Cancer seriously threatens the lives and health of people worldwide, and exosomes seem to play an important role in managing cancer effectively, which has attracted extensive attention from researchers in recent years. This study aimed to scientifically visualize exosomes research in cancer (ERC) through bibliometric analysis, reviewing the past, summarizing the present, and predicting the future, with a view to providing valuable insights for scholars and policy makers. Researches search and data collection from Web of Science Core Collection and clinical trial.gov. Calculations and visualizations were performed using Microsoft Excel, VOSviewer, Bibliometrix R-package, and CiteSpace. As of December 1, 2024, and March 8, 2025, we identified 8,001 ERC-related publications and 107 ERC-related clinical trials, with an increasing trend in annual publications. Our findings supported that China, Nanjing Medical University, and International Journal of Molecular Sciences were the most productive countries, institutions, and journals, respectively. Whiteside, Theresa L. had the most publications, while Théry, C was the most co-cited scholar. In addition, Cancer Research was the most co-cited journal. Spatial and temporal distribution of clinical trials was the same as for publications. High-frequency keywords were "extracellular vesicle," "microRNA" and "biomarker." Additional, "surface functionalization," "plant," "machine learning," "nanomaterials," "promotes metastasis," "engineered exosomes," and "macrophage-derived exosomes" were promising research topics. Our study comprehensively and visually summarized the structure, hotspots, and evolutionary trends of ERC. It would inspire subsequent studies from a macroscopic perspective and provide a basis for rational allocation of resources and identification of collaborations among researchers.

The mortality of pancreatic cancer in China showed an increasing trend between 2005 and 2020, with significant discrepancies in the burden of pancreatic cancer in provinces.

We analyzed numbers of death, incidence, disability-adjusted life years (DALY) and corresponding age-standardized rates for pancreatic cancer in China using data from the Global Burden of Disease Study 2021. We conducted trend analysis in pancreatic cancer burden over time by age group and gender. Decomposition analysis was used to assess the drivers of change in cancer-related deaths in China due to three explanatory factors: population growth, population ageing and age-specific mortality.

In 2021, the ASMR of pancreatic cancer in China was 5.72/100,000(95%UI: 4.59, 6.91), the age-standardized incidence (ASIR) rate was 5.64/100,000(95%UI: 4.52, 6.84) and the age-standardized DALY rate was 137.23/100,000 (95%UI:108.15, 166.74). From 1990 to 2021, the ASMR of pancreatic cancer in China generally showed an increasing trend (AAPC: 0.56, 95%UI: 0.52, 0.59). The burden of pancreatic cancer was consistently higher in Chinese men compared to women during the study period.Compared with 1990, the number of deaths from pancreatic cancer has increased in all provinces of China in 2021, with the overall number of deaths increasing by 67.49%. Population ageing was the major cause of the increase in deaths from pancreatic cancer in China, accounting for 45.89%.

The burden of pancreatic cancer in China is still at a high level and population ageing is the main reason for the increase in pancreatic cancer deaths.

To evaluate the performance of a software algorithm developed to streamline microwave liver ablation parameter selection and to compare performance of this algorithm to that of experienced interventional radiologists.

Patients who underwent microwave ablation for treatment of liver tumors were retrospectively identified. An automated software platform was developed to select the top three 'best fit' combinations of microwave ablation power, time, and vendor for a given tumor to achieve a 5 mm minimal ablative margin (MAM). Generalized linear modeling was used to compare the performance of the software algorithm and experienced interventional radiologists with respect to selected ablation parameters and estimates of total ablative volume (TAV) and MAM. Statistical significance was set at p < 0.05.

35 patients were identified who underwent single-antenna microwave ablation for liver tumors. Mean estimated TAV was not significantly different between clinical practice (24.96 cm3, 95% CI: 21.18 - 28.75 cm3) and algorithm-derived parameters (23.89 cm3, 95% CI: 20.04 - 27.74 cm3; p > 0.05), indicating agreement in overall treatment approach. However, the algorithm consistently generated ablation parameter combinations with more favorable estimated MAM metrics and significantly lower variability (first algorithm: -5.33 mm, 95% CI -5.40 - -5.26 mm; second algorithm: -5.83 mm, 95% CI -6.01 - -5.65 mm; third algorithm: -6.06 mm, 95% CI -6.30 - -5.83 mm) compared to interventional radiologists (-1.02 mm, 95% CI -2.02 - -0.03 mm).

Streamlining microwave liver ablation parameter selection using an automated software algorithm reduces variability and improves estimated MAM coverage of liver tumors.

Colorectal cancer (CRC) is a major global health burden, with immunotherapy often limited by immune tolerance and resistance. This study introduces an innovative approach using Selenium Nanoparticles-Loaded Extracellular Vesicles combined with Interleukin-32 and Engineered Probiotic Escherichia coli Nissle 1917 (SeNVs@NE-IL32-EcN) to enhance CD8+ T cell-mediated immune responses and overcome immunotherapy resistance.

Single-cell RNA sequencing (scRNA-seq) and transcriptomic analyses were performed to identify key immune cells and regulators involved in CRC immunotherapy resistance, focusing on CD8+ T cells and the regulatory factor IL32. A humanized xenograft mouse model was used to evaluate the impact of IL32 and SeNVs@NE-IL32-EcN on tumor growth and immune responses. The SeNVs@NE-IL32-EcN complex was synthesized through a reverse micelle method and functionalized using extracellular vesicles. Its morphology, size, antioxidant activity, and safety were characterized using electron microscopy, dynamic light scattering (DLS), and in vitro co-culture assays.

Single-cell analyses revealed a significant reduction in CD8+ T cell infiltration in immunotherapy-resistant CRC patients. IL32 was identified as a key regulator enhancing CD8+ T cell cytotoxic activity through granzyme B and IFN-γ secretion. Treatment with SeNVs@NE-IL32-EcN significantly improved the proliferation and activity of CD8+ T cells and reduced tumor progression in humanized mouse models. In vitro and in vivo results demonstrated the complex's biocompatibility, antioxidant properties, and ability to enhance CRC immunotherapy while mitigating immune tolerance.

SeNVs@NE-IL32-EcN offers a novel nano-biomaterial strategy that integrates nanotechnology and probiotic therapy to enhance CD8+ T cell-mediated immunity and overcome CRC immunotherapy resistance. This study lays the foundation for future therapeutic applications in cancer treatment by advancing immune-modulating biomaterials.

Treatment burden refers to the overall impact of medical treatments on a patient's well-being and daily life. Our objective is to evaluate the impact of treatment burden on quality of life (QoL) in patients with genitourinary (GU) malignancies, highlighting the importance of patient-reported outcomes (PROs) in clinical trials to inform treatment decisions and improve patient care.

We conducted a narrative review of clinical trials focused on GU malignancy (prostate, bladder, and kidney) between January 2000 and June 2024, analyzing related PROs and findings regarding treatment burden.

Recent landmark clinical trials demonstrate significant improvements in overall survival across GU malignancies with novel therapies. However, the reporting of QoL outcomes in these trials is often inadequate, with many lacking comprehensive data or long-term impact. Current publications are increasingly evaluating treatment burden and its impact on patient well-being as a critical outcome, but most clinical trials to date have failed to assess treatment burden across key domains including financial, time and travel, and medication management.

