Cancer Epidemiology[JOURNAL]
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200 papers
Endogenous antioxidant biomarkers and cancer risk among men with concurrent smoking and alcohol use: A prospective cohort study.
Shin JW, Jee Y, Yang YS
Cancer Epidemiol · 2026 Apr · PMID 42054754 · Publisher ↗
BACKGROUND: This study aimed to evaluate age-specific associations between endogenous antioxidant biomarkers and cancer risk in a high-risk male population characterized by concurrent smoking and alcohol use. METHODS: We...
BACKGROUND: This study aimed to evaluate age-specific associations between endogenous antioxidant biomarkers and cancer risk in a high-risk male population characterized by concurrent smoking and alcohol use. METHODS: We analyzed data from the Korean Cancer Prevention Study-II (KCPS-II), including 83,371 men. Associations between serum creatinine, bilirubin, albumin, and uric acid and cancer risk were evaluated using Cox proportional hazards models. Analyses were conducted among all men, ever smokers and drinkers, and current smokers and drinkers, with both overall and age-stratified analyses (<50 and ≥50 years). Restricted cubic spline analyses were performed to assess nonlinear age-dependent associations and age-biomarker interactions. RESULTS: Serum bilirubin, albumin, and uric acid were inversely associated with overall cancer risk, with the strongest associations observed among men aged ≥ 50 years with concurrent smoking and alcohol use. Creatinine demonstrated contrasting associations according to age. Lung cancer showed consistent inverse associations across biomarkers, whereas stomach, prostate, and pancreatic cancers exhibited heterogeneous age-specific patterns. Restricted cubic spline analyses further indicated significant nonlinear age-biomarker interactions. CONCLUSIONS: Among men with concurrent smoking and alcohol use, biomarker-cancer associations showed substantial age-dependent heterogeneity in both magnitude and direction.
Travel time to healthcare facilities and stage at diagnosis and breast cancer-specific mortality: A population-based cohort study from Northern Ireland.
Sharma M, McShane CM, McIntosh SA … +9 more , Bennett D, Lohfeld L, Middleton DRS, Savage G, Fitzpatrick D, McBrien A, McCallion D, Gavin A, Cardwell CR
Cancer Epidemiol · 2026 Apr · PMID 42054753 · Publisher ↗
BACKGROUND: Travel time has been associated with worse outcomes for several cancers. In breast cancer patients, we examined stage at diagnosis and mortality by travel time to General Practitioner (GP) practice and cancer...
BACKGROUND: Travel time has been associated with worse outcomes for several cancers. In breast cancer patients, we examined stage at diagnosis and mortality by travel time to General Practitioner (GP) practice and cancer treatment hospital. METHODS: Women newly diagnosed with breast cancer from 2011 to 2021 were identified using the Northern Ireland Cancer Registry. The travel times by car from home address to GP practice and to cancer treatment hospitals were determined. The primary outcome was time to breast cancer-specific mortality up to March 2023. Secondary outcomes included stage at diagnosis. Cox regression models calculated adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for breast cancer-specific mortality by travel time. RESULTS: The final cohort included 13,629 breast cancer patients. Among women living greater than 15 min by car from their GP practice, compared with less than 5 min, there was no association with later stage (5% versus 6% stage 4; adjusted odds ratio = 0.83 95% CI 0.61, 1.12) or breast cancer-specific mortality (adjusted HR = 1.10 95% CI 0.93, 1.10). Also, breast cancer-specific mortality was similar in women living greater than 60 min by car, compared with less than 15 min, from the hospital of their surgery (adjusted HR = 1.04 95% CI 0.88, 1.23), radiotherapy (adjusted HR=1.21 95% CI 0.99, 1.48) and systemic anti-cancer therapy (adjusted HR = 0.94 95% CI 0.75, 1.16). CONCLUSIONS: In our population-based cohort of breast cancer patients, longer travel times were not associated with worse outcomes or later stage at diagnosis.
Squamous cell carcinoma of the parotid gland: A population-based registry study of primary versus metastatic disease.
Oesterling F, Möller L, Kajüter H … +5 more , Stang A, Mayer M, Jansen L, Klußmann JP, Nachtsheim L
Cancer Epidemiol · 2026 Jun · PMID 42048759 · Publisher ↗
INTRODUCTION: Primary squamous cell carcinoma (SCC) of the parotid gland is considered exceedingly rare, yet cancer registry data from parts of Germany report unexpectedly high proportions. This raises concern that some...
