Search

Differences in the average age at cancer diagnosis are observed across countries. We therefore aimed to assess international variation in the median age at diagnosis of common cancers worldwide, after adjusting for differences in population age structure. We used IARC's Cancer Incidence in Five Continents (CI5) Volume XI database, comprising cancer diagnoses between 2008 and 2012 from population‐based cancer registries in 65 countries. We calculated crude median ages at diagnosis for lung, colon, breast and prostate cancers in each country, then adjusted for population age differences using indirect standardization. We showed that median ages at diagnosis changed by up to 10 years after standardization, typically increasing in low‐ and middle‐income countries (LMICs) and decreasing in high‐income countries (HICs), given relatively younger and older populations, respectively. After standardization, the range of ages at diagnosis was 12 years for lung cancer (median age 61‐Bulgaria vs 73‐Bahrain), 12 years for colon cancer (60‐the Islamic Republic of Iran vs 72‐Peru), 10 years for female breast cancer (49‐Algeria, the Islamic Republic of Iran, Republic of Korea vs 59‐USA and others) and 10 years for prostate cancer (65‐USA, Lithuania vs 75‐Philippines). Compared to HICs, populations in LMICs were diagnosed with colon cancer at younger ages but with prostate cancer at older ages (both pLMICS‐vs‐HICs < 0.001). In countries with higher smoking prevalence, lung cancers were diagnosed at younger ages in both women and men (both pcorr < 0.001). Female breast cancer tended to be diagnosed at younger ages in East Asia, the Middle East and Africa. Our findings suggest that the differences in median ages at cancer diagnosis worldwide likely reflect population‐level variation in risk factors and cancer control measures, including screening. [ABSTRACT FROM AUTHOR]

The EarlyCDT‐Lung test is a blood‐based autoantibody assay intended to identify high‐risk individuals for low‐dose computed tomography lung cancer screening. However, there is a paucity of evidence on the performance of the EarlyCDT‐Lung test in ever‐smokers. We conducted a nested case‐control study within two prospective cohorts to evaluate the risk‐discriminatory performance of the EarlyCDT‐Lung test using prediagnostic blood samples from 154 future lung cancer cases and 154 matched controls. Cases were selected from those who had ever smoked and had a prediagnostic blood sample <3 years prior to diagnosis. Conditional logistic regression was used to estimate the association between EarlyCDT‐Lung test results and lung cancer risk. Sensitivity and specificity of the EarlyCDT‐Lung test were calculated in all subjects and subgroups based on age, smoking history, lung cancer stage, sample collection time before diagnosis and year of sample collection. The overall lung cancer odds ratios were 0.89 (95% CI: 0.34‐2.30) for a moderate risk EarlyCDT‐Lung test result and 1.09 (95% CI: 0.48‐2.47) for a high‐risk test result compared to no significant test result. The overall sensitivity was 8.4% (95% CI: 4.6‐14) and overall specificity was 92% (95% CI: 87‐96) when considering a high‐risk result as positive. Stratified analysis indicated higher sensitivity (17%, 95% CI: 7.2‐32.1) in subjects with blood drawn up to 1 year prior to diagnosis. In conclusion, our study does not support a role of the EarlyCDT‐Lung test in identifying the high‐risk subjects in ever‐smokers for lung cancer screening in the EPIC and NSHDS cohorts. [ABSTRACT FROM AUTHOR]

Background: Little is known about the prognostic advantage of sex for pulmonary adenocarcinoma among Chinese patients. In this study, we aimed to investigate the true sex differences in prognosis by adjusting for confounders and to explore whether the differences were time‐varying. Methods: We identified 4438 lung adenocarcinoma patients who underwent surgery at a regional Cancer Center of China from 2008 to 2016, retrospectively. Sex, age group, smoking history, year of diagnosis and pathological stage were collected. Time‐dependent Cox regression models with inverse probability of treatment weighting (IPTW) based on propensity score were used to assess the effect of sex and account for confounders. Landmark analyses were conducted to assess survival before, and after, five years. Results: Of these patients, 1761 (39.7%) were men and 2677 (60.3%) were women. Median follow‐up time was 52.6 months. After IPTW adjustment, women were found to have significantly better survival than men varying with time in both crude and IPTW models (hazard ratio [HR] [t] = 0.453*1.015t, where t is the length of time from treatment and its unit is month, p < 0.001). Women had significantly better survival than men within 0–5 years after surgery (HR = 0.763, 95% CI: 0.649–0.897, p = 0.001), whereas there was no difference after five years (HR = 1.135, 95% CI: 0.803–1.605, p = 0.472). In subgroup analysis, women in the 61–71+ age group, in the more than 20 year packs group, pathological stage 0–IB group, and 2013–2016 diagnosis period group revealed the same prognostic pattern. Conclusions: Compared with men, women had better survival after surgical resection of lung adenocarcinoma, especially those who were older and nonsmokers or heavy‐smokers and were pathological stage 0–IB in early years, while the advantage for women diminished with time. [ABSTRACT FROM AUTHOR]