While advancements in treatment have extended longevity in patients with GU malignancies, the treatment burden associated with the receipt of novel agents and its implications for QoL remain inadequately uncharacterized.

Metabolic-associated fatty liver disease (MAFLD) is a growing global health concern, particularly among women of childbearing age (WCBA). We aimed to analyze the global burden of MAFLD among WCBA from 1990 to 2021 and project trends to 2040.

Data on incidence, prevalence, deaths, and disability-adjusted life years (DALYs) were extracted from the Global Burden of Disease Study 2021. Joinpoint regression and decomposition analysis were used to assess historical trends, and Bayesian Age-Period-Cohort (BAPC) modeling projected future burdens.

From 1990 to 2021, the age-standardized rate (ASR) of MAFLD incidence and prevalence among WCBA increased globally (EAPC = 0.76 and 0.71, respectively). China showed declining trends in deaths (EAPC = -2.63) and DALYs (EAPC = -2.62). By 2040, BAPC modeling predicts a continued rise in global incidence and prevalence, with regional disparities in mortality. Population growth was the primary driver of the global increase in MAFLD incidence, accounting for 63.38% of the rise.

MAFLD imposes a significant burden on WCBA globally, with socioeconomic disparities driving regional variations. Targeted interventions addressing obesogenic environments and healthcare inequities are urgently needed.

Hypoxia and lactate metabolism are both distinctive characteristics of cancerous cells. Head and neck squamous cell carcinoma (HNSCC) is one of the most prevalent forms of cancer. The objective of this study was to construct a prognostic model of genes related to hypoxia and lactate metabolism in order to facilitate the study of the prognosis, tumor immune microenvironment and therapeutic response of patients with HNSCC. The RNA-seq and clinical data for HNSCC were obtained from The Cancer Genome Atlas database and gene expression omnibus. The hypoxia- and lactate metabolism-related genes were obtained from the Molecular Signatures Database. The identification of differentially expressed genes was conducted using the "limma" R package. Subsequently, protein-protein interaction networks of the differentially expressed genes were constructed using the STRING database and Cytoscape software. A hypoxia-lactate metabolism-related prognostic model was constructed through the application of univariate Cox regression, random survival forest, and stepwise multivariate Cox regression analyses. Subsequently, further analyses were conducted, including principal component analysis, gene enrichment analysis, CIBERSORT (Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts), ImmuCellAI, ESTIMATE, tumor immune dysfunction and exclusion, IPS, oncoPredict, and CellMiner. These were performed to analyze the differences in immune landscapes and treatment responses. The results of our study demonstrate that hypoxia- and lactate metabolism-related features are promising biomarkers for predicting outcomes in patients with HNSCC.

Colorectal cancer (CRC) is a common malignant tumor in the gastrointestinal tract with inconspicuous early symptoms, high morbidity and mortality, and poor prognosis. Gut microbiota are present in the human intestinal system and have certain functions, which include the integrity of the epithelial barrier and the enhancement of protective immune responses. The etiology of CRC is numerous and complex, including poor lifestyle and dietary habits, and instability of the gut microbiota, which is considered to be one of the major factors in the development of CRC, includes mainly Bacteroides fragilis, Fusobacterium nucleatum, Escherichia coli, and Enterococcus faecalis. Enrichment of these bacteria in CRC tumor tissues may increase other pro-inflammatory opportunistic pathogens and decrease butyrate-producing bacteria, leading to an imbalance in intestinal homeostasis (dysbiosis) and ultimately tumor formation. Antibiotic-induced changes in the gut microbiota affect tissue utilization and redox homeostasis of macronutrients and micronutrients. However, the long-term use and abuse of antibiotics has made the problem of drug resistance a difficult problem that currently plagues the regulation of gut microbiota, as well as a complicated issue in the prevention and treatment of CRC. In this review, we elucidated the drug resistance of four CRC-associated gut microbiota, namely Bacteroides fragilis, Fusobacterium nucleatum, Escherichia coli, and Enterococcus faecalis, and discussed the common and different aspects of the resistance mechanisms of the four gut microbiota, with the aim of providing a basis for the prevention and control of CRC.

Cancer is rapidly increasing worldwide and urgent global action towards cancer control is required. Consistent with global trends, Canada is expected to experience a near doubling in new cases and cancer deaths between 2020-2040; population growth and ageing being the primary drivers. The projected increased cancer incidence and its associated costs is expected to further exacerbate socioeconomic inequities. Focused actions to prevent cancer, to detect it earlier when more treatable, and, to lower the risk of recurrence, must be prioritized. Almost half of all cancers are preventable, caused by risk factors that are potentially avoidable and modifiable. Integrating cancer prevention with care-based models is necessary and represents the most cost-effective and sustainable approach to control cancer. To be effective, prevention efforts must consider the cancers impacting local populations and understand how community and individual factors interact within the spatial and temporal contexts in which people live. This study is part of the Nova Scotia Community Cancer Matrix project which profiles the cancers impacting communities over time; measuring associations between cancer and socioeconomic status (SES); and determining how the joint spatial distribution of cancers can be used to address inequities, identify priority populations and strengthen prevention efforts. Using Bayesian inference to model spatio-temporal variations in 58,206 cases diagnosed in 301 communities between 2001-2017, across 10 preventable cancer types, we report significant disparities in cancer risk across communities based on sex and community SES. The work highlights the utility of small-area mapping to identify at-risk communities and understand how community-SES impacts risk. It also uncovers significant inequities rooted in the differential distribution of material and social capacity, operating beyond the control of individuals. The approach is implementable to other regions to inform and strengthen prevention efforts aiming at reducing the burden of cancer or that of other diseases.

Colorectal cancer ranks among the top causes of both cancer incidence and mortality, posing a severe threat to global health. Currently, chemotherapeutic drugs used for treating colorectal cancer, such as camptothecin (CPT) and its derivatives, are limited in their application due to gastrointestinal reactions and myelosuppression. Mitochondria-targeted therapy aims to deliver active drug molecules into the mitochondria via electrostatic adsorption, allowing them to exert their effects directly within the mitochondria while reducing side effects during treatment. In this work, we used camptothecin as the parent compound, then we synthesized three series of 13 camptothecin derivatives by attaching alkyl chains of different length to delocalized lipophilic cations such as triphenylphosphonium, F16 and rhodamine B. The in vitro cytotoxicity screening revealed that compounds 8a and 8c, which are connected to rhodamine B, showed significantly higher antiproliferative activity against HCT116 colorectal cancer cells than CPT. Furthermore, compound 8a exhibited lower toxicity towards normal liver cells. Cellular imaging experiments demonstrated excellent mitochondria-targeted abilities of compounds 8a and 8c. Flow cytometry analysis indicated that compound 8a can induce apoptosis in a concentration-dependent manner. Overall, compound 8a can be a potential anti-cancer agent for colorectal cancer.