INTRODUCTION: Primary squamous cell carcinoma (SCC) of the parotid gland is considered exceedingly rare, yet cancer registry data from parts of Germany report unexpectedly high proportions. This raises concern that some tumors recorded as primary parotid SCC may represent secondary disease arising from earlier squamous cell carcinomas of the head and neck (SCCHN). METHODS: We conducted a nationwide, population-based study using individual-level data from the German Centre for Cancer Registry Data (ZfKD) for 2009-2022. Parotid gland cancers were identified using ICD-10 codes, and prior SCCHN using ICD-O-3 morphology and topography codes. We analyzed incidence patterns, relative survival, diagnostic intervals, and the association between prior SCCHN and parotid cancer histology using logistic regression adjusted for age and sex. RESULTS: Among 12,021 parotid gland cancer cases, 2767 (23%) were classified as SCC. Patients with SCC-type parotid cancer had substantially higher odds of a prior SCCHN compared with patients with non-SCC parotid cancer (adjusted OR 5.48; 95% CI 4.59-6.57). The median interval between SCCHN and parotid cancer diagnosis was 365 days for SCC-type tumors and 303 days for non-SCC tumors. Five-year age-standardized relative survival was lower for SCC parotid cancer than for non-SCC parotid cancer. CONCLUSION: Our findings suggest that a considerable proportion of parotid SCCs recorded as primary tumors may represent misclassified secondary disease.
The effect of vigorous physical activity on the incidence of kidney cancer.
Kim LH, Bang A, Galvao DA … +2 more , Smith DP, Patel MI
Cancer Epidemiol · 2026 Jun · PMID 42048758 · Publisher ↗
BACKGROUND: Kidney cancer incidence is increasing. While physical activity can reduce the risk of several cancers, the role of vigorous physical activity (VPA) in kidney cancer prevention remains unclear. We examined ass...
BACKGROUND: Kidney cancer incidence is increasing. While physical activity can reduce the risk of several cancers, the role of vigorous physical activity (VPA) in kidney cancer prevention remains unclear. We examined associations between physical activity intensity and kidney cancer incidence in a large Australian cohort. METHODS: Data were obtained from 267,357 adults aged ≥ 45 years in the New South Wales 45 and Up Study. Physical activity, including walking, moderate physical activity (MPA), and VPA, was self-reported at baseline using the validated Active Australia Survey and categorised according to WHO guidelines. Multivariable Cox proportional hazards models estimated hazard ratios and 95% confidence intervals, adjusting for sex, body mass index, smoking, and hypertension. RESULTS: Over a mean follow-up of 10.9 years, 1010 kidney cancer cases were identified. Compared to no MPA, participants engaging in 150-< 300 min per week demonstrated a modest reduction in kidney cancer risk (Hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.63-0.95), with a curvilinear dose-response relationship that plateaued at 150-200 min per week. VPA was also associated with a lower risk of kidney cancer. Compared to no VPA, those performing < 75 min per week had lower risk (HR 0.70, 95% CI 0.58-0.84). However, the dose-response relationship for VPA was less consistent across higher exposure levels. CONCLUSIONS: Moderate and vigorous physical activity were associated with lower kidney cancer risk. MPA demonstrated a consistent, guideline-aligned protective association, while VPA showed evidence of benefit, particularly at lower volumes. These findings support the role of physical activity in kidney cancer prevention, although the dose-response relationship for VPA warrants further investigation.
Epidemiology, clinical characteristics, and survival of acral and non-acral melanoma in Colombia.
Acosta ÁE, Rodríguez-Betancourt JD, Cortés A … +13 more , Rueda R, Collazos P, Grillo-Ardila EK, Arias-Ortiz NE, García LS, Casas Cruz HM, Caballero Rojas H, Navarro-Lechuga É, Vargas-Moranth R, Prada JV, Núñez Lemus M, Uribe Pérez C, Henríquez-Mendoza G
Cancer Epidemiol · 2026 Jun · PMID 42035614 · Publisher ↗
BACKGROUND: Although the incidence of cutaneous melanoma in Colombia is lower than in predominantly Caucasian populations, survival outcomes remain comparatively poorer. This disparity may be partly explained by the high...
BACKGROUND: Although the incidence of cutaneous melanoma in Colombia is lower than in predominantly Caucasian populations, survival outcomes remain comparatively poorer. This disparity may be partly explained by the high proportion of melanomas arising in acral sites. However, no multicenter studies in Colombia have systematically compared the clinical behavior of acral versus non-acral melanomas. OBJECTIVE: To compare the clinical and epidemiological characteristics, as well as 5-year overall survival (OS), between acral and non-acral melanoma cases across six Colombian cities. MATERIALS AND METHODS: We conducted a retrospective, multicenter study of incident malignant cutaneous melanoma cases diagnosed between 2013 and 2019, using data from five population-based cancer registries and an institutional cancer registry. Exact or trend tests were used for categorical variables, and nonparametric tests for quantitative variables. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression. RESULTS: A total of 1408 cases were included; 32% were acral melanomas. Compared with non-acral tumors, acral melanomas were significantly thicker (4.0 mm vs. 1.8 mm), more frequently ulcerated (70% vs. 42%), more mitotically active (87% vs. 75%), and more often diagnosed at advanced stages (52% vs. 37%). Survival analysis included 854 patients. Five-year OS was markedly lower for acral melanoma (42.4% vs. 64.8%), particularly for tumors located on the foot (38.1%). Older age (≥65 years), male sex, advanced stage, and acral lentiginous or nodular subtypes were also associated with poorer OS. CONCLUSION: In Colombia, melanoma displays distinct clinical and histopathological patterns, characterized by a high burden of aggressive acral tumors and frequent late-stage diagnoses, factors that likely underpin the worse OS observed. These findings underscore the urgent need to tailor early detection strategies to the local epidemiology of melanoma and to strengthen public health policies aimed at improving timely diagnosis and management.
