Cancer screening in the United States, 2013: a review of current American Cancer Society guidelines, current issues in cancer screening, and new guidance on cervical cancer screening and lung cancer screening

Impact of Mammography Screening Frequency on Breast Cancer Mortality Rates

The frequency of mammography screening remains a topic of ongoing debate. This meta-analysis aimed to investigate the impact of annual vs. biennial mammography screenings on breast cancer mortality rates. A comprehensive search of relevant literature published up to 2021 was performed, with the primary outcome being the difference in breast cancer mortality rates between annual and biennial screenings. The extracted data included relative risks and 95% confidence intervals (CIs), with studies selected based on predetermined inclusion and exclusion criteria, emphasizing the quality of methodology and minimization of bias. Of the included studies, thirteen met the criteria, covering diverse demographic cohorts and screening frequencies. The synthesized data revealed a pattern of lower relative risk in annual screenings compared to biennial screenings across all studies. Notably, subgroup analyses indicated that age and racial background might modulate the effectiveness of screening frequency. In conclusion, this meta-analysis offers strong evidence suggesting that annual mammography screenings could be more effective than biennial screenings in reducing breast cancer mortality rates, especially in certain high-risk demographics. The results emphasize the importance of personalized, evidence-based approaches to mammography, with a call for future research to validate these findings and delve deeper into optimizing breast cancer screening strategies.

Evaluation of the clinical performance of p16/Ki-67 dual-staining cytology for cervical lesion detection in premenopausal and postmenopausal Chinese women

BACKGROUND

Studies on the clinical performance of p16/Ki-67 dual-staining in detecting cervical lesions by menopausal status were limited.

METHODS

4364 eligible women were enrolled with valid p16/Ki-67, HR-HPV, and LBC test results, including 542 cancer and 217 CIN2/3 cases. The positivity rates of p16 and Ki-67 single staining and p16/ Ki-67 dual-staining were analyzed by different pathological grades and age groups. The sensitivity (SEN), specificity (SPE), positive predictive value (PPV), and negative predictive value (NPV) of each test in different subgroups were calculated and compared.

RESULTS

P16/Ki-67 dual-staining positivity increased with histopathological severity in premenopausal and postmenopausal women (P < 0.05), while no increasing trends of individual expression of p16 single staining and Ki-67 single staining were observed in postmenopausal women. P16/Ki-67 showed higher SPE (88.09% vs. 81.91%, P < 0.001) and PPV (33.8% vs. 13.18%, P < 0.001) in detecting CIN2/3, and higher SEN (89.97% vs. 82.61%, P = 0.012) and SPE (83.22% vs. 79.89%, P = 0.011) in detecting cancer in premenopausal women than postmenopausal women. For triaging the HR-HPV+ population to identify CIN2/3, p16/Ki-67 performed comparably to LBC in the premenopausal women, and showed higher PPV (51.14% vs. 23.08%, P < 0.001) in premenopausal than postmenopausal women. For triaging ASC-US/LSIL population, p16/Ki-67 demonstrated higher SPE and lower colposcopy referral rate than HR-HPV in both premenopausal and postmenopausal women.

CONCLUSIONS

Expressions of p16/Ki-67 dual-staining between premenopausal and postmenopausal women are varied. P16/Ki-67 performs better in detecting cervical lesions in premenopausal women. For triaging, p16/Ki-67 is suitable for HR-HPV+ women, especially premenopausal women, to identify CIN2/3 and women with ASC-US/LSIL.

Uterine Neoplasms, Version 1.2023, NCCN Clinical Practice Guidelines in Oncology

Adenocarcinoma of the endometrium (also known as endometrial cancer, or more broadly as uterine cancer or carcinoma of the uterine corpus) is the most common malignancy of the female genital tract in the United States. It is estimated that 65,950 new uterine cancer cases will have occurred in 2022, with 12,550 deaths resulting from the disease. Endometrial carcinoma includes pure endometrioid cancer and carcinomas with high-risk endometrial histology (including uterine serous carcinoma, clear cell carcinoma, carcinosarcoma [also known as malignant mixed Müllerian tumor], and undifferentiated/dedifferentiated carcinoma). Stromal or mesenchymal sarcomas are uncommon subtypes accounting for approximately 3% of all uterine cancers. This selection from the NCCN Guidelines for Uterine Neoplasms focuses on the diagnosis, staging, and management of pure endometrioid carcinoma. The complete version of the NCCN Guidelines for Uterine Neoplasms is available online at NCCN.org.

Experiences of women awaiting cervical CANCER screening results from selected hospitals in Accra, Ghana

Background

The rate at which cervical cancer is diagnosed among women worldwide is alarming, nevertheless, millions of women have never undergone cervical cancer screening, and many more with cervical cancer die prematurely without accessibility to quality healthcare or effective treatment. Women’s experiences following cervical cancer screening have not been extensively studied especially in advancing countries like Ghana. Hence, the researchers aim to explore the experiences of women awaiting cervical cancer results at selected hospitals in Accra.

Methods

An exploratory-descriptive qualitative design was adopted to purposively sample 48 participants engaged in face-face in-depth interviews, which were audio-taped and transcribed verbatim after. The interviews were guided by semi-structured interviews.

Findings

The findings revealed 3 themes and 10 subthemes. The themes were pre-screening experience, intra-screening experience, and post-screening experience. Participants narrated the challenges they face before the screening, during the screening, and as they waited for their results to get ready. Despite some challenges reported, most of the participants indicated that they were willing to come for a retesting if recommended.

Conclusion

In conclusion, participants who have undergone CCS have several experiences that may either motivate or discourage them from subsequent screening. Being aware of such experiences could help the nurses address them in order to increase the interest of the women in CCS.

Integrated Bioinformatic Analysis of DNA Methylation and Immune Infiltration in Endometrial Cancer

Background

Endometrial cancer greatly threatens the health of female. Emerging evidences have demonstrated that DNA methylation and immune infiltration are involved in the occurrence and development of endometrial cancer. However, the mechanism and prognostic biomarkers of endometrial cancer are still unclear. In this study, we assess DNA methylation and immune infiltration via bioinformatic analysis.

Methods

The latest RNA-Seq, DNA methylation data, and clinical data related to endometrial cancer were downloaded from the UCSC Xena dataset. The methylation-driven genes were selected, and then the risk score was obtained using “MethylMix” and “corrplot” R packages. The connection between methylated genes and the expression of screened driven genes were explored using “survminer” and “beeswarm” packages, respectively. Finally, the role of VTCN1in immune infiltration was analyzed using “CIBERSORT” package.

Results

In this study, 179 upregulated genes, and 311 downregulated genes were identified and found to be related to extracellular matrix organization, cell–cell junctions, and cell adhesion molecular binding. The methylation-driven gene VTCN1 was selected, and patients classified to the hypomethylation and high expression group displayed poor prognosis. The VTCN1 gene exhibited highest correlation coefficient between methylation and expression. More importantly, the hypomethylation of promoter of VTCN1 led to its high expression, thereby induce tumor development by inhibiting CD8+ T cell infiltration.

Conclusions

Overall, our study was the first to reveal the mechanism of endometrial cancer by assessing DNA methylation and immune infiltration via integrated bioinformatic analysis. In addition, we found a pivotal prognostic biomarker for the disease. Our study provides potential targets for the diagnosis and prognosis of endometrial cancer in the future.

Breast Cancer Awareness Based on Health Information Literacy and Influential Factors among Female Nursing Students in China

This investigation aimed to study breast cancer awareness based on health information literacy and influential factors of breast cancer awareness among female nursing students in Changchun city in China. A four-part self-report questionnaire including the participants' general demographic characteristics, the participants' specialized characteristics concerning breast cancer screening, the Chinese version of the Breast Cancer Awareness Measurement (C-BCAM), and the Chinese version of the Health Information Literacy Self-rating Scale (HILSS) was designed to investigate breast cancer awareness and health information literacy and influential factors of breast cancer awareness among 205 female nursing students in Year 1-Year 3 using convenience sampling. The data were analyzed with SPSS 26.0 using descriptive statistics, nonparametric tests, and multiple regression analysis. The nursing students had an average level of HIL (median = 101.00, (93.00, 107.00)) and a good level of breast cancer awareness (median = 82.00, (76.00, 88.00)). A significant positive correlation was found between the HILSS and total C-BCAM score (r = 0.439, P < 0.01). Multivariate logistic regression analysis demonstrated that grades (P < 0.001), training in BSE (P = 0.025), and intention of undergoing breast cancer screening (P = 0.028) were three predictive factors for breast cancer awareness among female nursing students. The female nursing students' HIL was at an average level, and breast cancer awareness was at a good level. Health information literacy and breast cancer awareness among female nursing students in Changchun were significantly positively correlation, as demonstrated by this survey. Therefore, nursing education has the responsibility to improve female nursing students' awareness of breast cancer at different grades and to cultivate health information literacy. More training in BSE is needed. Greater efforts may be needed to develop targeted nursing education to strengthen female nursing students' awareness of breast cancer and HIL.

