers jointly, and (3) sequentially, accounting for upstream biomarkers based on an assumed causal sequence specified a priori. RESULTS: The adjusted odds ratio (OR) between obesity and endometrial cancer risk was 3.34 [95% confidence interval (CI) 1.97 to 5.65] in the postmenopausal analysis, and 3.24 (1.43 to 7.36) in the premenopausal analysis. Jointly, the ORNIE through all biomarkers was 1.82 [CI 1.21 to 2.74; proportion mediated (P.M.)=50%] in the postmenopausal analysis and 1.79 (0.97 to 3.29; 49%) in the premenopausal analysis. In sequential mediation analysis, estrone [ORNIE =1.20 (CI 1.02 to 1.41); P.M. = 15%] remained a key mediator beyond upstream biomarkers in the postmenopausal analysis and interleukin-6 (IL-6) [1.35 (1.03 to 1.78); 24%] remained a key mediator in the premenopausal analysis. CONCLUSIONS: Circulating biomarkers for inflammation, insulin resistance, and sex hormones may mediate the effect of obesity on endometrial cancer risk, with some overlaps in mediating pathways. Sex hormones were the most prominent mediators in postmenopausal obesity, whereas biomarkers for inflammation may play an important role in premenopausal obesity.
Braun-Inglis C, Myers J, O'Brien B
… +17 more, Kottschade L, Flannery M, Detroye AT, Elko T, Leatherwood A, Mader A, Wong SF, Foust M, Bakitas M, Benson AB, Berenberg JL, Primeaux B, Rosenzweig M, Demirhan K, Statler T, Vogel W, Sun V
Oncology Advanced Practice Providers (APPs) including Advanced Practice Registered Nurses, Physician Assistants, and Clinical Pharmacists (CPs), play a vital role in delivering high-quality, patient-centered cancer care...Oncology Advanced Practice Providers (APPs) including Advanced Practice Registered Nurses, Physician Assistants, and Clinical Pharmacists (CPs), play a vital role in delivering high-quality, patient-centered cancer care across the United States. Despite their widespread presence in oncology practices, APPs remain underutilized in cancer clinical research, representing a missed opportunity to expand trial access and improve patient outcomes. Clinical trials are essential to advancing oncology care, yet participation remains critically low among adult patients. Given Oncology APPs' and CPs' central role in cancer care delivery, their meaningful engagement in oncology clinical trial research is imperative as the standard of oncology care. This position paper, with contributions from five professional societies, presents solutions and resources to barriers limiting APPs' and CPs' involvement in cancer clinical research, including gaps in education, role expectations, limited protected time, restrictive policies, insufficient financial support, and under-recognition of contributions. Integrating APPs and CPs more fully into the clinical research enterprise is essential to improving trial access, patient outcomes, closing equity gaps, and accelerating innovation in oncology care.
BACKGROUND: UPF intake is associated with obesity. Despite obesity being a risk factor for postmenopausal breast cancer, evidence for an association between UPF and breast cancer is limited. Our objective was to assess t...BACKGROUND: UPF intake is associated with obesity. Despite obesity being a risk factor for postmenopausal breast cancer, evidence for an association between UPF and breast cancer is limited. Our objective was to assess the association between UPF intake and postmenopausal breast cancer risk in the NIH-AARP Diet and Health Study. METHODS: Participants reported dietary intake via a food frequency questionnaire at baseline in 1995 to 1996 and were followed through 2018. Food items were disaggregated into food codes and assigned Nova classification via database linkage. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for quintiles of UPF (g/1000 kcal/day) and postmenopausal breast cancer risk overall, by estrogen receptor (ER) status, and type (invasive or ductal carcinoma in situ (DCIS)), with and without adjustment for body mass index (BMI). RESULTS: Among 181,460 postmenopausal women, 14,484 were diagnosed with breast cancer over a median 21 years of follow-up. Median (IQR) UPF intake was 284.6 (191.1 to 466.6) g/1000 kcal/day. No associations between UPF intake and postmenopausal breast cancer risk overall (HRQ5vs.Q1=0.98, 95% CI = 0.93-1.03; Ptrend=0.32), by ER status (ER+ HRQ5vs.Q1=1.01, 95% CI = 0.94-1.09; P trend=0.95; ER-: HRQ5 vs Q1=1.02, 95% CI = 0.87-1.20; P trend=0.58), or by type (invasive: HRQ5vs.Q1=0.98, 95% CI = 0.92-1.04; P trend=0.14; DCIS HRQ5vs.Q1=1.00, 95% CI = 0.87-1.13; P trend=0.26) were observed. Following BMI adjustment, inverse trends for overall (P trend=0.03) and invasive (P trend=0.01) breast cancer were observed. CONCLUSION: UPF intake was not associated with postmenopausal breast cancer in the NIH-AARP cohort. Inverse trends observed after adjusting for BMI are likely spurious, owing to over-adjustment.
