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In adults, there is a link between socioeconomic status (SES) and cancer prognosis, notably due to increased time to diagnosis (TTD) in deprived population leading to the dissemination of the disease. In children, such an association has not been clearly reported. The objective of our study was to assess the impact of SES on TTD of childhood cancer and its potential consequences on cancer prognosis. We carried out a multicenter retrospective study based on the LOGAFTER multi centric database. We studied SES at the individual level (parental professions, family structure) and the ecological level (EDI score, travel time by car). We assessed the factors potentially associated with an increased TTD with a Cox regression model, and we illustrated TTD by categories by using Kaplan-Meier curves. 854 children were included. The median time to diagnosis was 28 days [12;64]. TTD differed significantly according to the type of tumor. An usual care pathway did not impact TTD. However, an initial management by professionals not usually involved in the specific childhood cancer context increased TTD. None of the SES ecological variables were strictly associated with an impact on TTD, and a trend was noted for single-parent families (increased TTD, p  = 0.057). In our cohort, TTD did not impact on the vital and relapse status. In this study, the impact of SES on TTD in children on both the individual and ecological levels was not clear. However, we noted some keys at the individual scale that require further investigation to explain potential associations.

Background: Serous effusion fluids serve as crucial cytological materials in diagnosing the underlying causes of fluid accumulation in various body cavities. The International System for Reporting Serous Fluid Cytopathology (TIS) outlined atypia of undetermined significance (AUS) and suspicious for malignancy (SFM) as two intermediate categories for atypical fluids., Materials and Methods: In our study, cases diagnosed as "atypical" by an experienced cytopathologist in the Hacettepe University Department of Pathology, between 2014 and 2023, were re-categorized according to TIS. The risk of malignancy (ROM) for AUS and SFM categories was calculated. Additionally, cases were re-evaluated according to the 5-tier categorical system by two observers with different level of experience., Results: A total of 3501 effusion fluids were included in the study, evaluated between 2014 and 2023. 50.7% of the cases were male, and 49.3% were female. 55.2% of the cases were pleural fluid, 41.5% were peritoneal fluid, and 3.3% were pericardial fluid. Two hundred sixty five cases (7.6%) were non-diagnostic, 2160 (61.7%) were negative for malignancy, 111 (3.2%) were AUS, 83 (2.4%) were SFM, and 883 (25.2%) were malignant (M). ROM calculated 27% for AUS, 49% for SFM 49%. The interobserver agreement for AUS was 46% with kappa value of 0.162, and 42% for SFM with kappa value of 0.188., Conclusion: The differentiation of atypical cases into AUS and SFM is effective in determining the ROM. The interobserver agreement tends to be lower in intermediate categories compared to others, emphasizing the potential significance of clinical expertise in diagnosis., (© 2024 Wiley Periodicals LLC.)

Background: Migrants face barriers accessing healthcare, risking delays in cancer diagnosis. Diagnostic delays result in later stage diagnosis which is associated with poorer cancer survival. This review aims to compare the differences in cancer stage at diagnosis between migrants and non-migrants., Methods: We conducted a systematic review and meta-analysis of three databases from 2000 to 2023 for studies conducted in OECD countries that compared stage at diagnosis between migrants and non-migrants. Meta-analysis compared odds ratios (OR) for early (stage I and II) stage at diagnosis. The Risk of Bias in Non-randomised Studies of Exposure tool was used to assess study quality., Results: 41 of the 11,549 studies identified were included; 34 studies had suitable data for meta-analysis. Overall, migrants were significantly less likely to be diagnosed with early stage cancer compared with non-migrants (OR 0.84; 95% CI 0.78-0.91). This difference was maintained across cancer types, although only statistically significant for breast (OR 0.78; 95% CI 0.70-0.87) and prostate cancer (OR 0.92; 95% CI 0.85-0.99)., Discussion: Published studies indicate that migrants are less likely to be diagnosed with early stage cancer. Variation by cancer type, study location and region of origin highlights the need for further research to understand these differences., Competing Interests: Competing interests: Harvey-Sullivan, Ali, Dhesi, and Painter are NIHR-funded academic clinical fellows. Otherwise, the authors declare no conflict of interest. Ethics approval and consent to participate: Ethical approval was not requested because this study retrieved and synthesised data from already published studies., (© 2024. The Author(s).)

Circulating tumor cells (CTCs) are shed from primary tumors and travel through the body via circulation, eventually settling to form micrometastases under favorable conditions. Numerous studies have identified CTCs as a negative prognostic indicator for survival across various cancer types. CTCs mirror the current heterogeneity and genetic and biological state of tumors, making their study invaluable for understanding tumor progression, cell senescence, and cancer dormancy. However, their isolation and characterization still poses a major challenge that limits their clinical translation. A wide array of methods, each with different levels of specificity, utility, cost, and sensitivity, have been developed to isolate and characterize CTCs. Moreover, innovative techniques are emerging to address the limitations of existing methods. In this review, we provide insights into CTC biology addressing spectra of markers employed for molecular analysis and functional characterization. It also emphasizes current label-dependent and label-independent isolation procedures, addressing their strengths and limitations. SIGNIFICANCE: A comprehensive overview of CTC biology, their molecular and functional characterization, along with their current clinical utility will help in understanding the present-day extent to which the clinical potential of CTCs is getting tapped in personalized medicine., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose of Review: With growing emphasis on data-driven research in pediatric oncology, particularly in the context of advances in molecular characterization and precision medicine, there is an urgent need for comprehensive data-sharing initiatives. This review explores how the Childhood Cancer Data Initiative (CCDI) addresses this critical need., Recent Findings: CCDI plays a key role in enhancing pediatric cancer research by improving data integration, sharing, and collaboration. Its Molecular Characterization Initiative advances the field by leveraging detailed molecular data to inform clinical trials and therapeutic strategies. For small patient populations, such as those with rhabdomyosarcoma, CCDI's efforts in integrating data across institutions are vital for advancing risk-based treatment strategies to achieve meaningful clinical outcomes., Summary: CCDI's advancements in data sharing have profound implications for both clinical practice and research. By enabling precise diagnoses, tailoring treatments based on individual genetic profiles, and addressing the challenges associated with small patient populations, CCDI is driving transformative changes in pediatric oncology. Continued support and expansion of such initiatives are crucial to fully realizing their potential in improving outcomes for children with cancer., (Copyright © Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.)