Post-treatment paternity in testicular cancer survivors: Do demographic variables matter?
Fosså SD, Myklebust TÅ, Brydøy M … +7 more , Negaard HFS, Klepp OH, Dahl AA, Stangenes KM, Kleveland CR, Seljeflot EB, Haugnes HS
Cancer Epidemiol · 2026 Jun · PMID 42033883 · Publisher ↗
BACKGROUND: Few commonly available factors are known which independently of treatment are associated with post- diagnosis paternity in Testicular Cancer Survivors (TCSs). In TCSs and age-matched controls we assessed the...
BACKGROUND: Few commonly available factors are known which independently of treatment are associated with post- diagnosis paternity in Testicular Cancer Survivors (TCSs). In TCSs and age-matched controls we assessed the associations between first-time post TC paternity and respectively the level of pre-diagnosis paternity and diagnostic age. METHODS: Using data from the Medical Birth Registry of Norway paternity was assessed during 30 post-diagnosis years in 1062 tumour-free TCSs, (treatment:1980-1994) and 10620 age-matched controls. Analyses comprised post-orchiectomy treatment type (loco-regional versus systemic), diagnostic age (<30 versus ≥30 years), number of pre-diagnosis children (0, 1 versus ≥2) and calender year of TC diagnosis (≤1987 versus ≥1988). STATISTICS: Kaplan-Meier estimates, log-rank tests, Cox regression analyses; significance level: p < 0.05 RESULTS: 30 years after the TC diagnosis 45% of the TCSs had fathered ≥ 1 post-TC child (controls: 55%; p < 0.001), Post-TC paternity increased during treatment de-escalation, Compared to pre-TC paternity of one child, pre-diagnosis childlessness (HR: 0.58;[55-0.62]) or fatherhood of ≥ 2 pre-TC children (HR: 0.34;[0.32-0.37]), as well as diagnostic age of ≥ 30 years (HR: 0.40; [0.38-0.43]) reduced post-TC fatherhood. 23% of the TCSs remained finally childless. (Controls: 17%; p < 0.001). Immortal time bias represents a limitation of this study. CONCLUSIONS: TCSs can be informed about the generally favourable probability of post-TC fatherhood at least once.The probability of post-TC paternity is, however,slightly lower in TCSs than in controls, even after de-escalated treatment. During post-TC paternity counselling age at diagnosis and the number of pre-diagnosis children should be considered together with treatment type and intensity.
Hypocholesterolemia is a consequence, not a cause, of kidney cancer: A bidirectional Mendelian randomization study with NHANES 2001-2018.
Zhang X, Tu Z, Zhao M … +1 more , Qiu W
Cancer Epidemiol · 2026 Jun · PMID 42033882 · Publisher ↗
BACKGROUND: Kidney cancer patients often exhibit reduced circulating cholesterol, yet whether dyslipidemia is a cause or consequence of the disease remains unclear due to inherent limitations of observational studies. We...
BACKGROUND: Kidney cancer patients often exhibit reduced circulating cholesterol, yet whether dyslipidemia is a cause or consequence of the disease remains unclear due to inherent limitations of observational studies. We integrated population-based data from NHANES with bidirectional Mendelian randomization (MR) to investigate the causal direction between lipid profiles and kidney cancer. METHODS: Observational data were derived from National Health and Nutrition Examination Survey (NHANES) 2001-2018, comprising 102 self-reported kidney cancer cases and 45,366 cancer-free controls. All analyses accounted for the complex sampling design using survey weights, stratification, and primary sampling units. Bidirectional two-sample MR was conducted using genetic instruments for four lipid traits (low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglycerides, total cholesterol [TC]) from IEU OpenGWAS and clear cell renal cell carcinoma (ccRCC) data from the largest available genome-wide association study (Purdue et al., n = 752,817), with no sample overlap. The primary analysis used inverse-variance weighted (IVW) estimation, complemented by sensitivity analyses including weighted median, MR-Egger, MR-PRESSO, and MR-RAPS. RESULTS: Weighted linear regression (adjusted for age, sex, BMI, statin use, smoking, hypertension, diabetes) showed kidney cancer associated with lower LDL (β = -21.08 mg/dL, Bonferroni-corrected P = 0.0016); TC, HDL, and TG showed no significant associations. Forward MR found no causal effect of any lipid trait on ccRCC risk. Reverse MR demonstrated genetic predisposition to ccRCC associated with lower LDL (β = -0.020, P = 0.011), HDL (β = -0.016, P = 0.022), and TC (β = -0.009, P = 0.037), with robust results across sensitivity analyses. CONCLUSIONS: These findings suggest genetic liability to ccRCC is associated with lower circulating cholesterol, not dyslipidemia predisposing to kidney cancer, providing insight into the directionality question and implications for etiologic understanding and clinical surveillance without overstating causality.