Awareness and Practices Related to Cervical Cancer among Females in Saudi Arabia

Human papilloma virus (HPV) is the most common risk factor for cervical cancer. Cervical cancer can be prevented with vaccination and early screening methods using pap smears. However, the acceptance of these approaches can be affected by the awareness level of the population. This cross-sectional study aimed to assess knowledge and practices related to cervical cancer among women in the Al Madinah Province in Saudi Arabia. A total of 1489 responses were included in the analysis. The median awareness score related to cervical cancer was eight out of 20 points. Vaginal bleeding, dyspareunia, and leg pain were correctly identified by 79.8%, 43.7%, and 19.3% of the women, respectively. Thirty-four percent of the study sample knew that the sexually transmitted virus is a risk factor for cervical cancer. Only 44.6% were able to correctly identify pap smear as a screening tool, and 12.6% knew that there was a HPV vaccine. This study revealed a low to moderate awareness level toward cervical cancer, pap smear, and HPV vaccine. Thus, awareness campaigns are urgently needed to increase the awareness level for early detection and prevention of the disease.

A real-world, population-based study of the trends for incidence and prognosis in high-grade neuroendocrine tumor of cervix

To explore the incidence and prognosis trends for high-grade cervical neuroendocrine tumor (HGCNET) and construct a nomogram to predict prognosis for HGCNET. Annual age-adjusted incidence of HGCNET from 1975 to 2015 was retrieved from the Surveillance, Epidemiology, and End Results program, the linear regression, poisson regression and annual percentage changes were used to assess the incidence trend. Also, trends for relative survival (RS) and overall survival (OS) in HGCNET patients from 1975 to 2015 were evaluated. From 1988 to 1975, 514 HGCNET patients were selected and divided into two cohorts with a ratio of 7:3. Nomogram to predict OS for these patients was constructed and validated. The incidence trend for HGCNET was unchanged in the past four decades (P = 0.734), but the proportion of HGCNET in diagnosed cervical cancer slightly increased from 0.9% in 1975 to 1.9% in 2015 (P < 0.001). The 5-year RS and OS for HGCNET in the study periods decreased steadily (RS: P = 0.009; OS: P = 0.008). Nomogram incorporating age, T stage, lymph-node positive, distant metastasis and surgery was constructed. The C-index of the nomogram was 0.716 (0.680-0.752), which was higher than the FIGO staging system. The incidence of HGCNET remained unchanged in the past four decades but the proportion of HGCNET has slightly increased. Besides, a steadily decreasing survival for HGCNET was observed in the study periods. A nomogram was constructed to better predict prognosis for HGCNET.

Salivary Biomarkers in Lung Cancer

A very low percentage of lung cancer (LC) cases are discovered at an early and treatable stage of the disease, leading to an abysmally low 5-year survival rate. This underscores the immediate necessity for improved diagnostic, prognostic, and predictive biomarkers for LC. Biopsied lung tissue, blood, and plasma are common sources used for LC diagnosis and monitoring of the disease. A growing number of studies have reported saliva to be a useful biological sample for early and noninvasive detection of oral and systemic diseases. Nevertheless, salivary biomarker discovery remains underresearched. Here, we have compiled the available literature to provide an overview of the current understanding of salivary markers for LC detection and provided perspectives for future clinical significance. Valuable markers with diagnostic and prognostic potentials in LC have been discovered in saliva, including metabolic (catalase activity, triene conjugates, and Schiff bases), inflammatory (interleukin 10, C-X-C motif chemokine ligand 10), proteomic (haptoglobin, zinc-α-2-glycoprotein, and calprotectin), genomic (epidermal growth factor receptor), and microbial candidates (Veillonella and Streptococcus). In combination, with each other and with other established screening methods, these salivary markers could be useful for improving early detection of the disease and ultimately improve the survival odds of LC patients. The existing literature suggests that saliva is a promising biological sample for identification and validation of biomarkers in LC, but how saliva can be utilized most effectively in a clinical setting for LC management is still under investigation.

High mobility group box 3 promotes cervical cancer proliferation by regulating Wnt/β-catenin pathway

Objective

High mobility group box 3 (HMGB3) plays an important role in the development of various cancer. This study aims to explore whether HMGB3 regulates cervical cancer (CC) progression and elucidate the underlying mechanism.

Methods

HMGB3 expression in clinical patients' tumor samples were determined by real-time quantitative polymerase chain reaction (qRT-PCR) and western blot. HMGB3 overexpression/knockdown were used to investigate its function. Cell apoptosis and cycle were detected by Annexin V/PI staining and flow cytometry. In vivo tumor model was made by subcutaneous injection of HeLa cells transfected with shRNAs targeting HMGB3 (sh-HMGB31) into the flank area of nude mice. Western blot was used to detect the levels of β-catenin, c-Myc, and matrix metalloproteinase-7 (MMP-7) in Hela and CaSki cells transfected with sh-HMGB3 or shRNAs targeting β-catenin.

Results

Both messenger RNA and protein levels of HMGB3 were upregulated in CC tissues from patients. High expression level of HMGB3 had positive correlation with serosal invasion, lymph metastasis, and tumor sizes in CC patient. Functional experiments showed that HMGB3 could promote CC cell proliferation both in vitro and in vivo. The expression levels of c-Myc and MMP-7 were increased, resulting in regulating cell apoptosis, cell cycle, and activating Wnt/β-catenin pathway.

Conclusions

Our data indicated that HMGB3 may serve as an oncoprotein. It could be used as a potential prognostic marker and represent a promising therapeutic strategy for CC treatment.

The development of 3-substituted indolin-2-one derivatives as kinase inhibitors for cancer therapy

Kinases are pivotal regulators in tumorigenesis and metastasis by modulating the expression of oncogenes and the transcription of antioncogenes directly or indirectly. Correspondingly, multifarious 3-substituted indolin-2-one derivatives as selective kinase inhibitors for cancer therapy exhibited a low nanomolar activity with prominent efficacy, superior response rate and admirable tolerability. Particularly, certain 3-substituted indolin-2-one derivatives have met the requirements for clinical trials or the pharmaceutical market. Herein, we focus on the traits of 3-substituted indolin-2-one derivatives as kinase inhibitors for cancer therapy, overview recent progress of 3-substituted indolin-2-one derivatives as kinase inhibitors for cancer therapy, analyze the selectivity for tyrosine kinases inhibitors and serine/threonine kinases inhibitors from the molecular aspects based on the molecular docking studies, summarize the structure-activity relationships (SARs) as selective kinase inhibitors and provide our perspectives for the development of 3-substituted indolin-2-one derivatives as kinase inhibitors for cancer therapy.

Synthesis of gold nanorods and their performance in the field of cancer cell imaging and photothermal therapy

Cancer is one of the most common incident in the world, with malignant tumors having a death rate of up to 19%. A new method of treating cancer cells effectively with minimal cytotoxicity is needed. In the field of biomedicine with unique shape-dependent optical properties, gold nanorods (GNRs) have attracted worldwide interest. These nanorods have two distinct plasmon bands. One is transverse plasmon band in the area of visible light, and the other is longitudinal band of plasmons in near infrared region. These specific characters provide promise for the design of new optically active reagents that simultaneously perform light-mediated imaging and photothermal cancer treatment. We begin our review by summarizing the latest developments in gold nanorods synthesis with a focus on seed-mediated growth method. Nanorods spontaneous self-assembly, polymer-based alignment and its applications as a novel agent for simultaneous bioimaging and photothermal cancer therapy are listed in particular.

Different disease characteristics in young patients with colorectal cancer: a large retrospective study in a city in Romania

OBJECTIVE

In 2018, colorectal cancer (CRC) was the second most frequent malignancy in Romania after lung cancer. Although CRC is typically encountered in patients >50 years old, CRC's global incidence among younger adults has been increasing. We aimed to compare the disease characteristics of patients with CRC aged ≤50 years with those >50 years old.

METHODS

We retrospectively evaluated data from patients with CRC who underwent standard surgery at "Pius Brinzeu" Emergency County Hospital, Timisoara, Romania. Patients were divided into two groups: Group 1 (patients ≤50 years old) and Group 2 (patients >50 years old). Six parameters were analyzed (sex, residence location, age, tumor localization, microscopic findings, pathological staging).

RESULTS

Data on age-related CRC were available for 1380 patients treated from January 2012 to December 2018. Group 1 included 120 patients while group 2 included 1260 patients. Significantly more Group 1 patients presented with advanced CRC compared with Group 2 patients (94.2% vs. 87.4%). Furthermore, CRC in younger adults was more likely to be diagnosed at an advanced stage.