Finite clinical genetics services combined with expanding genomic testing have driven development of mainstreaming models-of-care for genomic testing: specifically genetic counselor embedded (GEM) and upskilled-clinician (UPC) models. To determine feasibility, acceptability, and health economic impact in cancer mainstreaming settings we conducted a scoping review of the literature. A comprehensive PubMed search identified relevant manuscripts, published in English between 2013 and 2023. Of 156 identified articles, 37 proceeded to full review, encompassing five cancer types. In both models-of-care, testing uptake was > 90% and referral/testing rates increased 1.2-6.7-fold. Time from diagnosis to result disclosure decreased 1.5-6-fold and pathogenic variant detection rates were ≥ 10%. GEM model studies evaluated neither cost-effectiveness nor physician/patient outcomes. UPC models were economically viable, primarily through reducing genetics-related appointments. Physicians found the UPC model workload acceptable and reported improvements in knowledge and confidence. Patient distress in the UPC model was low overall and comparable to standard-of-care. Patients' acceptance and satisfaction/decisional satisfaction were high, and continuity-of-care was appreciated. Mainstreaming cancer genomic testing is feasible and beneficial to patients, physicians, and healthcare systems. More studies are needed to capture GEM model impacts and to compare GEM with UPC models. Further detail of allied health and nursing support for the UPC model is also required., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The gut microbiome, a complex community of trillions of microorganisms in the intestines, is crucial in maintaining human health. Recent advancements in microbiome research have unveiled a compelling link between the gut microbiome and cancer development and progression. Alterations in the composition and function of the gut microbiome, known as dysbiosis, have been implicated in various types of cancer, including, esophageal, liver, colon, pancreatic, and gastrointestinal. However, the specific gut microbial strains associated with the development or progression of cancers in various tissues remain largely unclear. Here, we summarize current research findings on the gut microbiome of multiple cancers. This review aims to identify key gut microbial targets that closely influence cancer development based on current research findings. To accurately evaluate the effectiveness of the gut microbiome as a clinical tool for cancer, further research is needed to explore its potential as a biomarker and therapeutic strategy., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest to disclose in relation to this manuscript., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Historically, surgical biopsy (SB) for diagnosis of pediatric solid tumors was considered necessary to provide adequate tissue for histologic and molecular analysis. Less invasive biopsy techniques such as image-guided core needle biopsy (CNB), have shown comparable accuracy with decreased morbidity in some adult studies. However, data regarding the safety and efficacy of CNB in pediatric tumors is limited. This study's aim was to assess the overall rate of successful diagnosis and safety of CNB compared to SB in children with malignancies., Methods: A PRISMA compliant systematic review was performed in MEDLINE via PubMed, Embase and CINAHL Plus database searches from 2010 to 2023. Studies were included with relevance to the following clinical question: For children with concern for malignancy requiring biopsy for diagnosis, how does CNB compare to open or laparoscopic/thoracoscopic SB in terms of safety and diagnostic efficacy? Data for patients ≤21 years requiring biopsy for diagnosis of liver tumors, neuroblastoma (NB), soft tissue sarcoma (STS), and lymphoma were included., Results: Twenty-seven studies including 2477 patients met inclusion criteria, with 2065 undergoing CNB and 412 SB. Of the 2477 patients, 820 patients had NB, 307 liver tumors, 96 STS, 151 lymphoma, and 1103 patients were from studies that included multiple diagnoses. The average complication rate for CNB was 2.9% compared to 21.4% for SB (p < 0.001). Bleeding was the most common complication in both groups, but significantly higher after SB (22.1% vs 2.3%) (p < 0.001). CNB was diagnostic in 90.8% of patients compared to 98.8% who underwent SB (p < 0.001)., Conclusions: Rates of successful diagnosis were greater than 90% for both CNB and SB, though significantly higher for SB. Conversely, complication rates were close to ten times higher after SB compared to CNB. Given its relatively lower risk profile, CNB can be a safe and useful diagnostic tool for children with solid malignancies. Research focused on enhancing CNB's diagnostic accuracy while maintaining low morbidity should be further explored., Level of Evidence: Treatment study, Level III., Competing Interests: Declaration of competing interest The authors have nothing to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Differences in the recording of cancer case status and diagnosis date have been observed between cancer registry (CR) - the reference standard - and electronic health records (EHRs); such differences may affect estimates of cancer risk or misclassify diagnostic pathways. This study aims to quantify differences in recording of case status and date of cancer diagnosis between cancer registry and EHRs., Methods: Linked primary care (Clinical Practice Research Datalink (CPRD)), secondary care (Hospital Episode Statistics (HES)) and national Cancer Registry (CR) data, were used to identify 14,301 patients with a recorded diagnosis of brain, colon, lung, ovarian, or pancreatic cancer between 1999 and 2018. Agreement in case status between datasets, differences in recorded diagnosis dates, and change in agreement over time were investigated for each cancer site., Results: Between 84 % (ovary) to 92 % (colon) of diagnoses in cancer registry were also recorded in combined CPRD-HES data. Agreement with cancer registry was slightly lower in HES (78 % (ovary) to 86 % (colon)) and CPRD (61 % (ovary, pancreas) to 72 % (brain)). The proportion of CPRD-HES diagnoses confirmed in CR varied by cancer site (50 % (brain) to 86 % (lung)). Agreement between CR and HES was relatively stable within cancer sites over time. Concordance between CR and CPRD was more heterogeneous between cancer sites and over time. Best agreement in diagnosis date was observed between CR and HES (median difference 0 or 1 days, all cancer sites)., Conclusion: Agreement between CR and EHR data is heterogeneous across cancer sites. Concordance does not appear to have improved over time. Combined data from primary and secondary care may be sufficient to approximate case status in CR in some circumstances, but the date we consider to represent the diagnosis may impact study outcomes., Competing Interests: Declaration of Competing Interest MEB receives personal fees from GRAIL Inc., for Independent Data Monitoring Committee (IDMC) membership unrelated to this study. All other authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose of Review: Due to the infrequent nature of rare pediatric cancers, rigorously studied treatment algorithms are usually nonexistent, and experience with a given tumor may be limited at a single institution. Development of treatment plans for these populations often requires extensive literature review and outreach to experts at other institutions. National or international virtual tumor boards provide a streamlined, collaborative approach to discussing diagnosis and management of these patients through dissemination of collective experience and knowledge. This review highlights current virtual tumor boards for rare pediatric cancers and their benefit as a resource for patient care., Recent Findings: Over the last several years, national virtual tumor boards sponsored by government and academic institutions and cancer foundations have expanded access of pediatric oncologists to rare tumor expertise and guidance. Recommendations from these tumor boards often have an impact on medical decision making, and some serve as a resource for enduring educational reference materials., Summary: National virtual tumor boards are a valuable resource to clinicians caring for patients with rare pediatric tumors. These conferences provide real-time management advice from peers and subject matter experts and provide essential educational content not easily accessible in other formats., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Exosomes, which are considered nanoscale extracellular vesicles (EVs), are secreted by various cell types and widely distributed in different biological fluids. They consist of multifarious bioactive molecules and use systematic circulation for their transfer to adjoining cells. This phenomenon enables exosomes to take part in intercellular and intracellular communications. They serve as novel and important cancer biomarkers due to their ability to be obtained from various biological fluids and the presence of nucleic acids, proteins, glycoconjugates, and lipids in their structure. The advancement of sensitive and selective exosome detection approaches continues to be a critical challenge that must be addressed. Metal-organic frameworks (MOFs) are a class of 2D and 3D synthetic organic and crystalline nanomaterials, forming through the self-assembly of organic linking molecules and metal ions. The exploration of MOF-based molecules in the recognition of exosomes is an essential aspect in the development of cutting-edge sensing platforms due to their tunable pore structures, excellent adsorption capabilities, and high surface area. Their advantages allow for the inclusion of a large number of electroactive molecules and biological elements, thereby enhancing their electrical conductivity and selectivity, respectively. The synergetic effect of nanomaterials and bioreceptors allows for efficient detection probes. In this review, the different roles of MOFs in the biosensing of exosomes are highlighted, providing a comprehensive understanding of biosensing approaches in this area. In addition, probes based on MOFs and different bioreceptors are investigated for detecting these important cancer biomarkers. The current gaps in this field and future perspectives are discussed.

Salivary cytokines have the potential to serve as biomarkers for evaluating cancer progression and treatment response in specific cancer types. This study explored salivary cytokine profiles in pediatric cancer patients and healthy controls, examining changes during chemotherapy. We conducted a prospective study involving newly diagnosed cancer patients and healthy controls under 19 years old. Saliva samples were collected at diagnosis, and three and six months post-diagnosis for cancer patients, while healthy controls provided samples at a single time point. Cytokine levels were analyzed using Luminex technology. Our study included 19 cancer patients (10 with leukemia, 5 with lymphoma, and 4 with solid tumors) and 128 healthy controls aged 4 to 18 years. At diagnosis, patients with leukemia and solid tumors showed elevated levels of interferon-γ, interleukin (IL)-1α, IL-1β, IL-4, IL-5, IL-8, IL-10, and tumor necrosis factor. After three months, IL-6, IL-10, and inducible protein-10 levels significantly increased, while IL-1α, IL-1β, and IL-8 rose by six months. These findings indicate that salivary cytokines are elevated at diagnosis and during initial treatment phases in pediatric cancer patients, highlighting saliva's potential as a noninvasive medium for early detection of systemic diseases in children., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Early detection and diagnosis of cancer are vital to improving outcomes for patients. Artificial intelligence (AI) models have shown promise in the early detection and diagnosis of cancer, but there is limited evidence on methods that fully exploit the longitudinal data stored within electronic health records (EHRs). This review aims to summarise methods currently utilised for prediction of cancer from longitudinal data and provides recommendations on how such models should be developed., Methods: The review was conducted following PRISMA-ScR guidance. Six databases (MEDLINE, EMBASE, Web of Science, IEEE Xplore, PubMed and SCOPUS) were searched for relevant records published before 2/2/2024. Search terms related to the concepts "artificial intelligence", "prediction", "health records", "longitudinal", and "cancer". Data were extracted relating to several areas of the articles: (1) publication details, (2) study characteristics, (3) input data, (4) model characteristics, (4) reproducibility, and (5) quality assessment using the PROBAST tool. Models were evaluated against a framework for terminology relating to reporting of cancer detection and risk prediction models., Results: Of 653 records screened, 33 were included in the review; 10 predicted risk of cancer, 18 performed either cancer detection or early detection, 4 predicted recurrence, and 1 predicted metastasis. The most common cancers predicted in the studies were colorectal (n = 9) and pancreatic cancer (n = 9). 16 studies used feature engineering to represent temporal data, with the most common features representing trends. 18 used deep learning models which take a direct sequential input, most commonly recurrent neural networks, but also including convolutional neural networks and transformers. Prediction windows and lead times varied greatly between studies, even for models predicting the same cancer. High risk of bias was found in 90% of the studies. This risk was often introduced due to inappropriate study design (n = 26) and sample size (n = 26)., Conclusion: This review highlights the breadth of approaches to cancer prediction from longitudinal data. We identify areas where reporting of methods could be improved, particularly regarding where in a patients' trajectory the model is applied. The review shows opportunities for further work, including comparison of these approaches and their applications in other cancers., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Glycosylation, the intricate process of adding carbohydrate motifs to proteins, lipids, and exosomes on the cell surface, is crucial for both physiological and pathological mechanisms. Alterations in glycans significantly affect cancer cell metastasis by mediating cell-cell and cell-matrix interactions. The subtle changes in glycosylation during malignant transformations highlight the importance of analyzing cell and exosome surface glycosylation for prognostic and early treatment strategies in cancer. This review focuses on recent advancements in sensors for detecting surface glycans on cancer cells, exosomes, and circulating cancer-derived glycoproteins. Among various methods, electrochemical biosensors stand out as a promising tool, offering rapid and cost-effective glycan detection. These devices detect glycan interactions by measuring changes in electrical signals resulting from specific binding events. Techniques such as differential pulse voltammetry, impedance spectroscopy, and chrono amperometry are commonly employed for glycan detection using electrochemical biosensors. Researchers are exploring novel electrode materials and surface functionalization strategies to enhance sensor performance. Notably, selective binding probes such as lectins, aptamers, antibodies, and boronic acids are discussed, with lectins being the most prevalent for specific glycan analysis. By highlighting the significance of electrochemical techniques, emphasizing the role of selective binding probes, integrating microfluidics and miniaturized devices could lead to point-of-care applications for cancer diagnosis and monitoring. This review aims to provide valuable insights for researchers and clinicians working in the field of cancer glycomics., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The discovery of circulating fetal and tumor cell-free DNA (cfDNA) molecules in plasma has opened up tremendous opportunities in noninvasive diagnostics such as the detection of fetal chromosomal aneuploidies and cancers and in posttransplantation monitoring. The advent of high-throughput sequencing technologies makes it possible to scrutinize the characteristics of cfDNA molecules, opening up the fields of cfDNA genetics, epigenetics, transcriptomics, and fragmentomics, providing a plethora of biomarkers. Machine learning (ML) and/or artificial intelligence (AI) technologies that are known for their ability to integrate high-dimensional features have recently been applied to the field of liquid biopsy. In this review, we highlight various AI and ML approaches in cfDNA-based diagnostics. We first introduce the biology of cell-free DNA and basic concepts of ML and AI technologies. We then discuss selected examples of ML- or AI-based applications in noninvasive prenatal testing and cancer liquid biopsy. These applications include the deduction of fetal DNA fraction, plasma DNA tissue mapping, and cancer detection and localization. Finally, we offer perspectives on the future direction of using ML and AI technologies to leverage cfDNA fragmentation patterns in terms of methylomic and transcriptional investigations., (© 2025 Tsui et al.; Published by Cold Spring Harbor Laboratory Press.)