Gynecological cancers account for one-sixth of disability-adjusted life years of women with malignancies. The burden of these diseases is more remarkable in low- and middle-income countries with limited access to human papillomavirus vaccines. Thus, early diagnosis and prompt treatment are vital in disease management. In connection, extracellular vesicles (EVs) are gaining traction in tumor biology. Biomolecular cargoes within EVs can be nucleic acids, proteins, or lipids that can reflect the biological state of the cell from which they are derived such as cancer cells, and consequently the influence of cancer cells to recipients including cancer and non-cancer cells. Combining this with the stability and detectability of EVs in biological samples, EVs present potential utility in the diagnosis and prognostic monitoring of gynecological malignancies. Therefore, this review discusses the role of extracellular vesicles in the pathophysiology of cervical, uterine, and ovarian cancers, and how these roles are exploited in the diagnosis and prognosis of patients with these malignancies through the presentation of evidence from in vitro, in vivo, and clinical studies.

Meta-analyses have reported lower cancer incidence in patients with Parkinson's disease (PD) compared to the general population but with considerable data heterogeneity.

To explore how the validity of the PD diagnoses is related to the association with cancer.

We conducted a systematic review and meta-analysis in which studies were stratified into groups based on the diagnostic validity of Parkinson's disease. Studies investigating mortality data and those examining cancer risk within certain genetic subgroups of PD were excluded.

Thirty-four articles encompassing 533,102 patients with PD from 11 countries met the inclusion criteria. Stratified analyses revealed no association between PD and overall cancer risk preceding or following the PD diagnosis in studies using validated PD data. Studies utilizing less robust PD identification methods, the majority of which were cohort studies, demonstrated a neutral or decreased cancer risk among PD patients. In the studies with the most rigorous PD validation organ-specific analyses showed an increased risk of cutaneous melanoma but no decreased risk in any type of cancer. The positive association between PD and melanoma was more pronounced in the studies with more robust PD diagnosis validity.

The reported associations between PD and cancer are substantially influenced by the quality of PD data. Future investigations should concentrate on organ-specific cancers, instead of pooling cancers together, and use only PD cohorts with validated diagnosis.

Exposure to metal(loid)s and glucose metabolism may influence the progression of gastric precancerous lesions (GPLs) or gastric cancer (GC), but their combined effects remain unclear. Our study aimed to elucidate the combined impact of metal (including metalloid and trace element) exposure and disturbances in glucose metabolism on the progression of GPLs and GC. From a prospective observational cohort of 1829 individuals, their metal(loid) levels and blood metabolism were analysed via inductively coupled plasma‒mass spectrometry and targeted metabolomics gas chromatography‒mass spectrometry, respectively. From healthy normal controls (NC) or GPLs to GC, we observed that the aluminum and arsenic levels decreased, whereas the vanadium, titanium and rubidium levels increased, but the iron, copper, zinc and barium levels initially decreased but then increased; these changes were not obvious from the NC to GPL group. With respect to glucose homeostasis, most metabolites decreased, except for phosphoenolpyruvate (PEP), which increased. Multiple logistic regression analysis revealed that titanium and phosphoenolpyruvate might be risk factors for GPLs, that barium is a protective factor for GC, and that D-glucaric acid might be a protective factor for GPLs and GC. Selenium, vanadium, titanium, succinate, maleate, isocitrate, PEP, and the tricarboxylic acid cycle (TCA) had good predictive potential for GPL and GC. Additionally, metal(loid)s such as arsenic, titanium, barium, aluminum, and vanadium were significantly correlated with multiple glucose metabolites involved in the TCA cycle in the GPL and GC groups. Our findings imply that metal(loid) exposure disrupts glucose metabolism, jointly influencing GPL and GC progression.

Colorectal cancer (CRC) is the fourth most diagnosed cancer in Australia. With advancements in treatment and an increase in survival rates, CRC survivors face an elevated risk of developing multiple primary cancers (MPCs), presenting a clinical challenge. Therefore, this study aimed to estimate the incidence, trend and risk of MPCs after a diagnosis of CRC in the South Australian population.

This study analysed South Australian Cancer Registry data on individuals diagnosed with CRC as their first cancer from 1982 to 2017. The incidence of MPCs was assessed using cumulative incidence functions, and age-standardised rates were estimated. Poisson regression was used to determine the risk, and standardised incidence ratios (SIR) and absolute excess risks (AER) were estimated. Trends over time were analysed using Joinpoint regression.

The study included 26,729 CRC survivors. Of the cohort, 15% (3917) developed 4453 MPCs, with 96% diagnosed six or more months after index CRC. The cumulative incidence of MPCs was 22.5% (95% CI: 21.6-23.4). The median follow-up time until MPC diagnosis was 6.4 years. Common MPCs included prostate (18.9%), subsequent CRC (13.1%), lung (10.8%), haematological (10.2%) and breast (8.0%) cancers. The overall risk of MPCs was higher in CRC survivors (SIR: 1.12, 95% CI: 1.09-1.16; AER: 22.6 per 10,000) compared to the incidence in the general South Australian population. The incidence of MPCs has increased over time (annual percentage change = 1.95, 95% CI: 1.33-2.51).

CRC survivors are at increased risk of subsequent cancers, highlighting the need for targeted surveillance, particularly for prostate, lung, breast and blood cancers, for early detection and treatment.

Little research has been conducted on the epidemiology of leukemia in Eritrea. In this retrospective study, we evaluated the burden and trends of acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), chronic lymphocytic leukemia (CLL), and overall leukemia in Eritrea.

An audit of leukemia cases recorded in laboratory logbooks at the National Health Laboratory and Orotta Referral and Teaching Hospital between January 2010 and December 2020 was performed. In addition to leukemia subtypes, variables such as age, sex, and year of incidence were retrieved. Relevant estimates assessed included crude incidence rates (CIR), age-standardized rates (ASIR), and estimated annual percentage change (EAPC). In total, 372 confirmed cases of leukemia were recorded between 2010 and 2020. The median (interquartile range [IQR]) age, maximum-minimum age, and male-to-female ratio were as follows: 48 years (24.5-60 years), 2-91 years, and 210:161 (1.3:1), respectively. The estimated all-age CIR and ASIR over the study period were 9.22 per 100,000 and 30.1 per 100,000, respectively. Analysis of cumulative (2010-2020) CIR per 100,000 (ASIR per 100 000) for ALL, AML, CLL, and CML were as follows: 2.01 (3.87); 0.94 (2.38); 2.94 (15.37); and 3.61 (24.03). Additionally, the median (IQR) age differed significantly across leukemia subtypes: ALL (23.0 years, IQR: 10.0-39.0); AML (30 years, IQR: 20-56 years); CLL (59.0 years, IQR: 40.75-66.75 years); and CML (49 years, IQR: 39.25-60 years), p value (Kruskal-Wallis) < 0.05. The proportion of leukemia types did not differ significantly between males and females. Unlike other leukemia subtypes, the evaluation of ALL's EAPC demonstrated that the incidence of leukemia increased over time, 21.9 (95% CI: 3.1-44.1), p value = 0.025.