CONCLUSIONS

Monitoring the CRC incidence in younger adults is essential to assess whether screening practices require changes and to raise awareness among clinicians of the increasing CRC incidence among younger patients.

Exosomes as new therapeutic vectors for pancreatic cancer treatment

Pancreatic cancer (PC) is one of the deadliest cancers with a very short rate of survival and commonly without symptoms in its early stage. This absence of symptoms can lead to a late diagnosis associated with an advanced metastasis process, for which therapy is not effective. Although with extensive research in this field, the 5-year survival rate has not increased significantly. Notwithstanding, novel insights on risk factors, genetic mutations and molecular mechanisms pave the way for novel therapeutics that urge with a significant part of PC patients presenting resistance to chemotherapy treatments. Exosomes are presented as a promising strategy, working as delivery systems, since they can transport and release their cargoes after fusing with the membrane of pancreatic cells. Exosomes present advantages over liposomes, being less toxic and reaching higher levels in the bloodstream, working as molecule carriers that can inhibit oncogenes, activating tumor suppressor genes and inducing immune responses as well as controlling cell growth. This review intends to provide an overview about the scientific and clinical studies regarding the entire process, from isolation and purification of exosomes, to their design and transformation into anti-oncogenic drug delivering systems, particularly to target PC cells.

Ethnic Differences Among Black Men in Prostate Cancer Knowledge and Screening: a Mixed-Methods Study

Black men are disproportionately affected by prostate cancer (PCa) incidence and mortality. Limited research has been reported on the ethnic differences among Black men in regard to family history, knowledge, and screening habits. Thus, this study was conducted to understand and compare knowledge levels and family history of the three main Black subgroups (African Americans, Caribbean immigrants, and African immigrants) in the USA and to assess the influence of knowledge on past screening behavior and intentionality for screening in the future for PCa. A concurrent mixed-methods design was used with participants (N = 396) recruited from different parts of the country. The grounded theory method of analysis was used for qualitative data and a logistic regression was used to explain the relationship between screening intentionality and PCa knowledge and family history. Qualitative results indicated that subjective PCa knowledge between the three subgroups was relatively similar but differed based on whether a person knew a family member or friend who had been affected by the disease. Themes focused on risk, PCa education, screening, and impact on sexuality. Quantitatively, result revealed that there are ethnic differences in knowledge across the three subgroups. Additionally, regression results revealed that family history is a stronger predictor of screening behavior and intentionality than knowledge. This study was able to unveil a deeper understanding on the role of family history and knowledge on PCa among Black subgroups.

Never Screened: Understanding Breast Cancer Nonadherence in Puerto Rico

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related death among women in Puerto Rico (PR). The purpose of this study was to identify factors associated with never screened status among a sample of women nonadherent to the 2013 American Cancer Society guidelines. The inclusion criteria for this study were being a woman (1) aged ≥40 years old and (2) nonadherent to breast cancer screening guidelines. We used baseline data from participants (N = 300; aged ≥40 years old) enrolled in the intervention trial Cultivando la Salud, implemented in Canóvanas, Puerto Rico, from 2012 to 2014. We used multivariate logistic regression models to identify factors associated with never screening status, adjusting by sociodemographical variables and psychosocial constructs about mammography (self-efficacy, beliefs about mammography pros [benefits] and cons [disadvantages], and subjective norms) as well as by health care insurance, usual source of care, and Pap test adherence. Among nonadherent women, 18.0% reported never having a mammography. Never screened women were significantly younger than previously screened women (adjusted prevalence odds ratio [aPOR] = 7.32, 95% confidence interval (CI): [2.38, 22.50]) and almost four times as likely to have the governmental health plan (GHP; aPOR = 3.78, 95% CI: [1.15, 12.46]). In addition, never screened women perceived more cons (disadvantages) to mammography than previously screened women (aPOR = 1.81, 95% CI: [1.18, 2.78]). We found that women who were younger, had GHP insurance, and had higher levels of beliefs against mammography were more likely to have never been screened. Results from this study can be used to target never screened women with health education messages addressing perceived cons of mammography. Additionally, women with GHP insurance may experience disparities in health care access and should be targeted with policies that facilitate access to mammography screening.

A Model-Based Meta-Analysis of Willingness to Participate in Cancer Screening

Although early screening tests are beneficial for the detection and treatment of cancers, many people have failed to participate in screening tests. The present study aims to explore the theoretical underpinning of low participation in screening programs using the method of meta-analytic structural equation modeling. It was found that the health belief model is the most adopted theoretical framework. Moreover, the intended uptake of screening was positively predicted only by cues to action, health literacy, and perceived susceptibility. As a result, a health intention model, including the three significant variables, is proposed. The practical implications of the findings are that health communication campaigns should focus on enlightening and engaging the public through all necessary means to raise awareness and transfer knowledge in relation to screening procedures as well as cancers per se.

Targeting mTOR by CZ415 Suppresses Cell Proliferation and Promotes Apoptosis via Lipin-1 in Cervical Cancer In Vitro and In Vivo

CZ415, a novel inhibitor of mammalian target of rapamycin (mTOR) kinase, has demonstrated anti-tumor activity in several types of cancer. However, its biological function and underlying mechanism of action in cervical cancer (CC) have not been fully studied. Two CC cell lines (Hela and Siha) were treated with increasing concentrations of CZ415. Cell viability was tested with the CCK-8 assay, cell proliferation was determined by Edu staining and the colony formation assay, and apoptosis was determined by flow cytometry and Hoechst 33342 staining. Protein expression was evaluated by western blotting. A nude mouse xenograft model was used to confirm the anti-tumor activity of CZ415 in vivo. Hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining were performed on samples of tumor tissue. Results showed that CZ415 inhibited CC cell survival in a dose- and time-dependent manner, and 100 nanomolar and 48 h were the optimal conditions. In vitro and in vivo experiments showed that treatment with CZ415 significantly inhibited spheroid formation, cell proliferation, and tumor growth. Further studies showed that the anti-cancer effects of CZ415 were due to an induction of apoptosis, which was accompanied by an upregulation of Bax and downregulation of Bcl-2 through Lipin-1. CZ415 also reduced the levels of mTOR/STAT3 expression. However, these phenotypic changes were reversed by overexpression of Lipin-1. Our results suggest that the novel mTOR inhibitor CZ415 mediates tumor malignancy via Lipin-1 and might be useful for treating CC.

Autonomy-supportive exercise behaviors promote breast cancer survivors' well-being

Background: Grounded in self-determination theory (SDT), this pilot study aimed to test an autonomy-supportive exercise instructing style to promote hedonic (seeking comfort and pleasure) and eudaimonic (seeking to develop the best within one and pursue excellence)orientations, exercise motivation, and psychological well-being of breast cancer survivors.

Methods: Twenty-four breast cancer survivors were randomized in either autonomy-supportive exercise instructing style (treatment condition) or usual exercise instructing style (control condition). The study consisted of a pre-intervention session followed by 22 exercise sessions and a post-intervention session. Hedonic and eudaimonic orientations, exercise motivation, and psychological well-being (subjective vitality) measured at baseline and post-intervention sessions.

Results: As expected, participants in the treatment condition reported greater eudaimonic and hedonic orientations and subjective vitality compared to the participants in the control condition. The results showed no difference in exercise motivation across conditions.

Conclusion: We concluded that the SDT-based intervention was successful in helping breast cancer survivors increase hedonic and eudaimonic orientations and subjective vitality. Practical and theoretical implications, along with limitations and future research suggestions are discussed inside.

Survival Rates of Breast Cancer Patients Aged 40 to 49 Years according to Detection Modality in Korea: Screening Ultrasound versus Mammography

Objective

The aim of this study was to compare the survival rates of Korean females aged 40 to 49 years with breast cancer detected by supplemental screening ultrasound (US) or screening mammography alone.

Materials and Methods

This single-institution retrospective study included 240 patients with breast cancer (mean age, 45.1 ± 2.8 years) detected by US or mammography who had undergone breast surgery between 2003 and 2008. Medical records were reviewed for clinicopathologic characteristics and detection methods. Disease-free survival (DFS) and overall survival (OS) were compared between patients with breast cancer in the US and mammography groups using the log-rank test. Multivariable cox regression analysis was used to identify independent variables associated with DFS and OS.

Results

Among the 240 cases of breast cancer, 43 were detected by supplemental screening US and 197 by screening mammography (mean follow-up: 7.4 years, 93.3% with dense breasts). There were 19 recurrences and 16 deaths, all occurring in the mammography group. While the US group did not differ from the mammography group in tumor stage, the patients in this group were more likely to undergo breast-conserving surgery and radiation therapy than the mammography group. The US group also showed better DFS (p = 0.016); however, OS did not differ between the two groups (p = 0.058). In the multivariable analysis, the US group showed a lower risk of recurrence (hazard ratio, 0.097; 95% confidence interval, 0.001–0.705) compared to the mammography group.

