CA Cancer J Clin
· 2026 · PMID 41776770
·
Full text
Genomics-and genomic testing in particular-has transformed oncology, facilitating both targeted therapies and personalized care. In pediatric oncology, unique clinical and ethical considerations arise. Compared with adul...Genomics-and genomic testing in particular-has transformed oncology, facilitating both targeted therapies and personalized care. In pediatric oncology, unique clinical and ethical considerations arise. Compared with adults, children and adolescents are affected by more limited evidence regarding test performance, variant interpretation, and the clinical utility of genomically informed interventions. Nevertheless, genomic findings may have implications beyond the patient, affecting their parents, siblings, and other relatives and raising questions around consent, assent, privacy, and psychosocial impact. This narrative review examines how ethical dimensions of genetic and genomic testing evolve across the pediatric cancer continuum, from diagnosis and treatment through survivorship and transition to adult care. Attention is given to communication strategies, interdisciplinary support, and equity concerns that influence the responsible integration of genomic medicine. The authors also identify priority areas for future inquiry, including incorporation of children's perspectives, longitudinal approaches to recontact and reconsent, and better understanding of how genomic information affects treatment decision-making. Pediatric genetic and genomic testing in oncology holds great promise, but its benefits can only be realized through thoughtfully developed and standardized communication practices, careful ethical deliberation, and equitable implementation. By proactively addressing these issues, pediatric oncologists can harness genomic advances in ways that respect and support children and their families.
Siegel RL, Wagle NS, Star J
… +3 more, Kratzer TB, Smith RA, Jemal A
CA Cancer J Clin
· 2026 · PMID 41769777
·
Full text
Colorectal cancer (CRC) is the second most common cancer-related death in the United States and ranks first in adults younger than 50 years. Every 3 years, the American Cancer Society reports on CRC occurrence based on i...Colorectal cancer (CRC) is the second most common cancer-related death in the United States and ranks first in adults younger than 50 years. Every 3 years, the American Cancer Society reports on CRC occurrence based on incidence from population-based cancer registries and mortality from the National Center for Health Statistics. Overall, CRC incidence declined by 0.9% annually during 2013-2022 driven by decreases of 2.5% annually in adults aged 65 years and older. In sharp contrast, incidence rates increased by 3% annually in adults aged 20-49 years and by 0.4% annually in adults aged 50-64 years dominated by tumors in the distal colon and rectum. Consequently, overall rectal cancer incidence increased by 1% annually from 2018 to 2022 after decades of decline and now accounts for 32% of all CRC, up from 27% in the mid-2000s. Increasing CRC incidence in adults aged 50-64 years was confined to regional and distant-stage diagnosis (1.1%-1.3% annually during 2013-2022), likely contributing to an upturn in mortality in this age group of 1% annually since 2019 that was steepest (2.3% annually) in White individuals. Mortality has increased in adults younger than 50 years by 1% annually since 2004, whereas rates have decreased in adults 65 years and older by 2.3% annually since 2012. Despite steady progress for older adults, both CRC incidence and mortality are increasing in adults younger than 65 years who are in the prime of life, underscoring an urgent need for etiologic research to discover the cause of the rising trend. Meanwhile, morbidity and mortality could be mitigated with earlier diagnosis, through screening and educating clinicians and the general public about CRC symptoms, and greater attention to the unique needs of younger patients, including discussion about the preservation of fertility and sexual health.