The burden of leukemia in Eritrea remained relatively stable. However, due to underreporting and underdiagnosis, we believe the true burden of leukemia is likely higher. Furthermore, an upward trend in the burden of ALL was observed. Lastly, expanding diagnostic services to other sub-zones, establishing a national cancer registry, and prioritizing research remain critical in Eritrea.

To analyze the efficacy of supervised exercise (SE) compared with control protocols on sleep parameters of women who survived breast cancer.

This systematic review with meta-analysis searched studies using the following electronic databases: PubMed, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Library, and EMBASE. The PEDro scale assessed the bias risk, and the study protocol was registered in the PROSPERO (no. CRD42023420894).

Of 3,566 identified studies, 13 randomized clinical trials involving 847 women diagnosed with breast cancer were included. Interventions consisted of SE in an outpatient setting (62%) or combined protocols with supervised and home exercises. Most interventions (85%) used multicomponent protocols with aerobic and resistance exercises. Usual care and health education were the most reported controls. SE decreased the sleep disturbance score (- 31.61 [95% confidence interval =  - 39.40 to - 23.83]) of the European Organisation for Research and Treatment of Cancer quality of life questionnaire and daytime dysfunction score (- 0.41 [95% confidence interval =  - 0.73 to - 0.09]) of the Pittsburgh Sleep Quality Index (PSQI). Also, SE presented a tendency to improve the self-reported sleep quality score of the PSQI (p = 0.06).

SE increased the subjective sleep quality and immobility time and decreased sleep disturbance and daytime dysfunction symptoms in women who survived breast cancer. Most SE protocols were multicomponent, with aerobic and resistance exercises ranging from moderate to high intensity.

Supervised exercise may improve sleep quality and reduce symptoms of sleep disorders, contributing to survival outcomes.

There have been conflicting studies on the associations between cancer and cardiovascular disease (CVD) risk. The hypothesis of this meta-analysis was to investigate whether cancer survivors had an increased risk of CVD compared to those without cancer based on population-based cohort studies.

We did a systematic review and meta-analysis of prospective and retrospective cohort studies. We searched PubMed, Embase, Web of Science, and Scopus published in any language from January 1, 1990 to February 24, 2025. We included cancer survivors and non-cancer controls. The primary outcome was the risk of CVD. The secondary outcomes included 17 CVD subtypes (e.g., ischemic heart, cerebrovascular, and peripheral vascular disease). Effect estimates (hazards ratios, HRs) with 95% CIs were pooled. Subgroup analyses, sensitivity analyses and meta-regression were performed to explore the stability of the results and the sources of heterogeneity. The protocol of this review was registered in PROSPERO: CRD42024559349.

A total of 160 population-based cohort studies involving 49,395,865 participants (9,092,869 cancer survivors vs. 40,302,996 non-cancer controls) were identified. Overall, the HR for CVD in cancer survivors was 1.47 [95% CI, 1.33-1.62] compared with that in non-cancer controls. Cancer increased the risk of all 17 CVD subtypes, with cancer having the greatest effect on venous embolism, thrombosis or thrombophlebitis (HR, 3.07 [2.03-4.65]) and the least on ischemic heart disease (HR, 1.13 [1.03-1.24]). The increased risk of CVD was consistently shown in cancer survivors of brain, hematological, respiratory, male genital, and breast cancers, whereas no significant higher CVD risk was observed for other cancer types. Elevated risk of CVD was consistently shown in subgroup analyses of study design, age at cancer diagnosis, sex, location, follow-up duration, control, disease diagnosis, and therapy. Male and younger cancer survivors had elevated risk of CVD than female and older cancer survivors.

This meta-analysis provides an up-to-date comprehensive global overview that cancer survivors had increased risk of CVD and 17 CVD subtypes than non-cancer controls. CVD risk evaluation and management need to be prioritized in cancer survivors, particularly among male, younger, and specific cancer survivors (brain, hematological, respiratory, male genital, and breast). This study provides supporting evidence that may inform future updates to guidelines for CVD prevention in cancer survivors, highlighting its public health relevance.

The National Key R&D Program of China, the National Natural Science Foundation of China and the Young Elite Scientists Sponsorship Program by CAST.

Enhanced recovery after surgery (ERAS) is an evidence-based, multidisciplinary protocol aimed at reducing surgical stress and expediting postoperative recovery. This meta-analysis will provide a comprehensive examination of the implications of ERAS care for the quality of life (QOL) of postoperative Lung cancer (LC) patients. The literature databases were searched to identify randomized controlled trials that implemented an ERAS program for adult patients with LC who underwent surgical treatment and reported QOL results. Thirty-one studies were included in the analysis. ERAS/FTS significantly improved the overall QOL of postoperative LC patients according to the Short Form-36 (SF-36) score (mean difference (MD): 8.58; 95% confidence interval (CI): 6.17, 11.00; p < 0.001). For physical functioning, the ERAS/FTS significantly improved the SF-36 score (MD: 10.45; 95% CI: 7.41, 13.50; p < 0.001). In the role-physical dimension, the ERAS/FTS nurse strategy had a significant advantage in improving the role-physical score on the SF-36 scale (MD: 10.06; 95% CI: 7.00, 13.13; p < 0.001). The ERAS has a highly positive impact on QOL in postoperative LC patients, especially in the physical functioning and role-physical dimensions.

Current methods for diagnosis and disease monitoring for leptomeningeal metastasis (LM) face significant challenges, as they are relatively complex and lack the precision needed to detect subtle changes.

We conducted a retrospective study with the primary endpoint of assessing the diagnostic effectiveness of cerebrospinal fluid (CSF) tumor markers in LM patients with non-small-cell lung cancer (NSCLC). Secondary endpoints included evaluating the concordance with EANO-ESMO response assessment, determining optimal thresholds, and comparing costs against CSF ctDNA tests.

We retrospectively included 368 patients (151 LM patients, 219 non-LM patients) as the training set, and another 137 patients (63 LM patients, 74 non-LM patients) on a consecutive basis as the validation set. The CSF tumor marker panel using a logistic model showed the best performance both in the training set (AUC [95% CI] = 0.992 [0.984-1.000]) and the validation set (AUC [95% CI] = 0.939 [0.891-0.986]). In the response assessment, 167 events were evaluated, with 33 classified as response, 59 as stable, and 75 as progression. We found a concordance with EANO-ESMO response assessment, and a threshold of ± 25% of the maximal CSF tumor marker level change (maxTML) yielded the optimal predictive performance. Finally, the cost of the CSF tumor marker test (0.76%, IQR (0.30%-1.67%)) was significantly lower in a single hospitalization than CSF ctDNA (62.45%, IQR (32.62%-85.81%)).

Our study demonstrated that the CSF tumor marker test was an accurate, easily interpretable, and cheap tool for both diagnosis and monitoring therapeutic response in LM patients with NSCLC.

Chinese Clinical Trial Registry (ChiCTR) number: ChiCTR2300078556.

Financial toxicity (FT) is the impairment of financial well-being experienced by patients with cancer, categorized into subjective (SFT) and objective (OFT) forms. This study aimed to investigate the associations between FT, health-related quality of life, and overall well-being in patients with breast cancer.