Conclusion

Our study found that Korean females aged 40–49 years with US-detected breast cancer showed better DFS than those with mammography-detected breast cancer. However, there were no statistically significant differences in OS.

Training cosmetology students in Arkansas to help dermatologists find skin cancers earlier: results of a cluster-randomized controlled trial

Background

We tested an educational video in cosmetology schools to increase students’ knowledge about skin cancer, sun-safety practices, identifying suspicious lesions and recommending clients consult a dermatologist when a suspicious lesion is observed.

Methods

We used a cluster-randomized controlled study design to randomize 22 cosmetology schools to receive our educational video or a publicly accessible healthy lifestyle video (control).

Results

Students who received the intervention were more likely than controls to increase their knowledge of skin cancer, risk factors and how to identify potential skin cancers (risk ratio [RR] and 95% confidence interval = 2.86 [1.58–5.20]). At follow-up, students in the intervention group were more likely than those in the control group to look for suspicious moles on their clients’ faces, scalps and necks (RRs = 1.75, 2.16 and 2.90, respectively). Additionally, students in the intervention group were more likely to communicate with clients about sun-safety practices (RR = 1.74 [1.11–2.73]) and consulting a dermatologist about suspicious moles (RR = 1.57 [1.03–2.41]).

Conclusions

Our educational video helped cosmetology students recognize potential skin cancers and talk with clients about sun safety and consulting a dermatologist about suspicious moles. Such videos may play a role in the public health surveillance of skin cancers in communities.

Risk of CIN2 or more severe lesions after negative HPV-mRNA E6/E7 overexpression assay and after negative HPV-DNA test: Concurrent cohorts with a 5-year follow-up

Aim of this study was to compare the 5-year risk of cervical intraepithelial neoplasia grade 2+ (CIN2+)/CIN3+ and the performance parameters at 3-year rescreening of a negative E6/E7 mRNA-human papillomavirus (HPV) test with those of a HPV-DNA-negative test. We studied a cohort of HPV-negative women tested with the Aptima HPV-mRNA Assay ("HPV-mRNA cohort") versus a cohort of HPV negatives tested with the Hybrid Capture 2 (HC2) DNA test living in neighboring areas. Both cohorts were rescreened after 3 years by a HPV-DNA test (HC2 or Cobas 4800 HPV test). HPV test positivity, referral to colposcopy and detection of CIN2+ at 3-year rescreening were computed. The Veneto Cancer Registry was checked to search for invasive cancers and CIN3 diagnosed up to 5 years from the negative baseline test. Some 22,338 HPV-mRNA and 68,695 HPV-DNA-negative women were invited to 3-year rescreening, and, respectively, 16,641 (74.5%) and 54,630 (79.6%) complied with the invitation. The proportion of HPV-positive tests, referral to colposcopy and detection of CIN2+ in the HPV-mRNA and HPV-DNA cohorts were, respectively. 4.0 and 3.9% (ratio 1.08; 95% confidence interval [CI] 0.99-1.17), 2.6 and 2.5% (ratio 1.06, 95% CI 0.95-1.18) and 1.4 and 1.7‰ (ratio 0.85, 95% CI 0.54-1.33). The relative 5-year cumulative risk of cancer and of CIN2+ in the HPV-mRNA and HPV-DNA cohorts were 4.5 and 8.7/100,000 (ratio 0.51; 95%CI 0.01-4.22) and 1.1 and 1.5/1,000 (ratio 0.74; 95%CI 0.45-1.16), respectively. A negative HPV-mRNA test confers a risk of invasive cervical carcinoma and of CIN2+ at 5 years comparable to that of a negative HPV-DNA test.

Long noncoding RNA RUSC1-AS1 promotes tumorigenesis in cervical cancer by acting as a competing endogenous RNA of microRNA-744 and consequently increasing Bcl-2 expression

The expression of a long noncoding RNA termed RUSC1-AS1 is dysregulated in breast cancer and laryngeal squamous cell carcinoma, and this dysregulation affects various tumor-associated biological processes. To our knowledge, the expression status and detailed roles of RUSC1-AS1 in cervical cancer as well as its regulatory mechanisms of action remain unknown. Therefore, the objectives of this study were to measure RUSC1-AS1 expression in cervical cancer, investigate the effects of RUSC1-AS1 on cervical cancer cells, and identify the mechanism underlying these effects. Herein, RUSC1-AS1 was found to be highly expressed in cervical cancer tissues and cell lines. High RUSC1-AS1 expression significantly correlated with the International Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis, and shorter overall survival among the patients with cervical cancer. Functional assays revealed that interference with RUSC1-AS1 expression suppressed cervical cancer cell proliferation, migration, and invasion in vitro; induced apoptosis in vitro; and impeded tumor growth in vivo. In addition, RUSC1-AS1 was demonstrated to act as a competing endogenous RNA of microRNA-744 (miR-744) and consequently increase B-cell lymphoma 2 (Bcl-2 or BCL2) expression levels in cervical cancer cells. Furthermore, either inhibition of miR-744 or restoration of Bcl-2 expression neutralized the effects of the RUSC1-AS1 silencing on the malignant characteristics of cervical cancer cells. Thus, RUSC1-AS1 promotes the aggressiveness of cervical cancer in vitro and in vivo by upregulating miR-744-Bcl-2 axis output. The RUSC1-AS1-miR-744-Bcl-2 pathway may be involved in cervical cancer pathogenesis and could serve as a novel target for anticancer therapies.

Long Noncoding RNA FOXD2-AS1 Promotes the Malignancy of Cervical Cancer by Sponging MicroRNA-760 and Upregulating Hepatoma-Derived Growth Factor

Although the functions of long noncoding RNA (lncRNA) called FOXD2 adjacent opposite strand RNA 1 (FOXD2-AS1) have been well studied in multiple human cancer types, its expression status and detailed roles in cervical cancer remain unknown and merit investigation. This study was aimed at assessing FOXD2-AS1 expression in cervical cancer and at determining its effects on the aggressive behavior of cervical cancer in vitro and in vivo. Expression of FOXD2-AS1 in cervical cancer tissues and cell lines was determined via reverse-transcription quantitative PCR. The effects of FOXD2-AS1 on cervical cancer cells were examined by a 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay, flow-cytometric analysis, migration and invasion assays, and an in vivo tumorigenicity assay. FOXD2-AS1 was found to be significantly upregulated in cervical cancer tissues and cell lines. High FOXD2-AS1 expression was notably linked with the Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis, and depth of cervical invasion in patients with cervical cancer. Kaplan-Meier survival analysis revealed significantly shorter overall survival of patients when the tumor expression of FOXD2-AS1 was higher in comparison with those in patients with lower FOXD2-AS1 expression. In vitro functional assays revealed that downregulation of FOXD2-AS1 led to suppression of proliferation, migration, and invasiveness as well as to the induction of apoptosis of cervical cancer cells. In addition, FOXD2-AS1 silencing hindered tumor growth in vivo. Mechanism investigation revealed that FOXD2-AS1 functioned as a molecular sponge of microRNA-760 (miR-760). Furthermore, hepatoma-derived growth factor (HDGF) was validated as a direct target gene of miR-760 in cervical cancer cells. Moreover, an miR-760 knockdown reversed the effects of FOXD2-AS1 silencing on cervical cancer cells. FOXD2-AS1 possesses significant oncogenic activity in cervical cancer progression; this activity is mediated by sponging of miR-760 with consequent upregulation of HDGF. The FOXD2-AS1-miR-760-HDGF axis might harbor promising targets for novel treatment strategies of cervical cancer.

Long Noncoding RNA SNHG7, a Molecular Sponge for microRNA-485, Promotes the Aggressive Behavior of Cervical Cancer by Regulating PAK4

Purpose

A long noncoding RNA called small nucleolar RNA host gene 7 (SNHG7) is known to be a key regulator of biological processes in multiple human cancer types. In this study, our aims were to determine the expression status of SNHG7 in cervical cancer, to figure out the detailed roles of SNHG7 in cervical cancer cells, and to identify the mechanism underlying the activity of SNHG7 in cervical cancer.

Methods

Reverse-transcription quantitative PCR was performed to measure SNHG7 expression in cervical cancer. A Cell Counting Kit-8 assay, flow-cytometric analysis, cell migration and invasion assays, and a tumor xenograft experiment were conducted to respectively determine the effects of SNHG7 on cervical cancer cell proliferation, apoptosis, migration, and invasion in vitro and tumor growth in vivo.