The direct copolymerization of p‐tosyl isocyanate (TSI) with epoxides, initiated by onium salts in the presence of trialkylborane, to produce polyurethanes is reported. The rate of copolymerization and the (regio)selectivity were investigated in relation to the trialkylborane and the initiator used. Under optimized conditions such copolymerizations have been successfully performed for a wide range of epoxides, including ethylene oxide, propylene oxide, 1‐octene oxide, cyclohexene oxide, and allyl glycidyl ether. These copolymerizations afford a new category of polyurethanes, clear of side products such as cyclic oxazolidinone, isocyanurate, and poly(isocyanate) linkages. The experimental conditions used in this work are compatible with those for the organocatalytic (co)polymerization of other oxygenated monomers and CO2, holding the potential for their terpolymerization with p‐tosyl isocyanate and the development of new materials with unprecedented properties. [ABSTRACT FROM AUTHOR]

Background: The role of adjuvant chemotherapy (ACT) for patients with stage IB–IIA non‐small cell lung cancer (NSCLC) according to the eighth edition of the AJCC TNM staging system remains controversial. Methods: Data were collected from patients with NSCLC stage IB–IIA according to the eighth edition of the AJCC TNM staging system who underwent surgical resection from 2008 to 2015. The relationship between ACT and overall survival (OS) or disease‐free survival (DFS) was analyzed using the Kaplan–Meier method and Cox proportional hazards model. Results: The study included 648 patients with completely resected NSCLC stage IB–IIA; 312 underwent ACT after surgical resection and 336 were placed under observation. After propensity score matching, 247 pairs of patients were matched and the five‐year OS was 88.08% and 83.12% (P = 0.13) in ACT and non‐ACT settings, respectively. Subgroup analyses demonstrated that ACT treatment was correlated with an improved five‐year OS in patients with visceral pleural invasion (VPI) in the 3 < tumor ≤ 4 cm subgroup (93.98% and 68.93%, P < 0.01). Conclusions: ACT was not significantly associated with improved five‐year OS in stage IB–IIA NSCLC patients. However, further subgroup analysis showed that patients with VPI in the 3 < tumor ≤ 4 cm (T2aN0M0, stage IB) subgroup might benefit more from ACT. Further studies are required to validate the findings and better systemic strategies need to be developed in these patients. Key points: Significant findings of the study: For patients with stage IB–IIA NSCLC according to the eighth edition of the AJCC TNM staging system, the effect of ACT remains unclear.ACT was not significantly associated with improved five‐year OS in stage IB–IIA NSCLC patients. However, it was correlated with better DFS before or after PSM.Patients with VPI in the 3 < tumor ≤ 4 cm subgroup may benefit from ACT. What this study adds: ACT was not significantly associated with improved five‐year OS in stage IB–IIA NSCLC patients. However, it was correlated with better DFS before or after PSM.Patients with VPI in the 3 < tumor ≤ 4 cm subgroup may benefit from ACT. [ABSTRACT FROM AUTHOR]

In this investigation, a metal‐free process was developed that enables the synthesis of poly(propylene carbonate) (PPC) diols/polyols by copolymerization of CO2 with propylene epoxide (PO) under environmentally friendly and cost‐effective conditions. This process implies the recycling of triethylborane and of ammonium salts that both enter in the composition of the initiators used to copolymerize CO2 and PO. In complement to the above approach, a polymeric support, poly(diallyl dimethylammonium chloride), was synthesized and modified to carry ammonium carboxylate salts along its chain. The prepared polymeric initiator was utilized to copolymerize CO2 with PO under heterogeneous conditions. Not only were the polymerization results similar to the samples obtained under homogeneous conditions, but the polymer substrate could easily be recovered by simple filtration. The integrity of the polycarbonate diols/polyols and the recycling process were followed by 1H and 11B NMR spectroscopy, gel permeation chromatography, and matrix assisted laser desorption ionization time of flight (MALDI‐TOF) MS. [ABSTRACT FROM AUTHOR]