Early-onset cancer mortality should be interpreted in light of age at diagnosis.
Szarpak L, Maslyk M, Pruc M
Cancer Epidemiol · 2026 Jun · PMID 42001580 · Publisher ↗
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Risk of incident hematopoietic cancers in Danish male agricultural workers, 1968-2016.
Pedersen JE, Hansen J
Cancer Epidemiol · 2026 Jun · PMID 41999701 · Publisher ↗
AIM: Modern agricultural workers may be exposed to a variety of agents that have the potential to cause hematopoietic cancers, including pesticides and viruses. Exposure levels may vary among different groups of agricult...
AIM: Modern agricultural workers may be exposed to a variety of agents that have the potential to cause hematopoietic cancers, including pesticides and viruses. Exposure levels may vary among different groups of agricultural workers and over time. However, epidemiologic studies examining different agricultural workers are lacking. SUBJECT AND METHODS: The Danish Cancer Registry was used to identify men with selected hematopoietic cancers. A total of 9021 cases were included, and for each case, 50 cancer-free male controls were matched by year of birth. Both cases and controls were required to be born in Denmark and have an employment history, which was obtained from the Supplementary Pension Fund Register. RESULTS: Ever employment in "agriculture, overall" was associated with an increased risk of Hodgkin's lymphoma (OR=1.39, 95% CI: 1.15-1.68) and myeloid leukemia (OR=1.42, 95% CI: 1.16-1.74). When focusing on ever employment in different agricultural industries, noteworthy increased risk estimates were observed for Hodgkin's lymphoma and "agriculture, unspecified" (OR=1.90, 95% CI: 1.39-2.60) and "farming, livestock" (OR=1.51, 95% CI: 1.12-2.05); non-Hodgkin's lymphoma and "horticulture" (OR=1.33, 95% CI: 1.01-1.74); and myeloid leukemia and "agricultural service" (OR=1.87, 95% CI: 1.17-2.98). CONCLUSION: Findings indicated an elevated risk of Hodgkin's lymphoma and myeloid leukemia among Danish men employed in agriculture. Additionally, certain agricultural sectors were associated with a higher risk of specific hematopoietic cancers. Future studies should differentiate between agricultural sectors and include detailed exposure data to better understand the unique disease patterns among agricultural workers.
Contrasting cancer inequalities in Europe: Patterns of geographical variations in cancer mortality by country and sex.
Serraino D, Sampogna F, Careccia S … +4 more , D'Agostini C, Galanopoulou A, Russo G, Paoli P
Cancer Epidemiol · 2026 Jun · PMID 41999700 · Publisher ↗
OBJECTIVE: This work is part of the Joint Action "European Network of Comprehensive Cancer Centers - flahship n.5 of the European Beating Cancer Plan (EBCP)" which is aimed at contrasting cancer inequalities in the Europ...
OBJECTIVE: This work is part of the Joint Action "European Network of Comprehensive Cancer Centers - flahship n.5 of the European Beating Cancer Plan (EBCP)" which is aimed at contrasting cancer inequalities in the European Union. Herein we aimed at describing geographic variations in cancer mortality across the European Union (EU-27) by individual country and sex. METHODS: Updated information from the European Cancer Information System were used to describe patterns of cancer mortality in EU-27 in 2024. For each country, separately in men and women, a comparison between observed and expected number of deaths was carried out based on EU-27 average mortality rates. RESULTS: In 2024 cancer was the cause of 1.268.374 deaths in EU-27 i.e., 249.4 deaths per 100.000 inhabitants (323.3 and 195.0 per 100.000 in men and women, respectively). Overall. mortality rates varied 1.5 times from the lowest (Luxembourg) to the highest (Slovakia) country. 55.924 cancer deaths (30.674 in men, 25.250 in women) were in excess in countries with mortality rates higher than EU-27 average. Noteworthy geographic variations were particularly marked in men, with a peak for lung cancer (e.g., +4.745 deaths than expected in Poland, -4.490 in Germany). In women, geographic variations were generally less marked than in men apart from deaths due to breast cancer (e.g., + 2.764 deaths than expected in Germany; -3.110 in Spain), or lung cancer (e.g., + 2.389 deaths than expected in Poland; -2.940 in Spain). CONCLUSIONS: As of 2024, noteworthy geographic variations in cancer mortality persisted in EU-27, with diverging patterns in men and women also within countries. Contrasting factors that contribute to inequalities in cancer outcomes (e.g., socioeconomic factors, education) remains a key priority of the EBCP.