Results

SNHG7 was found to be markedly upregulated in cervical cancer tissues and cell lines. Higher SNHG7 expression significantly correlated with FIGO stage, lymph node metastasis, the depth of cervical invasion, and shorter overall survival in patients with cervical cancer. Functional experiments indicated that a SNHG7 knockdown attenuated proliferation, migration, and invasiveness and promoted apoptosis of cervical cancer cells in vitro. The SNHG7 knockdown also slowed tumor growth in vivo. Further investigation showed that SNHG7 acts as a competing endogenous RNA for microRNA-485 (miR-485) in cervical cancer cells, and the inhibitory actions of the SNHG7 knockdown on the malignant phenotype were reversed by miR-485 inhibition. P21-activated kinase 4 (PAK4) was identified as a direct target gene of miR-485 in cervical cancer, and PAK4 expression was promoted by SNHG7.

Conclusion

SNHG7 functions as an oncogenic RNA in cervical cancer, competitively binds to miR-485, and thereby upregulates PAK4. This SNHG7–miR-485–PAK4 regulatory network may provide insights into the pathogenesis of cervical cancer, and can help in the identification of novel diagnostic and therapeutic approaches for cervical cancer.

LINC00319 promotes migration, invasion and epithelial-mesenchymal transition process in cervical cancer by regulating miR-3127-5p/RPP25 axis

Cervical cancer is among the most prevalent malignancies for women. An increasing number of evidences have been proved that long non-coding RNAs (lncRNAs) play significant role in the initiation and progression of cervical cancer. However, the function of long intergenic non-protein coding RNA 319 (LINC00319) in cervical cancer still remains vague. In this study, our purpose was to investigate the effects of LINC00319 on cell migration, invasion and epithelial-mesenchymal transition (EMT) process in cervical cancer. It confirmed that LINC00319 was highly expressed in tissues and cell lines in cervical cancer. Further, overexpression of LINC00319 accelerates cell migration, invasion and EMT in cervical cancer. Moreover, LINC00319 could bind with miR-3127-5p and negatively regulated its expression. Besides, RPP25 was targeted by miR-3127-5p, and its expression was negatively/positively regulated by miR-3127-5p/LINC00319. Additionally, miR-3127-5p mimics or RPP25 insufficiency could offset the encouraging effects of LINC00319 overexpression on migration, invasion and EMT process in cervical cancer. Generally speaking, LINC00319 promotes migration, invasion and EMT process in cervical cancer by regulating miR-3127-5p/RPP25 axis, which may be conductive to cervical cancer treatment.

Circular RNA cSMARCA5 regulates the progression of cervical cancer by acting as a microRNA‑432 sponge

Circular RNAs (circRNAs) have been shown to be involved in the development of cancer. The aim of the present study was to investigate the role of circRNA SMARCA5 (cSMARCA5) in human cervical cancer. In the present study, cSMARCA5 expression was upregulated in cervical cancer tissues and cell lines. Furthermore, the proliferation rate of cells transduced with viral plasmids expressing small interfering RNA targeting cSMARCA5 was downregulated. Bioinformatics analysis predicted that microRNA (miR)‑432 targeted cSMARCA5, and miR‑432 was able to interact with epidermal growth factor receptor (EGFR) by binding to its 3'‑untranslated region. The expression levels of EGFR, ERK1 and ERK2 were increased in cervical cancer tissues. Furthermore, correlation analysis revealed that cSMARCA5 levels were positively correlated with ERK1 and ERK2 levels. In conclusion, the present findings suggested that cSMARCA5 may play an important role in the progression of cervical cancer via the ERK signaling pathway by modulating miR‑432.

Head and Neck Melanoma Incidence Trends in the Pediatric, Adolescent, and Young Adult Population of the United States and Canada, 1995-2014

Importance

Melanoma is one of the most common cancers worldwide, typically diagnosed in older adults. There is an increasing incidence in the younger population (age ≤40 years) in America. In addition, approximately 1 in 5 cases of melanoma affect the head and neck. However, there are limited data on the incidence of head and neck melanoma in the pediatric, adolescent, and young adult population in North America (United States and Canada).

Objective

To assess 20-year demographic and incidence changes associated with head and neck melanoma in the pediatric, adolescent, and young adult population in North America.

Design, Setting, and Participants

A descriptive analysis of retrospective data on head and neck melanoma from the North American Association of Central Cancer Registries' Cancer in North America public use data set from 1995 to 2014 was conducted. The data set currently includes 93% of the United States and 64% of the Canadian populations. Eligible data were from 12 462 pediatric, adolescent, and young adult patients (aged 0-39 years) with a confirmed diagnosis of melanoma (International Classification of Diseases-Oncology 3 histologic types 8720-8790) in primary head and neck sites: skin of lip, not otherwise specified (C44.0); eyelid (C44.1); external ear (C44.2); skin of other/unspecified parts of face (C44.3); and skin of scalp and neck (C44.4). The study was conducted from January 26 to July 21, 2019.

Main Outcomes and Measures

Log-linear regression was used to estimate annual percentage change in age-adjusted incidence rates (AAIRs) of head and neck melanoma.

Results

Of the 12 462 patients with head and neck melanoma included in the study, 6810 were male (54.6%). The AAIR was 0.51 per 100 000 persons (95% CI, 0.50-0.52 per 100 000 persons). In North America, the incidence of head and neck melanoma increased by 51.1% from 1995 to 2014. The rate was higher in the United States (AAIR, 0.52; 95% CI, 0.51-0.53 per 100 000 person-years) than Canada (AAIR, 0.43; 95% CI, 0.40-0.45 per 100 000 persons). In the United States, the incidence increased 4.68% yearly from 1995 to 2000 and 1.15% yearly from 2000 to 2014. In Canada, the incidence increased 2.18% yearly from 1995 to 2014. Male sex (AAIR, 0.55; 95% CI, 0.54-0.57 per 100 000 persons), older age (AAIR, 0.79; 95% CI, 0.79-0.80 per 100 000 persons), and non-Hispanic white race/ethnicity (AAIR, 0.79; 95% CI, 0.77-0.80 per 100 000 persons) were associated with an increased incidence of head and neck melanoma.

Conclusions and Relevance

The incidence of pediatric, adolescent, and young adult head and neck melanoma in North America appears to have increased by 51.1% in the past 2 decades, with males aged 15 to 39 years the main cohort associated with the increase.

Cancer Survival by Stage at Diagnosis in Kuwait: A Population-Based Study

OBJECTIVE

To examine the distribution of stage at diagnosis for 12 cancers in Kuwait, to estimate stage-specific net survival at 1 and 5 years after diagnosis, and to assess differences in stage-specific survival between Kuwait and the United States.

MATERIAL AND METHODS

Data were obtained from the Kuwait Cancer Registry, for Kuwaiti patients diagnosed during 2000-2013, with follow-up to 31 December 2015. The distribution of Surveillance Epidemiology and End Results (SEER) Summary Stage for 12 malignancies was examined. We estimated net survival by stage up to 5 years after diagnosis, controlling for background mortality with life tables of all-cause mortality in the general population by single year of age, sex, and calendar period. Survival estimates were age-standardised using the International Cancer Survival Standard (ICSS) weights.

RESULTS

Only 14.2% of patients were diagnosed at a localised stage and 38.9% at the regional stage. The proportion of patients with known stage was 88.9% during 2000-2004 but fell to 59.4% during 2010-2013. During 2005-2009, 1- and 5-year survival for colon, rectal, breast, cervical, and prostate cancer was about 90% or higher for patients diagnosed at the localised stage. During 2004-2009, the proportion of patients diagnosed at a localised stage was lower in Kuwait than in the US for colon, breast, and lung cancer. Age-standardised 5-year net survival for all stages combined was lower in Kuwait than the US for colon, lung, and breast cancer, but stage-specific survival was similar.

CONCLUSION

Since stage-specific survival is similar in Kuwait and the US, late stage at diagnosis is likely to be a major contributing factor to the overall lower survival in Kuwait than in the US. Increasing public awareness of cancer risk factors and symptoms and investment in early detection will be vital to reduce the proportion of patients diagnosed at a late stage and to improve survival.

Suboptimal uptake of human papillomavirus (HPV) vaccine in survivors of childhood and adolescent and young adult (AYA) cancer

PURPOSE

To estimate the population-based incidence of HPV vaccination after childhood cancer.

METHODS

Pediatric and young adult cancer survivors identified in the institutional Comprehensive Cancer Center registry were linked to the North Carolina Immunization Registry (NCIR). Initiation and completion of any HPV vaccine was evaluated in survivors born between 1984 and 2002 with an NCIR record by December 2014. Descriptive statistics and Kaplan-Meier estimates of cumulative incidence were stratified by sex and age at eligibility for vaccine. Cox proportional hazards were conducted and stratified by sex.

