AI is increasingly integrated into prostate cancer diagnostics, with the potential to improve accuracy and efficiency. However, it also raises important questions about the conditions and barriers that may influence its successful implementation in this clinical context.

This study aimed to examine how patients and physicians perceived the integration of AI in prostate cancer diagnostics, with particular attention to its impact on the clinical relationships and the roles of patients and physicians.

A sequential explanatory mixed methods design was used. Quantitative data were collected using an online questionnaire administered to patients with localized prostate cancer (N=51). Descriptive analyses focused on perceived benefits, willingness to use AI, and associated concerns. Qualitative data were collected through focus groups and semistructured interviews with patients (n=16) and physicians (n=11). Data were analyzed using an iterative, inductive thematic analysis.

Quantitative findings showed that despite recognizing the potential benefits of AI, patients remained divided regarding the use of such tools in their own care. Qualitative findings suggested that this hesitation cannot be explained solely in terms of perceived performance or utility. Rather than simply reducing complexity in clinical decision-making, AI appeared to reconfigure the certainties on which trust within the patient-physician relationship was established. This reconfiguration was reflected across epistemic, ethical, and role-related dimensions. Patients emphasized difficulties in understanding AI-generated knowledge, whereas physicians focused on issues of reliability, validation, and clinical relevance. Ethical concerns centered on responsibility, which was consistently attributed to physicians, while errors made by AI were perceived as less acceptable than those made by physicians. Role-related uncertainties were reflected in ambivalent patient positions: while some participants sought more information to remain involved in decision-making, others preferred to rely on physicians, reflecting variation in how patients engaged with complex clinical information. AI was generally viewed as a supportive tool rather than a replacement for clinical judgment, while its integration was associated with evolving professional roles, including increased demands for interpretation, communication, and oversight.

The integration of AI in prostate cancer diagnostics is shaped not only by its technical performance but also by how it interacts with trust within the patient-physician relationship. Our findings suggest that AI may reshape, rather than eliminate, uncertainty related to knowledge, responsibility, and social roles. Its integration into clinical practice therefore requires careful attention to clinician oversight, communication, and the relational context in which decisions are made.

Concurrent use of antidepressants, particularly cytochrome P450 2D6 (CYP2D6) inhibitors, may reduce tamoxifen bioactivation and effectiveness. However, the clinical significance of this potential interaction remains inconclusive. This study examined whether concurrent antidepressant use is associated with increased metastasis risk among women receiving tamoxifen for nonmetastatic breast cancer.

We conducted a cohort study using the Merative MarketScan Database. Eligible women with nonmetastatic breast cancer were followed from tamoxifen initiation until metastasis, disenrollment, or study end, whichever occurred first. Patients were classified as concurrent users (tamoxifen with overlapping antidepressant prescriptions) or nonusers (tamoxifen only). Time-dependent Cox models estimated metastasis risk. Analyses were stratified by concurrent exposure duration and CYP2D6 inhibition degree and adjusted for relevant covariates.

Among 14,771 women (mean age: 51 ± 10 years), 4780 (32.4%) used tamoxifen concurrently with an antidepressant, most commonly moderate inhibitors (n = 1815) and least commonly strong inhibitors (n = 427). Median overlap duration was 8 months (IQR: 3-20). During follow-up, 443 patients (3.0%) developed metastasis: 161 of 4780 concurrent users (3.4%) versus 282 of 9991 nonusers (2.8%). Concurrent antidepressant use was not significantly associated with metastasis risk (HR = 0.99; 95% CI: 0.81-1.21). Exposure duration was also not significantly associated with metastasis. Use of mixed-inhibitor regimens was associated with higher risk in partially adjusted models (HR = 1.39; 95% CI: 1.04-1.87), though full adjustment attenuated the association.

Concurrent antidepressant use was not significantly associated with increased metastasis risk among women receiving tamoxifen for nonmetastatic breast cancer. Individualized and coordinated decisions regarding antidepressant selection may help balance cancer control goals with the psychological and symptomatic management needs in this population.

Anterior tumour location is an established risk factor for local recurrence (LR) in advanced rectal cancer, but its significance in stage I ultra-low rectal cancer remains unclear.

This exploratory supplemental analysis used data from Ultimate trial, a multicentre prospective phase II study across 47 Japanese institutions (2014-2017). Patients with cT1-2 N0 M0 ultra-low rectal cancer (≤ 5 cm from the anal verge) underwent laparoscopic resection. Tumour location was categorized as anterior (10-2 o'clock) or non-anterior (2-10 o'clock). The primary endpoint was LR; secondary endpoints included recurrence-free survival, overall survival, and stoma-free survival.