Nanotechnology has significantly transformed the field of cancer diagnostics and therapeutics by introducing advanced biomedical devices. These nanotechnology-based devices exhibit remarkable capabilities in detecting and treating various cancers, addressing the limitations of traditional approaches, such as limited specificity and sensitivity. This review aims to explore the advancements in nanotechnology-driven biomedical devices, emphasizing their role in the diagnosis and treatment of cancer. Through a comprehensive analysis, we evaluate various nanotechnology-based devices across different cancer types, detailing their diagnostic and therapeutic effectiveness. The review also discusses FDA-approved nanotechnology products, patents, and regulatory trends, highlighting the innovation and clinical impact in oncology. Nanotechnology-based devices, including nanobots, smart pills, and multifunctional nanoparticles, enable precise targeting and treatment, reducing adverse effects on healthy tissues. Devices such as DNA-based nanorobots, quantum dots, and biodegradable stents offer noninvasive diagnostic and therapeutic options, showing high efficacy in preclinical and clinical settings. FDA-approved products underscore the acceptance of these technologies. Nanotechnology-based biomedical devices offer a promising future for oncology, with the potential to revolutionize cancer care through early detection, targeted treatment, and minimal side effects. Continued research and technological improvements are essential to fully realize their potential in personalized cancer therapy., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: No need for any ethical approval., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Although physical activity (PA) is recommended for patients with cancer, changes in PA across cancer diagnosis and treatment have not been objectively evaluated., Objective: This study aimed to assess the impact of cancer diagnosis and treatment on PA levels., Methods: This was a retrospective cohort study using a Japanese claims database provided by DeSC Healthcare Inc, in which daily step count data, derived from smartphone pedometers, are linked to the claims data. In this study, we included patients newly diagnosed with cancer, along with those newly diagnosed with diabetes mellitus for reference. We collected data between April 2014 and September 2021 and analyzed them. The observation period spanned from 6 months before diagnosis to 12 months after diagnosis. We applied a generalized additive mixed model with a cubic spline to describe changes in step counts before and after diagnosis., Results: We analyzed the step count data of 326 patients with malignant solid tumors and 1388 patients with diabetes. Patients with cancer exhibited a 9.6% (95% CI 7.1%-12.1%; P<.001) reduction in step counts from baseline at the start of the diagnosis month, which further deepened to 12.4% (95% CI 9.5%-15.2%; P<.001) at 3 months and persisted at 7.1% (95% CI 4.2%-10.0%; P<.001) at 12 months, all relative to baseline. Conversely, in patients with diabetes, step counts remained relatively stable after diagnosis, with a slight upward trend, resulting in a change of +0.6% (95% CI -0.6% to 1.9%; P=.31) from baseline at 3 months after diagnosis. At 12 months after diagnosis, step counts remained decreased in the nonendoscopic subdiaphragmatic surgery group, with an 18.0% (95% CI 9.1%-26.2%; P<.001) reduction, whereas step counts returned to baseline in the laparoscopic surgery group (+0.3%, 95% CI -6.3% to 7.5%; P=.93)., Conclusions: The analysis of objective pre- and postdiagnostic step count data provided fundamental information crucial for understanding changes in PA among patients with cancer. While cancer diagnosis and treatment reduced PA, the decline may have already started before diagnosis. The study findings may help tailor exercise recommendations based on lifelog data for patients with cancer in the future., (©Yoshihide Inayama, Ken Yamaguchi, Kayoko Mizuno, Sachiko Tanaka-Mizuno, Ayami Koike, Nozomi Higashiyama, Mana Taki, Koji Yamanoi, Ryusuke Murakami, Junzo Hamanishi, Satomi Yoshida, Masaki Mandai, Koji Kawakami. Originally published in JMIR Cancer (https://cancer.jmir.org), 20.01.2025.)

Background and Objectives : The incidence and prevalence of cancers are increasing worldwide, with special emphasis placed on prevention, early detection, and the development of new therapeutic strategies that strongly impact patient outcomes. Limited data are available about emergency care's role in treating patients with cancer. This study aims to determine the burden of end-stage and first-time diagnosis of cancer on emergency care in a high-turnover emergency care center. Materials and Methods : A retrospective observational study was conducted to identify patients requesting emergent aid for cancer-related symptoms in the Emergency Department of "St. Spiridon" Hospital from Iasi (Romania) between 1 October 2022 and 30 September 2023. The proportion and demographic characteristics of end-stage patients and those who received a first-time diagnosis during the emergency visit were evaluated. Risk analysis was performed to understand these patients' care needs (such as medical care, surgical care, specialty consults, intensive care, ward admission, and other hospital transfers) and immediate care outcomes (such as in-hospital mortality and home discharge). Results : 2318 patients with cancer requested emergent care (patient presentation rate of 3.08%), of which 444 (19.15%) were diagnosed for the first time, and 616 (26.57%) were at the end-stage. First-time diagnosed patients had a significantly different distribution of cancer types ( p < 0.001), were more likely to need any form of medical care, to require a specialty consultation, or to be admitted to a ward (OR 2.65, 95% CI: 2.12-3.32; p < 0.001; OR 3.28, 95% CI: 2.48-4.35, p < 0.001; OR 2.09, 95% CI: 1.70-2.59; p < 0.001, respectively) but were less severe, while end-stage patients were more likely to address repeatedly to the emergency room (OR 1.86, 95% CI: 1.32-2.59; p = 0.001) and had higher odds of needing intensive care, assisted ventilation and death (OR-4.63, 95% CI: 1.10-19.45, p = 0.04; OR 2.59, 95% CI: 1.57-4.28; p < 0.001, and OR 4.06, 95% CI: 1.73-9.54; p = 0.001, respectively). Conclusions: The emergency department often carries the weight of diagnosing patients with cancer and treating patients with end-stage disease. These data highlight the importance of prehospital care, particularly for cancer screening and palliative care, and the importance of fostering multidisciplinary collaboration in the emergency room with oncologists, geriatricians, and palliative care specialists to improve patient outcomes.

MUC16/CA125 is a common diagnostic marker for many types of cancer. However, due to the widespread expression of MUC16 in cancer, its specificity and sensitivity as a target are poor, which severely limits its clinical application. In recent years, various studies have shown that the clinical application potential of MUC16/CA125 has been greatly improved. The update of detection technology improves the accuracy and range of detection, and improves the early diagnosis rate of cancer. Targeting MUC16/CA125 is an important strategy for tumor therapy. Targeting residual amino acids, n-glycoylation structures or other targets on the surface of MUC16 cells can greatly improve the accuracy of detection and therapy. The new drug delivery method broke through the original technical shackles, targeted MUC16 positive cells more specifically and improved the drug efficacy. In this paper, the technological advances in detecting and identifying MUC16 targets and the great progress in cancer screening and treatment based on MUC16 as a target are described in detail, revealing the great potential of MUC16 as a target in cancer screening and treatment, and illustrating the potential clinical application value of MUC16., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Cancer remains a major global health challenge with a high mortality rate, as evidenced by the rise in new cases every year. Conventional diagnostic methods like PET scans, MRIs, and biopsies, despite being widely used, suffer from significant drawbacks such as high radiation exposure, difficulty in distinguishing malignant from benign tumors, and invasiveness. Early detection, which is crucial for improving treatment outcomes and survival rates, is hindered by the asymptomatic nature of early-stage cancer and the limitations of current diagnostic tools. Cancer biomarkers, detectable in body fluids, offer valuable diagnostic information, and recent advances in nanotechnology have led to the development of highly sensitive nano-biosensors. This review explores recent advancements (2022-2024) in the field of ultrasensitive nano-biosensors, emphasizing the strategic integration of nanomaterials to enhance sensitivity and accuracy in cancer biomarker detection. It highlights how precise nanomaterial positioning in sensor components like electrodes and bioreceptors enables early cancer diagnosis at low biomarker concentrations. These innovations underscore the transformative potential of nanomaterials in revolutionizing early cancer diagnostics, improving patient care, and enhancing survival outcomes.