RESULTS

Among 879 (n = 428 female; n = 451 male) study-eligible cancer survivors without prior HPV vaccination (n = 501 < 18 years, n = 378 ≥ 18 years at the time of eligibility), the cumulative incidence of HPV vaccine initiation following cancer therapy was 48.1% among females at 8.2 years and 29.2% among males at 5.0 years after vaccine eligibility among those < 18 years, and 6.2% among females at 8.1 years and 2.0% among males at 4.2 years after vaccine eligibility among those ≥ 18 years. Among those who initiated vaccination, 53% of females and 43% of males completed a 3-dose series. Younger age at cancer diagnosis (≤ 10 and 11-14 years vs. ≥ 15 years) and shorter interval from diagnosis to vaccine eligibility were more likely to initiate vaccination in models adjusted for age at eligibility, race/ethnicity, cancer type, relapse, and transplant.

CONCLUSIONS

Despite the benefit of a cancer prevention strategy, cancer survivors are sub-optimally vaccinated against HPV.

IMPLICATIONS FOR CANCER SURVIVORS

Immunization registries can help oncologists and primary care providers identify gaps in vaccination and target HPV vaccine delivery in survivors.

Tools for the assessment of breast cancer screening beliefs in women: a literature review

Aim: This review aims to compare the development, characteristics and validity of three widely used breast cancer screening belief tools (the Champion's Health Belief Model Scale [CHBMS], the Breast Module of a Cancer Awareness Measures [BCAM] and the Breast Cancer Screening Beliefs Questionnaire [BCSBQ]). Materials & methods: Literature reports were retrieved from electronic databases, including PubMed, EMBASE, Web of Science and the Cochrane Library, and other references. All three tools had good reliability and validity. Certain significant differences between these tools should be noted. Results: CHBMS, BCAM and BCSBQ are valid and reliable instruments within certain populations. Due to the high heterogeneity among the targeted population, their characteristics and those of the instruments should be fully considered for clinical decision-making. Conclusion: The conclusion of this review contributes to the development of a more comprehensive and objective instruments based on the deficiencies of the existing studies.

Utilising network pharmacology to explore the underlying mechanism of Wumei Pill in treating pancreatic neoplasms

Background

Wumei Pill (WMP), a famous herbal formula, has been widely used to treat digestive system diseases in clinical practice in China for centuries. We have found a correlation between the indications of WMP and the typical symptoms of pancreatic neoplasms. However, the pharmacological mechanisms of WMP still remain unknown.

Methods

In the present work, we used a network pharmacological method to predict its underlying complex mechanism of treating pancreatic neoplasms. Firstly, we obtained relative compounds of WMP based on TCMSP database, TCM database@Taiwan and TCMID database and collected potential targets of these compounds by target fishing. Then we built the pancreatic neoplasms target database by CTD, TTD, PharmGKB. Based on the matching results between WMP potential targets and pancreatic neoplasms targets, we built a PPI network to analyze the interactions among these targets and screen the hub targets by topology. Furthermore, DAVID bioinformatics resources were utilized for the enrichment analysis on GO_BP and KEGG.

Results

A total of 80 active ingredients and 77 targets of WMP were picked out. The results of DAVID enrichment analysis indicated that 58 cellular biological processes (FDR < 0.01) and 17 pathways (FDR < 0.01) of WMP mostly participated in the complex treating effects associated with proliferation, apoptosis, inflammatory response and angiogenesis. Moreover, 17 hub nodes of WMP (PTGS2, BCL2, TP53, IL6, MAPK1, EGFR, EGF, CASP3, JUN, MAPK8, MMP9, VEGFA, TNF, MYC, AKT1, FOS and TGFB1) were recognized as potential targets of treatments, implying the underlying mechanisms of WMP acting on pancreatic neoplasms.

Conclusion

WMP could alleviate the symptoms of pancreatic neoplasms through the molecular mechanisms predicted by network pharmacology. This study proposes a strategy to elucidate the mechanisms of Traditional Chinese Medicine (TCM) at the level of network pharmacology.

Electronic supplementary material

The online version of this article (10.1186/s12906-019-2580-y) contains supplementary material, which is available to authorized users.

MicroRNA-758 inhibits cervical cancer cell proliferation and metastasis by targeting HMGB3 through the WNT/β-catenin signaling pathway

Cervical cancer (CC) remains a highly prevalent cancer and cause of mortality amongst women worldwide. miR-758 has been demonstrated to be associated with tumorigenesis by controlling the expression of oncogenic or tumor suppressor genes. However, the function and mechanisms of miR-758 in CC have not been well illustrated. The present study aimed to dissect the effect of miR-758 on the proliferation, migration and invasion of CC cells and determine the potential underlying molecular mechanism of these effects. qPCR results revealed that the expression of miR-758 was significantly decreased in CC tissues and cell lines compared with that in normal tissues and normal cells. Results of CCK-8, colony formation and Transwell assays revealed that miR-758 overexpression markedly decreased cell viability, proliferation, invasion and migration. However, miR-758 inhibitors significantly increased viability, proliferation, invasion and migration. In the mechanism study, we demonstrated that high mobility group box 3 (HMGB3) was a direct target of miR-758, and HMGB3 overexpression rescued the viability, proliferation, invasion and migration of HeLa cells reduced by an miR-758 mimic. It was demonstrated that HMGB3 regulated the WNT/β-catenin signaling pathway under miR-758 regulation. In summary, these observations suggested that miR-758 is a tumor suppressor gene that can inhibit the metastatic phenotype of CC cells by negatively regulating HMGB3, which may present a path to novel therapeutic stratagems for CC therapy.

The lncRNA TDRG1 promotes cell proliferation, migration and invasion by targeting miR-326 to regulate MAPK1 expression in cervical cancer

BACKGROUND

Recently, lncRNA-Testis developmental related gene 1 (TDRG1) was proved to be a key modulator in reproductive organ-related cancers. The biological role of TDRG1 in cervical cancer (CC) progression remains largely unknown.

METHOD

Real-time PCR (qRT-PCR) examined the expression level of TDRG1, microRNA (miR)-326 and MAPK1 mRNA. OS tissues and corresponding relative normal tissues, as well as CC cell lines and normal cell line Ect1/E6E7 were collected to determine the expression of TDRG1 in CC. MTT, colony formation, wound-healing, transwell and flow cytometer assay detected the influence of TDRG1 and miR-326 on CC cells growth, metastasis and apoptosis. Western blot examined proteins level. Bioinformatics, RNA pull-down assay, RNA immunoprecipitation and dual-luciferase reporter assays detected the molecular mechanism of TDRG1 in CC. Xenograft tumour model was established to determine the role of TDRG1 in vivo.

RESULTS

The expression of TDRG1 was significantly increased in CC tissues and cell lines compared with normal tissue and normal cell line respectively and its expression was associated with clinicopathological characteristics of CC patients. Knockdown of TDRG1 inhibited the cell proliferation, migration and invasion in Hela and SIHA cells. Moreover, TDRG1 directly interacted with miR-326, and the inhibition effect on cell growth and metastasis induced by TDRG1 siRNA can be abrogated by miR-326 silencing by its inhibitor in Hela and SIHA cells. Further, MAPK1 was proved to be a direct target of miR-326, and its expression was negatively regulated by miR-326 while positively modulated by TDRG1.

CONCLUSION

TDRG1 acts as a competing endogenous lncRNA (ceRNA) to modulate MAPK1 by sponging miR-326 in CC, shedding new light on TDRG1-directed diagnostics and therapeutics in CC.

Healthy behavioral choices and cancer screening in persons living with HIV/AIDS are different by sex and years since HIV diagnosis

PURPOSE

The prevalence of non-AIDS-related malignancies is on the rise among people aging with HIV population, but the evidence on healthy behaviors including cancer screening practices in this population subgroup is extremely limited. Therefore, we investigated the prevalence of healthy behaviors and sex-specific cancer screening among persons living with HIV, by sex and time since HIV diagnosis.

METHODS

We included 517 persons living with HIV from the Florida Cohort. Data were obtained from the baseline and follow-up questionnaires, electronic medical records, and Enhanced HIV/AIDS Reporting System. The prevalence of self-reported, age-appropriate cancer screening (anal, colorectal, prostate, breast, and cervical), and healthy behaviors (sustaining healthy body weight, refraining from smoking and alcohol and engaging in physical activity) was compared by sex and years since HIV diagnosis (≤ 13 vs. > 13 years).

RESULTS

In the analyses by sex, females were more likely to be obese than males (56.5% vs. 22.2%, p < 0.0001). Distribution of healthy behaviors did not differ by time since diagnosis among males and females. In the analysis of age-appropriate screening among males, 64.8% never had an anal Pap-smear, 36.2% never had a colonoscopy, and 38.9% never had prostate cancer screening. In the analysis of age-appropriate screening among females, 50.0% never had an anal Pap-smear, 46.5% never had a colonoscopy, 7.9% never had a cervical Pap-smear, and 12.7% never had a mammogram. The difference in anal Pap-smear by sex was statistically significant (p < 0.0001). Among males, the age-adjusted prevalence of never having a colonoscopy was higher in those who had HIV for ≤ 13 years (50.8% vs. 30.6%, p = 0.03).