We analyzed baseline data from a single-center longitudinal study in Indonesia. Patients completed the EQ-5D-5L, EQ Health and Wellbeing (EQ-HWB), COST: A FACIT Measure of Financial Toxicity (FACIT-COST, for measuring SFT), and OFT-related questions. Ordinal logistic regression was used to examine the associations between FT and selected EQ-5D-5L and EQ-HWB items. Multivariable linear regression was used to assess the associations of FT and EQ-5D-5L and EQ-HWB-S index values. The main regression models were adjusted for socio-demographic and clinical factors such as age, income, metastasis status, and symptoms.

The survey included 300 female patients with breast cancer undergoing treatment (mean age = 51). Overall, 21% experienced high SFT (FACIT-COST ≤ 17.5) and 51% reported any OFT (e.g., incurring debt). Adjusted for covariates, higher SFT was associated with more problems in EQ-5D-5L pain/discomfort and anxiety/depression, and in EQ-HWB exhaustion, anxiety, sadness/depression, frustration, pain, and discomfort. OFT was associated with more problems in exhaustion. Higher SFT was associated with lower EQ-5D-5L and EQ-HWB-S index values, with explained variances of 46.3% for EQ-HWB-S and 31.2% for EQ-5D-5L.

This study is the first to explore the associations between financial toxicity, EQ-5D-5L, and EQ-HWB outcomes in breast cancer. Our findings provide insight into the cancer burden and its link to health and well-being.

Cancer remains a significant global health concern, with familial cases often involving complex interactions between genetic predispositions and environmental factors. Variants of Uncertain Significance (VUS) pose challenges in genetic counseling and risk assessment, particularly in genes like MRE11, which plays a crucial role in DNA double-strand break repair and genomic stability.

This study aimed to investigate the effect of the MRE11 c.1138 C > T (p.Arg380Cys) variant in a family affected by familial cancer, focusing on its potential contribution to inherited cancer risk and the challenges it poses for genetic counseling in families with clustering of malignancies. Whole-exome sequencing was used to identify the variant, which was validated by Sanger sequencing. In silico protein modeling and bioinformatics analyses, including pathogenicity prediction tools like REVEL, SIFT, PolyPhen-2, and MutationTaster, were employed to assess the variant's functional effects. The MRE11 c.1138 C > T (p.Arg380Cys) variant was identified in a family with a history of breast, ovarian, and colorectal cancers.

Bioinformatics analyses suggested that this variant may destabilize the MRE11 nuclease domain, potentially impairing its function in DNA repair. Pathogenicity prediction tools consistently classified the variant as deleterious, although some family members with cancer did not carry the variant, indicating a complex interplay between genetic and environmental factors. The MRE11 p.Arg380Cys variant poses challenges in clinical interpretation due to its incomplete segregation within families. This pattern may reflect reduced penetrance, epistatic interactions with other genes (within MRN complex or others), or environmental influences.

The Ki-67 index, which is a proliferative index, has become more important in making treatment decisions for patients with breast cancer (BC) and plays both a predictive role and a prognostic role. However, a few factors limit its use in clinical practice, particularly the assessment of the percentage of Ki-67-positive cells and the cutoff value of Ki-67. In this study, we examined the expression of Ki-67 via immunohistochemistry and systematically evaluated the value of the Ki-67 index in patients with BC. This was a retrospective study including 280 patients diagnosed with BC. There were marked differences in overall survival (OS) between patients with BC when the Ki-67 index ranged from 46 to 68% (χ2 = 5.87, P = 0.0154; χ2 = 7.64, P = 0.0057, respectively), and the same results were also found when the staining density was added to the Ki-67 index; however, the staining density alone has limited value in assessing the value of Ki-67. There were marked differences in disease-free survival (DFS) among BC patients when the Ki-67 index ranged from 50 to 58% (χ2 = 7.31, P = 0.0069; χ2 = 7.88, P = 0.005). When 14% was used as a cutoff point to classify the molecular type of BC, the luminal A-type patients were significantly different from patients with HER2-overexpressing subtype BC in terms of OS (χ2 = 5.33, P = 0.021). There was a significant difference in the OS of patients with human epidermal growth factor receptor 2 (HER-2)-overexpressing subtype BC when the Ki-67 index fell within the range of 49-60% (χ2 = 4.86, P = 0.0275; χ2 = 5.50, P = 0.019, respectively). There were significant differences between luminal A-type BC and HER2-overexpressing subtype BC in terms of OS (χ2 = 5.53, P = 0.019), according to suggestions of the 2019 CSCO consensus. There were significant differences between the two groups of luminal B HER-2(-) BC when the Ki-67 index was 52% (χ2 = 6.61, P = 0.0101). The differentiated Ki-67 index can be used to assess the OS and DFS of patients with BC, and the staining density of Ki-67 has little value in assessing prognosis in these patients. Different molecular classification methods may influence the assessment of prognosis and the results of molecular subtype in patients with BC. To predict the prognosis of BC patients, it is more scientifically feasible to use the interval values of Ki-67 than a specific value.

Postdiagnosis physical activity is an important component of healthy lifestyle in cancer survivors. In this study, we aimed to explore the association between intensity and duration of physical activity measured by wearable accelerometers and mortality among pan-cancer survivors.

A prospective cohort study involving cancer survivors (n = 11,708) from UK Biobank was performed. All participants had thorough physical activity data that was measured by wrist-worn accelerometers. Restricted cubic splines and multivariate Cox proportional hazards models were employed to assess the dose-response associations between physical activity time at varying intensities and both all-cause and cancer-specific mortality.

During a median follow-up of 8.9 years, a total of 983 deaths occurred, including 656 cancer-related deaths. Multivariate models identified significant dose-response associations between moderate to vigorous-intensity physical activity (MVPA) time and mortality. Hazard ratios (HRs) for all-cause mortality were 0.64 (95% CI, 0.54-0.76), 0.61 (95% CI, 0.51-0.74) and 0.52 (95% CI, 0.42-0.66) in participants with MVPA time of 272-407, 407-579 and ≥579 min per week, respectively. HRs for cancer-specific mortality were 0.71 (95% CI, 0.58-0.88), 0.69 (95%CI, 0.55-0.87) and 0.61 (95%CI, 0.47-0.81) for the aforementioned groups. Similar patterns were observed for moderate-intensity physical activity but not for light-intensity physical activity. Survival benefits of active physical activity were pronounced in cancers from multiple organs.

Active physical activity substantially reduced all-cause mortality in pan-cancer survivors and cancer-specific mortality in cancer survivors of specific sites. However, the benefits were significant only when intensity of physical activity reached moderate to vigorous level.