Some older patients with suspected malignancy are not automatically eligible for a standard care process due to frailty or limited treatment wishes. For this group we recommend a personalized approach in which frailty is identified and the patient's wishes are central. To achieve appropriate care, cooperation and timely consultation between primary care or elderly care with a geriatric and/or oncological specialist from secondary care is important. Together, a care plan can be realized, and agreements can be made as to who will have the management role.

Positive results from cancer screenings, like a cancer diagnosis, can increase the risk of cardiovascular disease (CVD) mortality due to heightened psychological stress. However, positive screening results may also serve as a teachable moment to encourage the adoption of a healthier lifestyle. Consequently, the overall association between positive screenings and CVD mortality risk remains unclear. Based on PLCO data, the risk of CVD mortality associated with the number and types of positive screens was evaluated using Cox regression models among 149,258 eligible participants enrolled between 1993 and 2001. Additional analyses explored these associations stratified by prior CVD history. Exploratory analyses were also conducted to investigate whether positive screens were linked to the potential adoption of a healthier lifestyle. After a median follow-up of 19 years, significantly decreased risk of CVD mortality was observed for individuals with occasional positive screening (≤ 2 positive screens) [adjusted hazard ratio (HR, 95%CIs): 0.931 (0.897-0.968), P < 0.001] compared to the control arm. This effect was particularly notable for flexible sigmoidoscopy [0.842 (0.802-0.884), P < 0.001] and transvaginal ultrasound [0.855 (0.776-0.942), P = 0.002]. However, when the number of positive screens increased to more than two, the reduced risk of CVD mortality became non-significant [0.977 (0.941-1.014), P = 0.220]. Subgroup analyses revealed a greater reduction in CVD mortality risk among participants without a history of CVD [0.917 (0.864-0.973)] compared to those with a history of CVD [0.944 (0.898-0.993)]. Sensitivity analyses excluding screening-detected cancers showed similar association in the overall population [0.933 (0.897-0.970)], as well as in both subgroups with [0.945 (0.898-0.995)] and without previous CVD [0.919 (0.865-0.976)]. Exploratory analyses indicated a significantly higher proportion of any body mass index (BMI) reduction among those with a baseline BMI ≥ 25 kg/m2 who had positive screens compared to the control arm, particularly for individuals with occasional positive screens (48.07% vs. 47.04%, P value = 0.037). Occasional positive cancer screening are associated with reduced risk of CVD mortality, regardless of prior CVD history, cancer diagnosis, and other competitive risks., Competing Interests: Declarations. Ethical approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: A standard questionnaire for generalized anxiety disorders is the GAD-7. Attempts to improve its screening capacity in oncological settings resulted in a discussion about lowering its cut-off. This study examines the diagnostic accuracy of the GAD-7 items depending on applied cut-offs and whether, similar to depressive symptoms, a distinction between somatic-emotional and cognitive items might be relevant., Patients and Methods: Screening data from 4705 patients with cancer who were treated at the outpatient clinic of the National Centre for Tumour Diseases in Heidelberg were analysed. For the individual GAD-7 items sensitivity, specificity, positive and negative predictive values, and Clinical Utility Index were determined for cut-off ≥ 7, ≥ 8, ≥ 10 and ≥ 15 in the GAD-7 questionnaire., Results: The best overall diagnostic accuracy was found for a cut-off ≥ 8. The cognitive items had the best diagnostic accuracy for identifying severe GAD (cut-off ≥ 15), and the somatic-emotional items had the best diagnostic accuracy for identifying mild to moderate GAD (cut-off ≥ 7, ≥ 8 and ≥ 10)., Conclusions: Our data support the recommendation of lowering the GAD-7 cut-off in oncology settings and suggest that in anxiety disorders, a symptom overlap between the physical illness and a possible mental disorder should be considered., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Grapp et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The high sensitivity, high selectivity, real-time monitoring capability, non-destructiveness, and versatility of small molecule fluorescent probes make them indispensable and powerful tools in bioscience research. Self-assembling fluorescent probes are a novel type of material that spontaneously assemble fluorescent dyes with specific molecules into nanoscale structures. Compared with ordinary small molecule fluorescent probes, self-assembled fluorescent probes have higher stability, selectivity, sensitivity, and temporal stability in detection. In recent years, the incidence and mortality of cancer have increased year by year, which has brought great challenges to the safety of human life, and traditional diagnostic methods such as nuclear magnetic resonance, ultrasound diagnosis, and X-ray tomography are time-consuming and have low resolution. The boundary between normal tissue and cancer tissue cannot be accurately distinguished during surgical resection, resulting in the possibility of recurrence after surgery. Fluorescent probes can quickly and efficiently diagnose and label cancerous tumor cells, which is of great significance for cancer discovery and treatment. In this paper, we review the classification of self-assembled fluorescent probes (molecular self-assembled fluorescent probes, nanomaterial self-assembled fluorescent probes and biological macromolecule self-assembled fluorescent probes) that are used in identifying and imaging cancerous tumor tissues. Furthermore, we discuss the current problems faced by self-assembled fluorescent probes through the specific identification and monitoring of enzymes with abnormal contents, active substances and low pH in the tumor microenvironment, hoping to give readers more inspiration.

Understanding tumor heterogeneity is a major challenge that was recognized as one of the first Cancer Grand Challenges, with a call to provide solutions to visualize tumor heterogeneity. The Rosetta team took on this challenge, exploiting advances in spatial-omics approaches centered around mass spectrometry imaging to map tumor heterogeneity at the cellular and molecular scales with different levels of resolution. See related article by Bressan et al., p. 16 See related article by Stratton et al., p. 22 See related article by Bhattacharjee et al., p. 28., (©2025 American Association for Cancer Research.)

Background: Barriers to the cancer continuum organization and interventions to approach them have been identified; however, there is a lack of a tool matching them. Our aim was to develop a web-based tool to identify the main barriers to the process of the cancer continuum organization, and propose matched evidence-based interventions (EBI) to overcome them., Methods: A questionnaire on barriers at six steps of the process of the cancer continuum organization was answered by collaborators. Each question included several options of barriers to be ranked. Barriers were organized in a framework based on the Tanahashi conceptual model, and were categorized in these dimensions: availability of services, accessibility, affordability, acceptability, user-provider interaction, governance, protocols and guidelines, information system, and quality assurance. Systematic searches were conducted on interventions for breast, cervical and colorectal cancer. Interventions were matched with the barriers they helped to overcome, and were classified in one of these groups for each barrier and cancer site: EBI as a single strategy, EBI within a multicomponent strategy, limited-evidence interventions, and macro level approaches. Barriers and interventions were matched on a web-based tool named INTERVENER, that allows the selection of up to 3 barriers for each step. It displays the visual representation of the selected barriers, the size of each dimension being proportional with the importance of that dimension as a barrier. Experts on different aspects of screening and cancer sites provided feedback on the tool. Collaborators from 41 countries worldwide tested it., Results: The tool matched 81 barriers with over 60 interventions. Collaborators reported the webpage to be organized logically (N = 17, 94%) and clearly formatted (N = 15, 83%). The tool was found useful for conducting a situational analysis of the barriers to cancer screening (N = 16, 89%), facilitating discussion with stakeholders on prioritization of interventions (N = 15, 83%), and planning their implementation (N = 15, 83%)., Conclusion: This tool supports countries in conducting a systematic assessment of barriers, including their prioritization, and identifying EBI to overcome them, ultimately facilitating reduction of health inequalities. This tool can support governments, policymakers, managers, and healthcare providers to make better informed decisions to improve their cancer screening programmes., Competing Interests: Declarations. Ethics approval and consent to participate: No formal approval was sought from the ethics committee as the survey findings were the outcome of a fully anonymised expert consultation process. The standard protocols of the International Agency for Research on Cancer/World Health Organization (IARC/WHO) for expert consultation process were followed. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Ferritin, an iron storage protein and acute phase reactant, has been implicated in various aspects of human health and disease, including cancer. Previous studies have identified elevated serum ferritin (SF) levels in several cancer types, but a comprehensive examination across different malignancies remains lacking. This study aims to fill this gap by utilizing anonymized data from Maccabi Health Services (MHS), one of Israel's largest health organizations, to explore the association between elevated SF levels and the diagnosis of different malignancies., Methods: An extensive dataset from MHS, comprising 2.7 million members, including 1.3 million individuals who underwent SF level testing, was analyzed. ORs and 95% confidence intervals were calculated to assess the association between high SF levels and cancer diagnosis. Subgroup analysis was conducted to investigate variations across different malignancies., Results: The analysis revealed a significant association between elevated SF levels and cancer diagnosis among MHS members, with an OR of 1.9 (95% confidence interval, 1.71-2.15). Subgroup analysis unveiled differences in the association across malignancy types, with hematologic, hepatobiliary, and respiratory malignancies more strongly associated with high SF levels., Conclusions: This study provides further support for the link between elevated SF levels and malignancy, leveraging a vast dataset from MHS, underscoring potential utilities of elevated SF levels as a potential indicator for cancer with a variable role among different malignancy types., Impact: The identification of elevated SF levels as a potential indicator for underlying malignancy for seemingly healthy individuals., (©2024 American Association for Cancer Research.)