CONCLUSION

The prevalence of selected healthy behaviors and cancer screening differed by sex and/or years since HIV diagnosis suggesting a need for tailored cancer prevention efforts among persons living with HIV via long-term sex-specific interventions.

Machine learning-based prediction of future breast cancer using algorithmically measured background parenchymal enhancement on high-risk screening MRI

BACKGROUND

Preliminary work has demonstrated that background parenchymal enhancement (BPE) assessed by radiologists is predictive of future breast cancer in women undergoing high-risk screening MRI. Algorithmically assessed measures of BPE offer a more precise and reproducible means of measuring BPE than human readers and thus might improve the predictive performance of future cancer development.

PURPOSE

To determine if algorithmically extracted imaging features of BPE on screening breast MRI in high-risk women are associated with subsequent development of cancer.

STUDY TYPE

Case-control study.

POPULATION

In all, 133 women at high risk for developing breast cancer; 46 of these patients developed breast cancer subsequently over a follow-up period of 2 years.

FIELD STRENGTH/SEQUENCE

5 T or 3.0 T T₁ -weighted precontrast fat-saturated and nonfat-saturated sequences and postcontrast nonfat-saturated sequences.

ASSESSMENT

Automatic features of BPE were extracted with a computer algorithm. Subjective BPE scores from five breast radiologists (blinded to clinical outcomes) were also available.

STATISTICAL TESTS

Leave-one-out crossvalidation for a multivariate logistic regression model developed using the automatic features and receiver operating characteristic (ROC) analysis were performed to calculate the area under the curve (AUC). Comparison of automatic features and subjective features was performed using a generalized regression model and the P-value was obtained. Odds ratios for automatic and subjective features were compared.

RESULTS

The multivariate model discriminated patients who developed cancer from the patients who did not, with an AUC of 0.70 (95% confidence interval: 0.60-0.79, P < 0.001). The imaging features remained independently predictive of subsequent development of cancer (P < 0.003) when compared with the subjective BPE assessment of the readers.

DATA CONCLUSION

Automatically extracted BPE measurements may potentially be used to further stratify risk in patients undergoing high-risk screening MRI.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019;50:456-464.

Intention to undergo faecal occult blood testing in an ethnic minority

AIM

To explore factors associated with the intention of an ethnic minority of Israeli Arabs to undergo faecal occult blood testing using the Health Belief Model.

METHODS

This was a quantitative correlational study that utilized a questionnaire constructed based on the Health Belief Model. The questionnaire was administered to a convenience sample of 200 Israeli Arabs aged 50 and over. Data were collected during January to March 2018.

FINDINGS

The research findings show that respondents had a high intention to undergo faecal occult blood testing in the future, although only 66.5% of the respondents had ever undergone it in the past. Physicians and nurses were the most significant sources of information regarding the faecal occult blood testing. The Health Belief Model explained 46% of variance in the intention to undergo the faecal occult blood testing among Israeli Arabs, with perceived benefits of testing being the most significant predictor of this intention.

CONCLUSION

The Health Belief Model can serve as a basis for planning intervention programmes to be implemented by health care professionals to raise the intention of ethnic minorities to undergo faecal occult blood testing.

miRNA-641 inhibits the proliferation, migration, and invasion and induces apoptosis of cervical cancer cells by directly targeting ZEB1

Background

miRNAs have been found to be dysregulated in cervical cancer. The dysregulation of miRNA has been implicated in cervical carcinogenesis and progression. Therefore, further studies of the specific roles of deregulated miRNAs in cervical cancer and underlying molecular mechanisms may facilitate the identification of novel therapeutic techniques for patients with this disease. miRNA-641 (miR-641) was previously reported to serve an important role in lung cancer. However, the expression pattern and roles of miR-641 in cervical cancer remain unclear.

Method

In this study, the expression level of miR-641 in cervical cancer tissues and cell lines was detected using RT-qPCR. The influence of miR-641 upregulation in cervical cancer cell proliferation, apoptosis, migration and invasion was evaluated using CCK-8 assay, flow cytometry assay, migration and invasion assays, respectively. In vivo tumor growth assay was utilized to determine the effect of miR-641 overexpression in the tumor growth of cervical cancer cells in vivo. The molecular mechanisms underlying the action of miR-641 in cervical cancer cells were also explored.

Results

We found that miR-641 expression was obviously decreased in cervical cancer tissues and cell lines, which strongly correlated with the International Federation of Gynecology and Obstetrics stage and lymph node metastasis. Upregulation of miR-641 inhibited cell proliferation, induced apoptosis, and reduced metastasis in cervical cancer. Additionally, bioinformatics analysis predicted ZEB1 as a novel target gene of miR-641. Notably, luciferase reporter assay, RT-qPCR, and Western blot analysis revealed that miR-641 decreased ZEB1 expression in cervical cancer cells by directly targeting its 3'-untranslated region. Furthermore, ZEB1 was upregulated in cervical cancer tissues, which was negatively correlated with miR-641 expression. Moreover, recovered ZEB1 expression attenuated the tumor suppressive action of miR-641 overexpression in the malignant phenotypes of cervical cancer cells. Besides, miR-641 could hinder cervical cancer tumor growth in vivo by inhibiting ZEB1.

Conclusion

These results indicate that miR-641 has tumor suppressive roles in the development of cervical cancer by directly targeting ZEB1, suggesting that miR-641 is a novel, effective therapeutic target for treating patients with this disease.

Utilization of Pap testing among women living with HIV enrolled in primary care in Baltimore, Maryland: A 10-year longitudinal study, 2005-2014

Frequent Pap testing is recommended among women living with HIV (WLWH) due to their elevated risk for cervical cancer. However, there are few recent longitudinal evaluations of utilization and determinants of Pap testing among WLWH. Medical and pathology records of WLWH seen at Johns Hopkins Hospital between 2005 and 2014 were assessed using Prentice, Williams, Peterson models. Of 554 WLWH in care for ≥ 18 months, 79% received Pap testing, however only 11% consistently received Pap testing at the recommended interval. Some women (5%) were consistently under-screened (tested at longer intervals) and 21% did not receive any Pap testing at during follow-up. WLWH with decreased likelihood of screening included older women, injection drug users, whites and those who had lived for longer with HIV. In contrast, only women with a prior abnormal Pap result were more likely to receive Pap testing. CD4 cell count and health insurance were not significant determinants. Although many WLWH in care received Pap testing, some WLWH were unscreened or underscreened. Determinants of Pap testing for WLWH include socio-demographic factors and a prior abnormal result; these present potential targets in an urban HIV care setting for closer monitoring and directed interventions to improve utilization among WLWH.

Identifying the Best Marker Combination in CEA, CA125, CY211, NSE, and SCC for Lung Cancer Screening by Combining ROC Curve and Logistic Regression Analyses: Is It Feasible?

The detection of serum biomarkers can aid in the diagnosis of lung cancer. In recent years, an increasing number of lung cancer markers have been identified, and these markers have been reported to have varying diagnostic values. A method to compare the diagnostic value of different combinations of biomarkers needs to be established to identify the best combination. In this study, automatic chemiluminescence analyzers were employed to detect the serum concentrations of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), cytokeratin 19 fragment (CY211), neuron-specific enolase (NSE), and squamous cell carcinoma antigen (SCC) in 780 healthy subjects, 650 patients with pneumonia, and 633 patients with lung cancer. Receiver operating characteristic (ROC) curve and logistic regression analyses were also used to evaluate the diagnostic value of single and multiple markers of lung cancer. The sensitivities of the five markers alone were lower than 65% for lung cancer screening in healthy subjects and pneumonia patients. SCC was of little value in screening lung cancer. After combining two or more markers, the areas under the curves (AUCs) did not increase with the increase in the number of markers. For healthy subjects, the best marker for lung cancer screening was the combination CEA + CA125, and the positive cutoff range was 0.577 CEA + 0.035 CA125 > 2.084. Additionally, for patients with pneumonia, the best screening markers displayed differences in terms of sex but not age. The best screening marker for male patients with pneumonia was the combination CEA + CY211 with a positive cutoff range of 0.008 CEA + 0.068 CY211 > 0.237, while that for female patients with pneumonia was CEA > 2.73 ng/mL, which could be regarded as positive. These results showed that a two-marker combination is more suitable than a multimarker combination for the serological screening of tumors. Combined ROC curve and logistic regression analyses are effective for identifying the best markers for lung cancer screening.

