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Prostate cancer (PCa) is a major health concern in Sub-Saharan Africa (SSA), with high incidence and mortality rates. However, the widely used prostate-specific antigen (PSA) screening is not readily available or affordable in SSA. Alternative screening strategies, such as risk stratification approaches and cost-effective PSA tests, are being explored to target high-risk individuals and improve access to screening. Diagnosis of PCa in SSA is challenging due to the lack of access to diagnostic tools and limited healthcare resources. Clinical evaluation and digital rectal examination are commonly used, but PSA testing, magnetic resonance imaging, and biopsy are often limited. As a result, many men in SSA are diagnosed at advanced stages of the disease. Treatment options for PCa in SSA are often limited by a lack of resources and trained healthcare providers. Surgery, radiation therapy, and androgen-deprivation therapy are available but may be inaccessible to many patients. Cultural beliefs and stigma surrounding PCa further impact treatment decisions. Improved patient and community awareness, electronic medical records, and communication between patients and healthcare professionals can enhance evidence-based decision-making and advocate for policy changes. Understanding the genetic determinants and implementing comprehensive strategies can lead to improved outcomes and better control of PCa in SSA., (© 2023 BJU International.)

Purpose: Globally, there were 19.3 million new cancer cases and 10 million cancer deaths, with the African continent contributing approximately 1.1 million new cases and over 700,000 deaths to the global cancer burden in 2020. High quality research is required to understand the etiology and risk factors for common cancers in the region to develop context specific strategies aimed at minimizing the future cancer burden in Africa. Our study addresses a significant gap in the knowledge and resources available for training a project management (PM) workforce for cancer research in Africa., Methods: We developed and evaluated a training program to strengthen the research capacity of project managers involved in cancer research in Africa. This workshop was held in collaboration with the Men of African Descent and Carcinoma of the Prostate (MADCaP) Consortium. The PM working group of the MADCaP Consortium had previously developed a project manager toolkit to provide a structured approach to PM for cancer research in Africa. We implemented and evaluated this training toolkit in a hybrid workshop in Nigeria., Results: Among 29 participants from 10 African institutions, PM skills improved after training by 16.6% compared with pretraining levels. In a 1-year follow-up survey, training skills remained better (80.8%) than before the training (70.8%). The training program successfully upskilled the trainees with a significant improvement in knowledge of PM practices including planning, execution, monitoring, and evaluation of projects. The majority (80%) reported an excellent training experience., Conclusion: PM skills training can be successfully implemented in Africa with long-term retention of knowledge geared toward developing a workforce critical for the implementation of cancer research in the region.

Men of African descent have the highest prostate cancer incidence and mortality rates, yet the genetic basis of prostate cancer in African men has been understudied. We used genomic data from 3,963 cases and 3,509 controls from Ghana, Nigeria, Senegal, South Africa and Uganda to infer ancestry-specific genetic architectures and fine-map disease associations. Fifteen independent associations at 8q24.21, 6q22.1 and 11q13.3 reached genome-wide significance, including four new associations. Intriguingly, multiple lead associations are private alleles, a pattern arising from recent mutations and the out-of-Africa bottleneck. These African-specific alleles contribute to haplotypes with odds ratios above 2.4. We found that the genetic architecture of prostate cancer differs across Africa, with effect size differences contributing more to this heterogeneity than allele frequency differences. Population genetic analyses reveal that African prostate cancer associations are largely governed by neutral evolution. Collectively, our findings emphasize the utility of conducting genetic studies that use diverse populations., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Ayun Cassell III,1,2 Mohamed Jalloh,1 Medina Ndoye,1 Mouhamadou Mbodji,1 Oumar Gaye,1 Ngor Mack Thiam,1 Abdourahmane Diallo,1 Issa Labou,1 Lamine Niang,1 Serigne Gueye1 1Department of Urology and Andrology, Hospital General De Grand Yoff, Dakar, Senegal; 2Department of Surgery, Liberia College of Physicians and Surgeons, Monrovia, LiberiaCorrespondence: Ayun Cassell IIIDepartment of Urology and Andrology, Hospital General De Grand Yoff, Dakar, SenegalTel +221770135805Email ayuncasselliii@gmail.comAbstract: Urolithiasis is a global pathology with increasing prevalence rate. The lifetime recurrence of urolithiasis ranges from 10– 75% creating a public health crisis in affected regions. The epidemiology of urolithiasis in most parts of Africa and Asia remains poorly documented as incidence and prevalence rates in these settings are extrapolated from hospital admissions. The surgical management of kidney and ureteral stones is based on the stone location, size, the patient’s preference and the institutional capacity. To date, the available modalities in the management of urolithiasis includes external shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy (URS) including flexible and semirigid ureteroscopy. However, regarding the lack of endourological equipment and expertise in most parts of Sub-Saharan Africa (SSA), most urological centers in these regions still consider open surgery for kidney and ureteral stones. This review explores the current trend and surgical management of upper tract urolithiasis in SSA with insight on the available clinical guidelines.Keywords: endourology, kidney stones, ureteral stones, urolithiasis