Cancer is a fatal disease with a high global prevalence and is associated with an increased incidence of metabolic disorders. This study aimed to develop a novel metabolic prognostic system to evaluate the overall metabolic disorder burden in cancer patients and its relationship with their prognosis. The patients in this study were enrolled from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) project. The least absolute shrinkage and selection operator (LASSO) analysis was used to screen for indicators of metabolic disorders. Cox regression analysis was used to evaluate the independent association between indicators of metabolic disorders and mortality in patients. The Kaplan-Meier method was used to evaluate the survival of patients with varying burdens of metabolic disorders. Finally, nomogram prognostic models and corresponding calculators were constructed and evaluated using the areas under the receiver operating characteristic curves (AUC), decision curve analysis (DCA), and calibration curves. Five of the 19 hematological indexes, including hemoglobin, neutrophils, direct bilirubin, albumin, and globulin, were selected as the evaluation indicators of metabolic disorder burden and independent risk factors for prognosis in cancer patients. Patients with a higher metabolic disorder burden had poorer survival rates. The AUC of the 1-year, 3-year, and 5-year overall survival of the prognostic nomogram was 0.678, 0.664, and 0.650, respectively. DCA and calibration curves indicated that the clinical benefit rate of metabolic disorder burden prognostic markers was high. Patients with a higher metabolic disorder burden had poorer survival rates. The nomogram and corresponding calculator can accurately evaluate the metabolic disorder burden and predict the prognosis of patients with cancer., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study followed the Helsinki declaration. All participants signed an informed consent form, and this study was approved by the Institutional Review Board of each hospital (Anhui Provincial Cancer Hospital, Affiliated Cancer Hospital of Harbin Medical University, Affiliated Cancer Hospital of Zunyi Medical College, Guizhou Province, Beijing Shijitan Hospital, Beijing Cancer Hospital, Cancer Hospital of Chinese Academy of Medical Sciences, Chongqing Daping Hospital, Chongqing Third People’s Hospital, Chongqing Cancer Hospital, First Hospital of Jilin University, Foshan First People’s Hospital, Fujian Provincial Cancer Hospital, First Affiliated Hospital of Guangxi Medical University, First Hospital of Shanxi Medical University, Guangxi Zhuang Autonomous Region People’s Hospital, Guangdong Provincial People’s Hospital, Guigang People’s Hospital of Guangxi Province, Hebei province people’s Hospital, Huizhou Central People’s Hospital, Liaoning Provincial Cancer Hospital, Sichuan Provincial Cancer Hospital, Shanghai Ruijin Hospital, Shanghai Tenth People’s Hospital, The Affiliated Hospital of Chengde Medical College, Tangdu Hospital of the Fourth Military Medical University, The Fourth Affiliated Hospital of Harbin Medical University, The First Hospital of Hebei Medical University, The Third Affiliated Hospital of Kunming Medical University, Tianjin Medical University Cancer Hospital, The First Affiliated Hospital of Zhejiang University, The Second Affiliated Hospital of Zhejiang University, The First Affiliated Hospital of Sun Yat-sen University, The Second Hospital of Hebei Medical University, The Fourth Hospital of Hebei Medical University, The First Affiliated Hospital of Kunming Medical University, West China Hospital of Sichuan University, Wuhan Tongji Hospital, Xijing Hospital, Xinjiang Kashgar First People’s Hospital, Xingtai People’s Hospital, Yunnan Cancer Hospital, Yuncheng Central Hospital, Zhejiang First Hospital, Zhejiang People’s Hospital, and Zhejiang Cancer Hospital) (Registration number: ChiCTR1800020329). Consent for publication: All authors approved the publication., (© 2025. The Author(s).)

The analysis of circulating tumour DNA (ctDNA) through minimally invasive liquid biopsies is promising for early multi-cancer detection and monitoring minimal residual disease. Most existing methods focus on targeted deep sequencing, but few integrate multiple data modalities. Here, we develop a methodology for ctDNA detection using deep (80x) whole-genome TET-Assisted Pyridine Borane Sequencing (TAPS), a less destructive approach than bisulphite sequencing, which permits the simultaneous analysis of genomic and methylomic data. We conduct a diagnostic accuracy study across multiple cancer types in symptomatic patients, achieving 94.9% sensitivity and 88.8% specificity. Matched tumour biopsies are used for validation, not for guiding the analysis, imitating an early detection scenario. Furthermore, in silico validation demonstrates strong discrimination (86% AUC) at ctDNA fractions as low as 0.7%. Additionally, we successfully track tumour burden and ctDNA shedding from precancerous lesions post-treatment without requiring matched tumour biopsies. This pipeline is ready for further clinical evaluation to extend cancer screening and improve patient triage and monitoring., Competing Interests: Competing interests: A.S. is on the advisory board for Janssen and BeiGene and is the Founder of SERENOx. She also receives research funding from AstraZeneca and Janssen and in-kind contributions from Illumina and Oxford Nanopore Technologies. BDN has received research funding from GRAIL and is an unpaid member of the GRAIL Clinical Advisory Group. D.V.V., A.C. and H.D. own shares in SerenOx. N.T., J.B., R.S., A.R., T.S., B.M., Y.B.L. and C.T. were employees at Exact Sciences Innovation LTD for the duration of the study. The remaining authors declare no competing interests., (© 2024. The Author(s).)

Cancer's heterogeneity presents significant challenges in accurate diagnosis and effective treatment, including the complexity of identifying tumor subtypes and their diverse biological behaviors. This review examines how feature selection techniques address these challenges by improving the interpretability and performance of machine learning (ML) models in high-dimensional datasets. Feature selection methods-such as filter, wrapper, and embedded techniques-play a critical role in enhancing the precision of cancer diagnostics by identifying relevant biomarkers. The integration of multi-omics data and ML algorithms facilitates a more comprehensive understanding of tumor heterogeneity, advancing both diagnostics and personalized therapies. However, challenges such as ensuring data quality, mitigating overfitting, and addressing scalability remain critical limitations of these methods. Artificial intelligence (AI)-powered feature selection offers promising solutions to these issues by automating and refining the feature extraction process. This review highlights the transformative potential of these approaches while emphasizing future directions, including the incorporation of deep learning (DL) models and integrative multi-omics strategies for more robust and reproducible findings.