Socio-demographic Moderators of Associations Between Psychological Factors and Latinas' Breast Cancer Screening Behaviors

This study tested whether socio-demographic factors moderated associations between psychological factors and Latinas' breast cancer screening behaviors. 222 churchgoing Latinas (40-65 years) in San Diego, CA completed surveys assessing socio-demographics (e.g., income and acculturation), psychological factors (e.g., perceived barriers to screening), and cancer screening behaviors. Multilevel models examined associations of socio-demographic and psychological factors (and their interactions) with adherence to annual mammography or clinical breast exam (CBE) screening. Although no main effects were found, there were moderation effects. Acculturation moderated associations between perceived barriers to screening and both screening outcomes, with inverse associations only among the high-acculturation group. Education moderated the relationship between perceived barriers to screening and CBE screening, with an inverse association only among the low-education group. Marital status moderated the relationship between depressive symptoms and CBE screening, with an inverse association only among single/non-partnered participants. Interventions are needed targeting psychological barriers to breast cancer screening among Latinas.

MicroRNA‑485 targets MACC1 and inhibits cervical cancer cell proliferation and invasion

A large body of evidence has indicated that microRNAs (miRNAs/miRs) have essential roles in the development and progression of cervical cancer. Thus, miRNAs with dysregulated expression are potential biomarkers for cervical cancer diagnosis and prognosis. In the present study, expression levels of miR‑485 were detected in cervical cancer tissues and cell lines. The effects of miR‑485 overexpression on the proliferation and invasion of cervical cancer cells were determined with Cell Counting kit‑8 and Transwell invasion assays. The mechanisms underlying the action of miR‑485 in cervical cancer were investigated using bioinformatics analysis, a luciferase reporter assay, reverse transcription‑quantitative polymerase chain reaction and western blot analysis. In addition, the association between miR‑485 and metastasis associated in colon cancer‑1 (MACC1) in cervical cancer tissues was examined. The present study demonstrated that miR‑485 expression was significantly downregulated in cervical cancer tissues and cell lines. Reduced miR‑485 expression in patients with cervical cancer was correlated with International Federation of Gynecology and Obstetrics stage and lymph node metastasis. Furthermore, restored expression of miR‑485 significantly reduced cervical cancer cell proliferation and invasion. MACC1 was identified as a direct target gene of miR‑485 in cervical cancer. MACC1 expression was significantly upregulated in cervical cancer specimens and was inversely correlated with miR‑485 expression. Additionally, the restored expression of MACC1 eliminated the suppressive effects of miR‑485 overexpression on the proliferation and invasion of cervical cancer cells. Notably, the upregulation of miR‑485 suppressed the MET proto‑oncogene, receptor tyrosine kinase (Met)/RAC‑α serine/threonine‑protein kinase (AKT) signaling pathway. These results demonstrated that miR‑485 may perform its tumor suppressive function in cervical cancer by directly targeting MACC1 and inhibiting the Met/AKT signaling pathway. Therefore, the miR‑485/MACC1 axis may be a novel and effective therapeutic target in cervical cancer.

Design, synthesis and cytotoxic effects of curcuminoids on HeLa, K562, MCF-7 and MDA-MB-231 cancer cell lines

Background

Curcumin is one of the leading compound extracted from the dry powder of Curcuma longa (Zingiberaceae family), which possess several pharmacological properties. However, in vivo administration exhibited limited applications in cancer therapies.

Results

Twenty-four curcumin derivatives have synthesized, which comprises cyclohexanone 1–10, acetone 11–17 and cyclopentanone 18–24 series. All the curcuminoids were synthesized by the acid or base catalyzed Claisen Schmidt condenstion reactions, in which β-diketone moiety of curcumin was modified with mono-ketone. These curcuminoids 1–24 were screened against HeLa, K562, MCF-7 (an estrogen-dependent) and MDA-MB-231 (an estrogen-independent) cancer cell lines. Among them, acetone series 11–17 were found to be more selective and potential cytotoxic agents. The compound 14 was exhibited (IC₅₀ = 3.02 ± 1.20 and 1.52 ± 0.60 µg/mL) against MCF-7 and MDA-MB-231 breast cancer cell lines. Among the cyclohexanone series, the compound 4 exhibited (IC₅₀ = 11.04 ± 2.80, 6.50 ± 01.80, 8.70 ± 3.10 and 2.30 ± 1.60 µg/mL) potential cytotoxicity against four proposed cancer cell lines, respectively. All the curcucminoids were characterized with the detailed ¹H NMR, IR, UV–Vis, and mass spectroscopic techniques. The structure of compound 4 was confirmed by using the single X-ray crystallography. Additionally, we are going to report the first time spectral data of (2E,6E)-2,6-bis(2-methoxybenzylidene)cyclohexanone (1). Structure–activity relationships revealed that the mono-carbonyl with 2,5-dimethoxy substituted curcuminoids could be an essential for the future drugs against cancer diseases.

Conclusions

Curcuminoids with diferuloyl(4-hydroxy-3-methoxycinnamoyl) moiety with mono carbonyl exhibiting potential cytotoxic properties. The compound 14 was exhibited (IC₅₀ = 3.02 ± 1.20 and 1.52 ± 0.60 µg/mL) against MCF-7 and MDA-MB-231 breast cancer cell lines.

Stage-specific incidence rates and trends of prostate cancer by age, race, and ethnicity, United States, 2004-2014

PURPOSE

Current literature shows different findings on the contemporary trends of distant-stage prostate cancer incidence, in part, due to low study population coverage and wide age groupings. This study aimed to examine the stage-specific incidence rates and trends of prostate cancer by age (5-year grouping), race, and ethnicity using nationwide cancer registry data.

METHODS

Data on prostate cancer cases came from the 2004-2014 United States Cancer Statistics data set. We calculated stage-specific incidence and 95% confidence intervals by age (5-year age grouping), race, and ethnicity. To measure the changes in rates over time, we calculated annual percentage change (APC).

RESULTS

We identified 2,137,054 incident prostate cancers diagnosed during 2004-2014, with an age-adjusted incidence rate of 453.8 per 100,000. Distant-stage prostate cancer incidence significantly decreased during 2004-2010 (APC = -1.2) and increased during 2010-2014 (APC = 3.3). Significant increases in distant prostate cancer incidence also occurred in men aged older than or equal to 50 years except men aged 65-74 and older than or equal to 85 years, in men with white race (APC = 3.9), and non-Hispanic ethnicity (APC = 3.5).

CONCLUSIONS

Using data representing over 99% of U.S. population, we found that incidence rates of distant-stage prostate cancer significantly increased during 2010-2014 among men in certain ages, in white, and with non-Hispanic ethnicity.

MicroRNA-454-3p inhibits cervical cancer cell invasion and migration by targeting c-Met

Increasing evidence has demonstrated that microRNAs (miRNAs) have a crucial role in the initiation and progression of tumors. The present study aimed to investigate the expression and the role of miRNA-454-3p in human cervical cancer. Human cervical cancer cells were transfected with miRNA-454-3p mimics or negative control miRNA. MTT, Transwell and wound healing assays were performed to investigate the effects of miRNA-454-3p overexpression on cell proliferation, invasion and migration, respectively. The results indicated that miRNA-454-3p was down-regulated in human cervical cancer cell lines, while its ectopic overexpression significantly inhibited their proliferation, migration and invasion. Furthermore, a luciferase reporter assay confirmed that c-met was a novel target of miRNA-454-3p in HeLa cells. In conclusion, the results of the present study suggested that miRNA-454-3p exhibits significant tumor-suppressive effects in cervical cancer by targeting c-met, and may be a potential means of treating cervical cancer.

LncRNA NCK1-AS1 promotes proliferation and induces cell cycle progression by crosstalk NCK1-AS1/miR-6857/CDK1 pathway

The purpose of this study was to develop an lncRNA signature to improve the prediction of the prognosis of cervical cancer through integration bioinformatics and analysis of TCGA RNA sequencing data. In this study, we established a set of four lncRNA signatures that was significantly associated with recurrence-free survival using the Cox regression model. Functionally, we screened the CC-associated lncRNA NCK1-AS1 as a new candidate lncRNA and regulator which promotes development and progression in CC. qRT-PCR and RNA in situ hybridization (RISH) results showed that NCK1-AS1 was significantly up-regulated in 77.4% (24/31) of the CC tissue group compared with the normal group (P < 0.01). Interestingly, we demonstrated that transcription factor SP1 directly binds to the promoter to activate NCK1-AS1 expression in SiHa cells. In vitro and in vivo assays of silencing NCK1-AS1 significantly inhibited cell proliferation and invasion, with induction of cell arrest in S phase of the cell cycle. Furthermore, Human Transcriptome Array 2.0 analysis after NCK1-AS1 silencing highlighted alterations in cell proliferation and cell cycle pathways. NCK1-AS1 functioned as a molecular sponge for miR-6857, antagonizing its ability to repress CDK1/6 protein translation. In conclusion, these findings suggest that NCK1-AS1/miR-6857/CDK1 crosstalk serve as a critical effector in cervical cancer progression and may serve as a potential target in cervical cancer.