Li W, Huang S, Chen Q
… +27 more, Wang T, Lu G, Niu X, Song Q, Xu Y, Mo K, Cui C, Zhang R, Du W, He F, Shi L, Lin Y, Wei Q, Jiang L, Chen Y, Song B, Zhang H, Fu Z, Liao W, Sun J, Guan W, Zhuang W, Zhong N, Zhou C, Liang W, Kang M, He J
CA Cancer J Clin
· 2026 · PMID 41757686
·
Full text
Reliable, contemporary estimates of the global childhood cancer burden remain scarce, particularly in the post-coronavirus disease 2019 (COVID-19) era. By using data from the Global Burden of Disease 2021 and Global Canc...Reliable, contemporary estimates of the global childhood cancer burden remain scarce, particularly in the post-coronavirus disease 2019 (COVID-19) era. By using data from the Global Burden of Disease 2021 and Global Cancer Observatory 2022 projects, the authors evaluated the childhood cancer burden at global, regional, and national levels, characterizing temporal and projected trends, and analyzed the data according to disparities by geography and socioeconomic development. From 2000 to 2021, the age-standardized incidence rate (ASIR) and the age-standardized mortality rate (ASMR) of childhood cancer declined overall (average annual percent change, -0.88 and -2.13, respectively), especially during the COVID-19 pandemic. During this period, the disparities in childhood cancer burden were mainly concentrated in countries/territories with a lower Sociodemographic Index. In 2022, an estimated 202,164 new cases and 77,182 deaths from childhood cancer occurred worldwide (ASIR and ASMR, 10.3 and 3.9 per 100,000 children, respectively). Countries/territories with higher a Human Development Index (HDI) had a higher incidence (ASIR, 8.0 [low HDI] vs. 15.3 [very high HDI] per 100,000), whereas those with a lower HDI had higher mortality (ASMR, 4.4 [low HDI] vs. 2.8 [very high HDI] per 100,000). Analyses indicated that, by 2050, there will be 204,925 projected new cases and 78,210 deaths globally, with increases only in low HDI countries/territories, exacerbating existing health inequities. Childhood cancer remains a global health challenge, with notable geographic and socioeconomic disparities. These data serve as the impetus for governments and policymakers to prioritize resources and equitable access to interventions, particularly in regions with lower levels of development, while addressing health care vulnerabilities exposed by global crises like the COVID-19 pandemic.
Burshtein J, Witkowski A, Zakria D
… +6 more, Shah M, Rosenberg A, DeBusk L, Ludzik J, Pellacani G, Rigel D
CA Cancer J Clin
· 2026 · PMID 41614452
·
Full text
The early detection of cutaneous melanoma is critical to survival outcomes. Because less than one half of melanomas in the United States are diagnosed by dermatologists, the ABCD (asymmetry, border irregularity, color va...The early detection of cutaneous melanoma is critical to survival outcomes. Because less than one half of melanomas in the United States are diagnosed by dermatologists, the ABCD (asymmetry, border irregularity, color variation, diameter >6 mm) acronym, created 40 years ago with the later addition of "E" for evolution (ABCDE), was developed for nondermatologist health care professionals and the public to simplify and enhance the diagnosis of early melanoma. It continues to be the global, naked-eye, nondevice-assisted standard for initial triage of pigmented lesions. This clinical review discusses the changing clinical diagnostic landscape and examines the currently available first-line and second-line detection modalities for melanoma. It also provides updates to the first-line triage approach and discusses the challenges of regulatory agency oversight for the safe and effective use of current and emerging skin cancer detection technologies. It is critical that health care professionals globally have knowledge of these technologies to enhance their diagnosis of melanoma.
CA Cancer J Clin
· 2026 · PMID 41528114
·
Full text
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using data collected b...Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using data collected by central cancer registries (incidence, through 2022) and the National Center for Health Statistics (mortality, through 2023). In 2026, approximately 2,114,850 new cancer cases and 626,140 cancer deaths are projected to occur in the United States. The cancer mortality rate continued to decline through 2023, averting 4.8 million deaths since 1991, largely because of smoking reductions, earlier detection, and improved treatment. These interventions are also evident in rising 5-year relative survival, which reached a milestone 70% for diagnoses during 2015-2021 overall, 69% for regional-stage disease, and 35% for distant-stage (metastatic) disease, up from 63%, 54%, and 17%, respectively, in the mid-1990s. People with high-mortality cancers and advanced diagnoses had the largest gains, including increases from 32% to 62% for myeloma, 7% to 22% for liver cancer, 16% to 35% for metastatic melanoma, 8% to 18% for metastatic rectal cancer, 20% to 37% for regional lung cancer, and 2% to 10% for metastatic lung cancer. Nevertheless, lung cancer will cause more deaths in 2026 than second-ranking colorectal cancer and third-ranking pancreatic cancer combined. In summary, decades of scientific investment have translated to longer lives for people with even the most fatal cancers. However, continued progress is threatened by proposed federal cuts to cancer research and health insurance, which provides access to life-saving cancer treatment.