Comprehensive genomic profiling (CGP) is increasingly used as a clinical laboratory test and being applied to cancer treatment; however, standardization and external quality assessments (EQA) have not been fully developed. This study performed cost-effective EQA and proficiency tests (PT) for CGP testing among multiple institutions those belong to the EQA working group of Japan Association for Clinical Laboratory Science (JACLS). This study revealed that preanalytical processes, such as derived nucleic acids (NA) extraction from formalin fixed paraffine embedded (FFPE) samples, are critical. First, EQA with extracted DNA from cell lines showed a detection rate of 100% (9 out of 9) in KRAS (c.38G > A; p.G13D), PIK3CA (p.H1047R), and B-Raf proto-oncogene, serine/threonine kinase (BRAF) (c.1799 T > A; p.V600E) in cases of > 10% variant allele frequency (VAF). However, BRAF (c.1799 T > A; p.V600E) detection decreased to 67% (6 out of 9) for a VAF of 4.9%. Second, when DNA was extracted from FFPE samples, pathogenic variants and variants with companion diagnostic indications were detected in all 10 participating laboratories. Each variant had < 20% VAFs on average (8.1-19.1%) and wide variability among laboratories was observed (relative standard deviation, 13-60%). Nonetheless, BRAF (c.1798&#95;1799delinsAA; p.V600K) of 8.1% VAF, EGFR (c.2235&#95;2249del; p.E746&#95;A750del) of 9.7% VAF, and EGFR (c.2254&#95;2277del; p.S752&#95;I759del) of 9.8% VAF were detected with 70% (7/10), 70% (7/10), and 60% (6/10) frequency, respectively. Therefore, 10% VAF in pre-analytic processing for DNA extraction from FFPE was critical for variant detection in CGP analysis. Further, incorrect results were reported in case independent variant calling of BRAF; c.1798&#95;1799delinsAA (p.V600K) was mistakenly interpreted as c.1798G > A, and c.1799 T > A was on the other strand. In conclusion, the EQA/PT among 10 institutes with common samples revealed the importance of VAF in pre-analysis and helped us understand the significance of the pipeline and common pitfalls usually ignored by the internal quality control in a single institute., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Neuropeptide Y (NPY) is a sympathetic neurotransmitter widely distributed in the peripheral and central nervous system, affecting many physiological functions. Consequently, dysregulation of the NPY system contributes to numerous pathological disorders, including stress, obesity, and cancer. The pleiotropic functions of NPY in humans are mediated by G protein-coupled receptors (Y1R, Y2R, Y5R), which activate several signaling pathways and thereby regulate cell growth, differentiation, apoptosis, proliferation, angiogenesis, and metabolism. These activities of NPY are highly relevant to tumor biology and known hallmarks of cancer, including sustained proliferative potential, resisting cell death, angiogenesis, invasion, and metastases. In this comprehensive review, we describe the cellular functions of NPY and discuss its role in cancer pathobiology, as well as provide the current state of knowledge pertaining to NPY and its receptors in various cancer types. Moreover, we focus on potential clinical applications targeting the NPY system, such as its role as a prognostic and predictive factor, as well as its utility in cancer diagnostics, imaging, and treatment. Altogether, growing evidence supports the significant role of the NPY system in tumor pathobiology and implicates its potential therapeutic and diagnostic value in modern oncology., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Cancer has emerged as a global health crisis, claiming millions of lives annually. Dendrimers and dendronized nanoparticles, a novel class of nanoscale molecules with highly branched three-dimensional macromolecular structures, have gained significant attention in cancer treatment and diagnosis due to their unique properties. These dendritic macromolecules offer a precisely controlled branching architecture, enabling functionalization with specific targeting molecules to enhance the selective delivery of therapeutic agents to tumor cells while minimizing systemic toxicity. Through surface modifications and the incorporation of various components, dendrimers demonstrate remarkable adaptability as nanocarriers for biomedical imaging and theranostic applications. Surface functionalization strategies, including PEGylation and ligand attachment (e.g., folic acid, RGD peptide, lactobionic acid), further enhance biocompatibility and facilitate targeted tumor cell imaging. Leveraging their improved biocompatibility and target specificity, dendritic nanosystems offer heightened sensitivity and precision in cancer diagnostics. Notably, the encapsulation of metal nanoparticles within dendrimers, such as gold nanoparticles, has shown promise in enhancing tumor imaging capabilities. Ongoing advancements in nanotechnology are poised to increase the sophistication and complexity of dendrimer-based systems, highlighting their potential as nanocarriers in drug delivery platforms, with a growing number of clinical trials on the horizon. This review provides a comprehensive overview of the potential and future prospects of dendrimers and dendrimer-based nanocarriers in targeted cancer therapy and diagnosis, exploring their ability to enhance biocompatibility, reduce toxicity, and improve therapeutic outcomes across various malignancies.

Background: Prenatal cell-free DNA (cfDNA) screening is a success story of clinical genomics that has translated to and transformed obstetric care. It is a highly sensitive and specific method of screening for the most common fetal aneuploidies, including trisomies 13, 18, and 21. While primarily designed to detect fetal chromosomal abnormalities, the test also analyzes maternal cfDNA, which can complicate interpretation of results. Occasionally, abnormalities in cfDNA that do not align with fetal aneuploidy may indicate benign or malignant maternal disease states, presenting unique diagnostic challenges and opportunities., Content: This review explores the methods and implications of incidental cancer detection through prenatal cfDNA screening. Early case reports noted instances in which abnormal cfDNA results, initially suggestive of fetal aneuploidies, led to post-pregnancy diagnoses of maternal cancers. Subsequent large retrospective studies have established significant correlations between atypical prenatal cfDNA results and undiagnosed maternal malignancies. Abnormal cfDNA profiles, particularly those indicating multiple aneuploidies, first require fetal diagnostic tests, such as amniocentesis. If the fetal studies are normal, further investigation into a maternal source should proceed. Clinical management of these findings may involve a multidisciplinary approach, incorporating advanced imaging techniques and genetic counseling to ensure timely and accurate maternal diagnoses., Summary: The integration of genome-wide analysis and innovative bioinformatics tools into prenatal cfDNA screening has enhanced its ability to identify potential cancer cases. Developing standardized guidelines for reporting and managing incidental findings is crucial to optimizing patient outcomes and mitigating psychological impacts on expectant persons and their partners., (Published by Oxford University Press on behalf of Association for Diagnostics & Laboratory Medicine 2025.)

With the rapid advancement of DNA technology, intelligent DNA nanoreactors (iDNRs) have emerged as sophisticated tools that harness the structural versatility and programmability of DNA. Due to their structural and functional programmability, iDNRs play an important and unique role in in vivo tumor diagnosis and therapy. This review provides an overview of the structural design methods for iDNRs based on advanced DNA technology, including enzymatic reaction-mediated and enzyme-free strategies. This review also focuses on how iDNRs achieve intelligence through functional design, as well as the applications of iDNRs for in vivo tumor diagnosis and therapy. In summary, this review summarizes current advances in iDNRs technology, discusses existing challenges, and proposes future directions for expanding their applications, which are expected to provide insights into the development of the field of in vivo tumor diagnostics and targeted therapies., (© 2024 Wiley-VCH GmbH.)

Comprehensive molecular profiling by next-generation sequencing has revolutionized tumor classification and biomarker evaluation. However, routine implementation is challenged by the scant nature of diagnostic material obtained through minimally invasive procedures. Here, we describe our long-term experience in profiling cytology samples with an in-depth assessment of the performance, quality metrics, biomarker identification capabilities, and potential pitfalls. We highlight the impact of several optimization strategies to maximize performance with 4,871 prospectively sequenced clinical cytology samples tested by MSK-IMPACT TM . Special emphasis is given to the use of residual supernatant cell-free DNA (ScfDNA) as a valuable source of tumor DNA. Overall, cytology samples are similar in performance to surgical samples in identifying clinically relevant genomic alterations, achieving success rates up to 93% with full optimization. While cell block (CB) samples have excellent performance overall, low-level cross-contamination is identified in a small proportion of cases (4.7%), a common pitfall intrinsic to the processing of paraffin blocks, suggesting that more stringent precautions and processing modifications should be considered in quality control initiatives. By contrast ScfDNA samples have negligible contamination. Finally, ScfDNA testing exclusively used as a rescue strategy, delivered successful results in 71% of cases where tumor tissue from CB was depleted., Competing Interests: Competing interests: C.V. reports intellectual property rights and equity interest in Paige.AI, Inc. A.R.B. has ownership/equity interests in Johnson and Johnson. M.B. has received advisory or consulting fees from AstraZeneca, Eli Lilly and Company, and PetDx, Inc. M.L. has received advisory or consulting fees from Takeda Oncology, Janssen Pharmaceuticals, AstraZeneca, ADC Therapeutics, Paige.AI, Merck, Bayer, and Lilly Oncology and has received research funding from Loxo Oncology, Helsinn Therapeutics, Merus NV, Elevation Oncology, and Rain Therapeutics. O.L. has received advisory or consulting fees from Hologic and Janssen Research & Development, LLC. M.A. has received advisory or consulting fees from Axis Medical Education, Clinical Education Alliance, LLC, Merck Sharp & Dohme, PeerView Institute for Medical Education (PVI), Physicians’ Education Resource, RMEI Medical Education, LLC, and Roche. The following Authors declare no competing interests: D.K., S.Y., S.N., K.N., R.F., N.R., I.R., J.C., and A.Y., (© 2024. The Author(s).)

Nucleic acids have enabled the fabrication of self-assemblies and dynamic operations. Among different functional nucleic acids, aptamers can specifically bind to a wide range of targets, including proteins, viral antigens, living cells and even tissues, and have thus emerged as molecular recognition tools in molecular medicine. Hence, aptamer-functionalized nucleic acid nanotechnology offers applications of biosensing, bioimaging, and cancer therapy. In this review, after a brief overview of nucleic acid nanotechnology, we focus on the integration of aptamers with nucleic acid nanotechnology, including self-assembly constructions and dynamic molecular manipulations. The emerging applications in molecular medicine are subsequently reviewed with aptamer-based self-assemblies and aptamer-involved dynamic molecular manipulation. For convenience, applications are broadly categorized into biosensing, bioimaging, and cancer therapy. Finally, challenges and potential development of nucleic acid nanotechnology are discussed.

Objective: Cancer remains a leading cause of morbidity and mortality globally, with India experiencing a significant cancer burden. Effective population-based cancer screening is crucial for early detection and reduction of cancer-related deaths. This study aims to develop a mobile application-based Cancer Screening and Surveillance System (CSMS) to enhance the efficiency and effectiveness of population-based cancer screening by community health workers (CHWs)., Methods: An applied research approach was employed, integrating traditional cancer screening procedures with a newly developed mobile application system. The CSMS includes an Android-based mobile application and a web portal designed for real-time data collection, monitoring, and rapid referral of screen-positive cases. The system was piloted in the Cachar district of Assam and training sessions were conducted to equip CHWs with traditional cancer screening procedures and the necessary skills to utilize the mobile application for cancer screening.  199 CHWs were trained and screened eligible population of 73,630 individuals., Results: The mobile application facilitated efficient data collection and synchronization with a central server, enabling timely referrals and follow-ups. The system supported comprehensive data management, ensuring patient privacy and data security. The pilot implementation demonstrated improved screening coverage and streamlined referral processes, highlighting the system's potential to enhance cancer screening programs., Conclusion: Mobile application-based Cancer Screening and Surveillance System provides a cost-effective and robust solution for population-based cancer screening. The developed system can improve data accuracy, facilitate timely referral and aid in early detection of cancer. Further studies should be conducted to evaluate the impact of the developed system and its scalability in more diverse settings.