Chen KL, Craig TK, Blackford AL
… +13 more, Warren JL, Song D, Fan Q, Hussaini SMQ, Katana Ogongo M, Hu X, Smith RB, Kaplan J, Jordan RN, Gross CP, Polsky D, Yabroff KR, Pollack CE
BACKGROUND: Survival disparities in prostate cancer are driven in part by social and economic factors, including housing insecurity. Rent subsidies in the form of federal housing assistance are a well-established strateg...BACKGROUND: Survival disparities in prostate cancer are driven in part by social and economic factors, including housing insecurity. Rent subsidies in the form of federal housing assistance are a well-established strategy for alleviating housing insecurity, but their association with prostate cancer care and survival is unknown. METHODS: Using linked federal housing assistance data, SEER cancer registry data, and Medicare claims, we assessed workup and treatment receipt and two-year survival among individuals aged 66 to 95 who were diagnosed with prostate cancer in 2007 to 2019. We used logistic and Cox regression models to compare outcomes between individuals receiving housing assistance upon prostate cancer diagnosis and a comparison group without housing assistance, using propensity score matching to balance sociodemographic and clinical characteristics. RESULTS: There were 1,839 individuals with housing assistance (and 5,517 without assistance) included in the workup and treatment analyses and 4,451 individuals with housing assistance (and 13,353 without assistance) in the survival models. Receipt of housing assistance was not associated with guideline-concordant workup (62.7% vs 61.2%, OR 1.02 [95% CI 0.97, 1.07], p = 0.48) or active treatment (63.7% vs 62.2%, OR 1.02 [95% CI: 0.99, 1.06], p = 0.22) but was associated with improved overall survival in the 2 years following diagnosis (hazard ratio for mortality: 0.88 [95% CI: 0.81, 0.96]). CONCLUSIONS: Older adults receiving housing assistance at the time of a prostate cancer diagnosis experienced better overall survival than a matched comparison group without housing assistance. Results suggest that expanding access to housing assistance might support greater and more equitable survival in prostate cancer.
The growing population of cancer survivors underscores the need for models of care that effectively address their long-term needs. Over recent decades, various models have been proposed, but guidance regarding their deve...The growing population of cancer survivors underscores the need for models of care that effectively address their long-term needs. Over recent decades, various models have been proposed, but guidance regarding their development, testing, implementation, and evaluation remains limited. To address this gap, we conducted an overview of randomized controlled trials (RCTs) that assessed survivorship care models (1) to identify common features and methodological gaps; and (2) to assess how these models contribute to improving survivorship care by mapping their pre-defined endpoints to the quality domains of the Quality of Cancer Survivorship Care Framework and the goals of the Quintuple Aim. Lastly, we provide recommendations for future studies, specifically focusing on clarifying terminology, adopting trial methods that move beyond standard comparative designs, expanding research to more diverse populations and settings, and incorporating endpoints that capture both high-quality care and broader health system performance.
The WHO Classification of Tumours (WCT) serves as a global standard for cancer diagnosis, providing a consistent framework by integrating clinical, histopathological, and molecular tumor characteristics, ensuring unified...The WHO Classification of Tumours (WCT) serves as a global standard for cancer diagnosis, providing a consistent framework by integrating clinical, histopathological, and molecular tumor characteristics, ensuring unified interpretation of diagnostic findings. Uniform terminology and standardized diagnostic criteria applied by WCT facilitates effective interdisciplinary communication, reduces variability in cancer diagnosis and reporting, enhances collection and comparability of cancer surveillance data, and supports clinical and epidemiological cancer research. The WCT informs the development of cancer screening programs and bolsters early detection strategies through the identification and classification of precursor lesions, playing a pivotal role across the cancer care continuum. Moving towards the sixth edition, the WCT adopts an increasingly multidimensional, interdisciplinary, and global approach. The program will actively contribute to the strategic planning and implementation of cancer prevention and early detection initiatives.
The increased understanding of epigenetics has significantly advanced our understanding of cancer development, especially regarding environmental, occupational, and lifestyle exposures. Unlike genetic mutations, epigenet...The increased understanding of epigenetics has significantly advanced our understanding of cancer development, especially regarding environmental, occupational, and lifestyle exposures. Unlike genetic mutations, epigenetic changes may be reversible, making them critical mediators and promising targets for cancer prevention and control. This review synthesizes two decades of transformative research by the International Agency for Research on Cancer (IARC), which positioned the epigenome as a central focus in cancer epidemiology and mechanistic research among the 10 Key Characteristics (KCs) of carcinogens by the IARC Monographs program. From foundational in vitro and animal studies to large-scale population-based research, IARC researchers contributed to unraveling epigenetic mechanisms of carcinogenesis and identifying epigenetic biomarkers of exposures and cancer risk. We highlight progress in epigenetic biomarker development, mechanistic epigenomics, toxico-epigenomics, and the interplay between diet, microbiome, and epigenome. As IARC marks its 60th anniversary, this review underscores the growing role of epigenetics in guiding global cancer prevention efforts and public health strategies.