Nonmelanoma skin cancer (NMSC), accounts for approximately 90% of skin cancers. Global incidence is rising, with projections showing a significant increase in cases and disability-adjusted life years (DALYs). However, research on NMSC in the Middle East and North Africa (MENA) region is limited. This study aims to assess the epidemiology and burden of NMSC in the MENA region from 1990 to 2021, by sex, age, and socio-demographic index (SDI). The analysis used data from the Global Burden of Disease 2021 on age-standardized rates and cases of incidence, prevalence, deaths, and DALYs. Estimation of NMSCs death was performed by the Cause of Death Ensemble model, while DisMod-MR 2.1 was used for non-fatal outcomes. Counts and rates were presented with 95% uncertainty intervals. In 2021, the MENA region reported an age-standardized incidence rate of 6.7 per 100,000 population for NMSC, a 14% decrease from 1990. However, the age-standardized death rate increased by 10.5% to 0.3, and the DALY rate increased by 8.2% to 4.9 per 100,000. Among the countries, Turkey had the highest age-standardized DALY rate of 13.5 and the Syrian Arab Republic had the lowest with 0.1 per 100,000. Most cases of the disease were observed in older age groups, especially men aged 65-69 and women aged 60-64. Men had higher incidence, mortality, and DALYs than women in all age groups. From 1990 to 2021, the burden of NMSC increased with increasing SDI. There is variations in the NMSC burden in the MENA region. Interdisciplinary education, policy changes, and healthcare improvements are essential to reduce the burden and incidence of NMSCs in the coming years, particularly in the elderly and high SDI countries.

Professional medical writers assist authors with ethical and accurate publication of scientific research. We hypothesized that the support of a medical writer would enable timely publication of research and explored their association using papers reporting phase III oncology trials from 2019-2023. Given the time frame of this research, we also assessed the impact of the coronavirus disease 2019 (Covid-19) pandemic on publication volume as a secondary objective.

We searched PubMed for phase III clinical trials published in New England Journal of Medicine (NEJM) and the Lancet between 01/01/2019 and 12/31/2023. Publications reporting oncology trials were reviewed in full to document acknowledgement of medical writing support, data cut-off date, publication date and other key characteristics. Time from data cut-off to publication was compared for papers with and without medical writing support.

Our search identified 442 papers reporting any phase III clinical trials, of which 164 (37%) reported oncology trials; 122/164 (74%) disclosed medical writing support. Mean time to publication was significantly shorter for papers disclosing medical writing support than those without (307 vs. 466 days; p < 0.0001). Median time to publication for papers with medical writing support appeared stable from 2019 to 2023. The volume (oncology and non-oncology) of phase III trials published in NEJM and the Lancet between 2019 and 2023 was lowest during 2020 to 2022 (n = 70-88) and highest in 2023 followed by 2019 (n = 110 and n = 96, respectively).

Medical writing support is associated with timely publication of clinical trial results, even during events that may disrupt publication development such as the Covid-19 pandemic.

The most common methods of treating cancer are surgery, chemotherapy, and radiotherapy. However, given that some cancers are not operable, the best method is chemotherapy and radiotherapy. Over time, people become resistant to chemotherapy drugs, and increasing the dose of the drug leads to damage to normal cells. In this article, various sources such as Google Scholar, PubMed, and Semantic Scholar were used, and articles between 1997 and 2025 that were relevant to our topic were selected. Various factors are involved in drug resistance. Melatonin is a hormone that has various roles in the body. One of its most important functions is regulating the circadian rhythm of sleep and its anti-inflammatory and antioxidant properties. According to studies, melatonin plays a role in the treatment of some diseases and cancers. The roles of melatonin in cancer treatment include anti-apoptotic, anti-angiogenic, and anti-migratory effects, as well as drug resistance and cell cycle regulation. As mentioned, one of the main reasons for the failure of cancer treatment is drug resistance, and the role of melatonin in drug resistance in cancers has been proven. Therefore, in this study, our goal is to investigate the mechanisms through which melatonin plays a role in drug resistance in different types of cancer.

Sugar-coated nanoparticles (SCNPs) are revolutionizing nanomedicine by enhancing targeted drug delivery and precision therapeutics. Functionalized with sugars such as mannose, dextran, and maltose, SCNPs leverage glycan interactions to achieve superior therapeutic efficacy and reduced systemic toxicity. These nanoparticles address multifactorial diseases, including cancer, tuberculosis, and neurodegenerative disorders, by improving drug solubility, bioavailability, and targeted cellular uptake. Recent developments have expanded SCNP applications to include maltose-functionalized dendrimers and glycodendrimersomes, offering multivalent targeting and self-assembly properties. These systems have shown promise in overcoming challenges like multidrug resistance and achieving pH-responsive drug release. Clinical and preclinical studies highlight the efficacy of glycan-functionalized nanoparticles, from glucose-based carriers crossing the blood-brain barrier to galactose-coated systems targeting liver cancer. This review explores the structural diversity, mechanisms of action, and translational potential of SCNPs. By incorporating clinical case studies, discussions on glycodendrimers, and schematic illustrations, the manuscript provides a comprehensive overview of SCNP innovations. Future directions emphasize integrating AI-driven design and sustainable synthesis methods to optimize SCNPs for personalized medicine. As a cornerstone of next-generation therapeutics, SCNPs hold immense potential to transform healthcare by offering safer, more effective, and economically viable solutions for complex diseases, advancing the boundaries of precision nanomedicine.

The ICPD Programme of Action and the Sustainable Development Goals both underscore the essential role of sexual and reproductive health and reproductive rights in development. Despite significant progress on many aspects of sexual and reproductive health and rights (SRHR), challenges remain, and they are exacerbated by rising anti-rights movements in many countries. At a time when SRHR is under threat, it is important to surface evidence that speaks to its critical role in development and its inextricable connections to multiple global goals. In this commentary, we argue that investing in SRHR is strategic because it yields substantial benefits to individuals, economies, societies, the environment, and peace and security, and thus contributes to progress on related goals. We encourage SRHR advocates to leverage the broad array of arguments to bolster decision-makers' and other stakeholders' support of SRHR, alongside the well-established arguments grounded in cost-effectiveness, and returns on health and human rights. With the world falling short of achieving the Sustainable Development Goals and conservative forces threatening to undo the progress that has been made, urgent and collective action on multiple fronts is needed. By recognizing that many development priorities are interconnected, we can accelerate progress through cross-movement advocacy and mobilization.

The multicenter, prospective MiroCIP observational study investigated the incidence, risk factors, and outcomes of chemotherapy-induced peripheral neuropathy (CIPN) by oxaliplatin- and taxane-based chemotherapies but did not examine their differences in detail. This post hoc subanalysis explored the differences between oxaliplatin- and taxane-based chemotherapy, in terms of CIPN symptom profile, severity, and response to analgesics.

Patients with colorectal, gastric, non-small cell lung, or breast cancer, scheduled to receive oxaliplatin- or taxane-based chemotherapy, were followed for 12 months to assess the severity of sensory CIPN, by the Common Terminology Criteria for Adverse Events, and associated subjective and objective symptoms.

Overall, 91 patients received oxaliplatin and 131 received a taxane. At 12 months, CIPN prevalence was 74.6% with oxaliplatin and 55.2% with a taxane. Grade ≥ 2 CIPN peaked at 9 months with oxaliplatin and at 3 months with a taxane, with most symptom scores following a similar trajectory. Analgesic efficacy differed between subgroups, providing marked reductions in pain/tingling scores in the taxane group but minimal effect in the oxaliplatin group.