Of 300 enrolled patients, 297 were analysed (median follow-up 37.2 months); 93 tumours (31.3%) were anterior. Baseline characteristics, operative outcomes, and pathological findings were similar between the two groups. The 3-year cumulative LR rate was 11.9% for anterior tumours and 3.0% for non-anterior tumours (hazard ratio (HR) 4.46; 95% confidence interval (c.i.) 1.67 to 11.89; P = 0.001). Multivariable analysis showed an independent association between anterior location and LR (HR 4.68; 95% c.i. 1.72 to 12.74); subgroup analysis revealed no difference in clinical (c) T1 patients, but a significantly higher LR rate for anterior tumours in cT2 patients (25.3% versus 4.7%; P < 0.001). Three-year recurrence-free survival (83.9% for anterior tumours versus 88.9% for non-anterior tumours; P = 0.222), overall survival (> 95%), and stoma-free survival were comparable between the two groups.

Anterior tumour location in the ultra-low rectum was associated with an increased risk of LR, particularly in cT2 patients, highlighting the need for a more refined treatment strategy and vigilant monitoring.

Older adults undergoing colorectal cancer (CRC) surgery are at increased risk of postoperative complications, mortality, and loss of independence. Frailty screening tools may support perioperative risk stratification. This study evaluated the association between the Flemish Triage Risk Screening Tool (fTRST) and postoperative outcomes.

This retrospective multicentre cohort study analysed the Emilia-Romagna Surgical Colorectal Audit. Patients aged ≥ 70 years undergoing CRC surgery (2019-2023) were included. Patients with fTRST scores ≥ 2 and < 2 were matched 1 : 1 using propensity score matching. Primary outcomes were 30-, 90-, and 180-day mortality and complications. Secondary outcomes included prolonged hospital stay and discharge to a non-independent setting. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed.

In all, 1539 patients were included in the study. Mortality at 30, 90, and 180 days was 4.2%, 7.1%, and 10.5%, respectively. In the unmatched cohort, each 1-point increase in fTRST score was significantly associated with 30-day mortality (odds ratio (OR) 1.36; 95% confidence interval (c.i.) 1.12 to 1.66), complications (OR 1.12; 95% c.i. 1.02 to 1.23), prolonged hospital stay (OR 1.13; 95% c.i. 1.03 to 1.24), and discharge to a non-independent setting (OR 1.35; 95% c.i. 1.21 to 1.51). After matching 566 pairs, higher fTRST score remained significantly associated with 30-day mortality (OR 1.33; 95% c.i. 1.09 to 1.63) and discharge to a non-independent setting (OR 1.40; 95% c.i. 1.25 to 1.59). ROC analysis using an fTRST cut-off of ≥2 showed moderate discrimination for 30-day mortality and discharge to a non-independent setting, with areas under the ROC curve of 72.4% (negative predictive value 98.2%) and 67.2% (positive predictive value 66.3%), respectively.

The fTRST is a simple screening tool for identifying older adults at risk of adverse postoperative and functional outcomes after CRC surgery, supporting perioperative planning.

This study aimed to characterize the gastric cancer burden among non-Hispanic American Indian Alaska Native (NHAIAN) and White (NHW) individuals in North Carolina to provide a baseline assessment of the gastric cancer burden in North Carolina.

Data from the North Carolina Central Cancer Registry (2003-2021) were used to construct gastric cancer diagnosis (NHAIAN n = 111; NHW n = 7,685) and treatment (NHAIAN n = 97; NHW n = 6,040) cohorts. Race-stratified patient characteristics were summarized. We evaluated unadjusted associations between patient characteristics and receipt of no treatment and the multivariable-adjusted association risk ratio (RR) between race and no treatment using modified Poisson regression. Race-specific cumulative incidence functions (CIFs) for treatment initiation were estimated with bootstrapped 95% confidence intervals (CI) and adjusted for key covariates using inverse probability weighting.

NHAIANs were diagnosed at a younger age (65 vs 68 years; p = 0.006), with non-cardia cancer (80 vs 62%; p < 0.001), at a later stage (36 vs 32%; p = 0.021), and lived in an area with a lower residential population density than NHW gastric cancer patients (76 vs 26%; p < 0.001). The risk of not initiating treatment was higher among NHAIANs compared to NHWs (RR = 1.13 (95% CI = [0.87, 1.47]; p= 0.34). The CIF for treatment initiation was consistently lower for NHAIANs with a significant difference at 30 days (CIF difference = -0.09; 95% CI = [-0.17, -0.01]).

NHAIAN gastric cancer patients in North Carolina were diagnosed younger, at more advanced stages, and had a lower cumulative probability of initiating treatment within the first year after diagnosis compared to NHWs.

Financial toxicity threatens the survival and prognosis of cervical cancer patients, yet systematic exploration of its prevalence and full spectrum of protective and risk factors remains limited.

To investigate the prevalence and factors associated with financial toxicity among patients with cervical cancer.

A cross-sectional quantitative study.

We surveyed 351 cervical cancer patients from November 2023 to November 2024 using a general information questionnaire and the patient self-reported Comprehensive Score for Financial Toxicity. Binary logistic regression identified associated factors.