False-positive iFOBT in colorectal cancer screening: Association with prescription drug use in The Malaysian Cohort.
Abdullah N, Blin J, Khuzaimi AN … +9 more , Kamalul Arifin AS, Abd Jalal N, Ismail N, Husin NF, Mohd Azhar AT, Mohammad Azmi N, Mohd Azman ZA, Sagap I, Jamal R
Cancer Epidemiol · 2026 Jun · PMID 41999699 · Publisher ↗
BACKGROUND: Immunochemical faecal occult blood tests (iFOBTs) are preferred for population-based colorectal cancer (CRC) screening because of their improved diagnostic performance over guaiac-based tests, but false-posit...
BACKGROUND: Immunochemical faecal occult blood tests (iFOBTs) are preferred for population-based colorectal cancer (CRC) screening because of their improved diagnostic performance over guaiac-based tests, but false-positive (FP) results still pose a concern, often leading to unnecessary colonoscopy. This study investigated whether chronic medications, alongside proton pump inhibitors (PPIs), nonsteroidal anti-inflammatory drugs (NSAIDs), and antiplatelet agents, influence FP iFOBT risk. METHODS: Participants aged 38-79 who underwent colonoscopy after a positive iFOBT in CRC screening were included. We collected prescription data for statins, antiplatelet agents, alpha-blockers, beta-blockers, calcium channel blockers (CCBs), angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), PPIs, and NSAIDs. Drug intake referred to medication exposure from baseline to the latest visit before screening. An FP result was a positive iFOBT with no CRC, polyps, or other diseases on colonoscopy; a true positive (TP) required such pathology. Logistic regression evaluated associations between these drugs and FP risk. RESULTS: Of 438 eligible participants, 59.8% were on medication. The FP iFOBT rate was 49.3%. Statins were most used (n = 188), followed by CCBs (n = 102), NSAIDs (n = 55), ARBs (n = 49), ACE inhibitors (n = 46), beta-blockers (n = 43), PPIs (n = 16), antiplatelet (n = 12), and alpha-blockers (n = 8). Statin use was higher in the TP group (56.4% vs. 43.6% in FP; P = 0.039), while the FP group had more alpha-blockers (87.5% vs. 12.5% in TP; P = 0.029). Certain drug combinations, like antiplatelet plus statins (OR 0.658; 95% CI 0.450, 0.962; P = 0.031) and PPIs plus antihypertensives/CVD (OR 0.673; 95% CI 0.458, 0.990; P = 0.044), were initially associated with lower FP risk in unadjusted analyses. However, these associations became non-significant after adjusting for confounders, particularly age and sex (all P > 0.05), indicating that age and sex were more influential factors. CONCLUSION: Use of statins, CCBs, NSAIDs, PPIs, and antiplatelet agents, alone or in combination, was not independently associated with higher FP iFOBT risk after adjustment. However, inclusion of age and sex in the model attenuated these associations, suggesting that these may act as important confounding factors rather than independent determinants. These findings highlight the importance of considering host factors beyond medication use when interpreting iFOBT in CRC screening.
What is the question? Interpreting mortality trends in early-onset cancer.
Braggion A, Chiolero A
Cancer Epidemiol · 2026 Jun · PMID 41999698 · Publisher ↗
Abstract loading — click title to view on PubMed.
Seasonal variation in childhood acute lymphoblastic leukemia, but not in acute myeloid leukemia, or brain tumors - A Swedish population-based study.
Bychkov G, Bang B, Engsner N … +10 more , Tettamanti G, Heyman MM, Nordenvall AS, Herold N, Taylan F, Pontén E, Albert J, Jörnsten R, Strannegård C, Nordgren A
Cancer Epidemiol · 2026 Jun · PMID 41996759 · Publisher ↗
BACKGROUND: Acute lymphoblastic leukemia (ALL), the most common malignancy in children and adolescents, arises from a heterogeneous and multifactorial etiology involving genetic and environmental factors. Studies of seas...
BACKGROUND: Acute lymphoblastic leukemia (ALL), the most common malignancy in children and adolescents, arises from a heterogeneous and multifactorial etiology involving genetic and environmental factors. Studies of seasonal variation in ALL diagnosis have yielded inconsistent results, likely reflecting differences in study design and population characteristics. Here, we evaluated seasonal variation across ALL immunophenotypes, including two common genetic subtypes. METHODS: We analyzed seasonal variation by ALL subtype in 1504 ALL patients diagnosed before the age of 18 between 1995 and 2017 using data from the National Cancer Register and the Swedish Childhood Cancer Registry. Subgroup analysis included 1305 B-cell precursor ALL (BCP-ALL) cases, including 422 high hyperdiploid (HeH) and 259 ETV6::RUNX1 fusion-positive cases, and 175 T-cell ALL (T-ALL) cases. For comparison, 214 acute myeloid leukemia (AML) cases and 1367 brain tumor cases, including 224 medulloblastomas, were analyzed. Cases were grouped into overlapping 3-month diagnostic periods and analyzed using a Bayesian GARIMAX model, an extension of the autoregressive integrated moving average (ARIMA) framework. A sensitivity analysis was performed restricted to children aged 1-17 years. RESULTS: Seasonal variation was observed in the overall ALL cohort, with peaks between June and October. BCP-ALL and T-ALL also showed informative seasonality, with August consistently included among the peak months. Similar results were obtained in the sensitivity analysis. No seasonal variation was observed in AML, medulloblastoma, or other brain tumors. Informative seasonal variation was not detected in the HeH or ETV6::RUNX1-positive subgroups, although HeH showed peak quarters consistent with the overall ALL pattern. CONCLUSION: These findings support a role for seasonal triggers in ALL and warrant further investigation in larger, genetically stratified cohorts.