CIPN course and symptoms vary with oxaliplatin- or taxane-based chemotherapy. Effective management should be tailored to the type of chemotherapy: oxaliplatin-treated patients may benefit from continuous monitoring of CIPN symptoms, whereas it may be beneficial for taxane-treated patients to receive appropriate analgesics at CIPN onset.

Japan Registry of Clinical Trials jRCTs031210101.

Systemic inflammatory response (SIR) markers are prognostic in various cancers. In a prospective cohort study (2006-2019) involving 2044 head and neck squamous cell carcinomas (HNSCC) patients, we assessed the prognostic associations of SIR markers at diagnosis, including NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio), LMR (lymphocyte-to-monocyte ratio), NMR (neutrophil-to-monocyte ratio), SII (systemic immune-inflammation index), eosinophil and WBC (white blood cell) levels, with progression-free (PFS) and overall survival (OS). Training (two-thirds randomly selected patients) and withheld test sets were created. Separate multivariable Cox regression models by HPV status were created for each of the seven SIR markers for the training set, and validated in the withheld test set. We found that the majority of SIR markers are strongly and significantly associated with OS and PFS in HPV-positive HNSCC patients, while the results were less significant or of lesser magnitude of association in the HPV-negative HNSCC patients. Despite validating these prognostic associations, the addition of SIR markers to a clinical prognostic model did not significantly improve predictive performance for PFS/OS. Our study demonstrates that SIR markers may have a greater impact on the survival of HPV-positive HNSCC, and less so for HPV-negative HNSCCs. These results suggest differential prognostic impact of inflammation between HPV-driven HNSCCs and non-HPV-driven HNSCCs. Although biologically relevant, these associations do not improve survival prognostication in the clinical setting.

Due to the expensive and lengthy process of drug design and approval, drug repurposing (or repositioning) has become another option for identifying preexisting molecules that may be used for alternative purposes. Recently, some antimalarial compounds have been shown to display efficacy against cancer cell proliferation. In this study, we provide evidence to suggest that multiple preexisting antimalarial drugs can reduce the viability of human cancer cells in culture. Furthermore, we provide the first evidence that one antimalarial, Tafenoquine (LD50 = 9.6 μM in HCT116 cells), is capable of decreasing viability with an efficacy comparable to Etoposide (LD50 = 15.2 μM in HCT116 cells) Further, Tafenoquine induces apoptosis and increases the expression of genes involved in cell cycle arrest and cell death. We also show that cells are sensitized to the apoptotic effects of Tafenoquine following depletion of the heme oxygenase 1 (HMOX-1) gene. Collectively, our studies confirm that antimalarial compounds hold the potential for use as anticancer agents and provide the first evidence to detail the potent efficacy of Tafenoquine against cancer cells in culture.

As a serious public health problem, alcoholic cardiomyopathy (ACM) has caused a heavy burden of disease.

To summarize and deeply analyze the development trend of ACM at the global, regional, and national levels in the past 30 years, this study used the age-period-cohort model to analyze the age, period, and cohort effects of the prevalence, deaths, and disability-adjusted life years (DALYs) of ACM.

The results found that the overall time trend of ACM prevalence, deaths, and DALYs had been decreasing worldwide, but the opposite trend was observed in some countries and regions. The disease burden of male ACM patients was significantly higher than that of female patients. Moreover, the ASRs of prevalence, deaths, and DALYs for ACM were positively correlated with sociodemographic index levels. Finally, this study predicted that ACM prevalence will continue to decline over the next 10 years, while death rates and DALYs are expected to increase.

Overall, the results of this study provided an insightful, up-to-date global perspective on time trends in ACM-related disease burden, shedding light on the inadequacy of ACM prevention, control, and intervention programs at multiple levels.

With over 2 million cases diagnosed annually, breast cancer is a leading cause of cancer-related disability and mortality worldwide. Despite global efforts to implement screening programs, uptake rates vary widely across settings due to socioeconomic factors and accessibility challenges. In 2022 in Flanders (Belgium), breast cancer screening participation in municipalities with an income below the poverty line was 15% lower than average.

To tackle the limited participation of underserved women in the breast cancer screening program in Flanders, a culturally sensitive approach was used to investigate factors influencing screening participation and to realize a tailored reminder letter to be tested in a later phase. Working closely with community organizations, 33 women aged 50-69 (29 of whom were non-native Dutch speakers) with low-socioeconomic status were identified to participate in the study. Through an iterative process comprising 3 focus group discussions, 3 Delphi-consultations with sector experts, 1 co-creation session and a final member check, critical insights were gathered.

Key barriers included low health literacy and limited understanding of preventive care concepts. Once participants were effectively informed about the breast cancer screening program, they displayed increased help-seeking behaviors in relation to health, underscoring the importance of clear communication in fostering willingness to consider screening. An evaluation of the standard invitation letter employed in the program revealed several challenges related to readability and comprehension. These included the excessive text length, the use of complex vocabulary and grammar beyond an A2 level, slogans unrelated to the mammography appointment (e.g., 'We do it and what do you do?'), and the use of generic visuals. At the same time, simplifying the vocabulary to A1-A2 levels, employing straightforward sentence structures, and incorporating relevant visuals enhanced understandability and fostered interest in breast cancer prevention. Utilizing a color palette associated with breast cancer and featuring logos of local authorities instilled a sense of credibility and trustworthiness. Based on this feedback, a revised reminder letter was developed. The final communication was concise and included essential details such as time and place for screening and a QR code providing translation into 12 languages.

Simplifying vocabulary, grouping related information, and providing direct links and language options improved the clarity and accessibility of the reminder letter, thereby fostering help-seeking behaviors related to breast cancer screening.

Non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are common chronic liver diseases worldwide, both of which are closely associated with an increased risk of cardiovascular disease (CVD). Atherogenic index of plasma (AIP), as a biomarker of dyslipidemia, may predict CVD risk and mortality in these patients, but its specific role in patients with NAFLD and MASLD has not been studied in detail. This study adopted a cohort design, using data from the National Health and Nutrition Examination Survey (NHANES, 1988-1994) database, which was conducted by the Centers for Disease Control and Prevention. A total of 12,929 adult participants were analyzed. After participants were grouped according to AIP quartiles, the relationship between AIP levels and CVD risk was explored using multivariate logistic regression models and restricted cubic splines. The relationship between AIP levels and all-cause and CVD mortality was analyzed using multivariate Cox regression models.

Participants with the higher AIP quartiles showed high rates of CVD among participants with NAFLD (Quartile 1: 7.57%; Quartile 2: 10.00%; Quartile 3: 11.63%; Quartile 4: 15.08%). Participants with the higher AIP quartiles showed high rates of CVD among participants with MASLD (Quartile 1: 9.71%; Quartile 2: 11.30%; Quartile 3: 11.14%; Quartile 4: 15.00%). The findings suggested a linear association between the AIP index and the risk of CVD in participants with NAFLD or MASLD. AIP was significantly associated with CVD in the highest quartile of NAFLD or MASLD patients, and the adjusted hazard ratio indicated that high AIP levels were associated with high risk of CVD among participants with NAFLD (HR: 1.77, 95% CI: 1.24, 2.52) and MASLD (HR 1.76, 95% CI: 1.04, 2.98). In addition, higher AIP levels were also associated with increased all-cause mortality and CVD mortality among participants with NAFLD or MASLD.