To examine the associations between fasting blood glucose (FBG) trajectories, the changes in FBG over time and the risk of cancer, particularly for gastrointestinal cancer, we enrolled 69,742 participants without diabetes from the Kailuan cohort. FBG trajectories (2006–2010) were modeled by group‐based trajectory modeling, and five trajectories were identified: low‐increasing (n = 6,275), moderate‐stable (n = 44,120), moderate‐increasing (n = 10,149), elevated‐decreasing (n = 5,244) and elevated‐stable (n = 3,954). A total of 1,364 cancer cases were accumulated between 2010 and 2015, including 472 gastrointestinal cancer cases. We used Cox proportional hazards regression models to evaluate the associations between FBG trajectory patterns and the risk of cancer. We further assessed the associations while carefully controlling for initial body mass index (BMI) in 2006 and for changes in BMI during 2006–2010. Relative to the moderate‐stable group, we found a higher hazard ratio (HR) for overall cancer in the low‐increasing group (HR = 1.26, 95% confidence interval (CI) 1.06–1.50); and for gastrointestinal cancer in the elevated‐stable group (HR = 1.66, 95% CI 1.22–2.26). Moreover, among participants with an initial BMI ≥25 kg/m2, a positive association with the low‐increasing group was observed for both overall cancer and gastrointestinal cancer (HR = 1.54, 95% CI 1.17–2.04; HR = 1.65, 95% CI 1.02–2.66; respectively); among participants with a stable BMI (4.40% loss–5.15% gain), a positive association with the elevated‐stable group was observed both for overall cancer and gastrointestinal cancer (HR = 1.43, 95% CI 1.10–1.87; HR = 1.95, 95% CI 1.33–2.86; respectively). Our study observed that FBG trajectories were associated with cancer risk among participants without diabetes, and BMI may modify the associations. What's new? Impaired fasting blood glucose (IFG) is associated with an increased risk of cancer. In China, lifestyle changes have significantly increased the prevalence of IFG. But are high fasting blood‐glucose (FBG) levels the only culprit in increased cancer risk? In this study, the authors found that people with initially low FBG that rose over time (the "FBG trajectory") also had an increased risk both for overall cancer and especially for gastrointestinal cancer. BMI may modify these associations. A deeper understanding of these phenomena may improve future prevention strategies. [ABSTRACT FROM AUTHOR]

Background: Low‐dose computed tomography screening has been proved to reduce lung cancer mortality, however, the issues of high false‐positive rate and overdiagnosis remain unsolved. Risk prediction models for lung cancer that could accurately identify high‐risk populations may help to increase efficiency. We thus sought to develop a risk prediction model for lung cancer incorporating epidemiological and metabolic markers in a Chinese population. Methods: During 2006 and 2015, a total of 122 497 people were observed prospectively for lung cancer incidence with the total person‐years of 976 663. Stepwise multivariable‐adjusted logistic regressions with Pentry =.15 and Pstay =.20 were conducted to select the candidate variables including demographics and metabolic markers such as high‐sensitivity C‐reactive protein (hsCRP) and low‐density lipoprotein cholesterol (LDL‐C) into the prediction model. We used the C‐statistic to evaluate discrimination, and Hosmer‐Lemeshow tests for calibration. Tenfold cross‐validation was conducted for internal validation to assess the model's stability. Results: A total of 984 lung cancer cases were identified during the follow‐up. The epidemiological model including age, gender, smoking status, alcohol intake status, coal dust exposure status, and body mass index generated a C‐statistic of 0.731. The full model additionally included hsCRP and LDL‐C showed significantly better discrimination (C‐statistic = 0.735, P =.033). In stratified analysis, the full model showed better predictive power in terms of C‐statistic in younger participants (<50 years, 0.709), females (0.726), and former or current smokers (0.742). The model calibrated well across the deciles of predicted risk in both the overall population (PHL =.689) and all subgroups. Conclusions: We developed and internally validated an easy‐to‐use risk prediction model for lung cancer among the Chinese population that could provide guidance for screening and surveillance. [ABSTRACT FROM AUTHOR]

To build a simple predictive model as a guide to stratify average‐risk population for colonoscopy examinations. We collected data from 92 923 males without a prior history of cancer enrolled in the Kailuan Cohort Study of China. Risk factors included in the evaluation of colorectal cancer (CRC) were collected by questionnaire‐based interviews at the baseline. Logistic regression coefficients for incident CRC predictors were converted into risk scores by the absolute value of the smallest coefficient in the model and rounding up to the nearest integer. Receiver operating characteristic (ROC) analysis with the leave‐one‐out cross‐validation method was applied to evaluate model performance. In the 10‐year follow‐up, 353 CRC patients were in the cohort. Age, alcohol consumption, waist circumference, occupational sitting time, and history of diabetes were selected for the scoring system, and the adjusted area under the ROC was 0.66. Population in the highest risk group (16‐19 points) had a 33.12‐fold (95% CI: 13.44‐81.59) higher risk of CRC than those in the lowest risk group. When we defined 13 points as the cut‐off, the sensitivity and specificity of the scoring system for CRC were 67.99% and 62.42%, respectively. A simple scoring system for CRC has been developed to identify men at an increased relative risk of CRC within 10 years using several well‐established risk factors, which allows selection of asymptomatic candidates for priority of CRC screening and saving the health resource in cancer prevention and control. [ABSTRACT FROM AUTHOR]