Associations of smoking with the risk of second smoking-associated primary cancer among adults with a history of cancer.
Sung H, Newton CC, Westmaas JL … +7 more , Diver WR, Mitchell EL, Kelly K, Deubler EL, Jemal A, Patel AV, Bodelon C
Cancer Epidemiol · 2026 Jun · PMID 41996758 · Publisher ↗
Associations between smoking and smoking-associated second primary cancers (SSPC) have been documented predominantly among survivors of smoking-associated first primary cancers (FPC), with limited evidence among survivor...
Associations between smoking and smoking-associated second primary cancers (SSPC) have been documented predominantly among survivors of smoking-associated first primary cancers (FPC), with limited evidence among survivors of non-smoking-associated FPCs. We examined survivors of FPCs diagnosed from 1992 to 2015 in the Cancer Prevention Study II Nutrition Cohort, followed through June 30, 2017. Self-reported smoking status, intensity, and years since quitting were collected a mean of 1.6 years before FPC diagnosis. Among 28,272 survivors (58.8%, male; mean age at FPC diagnosis, 72.2 years [SD=7.08]), the most common FPCs were prostate (32.8%), breast (18.5%), colorectum (9.0%), and non-Hodgkin lymphoma (8.3%). Over a median follow-up of 7.0 years, 1926 survivors developed SSPCs. Based on Cox proportional hazards models, adjusted for key confounders, SSPC risk was higher among current (HR=3.78; 95%CI=3.22-4.44) and former (HR=1.63, 95%CI=1.46-1.81) smokers compared with never smokers, with similar associations for survivors of smoking-associated (HR=4.08; 95%CI=2.90-5.74 for current smokers) and non-smoking-associated (HR=3.74; 95%CI=3.11-4.51 for current smokers) FPCs. Among former smokers, risk decreased with increased years since quitting, approaching never-smoker levels after > 30 years of cessation. Post-diagnosis cessation (599 of 1518 current smokers) was associated with a 25% lower SSPC incidence versus continued smoking (HR=0.75; 95%CI=0.54-1.03). In conclusion, pre-diagnostic smoking was strongly associated with higher risk of SSPCs among survivors of both smoking- and non-smoking-associated FPCs. Longer duration since quitting and cessation after diagnosis reduced the elevated risk, highlighting smoking cessation at any time can help reduce the burden of SPCs among the growing population of cancer survivors.
Cancer trends among young adults in Russian Federation: An analysis of population-based cancer registry data.
Zhuikova LD, Kononova GA, Ananina OA … +5 more , Prostakishina EA, Kolegova ES, Denisov EV, Shakhzadova AO, Choinzonov EL
Cancer Epidemiol · 2026 Jun · PMID 41996757 · Publisher ↗
UNLABELLED: Globally, cancer incidence is increasing in young adults and can rise to 2.3 million by 2045 according to GLOBOCAN 2022. Here, we present the first nationwide, long-term analysis of cancer incidence and morta...
UNLABELLED: Globally, cancer incidence is increasing in young adults and can rise to 2.3 million by 2045 according to GLOBOCAN 2022. Here, we present the first nationwide, long-term analysis of cancer incidence and mortality trends among young adults in the Russian Federation from 2013 to 2023. MATERIALS AND METHODS: We analyzed 140,500 and 328,370 cases in men and women aged 20-44 years, along with 60,067 and 71,431 deaths, respectively. Age-standardized and crude incidence rates were calculated for 2013-2023 using data from the Cancer Registry of the Russian Federation and Russian Federal State Statistics Service. RESULTS: Overall, since 2013, cancer incidence remained stable in males but declined in females, with mortality decreasing in both sexes. By anatomical site, men showed a significant increase in thyroid, colorectal, liver, kidney, gallbladder cancers, ands melanoma, while cases of nasopharynx, lung, stomach, larynx, and connective or soft tissues cancers declined. Women demonstrated a higher incidence of small intestine, oropharynx, thyroid, oral cavity, pancreas, colorectal, breast, melanoma, and other skin tumors, whereas lip, stomach, cervical, and connective or other soft tissue cancers decreased. Mortality rates declined for the majority of cancer sites in both men and women, but remained stable for most cancers of the head and neck and gastrointestinal tract, as well as prostate, breast, and non-melanoma skin cancers. CONCLUSION: Our findings demonstrate a cancer incidence increase among young adults in the Russian Federation and highlight new preventive, organizational, and clinical strategies to improve medical monitoring, promote early detection of cancer, and ensure timely treatment for individuals of working and reproductive age.