Ayun Cassell,1 Mohamed Jalloh,1 Medina Ndoye,1 Bashir Yunusa,2 Mouhamadou Mbodji,1 Abdourahmane Diallo,1 Omar Gaye,1 Issa Labou,1 Lamine Niang,1 Serigne Gueye1 1Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal; 2Department of Surgery, Liberia College of Physicians and Surgeons, Monrovia, LiberiaCorrespondence: Ayun CassellDepartment of Urology and Andrology, Hopital General de Grand Yoff, Dakar, SenegalTel +221770135805Email ayuncasselliii@gmail.comAbstract: Testicular cancer is a common malignancy in young males with higher incidence in developed nations but with the lowest incidence in Africa (0.3– 0.6/100 000). Ironically, the global testicular cancer mortality rate has shown a reverse trend to its incidence with higher rates in low- and middle-income countries (0.5 per 100 000) than in high-income countries. Data from GLOBOCAN 2008 have shown relatively high mortality rates in sub-Saharan countries like Mali, Ethiopia, Niger and Malawi. The prognosis of testicular tumor is good with remarkable chemosensitivity to cisplatin-based regimen. Early diagnosis, careful staging and a multidisciplinary management approach is crucial to achieve this optimal result. These results are achievable in the sub-Saharan region if the relevant resources are appropriated for cancer care and clinical guidelines are formulated in a regional context.Keywords: germ cell, orchidectomy, testicular cancer

Background African American (AA) men suffer a higher prostate cancer (PCa) burden than other groups. Objective We aim to determine the impact of race on the risk of upgrading, upstaging, and positive surgical margins (PSM) at radical prostatectomy (RP) among men eligible for active surveillance. Design, setting, and participants We studied men with low-risk PCa treated with RP at two centers. Low clinical risk was defined by National Comprehensive Cancer Network criteria. Outcome variables were upgrading, upstaging, and PSMs at surgery. Associations between race and the outcomes were evaluated with logistic regression adjusted for age, relationship status, diagnostic prostate-specific antigen level, percentage of positive biopsy cores, surgical approach, year of diagnosis, and clinical site. Results and limitations Of 9304 men diagnosed with PCa, 4231 were low risk and underwent RP within 1 yr. Men were categorized as AA (n = 273; 6.5%), Caucasian (n = 3771; 89.1%), or other racial/ethnic group (Other; n = 187; 4.4%). AA men had a significantly younger mean age (58.7 yr; standard deviation: ±7.06), and fewer (85%) were married or had a partner. Upgrading (34%) and upstaging (13%) rates did not significantly differ among the groups. The PSM rate was significantly higher in AA men (31%) than in the Caucasian (21%) and Other (20%) groups (p < 0.01). We found an association between race group and PSM rate (p < 0.03), with higher odds of PSMs in AA men versus Caucasian men (odds ratio [OR]: 1.64; 95% confidence interval [CI], 1.08-2.47). No statistically significant associations between race and rates of upgrading and upstaging were found. This study was limited by the relatively low proportion of AA men in the cohort. Conclusions Among clinically low-risk men who underwent RP, AA men had a higher likelihood of PSMs compared with Caucasian men. We did not find statistically significantly different rates of upgrading and upstaging between the race groups. Patient summary We analyzed two large groups of men with what appeared to be low-risk prostate cancer based on the initial biopsy findings. The likelihood of finding worse disease (higher grade or stage) at the time of surgery was similar across different racial groups.

