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Aim: This narrative review aims to describe colorectal cancer (CRC) management landscape in low- and middle-income countries (LMICs), presenting the most recent and relevant papers on the topic. As a secondary aim, the authors suggest new ways of improving CRC patient care in LMICs. Background: Several studies show that the incidence of colon cancer in low- and middle-income countries (LMICs) is rising. In addition to the increasing incidence, lack of early detection and impeded access to optimal multidisciplinary treatment may worsen survival outcomes. Conclusion: Developing quality diagnostic services in the proper health context is crucial for early diagnosis and successful therapy of CRC patients, and applying a resource-sensitive approach to prioritize essential treatments based on effectiveness and cost-effectiveness is key to overcoming barriers in LMICs, with clinical research collaborations between high-income countries (HICs) and LMICs being a helpful strategy to improve health indicators and prevent the burnout of health workers.

Summary: Patients in Brazil continue to present with late-stage breast cancer. Notwithstanding these figures, policies and programs to overcome this long-lasting scenario have had limited results. We enlist the main barriers for advancing breast cancer diagnosis in Brazil, based on the available evidence, and we propose feasible strategies that may serve as a platform to address this major public health challenge.

Breast cancer is one of the most common malignancies and the leading cause of women's death, most of breast cancers are estrogen receptor-positive (ER+) breast cancer which can develop into advanced stage from early stage with treatment resistance. The purpose of this study was to investigate anti-ER+ breast cancer effects of 1,2,3,4,6-penta-O-galloyl-β-d-glucose (PGG) and its possible mechanisms. Cell viability was analyzed by MTT assay. The cell cycle distribution and apoptosis were detected by Flow cytometry. The expressions of cell proliferation- and apoptosis-related proteins were determined by western blot and immunofluorescence staining. The results showed PGG induced cytotoxicity and decreased viability of ER+ breast cancer T-47D and BT-474 cells. Flow cytometry analysis revealed that cell cycle was blocked in S phase at lower dose (25 μM PGG), and G1 phase at higher dose (50 or 75 μM PGG). One of the underlying mechanisms of the anti-cancer effect exerted by PGG was owed to inhibition of the expression of HURP, an up-regulated protein in human hepatocellular carcinoma which is closely related to tumor proliferation, invasion and metastasis. PGG affected cell cycle- or apoptosis-related proteins such as cyclin D1, Bcl-2 and Bax. These data suggest that PGG exerts anti-ER+ breast cancer effects. In this sense, our study provides new alternative therapies to treat breast cancer.