Cure rate estimation of skin cancer patients in São Paulo, Brazil, through a cure fraction model.
Schneider S, da Silva CM, Munhoz RR … +1 more , Pereira RP
Cancer Epidemiol · 2026 Jun · PMID 41996756 · Publisher ↗
INTRODUCTION: In survival analysis, cure fraction models are used to estimate the proportion of patients who have not experienced the event of interest (e.g., recurrence or death). These models consider both cured and no...
INTRODUCTION: In survival analysis, cure fraction models are used to estimate the proportion of patients who have not experienced the event of interest (e.g., recurrence or death). These models consider both cured and non-cured patients, allowing for a more comprehensive approach to understanding survival. Cure fraction models can be applied to analyze the survival of cancer patients. METHODS: This investigation aims to estimate the cure fraction in skin cancer patients based on the variables Treatment Type, Disease Stage, Gender, and Health Plan. The adjustment is performed using a mixture model applied to the GAMLSS regression methodology, which allows incorporating the cure fraction as a parameter in the population probability density function of the time to the event of interest. RESULTS: The results allow for the examination of the behavior of the cure fraction across different categories of the analyzed variables. CONCLUSION: The study demonstrates the feasibility of using cure fraction models to estimate the proportion of cured patients in different clinical and sociodemographic contexts, providing valuable insights for understanding survival in skin cancer patients.
Prevalence of Veteran-reported treatment barriers from the breast and gynecologic oncology system of excellence.
Smith IZ, Zullig LL, Berkowitz TS … +8 more , Cummin G, Weidenbacher HJ, Moss H, Colonna S, Kelley MJ, Patil V, Halwani AS, Shepherd-Banigan M
Cancer Epidemiol · 2026 Jun · PMID 41990711 · Publisher ↗
BACKGROUND: There are many barriers to cancer care for patients with breast and gynecologic cancers. While much is known about barriers to breast and gynecologic cancer in the civilian population, less is known about bar...
BACKGROUND: There are many barriers to cancer care for patients with breast and gynecologic cancers. While much is known about barriers to breast and gynecologic cancer in the civilian population, less is known about barriers reported by Veterans. We address this knowledge gap by using data from the Breast and Gynecologic Oncology System of Excellence (BGSoE) to identify key treatment barriers reported by Veterans diagnosed with gynecologic and breast cancers. METHODS: We employ cross-sectional data from the BGSoE dashboard to identify Veterans who were diagnosed with breast or gynecologic cancers from January 1, 2021 to March 15, 2024 and receive VA health care. We computed descriptive statistics for the barriers to treatment after breast and gynecologic cancer diagnosis. FINDINGS: Over half (56%) of Veterans reported one or more barriers to cancer treatment. There were no significant racial, sex, or age differences between Veterans who indicated any treatment barriers and those who did not. The most indicated barriers were related to care coordination (37%), logistical factors (29%), and psychosocial and behavioral factors (16%). CONCLUSIONS: Our findings among Veterans with breast and gynecologic cancers broadly echo the trends observed in studies of civilians. However, while Veterans do not report barriers related to medication costs and lacking insurance coverage, they do report barriers related to "eligibility problems" and "confusing financial paperwork." These findings speak to the nuances of treatment barriers among Veterans that need to be addressed to improve VA breast and gynecologic cancer treatment outcomes.
Maternal obesity and the intergenerational risk of cancer: Epidemiologic evidence and mechanistic insights.
Moeckli B, Rocha M, Wassmer CH … +4 more , El Hajji S, Collet TH, Lacotte S, Toso C
Cancer Epidemiol · 2026 Jun · PMID 41990710 · Publisher ↗
Over recent decades, the prevalence of obesity has markedly surged. While excess maternal weight is a well-established risk factor for adverse pregnancy outcomes, growing evidence suggests that maternal obesity may also...
Over recent decades, the prevalence of obesity has markedly surged. While excess maternal weight is a well-established risk factor for adverse pregnancy outcomes, growing evidence suggests that maternal obesity may also increase the long-term risk of cancer in offspring. This comprehensive review synthesizes epidemiological and experimental data linking maternal obesity to heightened cancer susceptibility in the next generation. Observational studies demonstrate increased risks of childhood leukemia and colorectal cancer in offspring of obese mothers, whereas preclinical models support associations with breast, liver, colon, and pancreatic cancers. Mechanistically, maternal obesity induces epigenetic reprogramming, immune dysregulation, and vertical transmission of a dysbiotic gut microbiota, which may lead to persistent alterations in metabolic and inflammatory signaling pathways in offspring, thereby promoting a pro-tumorigenic environment and potentially increasing cancer susceptibility. Given the global burden of obesity, this intergenerational risk has critical public health implications. Lifestyle modifications, weight-loss interventions, and targeted approaches such as probiotic supplementation may offer promising strategies to mitigate cancer risk in offspring, but require scientific confirmation in further studies. Future research should prioritize mechanistic dissection of exposure windows, identification of predictive biomarkers, and the development of effective, scalable preventive therapies.