Introduction: Over the last few decades, there has been an increase in the use of a minimally invasive (MIS) approach for complex hernias involving component separation. A robotic platform provides better visualization and mobilization of tissues for component separation. We aim to assess the outcomes of open and robotic-assisted approaches for large VHR utilizing the ACHQC national database., Methods: A retrospective review of prospectively collected data from the Abdominal Core Health Quality Collaborative (ACHQC) was performed to include all adult patients who had primary and incisional midline ventral hernias larger than 10 cm and underwent elective open and robotic hernia repairs with mesh from January 2013 to March 2023. Univariate and multivariate analyses were performed comparing Open and Robotic approaches., Results: The ACHQC database identified 5,516 patients with midline hernias larger than 10 cm who underwent VHR. The open group (OG) had 4,978 patients, and the robotic group (RG) had 538. The RG had a higher median BMI (33.3 kg/m 2 (IQR 29.8-38.1) vs 32.7 (IQR 28.7-36.6) (p < 0.001). Median hernia width was 15 cm (IQR 12-18) in the OG and 12 cm in the RG (10-14) (p < 0.001). Sublay positioning of the mesh was the most common. The fascial closure was higher in the RG (524; 97% versus 4,708; 95%-p = 0.005). Median Length of Stay (LOS) was 5 days (IQR 4-7) in the OG and 2 days (IQR 1-3) in the RG (p < 0.001). The readmission rate was higher in the OG (n = 374; 7.5% vs n = 16; 3%; p < 0.001). 30-day SSI were higher in the OG (343; 6.9%% vs 14; 2.6%; p < 0.001). Logistic regression analysis identified diabetes (OR 1.6; CI 1.1-2.1; p = 0.006) and BMI (OR 1.04, CI 1.02-1.06; p < 0.001) as predictors of SSIs, while the robotic approach was protective (OR 0.35, CI 0.17-0.64; p = 0.002). For SSO, logistic regression showed BMI (OR 1.04, CI 1.03-1.06; p < 0.001) and smoking (OR 1.8, CI 1.3-2.4; p < 0.001) as predictors Robotic approach was associated with lower readmission rates (OR .04, CI 0.2-0.6; p < 0.001)., Conclusion: A robotic approach improves early 30-day outcomes compared to an open technique for large VHR. There was no difference in SSO at 30 days., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

We conducted a multi-ancestry genome-wide association study of prostate-specific antigen (PSA) levels in 296,754 men (211,342 European ancestry; 58,236 African ancestry; 23,546 Hispanic/Latino; 3,630 Asian ancestry; 96.5% of participants were from the Million Veteran Program). We identified 318 independent genome-wide significant (p≤5e-8) variants, 184 of which were novel. Most demonstrated evidence of replication in an independent cohort (n=95,768). Meta-analyzing discovery and replication (n=392,522) identified 447 variants, of which a further 111 were novel. Out-of-sample variance in PSA explained by our genome-wide polygenic risk scores ranged from 11.6%-16.6% in European ancestry, 5.5%-9.5% in African ancestry, 13.5%-18.2% in Hispanic/Latino, and 8.6%-15.3% in Asian ancestry, and decreased with increasing age. Mid-life genetically-adjusted PSA levels were more strongly associated with overall and aggressive prostate cancer than unadjusted PSA. Our study highlights how including proportionally more participants from underrepresented populations improves genetic prediction of PSA levels, offering potential to personalize prostate cancer screening.

Objective: In Ghana, the shifting demographics of stroke incidence towards young adults have prompted the expansion of stroke care and rehabilitation efforts. Nevertheless, the precise impact of stroke rehabilitation remains unclear. We conducted a systematic review to explore the landscape and effects of stroke rehabilitation in Ghana., Method: We identified articles on stroke rehabilitation services in Ghana through searches of PubMed, Scopus, Embase, and Web of Science from inception until February 2024. The Critical Appraisal Skills Programme (CASP) Qualitative Checklist was employed to assess the risk of bias in the included studies, supplemented by qualitative synthesis., Results: Among the 213 articles screened, 8 were deemed suitable for review. These studies primarily focused on two groups: stroke survivors (n = 335) and healthcare professionals (HCPs) (n = 257). Many stroke survivors reported significant benefits from telerehabilitation, with increased participation in rehabilitation activities correlating with improved physical and cognitive outcomes. The findings also underscored a lack of knowledge about stroke rehabilitation among HCPs, alongside variations in the availability of protocols and guidelines for stroke management across different hospital levels., Conclusions: The review reveals several challenges in stroke rehabilitation in Ghana, including disparities in HCPs' perceptions and utilization of rehabilitation services. The findings emphasize the need for comprehensive, patient-centered approaches, standardized training for HCPs, improved resource allocation, and the integration of telehealth to overcome barriers and enhance stroke rehabilitation in Ghana. These insights hold significance not only for Ghana but also for guiding strategies in similar contexts worldwide, aiming to improve stroke rehabilitation outcomes., Competing Interests: Declaration of competing interest The authors of this manuscript declare no conflict of interest, (Copyright © 2024 Elsevier Inc. All rights reserved.)