Singareeka Raghavendra A, Damodaran S, Barcenas CH
… +3 more, Fuqua SA, Layman RM, Tripathy D
CA Cancer J Clin
· 2026 · PMID 41524544
·
Full text
The hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer subtype accounts for most early and metastatic breast cancer (MBC) cases. HR-positive/HER2-negative MBC is charact...The hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer subtype accounts for most early and metastatic breast cancer (MBC) cases. HR-positive/HER2-negative MBC is characterized by a relatively prolonged, although variable, disease course and substantial intertumoral and intratumoral heterogeneity. Although endocrine-based therapies remain the cornerstone of treatment, nearly all patients eventually develop resistance, which is increasingly addressed with biologically targeted agents and newer-generation cytotoxic drugs. This review summarizes the current understanding of HR-positive/HER2-negative MBC biology, highlighting mechanisms of intrinsic and acquired resistance, including driver genomic alterations that, along with clinical factors, help guide therapeutic choices and sequencing. The authors specify and discuss how genomic and transcriptomic profiling inform treatment selection and how side effects and overall patient experience are considered in decision making. Advances in targeted therapies, such as CDK4/6 (cyclin-dependent kinase 4/6), PI3K (phosphatidylinositol 3-kinase), and AKT (protein kinase B) inhibitors, and next-generation estrogen receptor degraders are reviewed along with the expanding role of antibody-drug conjugates and biomarker-guided tumor-agnostic biologic therapies. The authors also explore evolving biologic concepts, including the impact of the tumor microenvironment on resistance and disease progression, and consider the distinct clinical behavior of invasive lobular carcinoma and current approaches. Emerging data from contemporary clinical trials promise to refine clinical and biomarker-driven algorithms and improve outcomes for patients with HR-positive/HER2-negative MBC. Ongoing multi-omic research and adaptive clinical strategies will be essential to further the application of precision oncology in this most common subtype of MBC. Importantly, patient-reported outcomes, shared decision making, and real-world evidence are increasingly useful in formulating comprehensive care plans, guidelines, and policy. The modern treatment landscape features a personalized approach that integrates clinical features, biomarkers, and patient preferences across the disease continuum.
Islami F, Arias G, Lee D
… +18 more, Wiese D, Baeker Bispo J, Yabroff KR, Siegel RL, Bandi P, Nargis N, Patel AV, Thienprayoon PP, Kamal AH, Daniels EC, Annunziata CM, Sloan K, Lacasse LA, Winn RA, Brawley OW, Guerra CE, Dahut WL, Jemal A
CA Cancer J Clin
· 2026 · PMID 41400551
·
Full text
Since 2021, the American Cancer Society has published its biennial report on the status of cancer disparities in the United States. In this 2025 report, the authors provide updated data on disparities in cancer occurrenc...Since 2021, the American Cancer Society has published its biennial report on the status of cancer disparities in the United States. In this 2025 report, the authors provide updated data on disparities in cancer occurrence and outcomes by sex, race, ethnicity, socioeconomic status (SES [educational attainment as a proxy]), and geographic location (including urbanicity of county of residence and congressional district), along with contributors to these disparities, including major cancer risk factors, screening, and select social determinants of health (SDOH) and health-related social needs. The authors found substantial disparities across the cancer continuum, including risk factors, incidence, stage at diagnosis, receipt of care, survival, and mortality for many cancers and in evaluated SDOH by race and ethnicity, educational attainment, and geographic location. During 2019 through 2023, Black and American Indian/Alaska Native populations had the highest cancer mortality rates, both overall and for the leading causes of cancer death. Cancer mortality rates were also consistently higher among adults with lower SES. However, differences in cancer mortality were substantially larger by education than by race, indicating that SES plays a major role in driving racial disparities in cancer mortality. Overall cancer mortality rates were higher in Black adults than in White adults with the same education level by 7%-28% among males and by 2%-43% among females. Within each race, however, overall cancer mortality rates were higher in adults with ≤12 years of education than in those with ≥16 years of education by 143%-192% among males and by 71%-140% among females. Mortality from all cancers combined was 21% higher in nonmetropolitan than in large metropolitan counties, with the greatest differences for lung (45%) and cervical (36%) cancers and the smallest for prostate, female breast, and pancreatic cancers (7%-8%). By congressional district, the highest cancer mortality rates both overall and for lung, colorectal, and breast cancers were largely found in the South and East North-Central division of the Midwest; however, for prostate cancer, there was no distinct geographic pattern. Sociodemographic groups that had higher cancer mortality generally had higher exposure to risk factors, lower health insurance coverage, and limited access to cancer prevention, early detection, and treatment compared with groups that had lower cancer mortality, largely reflecting fundamental disparities in SDOH. Mitigating cancer disparities in the United States requires intersectoral stakeholder engagement, targeted funding, effective policies at the federal, state, and local levels, and broad implementation of evidence-based interventions, such as expanding health insurance coverage, including through strengthening Marketplaces and protecting and expanding access to Medicaid.