Comparison of early-onset and later-onset cervical cancer clinical characteristics and trends in Eswatini.
Vilakati LN, Ndlela MG, Hlophe NP … +1 more , Liu JJ
Cancer Epidemiol · 2026 Jun · PMID 41980368 · Publisher ↗
INTRODUCTION: Eswatini has the highest cervical cancer incidence and mortality rates globally. We conducted the first analysis of cervical cancer characteristics and trends by age at diagnosis in Eswatini, to inform surv...
INTRODUCTION: Eswatini has the highest cervical cancer incidence and mortality rates globally. We conducted the first analysis of cervical cancer characteristics and trends by age at diagnosis in Eswatini, to inform surveillance strategies to reduce the country's high mortality burden from cervical cancer. METHODS: We studied women diagnosed with invasive primary cervical cancer from 2016 to 2022 in the Eswatini National Cancer Registry (N = 2099). Cancer stage, histological type, and HIV status distributions were examined by age at cervical cancer diagnosis (15-39, 40-49, and ≥50 years). Log-linear regression was used to obtain the annual percent change values for the cervical cancer proportion trends by age and stage at diagnosis. RESULTS: The mean age at cervical cancer diagnosis was 49.0 years. Histological type distributions significantly differed by age at cervical cancer diagnosis (p < 0.001), with adenocarcinoma being more common in later-onset patients diagnosed at age ≥ 50 years than in early-onset patients diagnosed at age 15-39 years or 40-49 years. For cervical cancer patients diagnosed at age 15-39 or ≥ 50 years, those with HIV had a higher proportion of metastatic cancer. From 2016-2022, the proportion of advanced-stage cervical cancer significantly declined for all study participants, whereas the proportion of early-stage cervical cancer significantly increased for those diagnosed at age 40-49 or ≥ 50 years. CONCLUSION: Despite the declining proportion of advanced-stage cervical cancer for both early-onset and later-onset patients in Eswatini, HIV-positive patients were more commonly diagnosed with metastatic cancer. Attention is warranted to decrease metastatic cancer diagnoses in HIV-positive women.
Trends in lung cancer incidence by sex, age, tumour stage, and histological subtype in Bavaria, 2006-2023: A registry-based study.
Prechtl P, Voigtländer S, Köpf B … +8 more , Hakimhashemi A, Klug SJ, Twardella D, Grundmann N, Tufman A, Zeissig SR, Meyer M, Müller-Nordhorn J
Cancer Epidemiol · 2026 Jun · PMID 41967402 · Publisher ↗
BACKGROUND: Lung cancer is the leading cancer worldwide. We aimed to describe recent trends of lung cancer incidence in males and females in Bavaria, Germany, stratified by age, tumour stage, and histological subtype. ME...
BACKGROUND: Lung cancer is the leading cancer worldwide. We aimed to describe recent trends of lung cancer incidence in males and females in Bavaria, Germany, stratified by age, tumour stage, and histological subtype. METHODS: We retrieved 116,087 incident lung cancer cases from the population-based Bavarian Cancer Registry from 2006 to 2023 and calculated age-standardised incidence rates (ASR) per 100,000 by sex, age, tumour stage (Union of International Cancer Control (UICC) I, II, III, IV) and histological subtype. We performed Joinpoint regression analysis to estimate short- and long-term trends in lung cancer incidence based on annual percent change (APC) and average annual percent change (AAPC) with respective 95% confidence intervals (CI). Missing data on stage and histology were addressed using multiple imputation. RESULTS: Between 2006 and 2023, ASRs of lung cancer in males continuously decreased from 53.0 to 36.4 (AAPC: -2.2 [95% CI: -2.5, -1.9]), while they increased in females from 19.1 to 25.6 (AAPC: 1.4 [95% CI: 1.0, 1.8]) and reached a plateau after 2017 (APC 2006-2017: 2.4 [95% CI: 1.9, 3.4]; 2017-2023: -0.3 [95% CI: -2.6, 0.8]). Among males, declines in ASRs were observed for most tumour stages, especially for stage IV tumours. For females, ASR increased for earlier tumour stages, but not for stage IV. Adenocarcinoma was the most common subtype throughout the study period for both sexes. CONCLUSION: Sex-specific incidence trends of lung cancer varied by tumour stage and histological subtype. The plateau reached among females in 2017 suggests beginning trend reversal.
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