The provision of specialized spine care in Nigeria presents a pressing challenge amid limited resources and geographical disparities. This correspondence offers a comprehensive roadmap for improving spine surgery and care within the country. We examine the current state of spinal health infrastructure, highlighting barriers such as limited access to specialists and facilities, particularly in rural areas, and financial constraints for patients. Innovations in spinal treatment, including the adoption of minimally invasive techniques and advancements in surgical modalities, are discussed alongside persistent challenges such as disparities in access and equipment costs. Training and education of spine surgeons emerge as critical areas requiring attention, with a shortage of qualified professionals exacerbated by inadequate training programs and resource constraints. We advocate for fostering local and international collaborations to address these gaps, emphasizing the role of partnerships in capacity building and knowledge exchange. Additionally, we explore the potential of public-private partnerships and investments to enhance the Nigerian spine healthcare system, calling for strategic initiatives to modernize infrastructure and improve accessibility. Finally, we propose a strategic blueprint encompassing infrastructure enhancement, training programs, research initiatives, policy advocacy, and public awareness campaigns. Through concerted efforts from local stakeholders and international partners, we envision a future where spine care in Nigeria is comprehensive, accessible, and of high quality, leading to improved health outcomes and a higher quality of life for those affected by spinal conditions., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The Woven Endobridge (WEB) device is an FDA-approved intrasaccular flow disruptor to treat most intracranial wide-necked bifurcation aneurysms. 1 Based on the rising experience with safe and effective results, it has been increasingly utilized for the treatment of residual and recurrent aneurysms. 2, 3 Additionally, the device has been reported as an off-label treatment option for Posterior communicating (Pcom) artery aneurysms with optimal morphology. 4 A transfemoral or transradial artery access is conventionally utilized for WEB embolization. 1- 3 In this technical video, we share our experience with the use of direct carotid puncture to perform WEB embolization for a large recurrent Pcom aneurysm in an elderly female with a history of subarachnoid hemorrhage that was initially treated with surgical clipping. A direct puncture of the left common carotid artery (CCA) under ultrasound guidance was performed after failed attempts to select the left ICA via both transfemoral and transradial access due to type 3 aortic arch and extreme tortuosity of the proximal left CCA. The aneurysm was successfully treated with a 5 mm × 2 mm WEB SL device. There are limited studies of transcarotid access for neurointerventional procedures including mechanical thrombectomy, intracranial stent placement etc. 5, 6 To the best of our knowledge, this technical video represents the first documented report of WEB embolization via transcarotid access. We aim to highlight the feasibility of transcarotid arterial access for WEB embolization as an effective bailout strategy. In addition, the nuances of direct carotid puncture along with possible complications, and potential management strategies have been discussed., Competing Interests: Declaration of conflicting interestsDr. David Altschul is a consultant for Microvention. No other personal or institutional conflicts of interests to disclose.

Purpose: Prostate cancer disproportionately affects men of African descent, yet their representation in tissue-based studies is limited. This multinational, multicenter pilot study aims to establish the groundwork for collaborative research on prostate cancer in sub-Saharan Africa., Methods: The Men of African Descent and Carcinoma of the Prostate network formed a pathologist working group representing eight institutions in five African countries. Formalin-fixed paraffin-embedded prostate tissue specimens were collected from Senegal, Nigeria, and Ghana. Histology slides were produced and digitally scanned. A central genitourinary pathologist (P.L.) and eight African general pathologists reviewed anonymized digital whole-slide images for International Society of Urological Pathology grade groups and other pathologic parameters. Discrepancies were re-evaluated, and consensus grading was assigned. A virtual training seminar on prostate cancer grading was followed by a second assessment on a subcohort of the same tissue set., Results: Of 134 tissue blocks, 133 had evaluable tissue; 13 lacked cancer evidence, and four were of insufficient quality. Post-training, interobserver agreement for grade groups improved to 56%, with a median Cohen's quadratic weighted kappa of 0.83 (mean, 0.74), compared with an initial 46% agreement and a quadratic weighted kappa of 0.77. Interobserver agreement between African pathologist groups was 40%, with a quadratic weighted kappa of 0.66 (95% CI, 0.51 to 0.76). African pathologists tended to overgrade (36%) more frequently than undergrade (18%) compared with the reference genitourinary pathologist. Interobserver variability tended to worsen with a decrease in tissue quality., Conclusion: Tissue-based studies on prostate cancer in men of African descent are essential for a better understanding of this common disease. Standardized tissue handling protocols are crucial to ensure good tissue quality and data. The use of digital slide imaging can enhance collaboration among pathologists in multinational, multicenter studies.