McKay RR, Pal S, Xie W
… +51 more, Aggen D, Albiges L, Apolo A, Atkins MB, Bangs R, Beckermann KE, Bellmunt J, Berg SA, Bilen MA, Braun D, Carlo MI, Efstathiou J, Galsky M, Grivas P, Gupta S, Haas N, Hakimi AA, Hammers H, Heng DYC, Hirsch M, Iyer G, Jonasch E, Koshkin VS, Kryvenko O, Lewis B, Li R, Matin S, Maughan B, McDermott DF, McGregor B, Meeks J, Milowsky M, Motzer R, Necchi A, Petrylak D, Porten S, Powles T, Rini B, Shuch B, Siefker-Radtke A, Sonpavde G, Sridhar SS, Suarez C, Tang C, Tripathi A, Van Der Heijden MS, Voss M, Xu W, Zhang T, Rosenberg J, Choueiri TK
CA Cancer J Clin
· 2026 · PMID 41389316
·
Full text
The therapeutic landscape for renal cell carcinoma (RCC) and urinary tract cancer (UTC) has transformed dramatically, creating complexity in treatment selection and sequencing. The 2025 Advanced Urologic Cancer Consensus...The therapeutic landscape for renal cell carcinoma (RCC) and urinary tract cancer (UTC) has transformed dramatically, creating complexity in treatment selection and sequencing. The 2025 Advanced Urologic Cancer Consensus Conference was convened to establish evidence-based expert consensus recommendations for optimal management. A multidisciplinary panel of 51 experts participated in a modified Delphi process addressing questions developed through iterative consensus-building covering RCC and UTC management. Voting occurred before and after the conference, and analyses focused on postmeeting responses. Consensus was defined as ≥75% agreement, with strong consensus as >90%. Strong consensus was found on the use of adjuvant pembrolizumab for higher risk RCC (pathologic T2 [pT2], grade 4; pT3-pT4, any grade; pTXN1; or fully resected metastatic disease) and on neoadjuvant therapy before cystectomy for localized UTC. There was strong consensus on the use of enfortumab vedotin plus pembrolizumab as frontline therapy for metastatic UTC and the use of platinum-based chemotherapy postprogression in biomarker-negative UTC. For RCC, there was consensus on the role of single-agent vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy after progression on frontline immune checkpoint inhibitor/vascular endothelial growth factor receptor-tyrosine kinase inhibitor therapy or dual immune checkpoint inhibitor therapy. However, there was a lack of consensus on other critical areas in the management of RCC and UTC. The 2025 Advanced Urologic Cancer Consensus Conference provides evidence-informed guidance for complex clinical scenarios while identifying critical research priorities. The group recognizes that the lack of consensus across multiple areas highlights the need for improved patient selection and prospective studies enabling optimal combination and sequencing approaches. This iterative annual process will address evolving treatment paradigms to optimize outcomes.