Cancer remains a formidable global health challenge, necessitating the development of innovative diagnostic techniques capable of early detection and differentiation of tumor/cancerous cells from their healthy counterparts. This review focuses on the confluence of advanced computational algorithms with noninvasive, label-free impedance-based biophysical methodologies-techniques that assess biological processes directly without the need for external markers or dyes. This review elucidates a diverse array of state-of-the-art impedance-based technologies, illuminating distinct electrical signatures inherent to cancer vs healthy tissues. Additionally, the study probes the transformative potential of these diagnostic modalities in recalibrating personalized cancer treatment paradigms. These modalities offer real-time insights into tumor dynamics, paving the way for precision-guided therapeutic interventions. By emphasizing the quest for continuous in vivo monitoring, these techniques herald a pivotal advancement in the overarching endeavor to combat cancer globally., (© 2025 Bioelectromagnetics Society.)

Objective: This study aimed to investigate the mortality, survival rates, and prognostic indicators of cancer occurrence after Sjögren's syndrome (SS-CA)., Methods: The medical records of patients with SS-CA at the Peking Union Medical College Hospital (PUMCH) between January 2010 and August 2022 were retrieved. Clinical data and survival outcomes were compared to controls. The standard mortality ratio (SMR) versus the general population was calculated, and the survival and predictive markers of prognosis were analyzed using Kaplan-Meier curves and Cox regression., Results: In total, 114 SS-CA patients were included, with a median follow-up time of 105.1 (57.3-168.0) months. Non-Hodgkin lymphoma (32, 28.1%) was the most common cancer in patients with SS-CA. The SMR of SS-CA patients was 2.61 (95% confidence interval [CI] 1.73-3.77). Patients with SS-CA exhibited significantly inferior outcomes compared to controls (p = 0.010), with 5- and 10-year overall survival rates of 91.2% and 83.2%, respectively. SS patients with a diagnostic interval between SS and cancer (SS-CA diagnostic interval) ≤ 3 years or with hematological malignancies had poorer survival compared to those with a diagnostic interval > 3 years (p < 0.001) or with solid tumors (p = 0.019). Multivariate Cox regression analysis identified the prognosis-associated factors of SS-CA as age at SS diagnosis > 50 years (HR 3.129, 95% CI 1.224-7.998; p = 0.017), SS-CA diagnostic interval ≤ 3 years (HR 7.754, 95% CI 1.953-30.781; p = 0.004), and hematological malignancies (HR 2.648, 95% CI 1.201-5.838; p = 0.016)., Conclusion: Malignant comorbidities constituted a poor prognosis in patients with SS, wherein the SS-CA diagnostic interval and the types of cancer were associated with survival., (© 2025 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Aim: The exosomal programmed death ligand-1(exoPD-L1) has recently become a topic of interest in the field of oncology. But the prognostic role of exoPD-L1 in cancer patients is inconsistent across previous studies. Therefore, a quantitative meta-analysis was performed to evaluate the prognostic and clinicopathological value of exoPD-L1 in cancer patients., Materials and Methods: Twenty eligible studies were included in this study. The relationship between baseline level of exoPD-L1 and clinicopathological features, therapeutic response, overall survival (OS) and progression-free survival (PFS) was evaluated., Results: Pooled analysis indicated that high level of exoPD-L1 was significantly associated with higher tumor stage, positive lymph node metastasis, and advanced TNM stage. Elevated exoPD-L1 was associated with short OS [HR = 1.80 (1.27-2.55), p  = 0.001]. In the subgroup analysis, high-level exoPD-L1 was consistently associated with poor OS in sample source, detection method, and lymphoma patients. Moreover, elevated exoPD-L1 was predictive of worse PFS [HR = 1.28 (1.13-4.18), p  = 0.000]. In addition, a striking difference between cancer patients and healthy donors was observed in the level of exoPD-L1., Conclusion: exoPD-L1 is an original and effective liquid biomarker for cancer patients. However, large-scale, prospective investigations are still needed to confirm our findings.

Hypoxia, caused by rapid tumor growth and insufficient oxygen supply, is a defining characteristic of numerous solid tumors and exerts a significant influence on tumor growth, metastasis, and invasion. Early diagnosis and effective killing of tumor cells are crucial for cancer treatment. In recent years, the emergence of nanomaterials has overcome the difficulties in the delivery of chemotherapeutic drugs and contrast agents to tumor area. In this review, we summarize the development of hypoxia-responsive nanoparticles for fluorescence imaging and tumor therapy in the last five years, and further discuss their design strategies and applications in bioimaging. In addition, we discuss the therapeutic strategies of hypoxia-responsive prodrugs on different nanoplatforms and the future prospects of hypoxia-responsive nanomedicine in tumor therapy., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

The advent of multiomics has ushered in a new era of cancer research characterized by integrated genomic, transcriptomic and proteomic analysis to unravel the complexities of cancer biology and facilitate the discovery of novel biomarkers. This chapter provides a comprehensive overview of the concept of multiomics, detailing the significant advances in the underlying technologies and their contributions to our understanding of cancer. It delves into the evolution of genomics and transcriptomics, breakthroughs in proteomics, and overarching progress in multiomic methodologies, highlighting their collective impact on cancer biomarker discovery. Furthermore, this chapter explores the computational methods essential for multiomic studies, including clustering techniques for delineating cancer subtypes, strategies for estimating molecular features and activities, and utility of pathway enrichment analyses for interpreting multiomic datasets. Particular focus has been placed on the application of these methods for identifying distinct cancer subtypes, thereby enabling a more personalized approach to cancer treatment. Through a detailed discussion of the scientific principles, technological advancements, and practical applications of multiomics, this chapter aims to underscore the pivotal role of multiomics in advancing cancer research and paving the way for personalized medicine. The insights provided herein not only illuminate the current landscape of cancer biomarker discovery, but also forecast future directions of multiomics research in oncology, advocating for a more integrated and nuanced approach to understanding and combating cancer., (Copyright © 2025. Published by Elsevier Inc.)

Cancer-derived small extracellular vesicles (sEVs) in body fluids hold promise as biomarkers for cancer diagnosis. For sEV-based liquid biopsy, isolation of sEVs with a high-purity and cancer-sEV detection with an extremely high sensitivity are essential because body fluids include much higher density of normal-cell-derived sEVs and other biomolecules and bioparticles. Here, we propose an isolation-analysis-integrated cancer-diagnosis platform based on dielectrophoresis(DEP)-ELISA technique which enables a three orders of magnitude higher sensitivity over conventional ELISA method and direct cancer diagnosis from blood plasma with high accuracy. The limit of detection (LOD) for sEVs in human plasma was as low as 10 4 sEVs/mL without a time-consuming and low-yield sEV isolation and purification process. The capability of this platform was validated by monitoring mice with cancer cell inoculation and assessing the effect of cancer-sEV-inhibiting drug. Using the developed sEV-based liquid biopsy, we diagnosed clinical samples from healthy donors (N = 39) and cancer patients (N = 90). The diagnostic accuracy was 94.2%, 98.6%, and 91.3% for breast, colon, and lung cancers, respectively. This integrated sEV isolation and analysis platform could be applied for high-sensitivity biomarker profiling and sEV-based liquid biopsy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: To assess population-based quality of cancer care in sub-Saharan Africa and to identify specific gaps and joint opportunities, we assessed concordance of diagnostics and treatments with National Comprehensive Cancer Network Harmonized Guidelines for leading cancer types in 10 countries., Methods: Adult patients with female breast cancer, cervical cancer, colorectal cancer, non-Hodgkin lymphoma, and prostate cancer were randomly drawn from 11 population-based cancer registries. Guideline concordance of diagnostics and treatment was assessed using clinical records. In a subcohort of 906 patients with potentially curable cancer (stage I-III breast cancer, cervical cancer, colorectal cancer, prostate cancer, aggressive non-Hodgkin lymphoma [any stage]) and documentation for more than 1 month after diagnosis, we estimated factors associated with guideline-concordant treatment or minor deviations., Results: Diagnostic information based on guidelines was complete for 1030 (31.7%) of a total of 3246 patients included. In the subcohort with curable cancer, guideline-concordant treatment was documented in 374 (41.3%, corresponding to 11.7% of 3246 patients included in the population-based cohort): aggressive non-Hodgkin lymphoma (59.8%/9.1% population based), breast cancer (54.5%/19.0%), prostate cancer (39.0%/6.1%), colorectal cancer (33.9%/9.5%), and cervical cancer (27.8%/11.6%). Guideline-concordant treatment was most frequent in Namibia (73.1% of the curable cancer subcohort/32.8% population based) and lowest in Kampala, Uganda (13.5%/3.1%). Guideline-concordant treatment was negatively associated with poor ECOG-ACRIN performance status, locally advanced disease stage, origin from low Human Development Index countries, and a diagnosis of colorectal cancer or cervical cancer., Conclusions: The quality of diagnostic workup and treatment showed major deficits, with considerable disparities among countries and cancer types. Improved diagnostic services are necessary to increase the share of curable cancer in sub-Saharan Africa. Treatment components within National Comprehensive Cancer Network Guidelines for several cancers should be prioritized., (© The Author(s) 2024. Published by Oxford University Press.)