Background: Young adulthood represents a sensitive period in which cancer-related lifestyle behaviors (e.g., substance use, poor physical activity) are developed and sustained into adulthood, having consequences for cancer morbidity and mortality. However, cancer prevention and control (CPC) recommendations are often ambiguous and multifaceted which may increase health-compromising behaviors and psychological distress among this vulnerable young adult (YA) population., Objective: We examined relationships between ambiguity in CPC recommendations and health behaviors and psychological distress., Methods: YAs (n = 811, aged 18-39) without cancer were drawn from the Health Information National Trends Survey 2019 data., Results: Regression analyses indicated that higher perceived CPC ambiguity was associated with higher health behavior recommendations not being met and higher psychological distress., Conclusion: Focusing on elucidating CPC recommendations may reduce engagement in negative health behaviors and promote well-being. Future research may benefit from developing effective communication strategies aimed at elucidating health behavior recommendations to help educate this YA population., Practical Value: Health care providers should be more aware of, and ready to address the potential ambiguity surrounding CPC recommendations and what that means for engagement in health-promoting and health-compromising behaviors and for psychological well-being., Competing Interests: Declaration of Competing Interest The authors have no interests to disclose., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Aim: This narrative review aims to describe colorectal cancer (CRC) management landscape in low- and middle-income countries (LMICs), presenting the most recent and relevant papers on the topic. As a secondary aim, the authors suggest new ways of improving CRC patient care in LMICs., Background: Several studies show that the incidence of colon cancer in low- and middle-income countries (LMICs) is rising. In addition to the increasing incidence, lack of early detection and impeded access to optimal multidisciplinary treatment may worsen survival outcomes., Conclusion: Developing quality diagnostic services in the proper health context is crucial for early diagnosis and successful therapy of CRC patients, and applying a resource-sensitive approach to prioritize essential treatments based on effectiveness and cost-effectiveness is key to overcoming barriers in LMICs, with clinical research collaborations between high-income countries (HICs) and LMICs being a helpful strategy to improve health indicators and prevent the burnout of health workers., Competing Interests: Declaration of Competing Interest C.G.L. reports employment by Bristol Myers Squibb. Other author declares no conflict of interest., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Purpose: The incidence of Endometrial cancer (EC) has grown substantially in Asia over the past decade. However, few studies have addressed risk factors associated with EC incidence in Asian populations. We explored the association between reproductive and dietary risk factors and EC in the Singapore Chinese Health Study (SCHS), one of the largest prospective cohort studies in Asia., Methods: Data were collected from 34,028 ethnically Chinese women aged 45-74 residing in Singapore, enrolled between 1993 and 1998. Baseline demographic, dietary, and reproductive factors were collected via structured questionnaires. EC cases were identified from the Singapore Cancer Registry (n = 126) up to 2010. Cox proportional hazard models were used to analyze association between EC and personal, reproductive, and dietary factors., Results: The incidence of EC in this population was 28.8 per 100,000 person-years. Regardless of menopausal status, obesity (BMI ≥ 27) was associated with increased EC risk (HR = 2.22, 95% CI 1.26-3.92), while later age at menarche was associated with decreased EC risk (HR = 0.14, 95% CI 0.04-0.46). In postmenopausal women, later age at menopause was associated with increased EC risk (HR = 2.82, 95% CI 1.24-6.43). Lifestyle and nutritional factors were not associated with risk of EC in this cohort., Conclusions: This study is one of the largest cohort studies exploring EC risk factors in Asian populations. Our study identified similarities in EC risk factors for European and Asian populations, which potentially suggests that strategies developed for EC prevention in Western populations can be potentially appropriate for the Singapore Chinese population due to risk factor similarities., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The present contribution briefly overviews the major biological functions of the plasma membrane and of the transport proteins (transporters), which enable the movement of different molecules and substrates (either charged or uncharged) by passive (facilitated diffusion) or active transport. In particular, transporters are overviewed at the level of the skeletal muscles, which represent a highly complex, heterogeneous, plastic and dynamic tissue and are one of the most abundant tissues in humans, accounting for up to 40% of their total weight and containing up to 50%-75% of all body proteins. Moreover, it is shown how sport and physical activity finely tune and modulate human proteome, especially in terms of structural and functional improvements concerning the density of the transport proteins. These changes are among the factors responsible for the positive outcomes of training, which involve mainly the cardiovascular and the endocrine/metabolic systems. Different kinds of training (strength and endurance) enable to achieve such improvements, even though there seems to exist a dose-relationship intensity-dependent effect, with responses after 6-8 weeks of exercise and disappearing in the chronic period (years of training). Finally, exercise-induced changes at the level of transporters can play a role in terms of cancer prevention and management. Regular physical activity and exercise can, indeed, counteract the side-effects of chemotherapy drugs, including doxorubicin and other anthracycline derivatives, which may impair the functions of cardiac and skeletal muscles, probably modulating the expression of multidrug resistance proteins., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: First degree relatives (FDRs) of men diagnosed with prostate cancer (PCa) are at increased risk for developing the disease, due in part to multiple concurrent risk factors. There is a lack of innovative targeted decision aids to help FDRs make an informed decision about whether or not to undergo PCa screening., Purpose: This randomized pilot trial evaluated the efficacy of a targeted PCa screening decision aid in unaffected FDRs of PCa survivors., Methods: Seventy-eight Black and White FDRs were randomized to one of two decision aid groups; 39 to a FDR-targeted decision aid and 39 to a general decision aid. The targeted decision aid group received a general PCa decision aid booklet plus a newly developed decision aid DVD targeted specifically for FDRs. PCa screening decision outcomes included knowledge, decisional conflict, distress, and satisfaction with screening decision. Outcomes were assessed at baseline and 4 weeks after baseline., Results: There were no differences by intervention group for knowledge, decisional conflict, distress, or satisfaction with screening decision (p>0.05). However, men in both groups had significant increases in knowledge and decreases in decisional conflict (p<0.001). These changes were most pronounced (p<0.05) for younger men compared to older men., Conclusion: Results suggest that general and targeted information can play an important role in increasing knowledge and decreasing decisional conflict among FDRs. Additional research is needed to identify subgroups of men who benefit the most and better understand the outcomes of a screening decision aid among diverse samples of FDRs., (Copyright © 2014 Elsevier Inc. All rights reserved.)