Competing Interests: Declaration of interests NDJ reports advisory board and personal fees from AstraZeneca, Bayer, Clovis, Janssen, Merck, Merck Sharp & Dohme, Novartis, Sanofi, Astellas, and AAA Accelerator Solutions. FF reports personal fees from Janssen, Astellas, Serimmune, Foundation Medicine, Exact Sciences, Bristol-Myers Squibb, Varian Medical Systems, Novartis, Roivant, Myovant, Bayer, BlueStar Genomics, Artera, Tempus, Genentech, PFS Genomics, and Amgen, and holds stock options in Serimmune, BlueStar Genomics, and Artera. SG reports fees from Tolremo, Ipsen, Silvio Grasso Consulting, WebMD–Medscape, the American Society of Clinical Oncology, European Society for Medical Oncology, Peer Voice, SAKK, the German-speaking European School of Oncology, Radiotelevisione Svizzera Italiana, the Swiss Academy of Multidisciplinary Oncology, Meister ConCept, AdMeTech Foundation, EPG Health, Intellisphere, and Schweizerische Gessellschaft für Medizineische Onkologie. SG also reports travel support from AstraZeneca, Bayer, Intellisphere, and Gilead, paid advisory board participation for Merck Sharp & Dohme, Telixpharma, Bristol-Myers Squibb, AAA International, Orion, Bayer, Novartis, Modra Pharmaceuticals, AstraZeneca, Myriad Genetic, Daiichi Sankyo, Boehringer Ingelheim, Innomedica, Macrogenics, and Pfizer, and holds a patent (WO2009138392). BA-L reports fees from the Cancer Prevention and Research Institute of Texas, the Commonwealth Foundation, the Lyda Hill Foundation, Cancer Research UK, the Wellcome Trust, the Bob Champion Trust, AstraZeneca, Astex Pharmaceuticals, the New York Genome Center, and Existentia, travel support from Cancer Research UK, Astex, the STAT summit, the American Society of Hematology, and the American Association for Cancer Research, and participation in a Cancer Research UK data strategy board. GA reports fees from Janssen, Novartis, Astellas, the Institute of Cancer Research, Veracyte, Artera, Pfizer, AstraZeneca, Astellas, Novartis, Arvinas, Bayer, Sanofi, Propella, and Orion, holds a patent related to blood-based methylation markers (GB1915469.9), and has received equipment from Agilent. EC reports fees from Janssen. RE reports book royalties plus support and fees from the UK National Institute for Health and Care Research, AstraZeneca, Bayer, Ipsen, the Active Surveillance Movember Committee, the American Society of Clinical Oncology, University of Chicago, Dana Farber Cancer Institute, the Spanish National Cancer Research Center, Our Future Health, Jnetics UK, the Institute of Cancer Research, and Convergence Science Centre. RE also reports a pending Cancer Research UK patent, a stock ISA, receipt of gifts from patients (within limits allowed), and other financial interests in private medical practice. SH reports participation on data safety monitoring boards and advisory boards. DH reports fees from Techtrials, Astellas, Adium, Ipsen, Janssen, Bayer, Merck Sharp & Dohme, and Pfizer. MSH reports fees or grant funding from the Prostate Cancer Foundation, the Prostate Cancer Theranostics and Imaging Centre of Excellence, the Australian National Health and Medical Research Council, Movember, the US Department of Defense, Medical Research Future Fund, Bayer, the Peter MacCallum Foundation, Isotopia, the Australian Nuclear Science and Technology Organisation, Merck Sharpe & Dohme, Novartis, AstraZeneca, and Astellas. MSH also reports unrenumerated leadership or fiduciary role in Australian Friends of Sheba. MMog reports fees from NHS England, the UK National Institute for Health and Care Research, and Bayer. CM reports fees from UK National Institute for Health and Care Research, the UK Medical Research Council, Prostate Cancer UK, Cancer Rsearch UK, Sonacare, Ipsen, Bayer, and Astellas. AMo reports fees from Bayer, Myovant, Pfizer, Astellas, AstraZeneca, AAA, Bayer, Exelixis, Janssen, Lantheus, Myovant, Merck, Novartis, Sanofi, and Telix, participation in data Safety monitoring boards and advisory boards for Gilead, and a leadership or fiduciary role in ZERO Prostate Cancer. MMor reports fees from the National Cancer Institute Comprehensive Cancer Center, Lantheus, AstraZeneca, Amgen, Daiichi, Convergent, Pfizer, Clarity, Blue Earth Diagnostics, POINT Diagnostics, Z-Alpha, Ambrx, Flare, Fusion, Curium, Transtherabio, Doximity, BMS, and Celgene, reports a US patent application (18/448 609) for a method of treating prostate cancer, and holds stock options in Doximity. DM reports fees from Novartis, Janssen, Bayer, Astellas, Ipsen, and AstraZeneca. PLN reports fees from Bayer, Astellas, Boston Scientific, AIQ, Astellas, Novartis, Janssen, Blue Earth, Nanocan, and Theranano, and holds stock options in Stratagen Bio, Nanocan, and Reversal Therapeutics. CP reports fees from Artera, which has a financial relationship with University College London (his employer) as part of a data licensing agreement. All other authors declare no competing interests.