To investigate the independent and joint associations of blood lipids and lipoproteins with lung cancer risk in Chinese males, a prospective cohort study was conducted. A total of 109,798 males with baseline information on total cholesterol (TC), triglycerides (TG), low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C) and non‐HDL were prospectively observed from 2006 to 2015 for cancer incidence. Cox proportional hazards models and restricted cubic spline (RCS) analysis were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a 9‐year follow‐up, a total of 986 lung cancer cases were identified. Multivariable analyses showed that both males with low TC (HRQ1vs.Q2 = 1.27, 95%CI: 1.02–1.60) and males with high TC (HRQ5vs.Q2 = 1.30, 95%CI: 1.04–1.63) had an increased lung cancer risk, and the U‐shaped association was also revealed in the RCS analysis (poverall = 0.013, pnonlinear = 0.006). Furthermore, both low TG (HRQ1vs.Q2 = 1.24, 95%CI: 0.99–1.54) and high TG (HRQ5vs.Q2 = 1.27, 95%CI: 1.01–1.59) were associated with increased lung cancer risk, while low LDL‐C (HRQ1vs.Q2 = 1.38, 95%CI: 1.11–1.72) was associated with increased lung cancer risk. When TC, TG and LDL‐C were considered jointly, the number of abnormal indicators was linearly associated with an increased risk of lung cancer (ptrend < 0.001), as subjects with three abnormal indicators had a twofold higher risk of developing lung cancer (HR = 2.02, 95%CI: 1.62–2.54). Notably, these associations were statistically significant among never smokers, never drinkers and overweight/obese males. These findings suggest that dyslipidemia may potentially be a modifiable risk factor that has key scientific and clinical significance for lung cancer prevention. What's new? Lung cancer arises from more than just smoking: abnormal blood lipid levels also contribute to the disease. In this report, the authors evaluated the role of cholesterol and triglycerides in lung cancer. They collected information on total cholesterol, triglycerides, LDL‐C, HDL‐C, and non‐HDL‐C from more than 100,000 men in northern China, and tracked cancer incidence for 9 years. Men whose total cholesterol or triglycerides were either low or high had increased risk of lung cancer, they found. Low LDL‐C levels also associated with an increase. Considered jointly, the number of abnormal factors was linearly associated with lung cancer risk. [ABSTRACT FROM AUTHOR]

Janus-type dendrimer-like poly(ethylene oxide)s (PEOs) of 1st, 2nd, and 3rd generation carrying terminal hydroxyl functions on one side and cleavable ketal groups on the other were used as substrates to conjugate folic acid as a folate receptor and camptothecin (CPT) as a therapeutic drug in a sequential fashion. The conjugation of both FA and CPT was accomplished by 'click chemistry' based on the 1,3 dipolar cycloaddition coupling reaction. First, the hydroxyl functions present at one face of Janus-type dendrimer-like PEOs were transformed into alkyne groups through a simple Williamson-type etherification reaction. Next, the ketals carried by the other face of the dendrimer-like PEOs were hydrolyzed, yielding twice as many hydroxyls which were subsequently subjected to an esterification reaction using 2-bromopropionic bromide. Before substituting azides for the bromide of 2-bromopropionate esters just generated in the presence of NaN3, an azido-containing amidified FA derivative was reacted through click chemistry with alkyne functions introduced on the other face of the dendrimer-like PEOs. A purposely designed alkyne-functionalized biomolecule derived from CPT was conjugated to the azido functions carried by the dendritic PEOs by a second 'click reaction.' In this case, twice as many CPT as FA moieties were finally conjugated to the two faces of the Janus-type dendrimer-like PEOs, the numbers of folate and CPT introduced being 2 and 4, 4 and 8, and 8 and 16 for samples of 1st, 2nd, and 3rd generation, respectively (route A). An alternate route for functionalizing the dendrimer-like PEO of 1st generation consisted, first, in conjugating the azido-containing CPT onto the alkyne groups present on one face of the dendritic PEO scaffold. The alkyne-functionalized FA was further introduced by click chemistry after the bromides of 2-bromopropionate esters were chemically transformed into azido groups. The corresponding prodrug thus contains 2 CPT and 4 FA external moieties (route B). Every reaction step product was thoroughly characterized by 1H NMR spectroscopy. A preliminary investigation into the water solution properties of these functionalized dendritic PEOs is also presented. © 2011 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2011 [ABSTRACT FROM AUTHOR]