This study showed that AIP is an effective tool for predicting CVD risk and mortality in patients with NAFLD and MASLD. Regular monitoring of AIP levels can help identify high-risk patients early and provide clinical risk assessment before intervention, thereby improving patient management and prognosis. Future studies need to further explore the role of AIP in different ethnic and economic conditions to optimize cardiovascular disease prevention and treatment strategies.

Mortality due to ischemic heart disease (IHD) has declined in countries with high socioeconomic development. Whether these declines extend to other settings, and whether socioeconomic development influences IHD mortality among men and women differently, is unknown.

We obtained annual data on sex-specific IHD mortality rates for countries/territories in the GBD study (Global Burden of Disease) from 1980 to 2021. The sociodemographic index (SI), a measure of socioeconomic development, was retrieved for each country/territory. Age-adjusted IHD mortality rates were modeled as a smooth function of sex, year, and SI.

From 1980 to 2021, IHD mortality rates did not decrease in low SI settings for men or women. In contrast, mortality rates relative to 1980 declined by >25% in average SI settings (age-adjusted mortality per 100 000, 153-107 for women and 218-161 for men) and >50% in high SI settings (age-adjusted mortality per 100 000, 162-69 for women and 258-114 for men). Comparing the 20th versus 80th percentile of SI in 2021 (corresponding to lower versus higher socioeconomic development), mortality rates were 81% higher for men and 111% higher for women living in socioeconomically deprived settings (P for difference by sex: 0.01), although absolute differences were larger in men. The association of low SI with higher IHD mortality was especially pronounced for mortality attributable to environmental/occupational risk factors (eg, particulate matter air pollution, lead exposure, and extremes of temperature), with mortality rates being 174% higher among women and 199% higher among men.

Across the past 4 decades, low socioeconomic development was associated with no improvement in IHD mortality rates for men or women, in contrast to the large reductions observed in settings with high socioeconomic development. In contemporary settings, socioeconomic deprivation is associated with larger relative excess mortality in women and larger absolute excess mortality in men.

High body mass index (BMI), defined as a BMI greater than or equal to 20-25 kg/m2, is considered a rapid-increased risk factor for cancer. Based on comparative risk assessment framework, we elaborate the mortality burden of cancers attributable to high BMI in China. In 2018, we estimated that there were 85.19 thousand cancer-related deaths and 2,220.01 thousand cancer-related years of life lost (YLLs) attributable to high BMI in China. Of these, 62.14 thousand deaths and 1,698.81 thousand YLLs were from males. With higher socioeconomic levels, the burden generally increases initially and then decreases. By 2030, the projected age-standardized mortality rate attributable to high BMI in China will be 6.67 per 100,000 people, increased by 3.25% from that in 2005. In summary, the swift increase and substantial disparities in the cancer burden attributable to high BMI underscore the urgent need for evidence-based policies and interventions in China.

The global burden of diet-related chronic diseases and their future projections remain unclear. To address this gap, we present the latest data on deaths and disability-adjusted life years attributable to dietary factors from 1990 to 2021, focusing on noncommunicable diseases worldwide. Additionally, we provide predictions of mortality rates across different age groups through 2030.

Data from the Global Burden of Disease Study 2021 were analyzed to evaluate correlations between dietary factors and trends in chronic disease burden over a 30-year period. Moreover, we predicted the burden of chronic dietary diseases up to 2030.

From 1990 to 2021, global age-standardized mortality rates and disability-adjusted life year (DALY) rates associated with dietary factors decreased by approximately one-third for neoplasms and cardiovascular diseases (CVDs). In high sociodemographic index (SDI) regions, neoplasm-related deaths showed a stronger correlation with dietary factors, particularly high red meat intake. In cardiovascular diseases, the leading dietary factors are low-grain diets, whereas in diabetes, it is due to increased intake of processed meat. In low-SDI regions, diets low in vegetables showed the strongest association with neoplasm-related mortality, while diets low in fruits were significantly linked to CVD and diabetes burden. High-sodium diet was a significant risk factor for CVD in the middle-SDI regions. Moreover, the 2030 projections indicated a decline in mortality from neoplasms and CVDs, with a slight increase in mortality rates from diabetes.

The global burden of chronic diseases linked to dietary factors shows varying trends across different countries and regions, particularly influenced by their economic development levels. This variation underscores the necessity of enhancing dietary structures to mitigate chronic disease prevalence and foster overall health.

Cancer is a leading cause of death globally, with China accounting for a significant portion of new cases and deaths. The Government of China has introduced the National Drug Price Negotiation (NDPN) policy to mitigate the high costs of anticancer drugs, especially multi-indication drugs, aimed at improving patient access to effective treatments.

In this retrospective study, we examined 24 multi-indication anticancer drugs for solid tumours included in the National Reimbursement Drug List (NRDL) between 2016 and 2023. We collected characteristics of indication, clinical trial evidence, and clinical benefits of these drugs, calculated monthly drug costs, and assessed the associations the two by regression and correlation analyses.

We observed a significant reduction in the median monthly drug cost from USD 3863.08 before NDPN to USD 732.91 after their inclusion in the NRDL. However, the correlation analyses showed no significant relationships between drug costs and characteristics of indications, clinical trial evidence, and clinical benefits, while American Society of Clinical Oncology Value Framework scores demonstrated a negative correlation with costs, indicating that pricing may not accurately reflect clinical benefits.

While we found that the NDPN policy has significantly reduced drug costs, we did not observe a significant correlation between costs and specific characteristics. This highlights a need for a more transparent pricing mechanism linked to clinical efficacy to improve the accessibility and affordability of cancer therapies that effectively balance the interests of pharmaceutical companies, patients, and health insurance funds.

Chronic inflammation is increasingly recognized as a key driver of tumorigenesis, affecting both the tumor microenvironment and host response. In this context, circulating inflammatory proteins may provide valuable insights into cancer activity. This study evaluated the diagnostic performance of the inflammatory protein ratio (IPR), a composite index derived from serum protein electrophoresis, in detecting active cancer among hospitalized patients. We retrospectively analyzed clinical and laboratory data from 312 adult patients admitted to the Internal Medicine and Aging Department at Policlinico Foggia, Italy, between November 2023 and July 2024. Patients were stratified according to the presence of active cancer, defined by NICE criteria. The diagnostic accuracy of the IPR was compared with that of conventional inflammatory markers, including C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). The IPR showed the highest diagnostic performance, with a sensitivity of 88.1%, a specificity of 75.2%, and an area under the receiver operating characteristic curve (AUC) of 0.868. Its negative predictive value reached 97.6%, underscoring its potential as a rule-out tool for malignancy in hospitalized patients. These findings support the IPR as a promising and cost-effective inflammation-based biomarker for cancer detection, warranting further validation in prospective and molecularly characterized cohorts.