To a certain extent, theranostic nanoplatforms promote tumor treatment efficiency. However, timely monitoring of the critical stages and signal sustainability of the entire process is challenging. In this study, multi-chambered core/shell magnetic nanoparticles (MC-MNPs) as drug and imaging agent multi-loaded nanocarriers with a synergistic release function are reported. Supraparticles with stable chambers are formed by the supercooling self-assembly of several core/shell magnetic nanoparticles composed of amphiphilic copolymers as the core and hydrophilic magnetic iron oxide nanoparticles as the shell. Desalinized doxorubicin and coumarin 6 are stored in different cavities of nanocarriers, and chitosan is used as an outer encapsulation layer. Based on their construction properties, MC-MNPs can exhibit gradient-degraded and steady-released controllability in the tumor environment. Furthermore, real-time accumulation situations and full-time diagnostic signals of nanocarriers are thoroughly demonstrated using fluorescence imaging and T 2 -weighted magnetic resonance imaging before and after magnetic hyperthermia in targeted tumors under an alternating magnetic field. Thus, MC-MNPs as theranostic nanocarriers exhibit great potential for the timely monitoring and full-time guidance of tumor treatment., (© 2024 Wiley‐VCH GmbH.)

Exosomes, measuring between 30 and 150 nm in diameter, are small vesicles enclosed by a lipid bilayer membrane. They are released by various cells in the body and carry a diverse payload of molecules, including proteins, lipids, mRNA, and different RNA species such as long non-coding RNA, circular RNA, and microRNA (miRNA). With lengths of approximately 19-22 nucleotides, miRNAs constitute the predominant cargo in exosomes and serve as crucial regulators of protein biosynthesis. In cancer detection, exosomal miRNAs show promise as non-invasive biomarkers due to their stability and presence in various bodily fluids, aiding in early detection and precise diagnosis with specific miRNA signatures linked to different cancer types. Moreover, exosomal miRNAs influence treatment outcomes by affecting cellular processes like cell growth, cell death, and drug resistance, thereby impacting response to therapy. Additionally, they serve as indicators of disease progression and treatment response, providing insights that can guide treatment decisions and improve patient care. Through longitudinal studies, changes in exosomal miRNA profiles have been observed to correlate with disease progression, metastasis, and response to therapy, highlighting their potential for real-time monitoring of tumor dynamics and treatment efficacy. Understanding the intricate roles of exosomal miRNAs in cancer biology offers opportunities for developing innovative diagnostic tools and therapeutic strategies tailored to individual patients, ultimately advancing precision medicine approaches and improving outcomes for cancer patients. This review aims to provide an understanding of the role of exosomal miRNAs in cancer detection, treatment, and monitoring, shedding light on their potential for revolutionising oncology practices and patient care., Competing Interests: Declarations. Conflict of interest: The authors have no relevant financial or non-financial interests to disclose. Ethical approval and informed consent: The present study did not involve human participants, their data or biological material at any step of the process, in any way; thus ethical approval and informed consent do not apply to this study., (© 2024. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)

Objectives: This study aimed to explore the policy implementation of non-specific symptom pathways within the English National Health Service., Methods: A multi-site ethnographic project was conducted in four hospitals that contained non-specific symptom pathways between November 2021 and February 2023. The research involved observation (44 h), interviews ( n = 54), patient shadowing, and document review., Results: The study examined how the policy concept of 'holistic' care was understood and put into practice within four non-specific symptom pathways. Several challenges associated with providing holistic care were identified. One key challenge was the conflict between delivering holistic care and meeting timed targets, such as the Faster Diagnosis Standard, due to limited availability of imaging and diagnostic tools. The interpretation of a holistic approach varied among participants, with some acknowledging that the current model did not recognise holistic care beyond cancer exclusion. The findings also revealed a lack of clarity and differing opinions on the boundaries of holistic care, resulting in wide variation in NSS pathway implementation across health care providers. Additionally, holistic investigation of non-specific symptoms in younger patients were seen to pose difficulties due to younger patients' history of health anxiety or depression, as well as concerns over radiological risk exposure., Conclusions: The study highlights the complexity of implementing non-specific symptom pathways in light of standardised timed cancer targets and local cancer policies. There is a need for appropriately funded organisational models of care that prioritise holistic care in a timely manner over solely meeting cancer targets. Decision-makers should also consider the role of non-specific symptom pathways within the broader context of chronic disease management, with a particular emphasis on expanding diagnostic capacity., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Transforming Growth Factor-beta (TGF-β) is a multifunctional cytokine that exerts its biological effects through a complex process of activation and signaling. Initially synthesized in an inactive form bound to latency-associated peptide (LAP), TGF-β requires release from the extracellular matrix via proteolytic cleavage or integrin-mediated activation to engage with its receptors. Once active, TGF-β binds to type II receptor (TβRII), which then phosphorylates and activates type I receptor (TβRI), triggering downstream signaling cascades, including both Smad-dependent and non-Smad pathways. These signaling cascades regulate key processes like cell growth, differentiation, migration, and immune response modulation, thereby influencing tumor development, progression, and treatment outcomes. This review discusses the complex signaling pathways of TGF-β in cancer, including its interactions with other signaling molecules and its involvement in epithelial-mesenchymal transition (EMT) and in evading immune surveillance. Moreover, dysregulated TGF-β signaling due to alterations in receptor expression, mutations in key signaling proteins such as TβRII and Smads, and aberrant activation of non-canonical pathways, contributes significantly to tumor aggressiveness, metastasis, and therapy resistance. The article emphasizes the potential of TGF-β as a diagnostic biomarker for cancer, highlighting its use in early detection, prognosis assessment, and monitoring treatment response. Additionally, it underscores various therapeutic strategies targeting TGF-β, such as small molecule inhibitors, monoclonal antibodies, immunotherapies, and evaluates their efficacy and limitations in preclinical and clinical settings. Finally, the review provides a comprehensive analysis of TGF-β's role as both a diagnostic tool and a therapeutic target, while also discussing the challenges and opportunities in targeting TGF-β signaling for improving cancer treatment outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: Physical activity (PA) can improve cancer survival; however, whether the timing of PA differentially affects mortality risk is unclear. We evaluated the association between PA levels pre- and post-diagnosis and mortality risk in the Women's Health Study (WHS), Physicians' Health Study (PHS)-I, and PHS-II prospective cohorts., Methods: We categorized PA pre- and post-diagnosis as active (WHS: ≥ 7.5 metabolic equivalent (MET)-h/week; PHS: vigorous PA ≥ 2-4 times/week) or inactive. We analyzed changes in pre- and post-diagnosis PA levels as four joint categories: (1) Inactive → Inactive, (2) Active → Inactive, (3) Inactive → Active, and (4) Active → Active, on mortality risk using multivariable Cox proportional hazards regression., Results: We identified 10,541 participants with incident cancer and 3,696 deaths during follow-up. Compared to maintaining inactivity in both periods, remaining active pre- and post-diagnosis observed lower all-cause (Hazard Ratio [95% confidence interval]: WHS: 0.55 [0.47-0.64]; PHS-I: 0.77 [0.67-0.88]), cancer (WHS: 0.55 [0.45-0.67]; PHS-I: 0.75; [0.61-0.92]) and non-cancer/cardiovascular disease (CVD) mortality risks (WHS: 0.49 [0.38-0.65]). Similarly, becoming active post-diagnosis was associated with lower all-cause (WHS: 0.60 (0.48-0.75]; PHS-I: 0.72 [0.61-0.88]), cancer (WHS: 0.65 [0.49-0.86]; PHS-I: 0.64 [0.49-0.84]), and non-cancer/CVD mortality risk (WHS: 0.49 [0.33-0.75]). Being active pre- and post-diagnosis was associated with lower mortality risks in separate analyses, although significance differed by cohort and outcome., Conclusions: Remaining active pre- and post-diagnosis and becoming active post-diagnosis may be associated with improvements in cancer survival, however, research is needed across diverse cancer populations., Competing Interests: Declarations. Competing interests: The authors have no relevant financial or non-financial interests to disclose. Ethical approval: This is an observational study. Study approvals for the WHS, PHS-I, and PHS-II were obtained by the institutional review board (IRB) of the Mass General Brigham. This analysis did not require ethical approval. Consent to participate: Informed consent was obtained from all individual participants in the WHS, PHS-I, and PHS-II. Study approvals were obtained by the institutional review board IRB of the Mass General Brigham. Consent to publish: N/A., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)