In the 60 years since Epstein-Barr virus (EBV) was identified as the first human oncogenic virus, the International Agency for Research on Cancer (IARC) has classified 13 infectious agents as carcinogenic. Globally, appr...In the 60 years since Epstein-Barr virus (EBV) was identified as the first human oncogenic virus, the International Agency for Research on Cancer (IARC) has classified 13 infectious agents as carcinogenic. Globally, approximately 2.3 million cancer cases (12% of all cancers) are attributable to infection each year. Main causes are Helicobacter pylori (850 000), human papillomavirus (HPV; 730 000), hepatitis B virus (HBV; 380 000), EBV (240 000), and hepatitis C virus (160 000). Infection-attributable cancer burden varies greatly, exceeding 25% of all cancers in parts of Asia and in sub-Saharan Africa where HIV also causes an important cancer burden. Substantial progress in effective interventions has been made, often informed by IARC-led research. IARC Codes Against Cancer provide recommendations for reducing infection-attributable cancer risk including by prophylactic vaccines (HPV and HBV), diagnosis and treatment of infections (hepatitis C virus, HBV, HIV, and H. pylori), and screening to detect and treat precancerous lesions (HPV). Improving efficiency and implementation of existing interventions and developing novel tools (eg, EBV and H. pylori vaccines) are crucial.
McCormack V, Simba H, Abnet CC
… +12 more, Buckle G, Middleton DRS, Menya D, Muchengeti M, Kantelhardt EJ, Addissie A, Mmbaga BT, Lemmens V, Sheils O, Boucheron P, Kim J, Schüz J
J Natl Cancer Inst Monogr
· 2026 Apr · PMID 42008730
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On the International Agency for Research on Cancer's 60th birthday, we reflect on the continuing importance of the agency's international remit in cancer research, driven by its founding principle that the discovery of c...On the International Agency for Research on Cancer's 60th birthday, we reflect on the continuing importance of the agency's international remit in cancer research, driven by its founding principle that the discovery of carcinogenic agents is relevant to all humans globally. The present narrative elaborates on this continued stimulus through the discussion of three themes: (1) trust and independence, especially amid vested interests and misinformation; (2) equity and efficiency as essential elements of progress in cancer research, achieved by prioritizing research in underserved and understudied areas and locations where exposure doses or contrasts are high; and (3) a commitment to context-relevant research through strong local collaborations and capacity building. We demonstrate that the international research conducted at the International Agency for Research on Cancer is a core means to advance carcinogenic discovery, building reciprocal partnerships where all countries benefit when discoveries are shared across borders. If we do not attempt to understand cancer everywhere, we will never fully understand it anywhere.
Kim J, Beane Freeman LE, Deltour I
… +11 more, Foerster M, Kovalevskiy EV, Kromhout H, McCormack V, Olsson AC, Ostroumova E, Parent MÉ, Spycher BD, Turner MC, Zupunski L, Schüz J
J Natl Cancer Inst Monogr
· 2026 Apr · PMID 42008729
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Full text
Approximately half of cancers are attributed to modifiable risk factors or inherited genetic mutations, thus there remains the potential for as-yet unidentified environmental risk factors to explain substantially more of...Approximately half of cancers are attributed to modifiable risk factors or inherited genetic mutations, thus there remains the potential for as-yet unidentified environmental risk factors to explain substantially more of the global cancer burden. Current estimates of the environmental and occupational cancer burden account for a relatively small number of exposures, because of challenges in characterizing exposure patterns and human cancer risks. Hence, the environmental cancer burden may be underestimated because of combinations of not having identified all carcinogenic agents, lack of understanding of cancer risks at very low exposure levels of even known carcinogens, and lack of understanding of joint effects. The International Agency for Research on Cancer has a long history of addressing these challenges, and of advancing our understanding of occupational and environmental causes of cancer, with primary research predominantly conducted by the Environment and Lifestyle Epidemiology Branch. The International Agency for Research on Cancer's position within the World Health Organization has facilitated the conduct of cross-border collaborations on important and sensitive topics, ranging from asbestos, ionizing radiation, and pesticides to its current work on artisanal petroleum refining. Here, we highlight some important Environment and Lifestyle Epidemiology contributions to several areas of occupational and environmental cancer, describe recent progress in other important and emerging exposures, and finally, provide suggestions for future research. In our constantly changing world, with new products, technologies, and demands transforming our environment and workplaces, there is a continued need for high-quality human cancer investigations of potential occupational and environmental carcinogens, especially those characterizing environmental levels of exposure encountered by the general population in their daily life and in underresearched regions of the world.