Introduction: globally, antimicrobial resistance (AMR) kills around 1.27 million 700,000 people each year. In Sierra Leone, there is limited information on antibiotic use among healthcare workers (HCWs). We assessed antibiotic prescribing practices and associated factors among HCWs in Sierra Leone., Methods: we conducted a cross-sectional survey among HCWs. We collected data using a questionnaire containing a Likert scale for antibiotic prescribing practices. We categorized prescribing practices into good and poor practices. We calculated adjusted odds ratios (aOR) to identify risk factors., Results: out of 337 (100%) HCWs, 45% scored good practice. Out of the total, 131 (39%) of HCWS considered fever as an indication of antibiotic resistance and 280 (83%) HCWs prescribed antibiotics without performing microbiological tests and 114 (34%) prescribed a shorter course of antibiotics. Factors associated with good practice were being a doctor (aOR=1.95; CI: 1.07, 3.56), the internet as a source of information (aOR=2.00; CI: 1.10, 3.66), having a high perception that AMR is a problem in the health-facility (aOR=1.80; CI: 1.01, 3.23) and there is a connection between one´s prescription and AMR (aOR=2.15; CI: 1.07, 4.32)., Conclusion: this study identified a low level of good practice toward antibiotic prescription. We initiated health education campaigns and recommended continuous professional development programs on antibiotic use., Competing Interests: The authors declare no competing interests., (Copyright: Aminata Tigiedankay Koroma et al.)

The transferability and clinical value of genetic risk scores (GRSs) across populations remain limited due to an imbalance in genetic studies across ancestrally diverse populations. Here we conducted a multi-ancestry genome-wide association study of 156,319 prostate cancer cases and 788,443 controls of European, African, Asian and Hispanic men, reflecting a 57% increase in the number of non-European cases over previous prostate cancer genome-wide association studies. We identified 187 novel risk variants for prostate cancer, increasing the total number of risk variants to 451. An externally replicated multi-ancestry GRS was associated with risk that ranged from 1.8 (per standard deviation) in African ancestry men to 2.2 in European ancestry men. The GRS was associated with a greater risk of aggressive versus non-aggressive disease in men of African ancestry (P = 0.03). Our study presents novel prostate cancer susceptibility loci and a GRS with effective risk stratification across ancestry groups., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Purpose of Review: Urine volatile organic compound (VOC) testing for early detection of urological cancers is a minimally invasive and promising method. The objective of this review was to present the results of recently published work on this subject., Recent Findings: Organic volatile compounds are produced through oxidative stress and peroxidation of cell membranes, and they are eliminated through feces, urine, and sweat. Studies looking for VOCs in urine for the diagnosis of urological cancers have mostly focused on bladder and prostate cancers. However, the number of patients included in the studies was small. The electronic nose was the most widely used means of detecting VOCs in urine for the detection of urological cancers. MOS sensors and pattern recognition machine learning were more used for the composition of electronic noses. Early detection of urological cancers by detection of VOCs in urine is a method with encouraging results with sensitivities ranging from 27 to 100% and specificities ranging from 72 to 94%., Summary: The olfactory signature of urine from patients with urological cancers is a promising biomarker for the early diagnosis of urological cancers. The electronic nose with its ability to recognize complex odors is an excellent alterative to canine diagnosis and analytical techniques. Nevertheless, additional research improving the technology of Enoses and the methodology of the studies is necessary for its implementation in daily clinical practice., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)