The 351 participants ranged in age from 25 to 88 years (57.70 ± 11.47 years). The prevalence of financial toxicity was 66.4%. Multivariable analysis demonstrated that each 1-year increase in age, having commercial insurance and fewer hospitalizations (< 3 times) may be associated with a reduced risk of financial toxicity, whereas lower disposable household savings (< 100,000 CNY), having urban-rural resident basic medical insurance and receiving radiotherapy may be associated with an increased risk.

This study identified factors associated with financial toxicity in cervical cancer patients, with factors associated including age, commercial insurance, basic medical insurance type, disposable household savings, number of hospitalizations and radiotherapy. These findings may assist healthcare providers in identifying patients at higher risk of financial toxicity and inform the development of individualized care plans.

These findings may assist healthcare providers to identify patients who may be at higher risk of financial toxicity early, which may support treatment adherence and health-related quality of life.

This study examined financial toxicity prevalence and associated factors among cervical cancer patients, identified key modifiable and non-modifiable factors for clinical screening, and may inform nursing practice and healthcare policy adjustments.

This study followed the STROBE guidelines for cross-sectional studies.

No patient or public contribution.

Breast cancer survivorship requires attention to treatment-related changes in body composition, nutritional status, and quality of life. Bioelectrical impedance phase angle is influenced by tissue electrical properties and fluid distribution and may provide complementary whole-body and segmental information.

This study described perioperative body-composition and phase-angle measures in women undergoing breast cancer surgery after neoadjuvant chemotherapy or treated through a surgery-first pathway. It also estimated T0-to-T2 changes and documented the availability of selected longitudinal variables.

BC-NUTRITION (Body Composition and Nutrition Trajectories in Breast Cancer) is a prospective 2-cohort observational study with 5 planned assessments from admission to 6 months after discharge. The present exploratory pilot analysis included 30 women in cohort A, assessed after neoadjuvant chemotherapy, and 65 women in cohort B, who were treated through a surgery-first pathway. T1 measurements were displayed descriptively; inferential analyses used T0 values and participant-level T0-to-T2 changes. T0 between-cohort comparisons used Welch 2-sample t tests, within-cohort changes used paired t tests, and between-cohort differences in change used Welch tests. Benjamini-Hochberg q values were calculated across the 13 between-cohort change comparisons.

All 95 participants had complete data for the 13 selected longitudinal variables at T0, T1, and T2. At T0, cohort A had lower albumin, absolute lymphocyte count, prognostic nutritional index, and whole-body 50-kHz phase angle. The whole-body phase-angle means were 4.64° (SD 0.66) and 5.23° (SD 0.62), with a difference of -0.59° (95% CI -0.88° to -0.31°; P<.001). Cohort A had a higher whole-body extracellular water to total body water ratio (ECW/TBW) than cohort B (0.3890 vs 0.3815; P<.001). Ipsilateral upper-limb 50-kHz phase angle changed by -0.50° in cohort A and -0.51° in cohort B between T0 and T2. The between-cohort difference was 0.01° (95% CI -0.17° to 0.19°; P=.93). The corresponding difference in whole-body phase-angle change was 0.14° (95% CI -0.02° to 0.30°; P=.09). No q value for the 13 between-cohort change comparisons was below 0.05.

The treatment pathways differed in selected laboratory and whole-body bioelectrical measures at T0. The mean upper-limb phase angle ipsilateral to the recorded tumor side decreased in both cohorts between T0 and T2. All five prespecified perioperative feasibility thresholds were met in the available T0-to-T2 data. Assessment acceptability and T3/T4 follow-up were not evaluated. Definitive interpretation requires standardized acquisition, a prechemotherapy baseline, relevant clinical covariates, and outpatient follow-up.

Solid organ transplant recipients (SOTRs) have an increased risk of keratinocyte skin cancer (KC) due to lifelong immunosuppression. Photoaging, reflecting cumulative ultraviolet (UV) exposure, may serve as a biomarker of KC risk. This study characterized objective photoaging features in SOTRs and their association with age, photodamage, photoaging phenotype, actinic keratoses (AKs) and KC history. In 251 SOTRs, VISIA imaging showed significant age-related increases in photoaging features; median red- feature scores reflecting erythema and telangiectasia were 44 AU (arbitrary units) in patients >60 vs 22 AU in those <60. Higher clinical photodamage severity corresponded to higher VISIA scores, especially red- features and visible- spots. The atrophic photoaging phenotype, observed in 60 % of patients, showed higher red- features (40 AU) than the hypertrophic type (27 AU). Patients with AKs had elevated UV- spots and red- features. A history of KC (32 % of participants) was associated with older age, longer time since transplantation, fairer skin type, more severe photodamage, higher VISIA scores, especially red- features (45 AU vs 29 AU) and greater pigmentation on sun-exposed sites. Objective imaging identified photoaging features associated with cumulative UV damage. Further studies should evaluate their predictive value for KC development to improve individualized risk stratification and surveillance strategies in this high-risk population.

Lung cancer predominantly affects older adults who already experience comorbidities and are at increased risk of drug-drug interactions (DDIs) due to polypharmacy. Traditional DDI assessments often do not fully capture complex co-medication patterns observed in real-world practice due to the risk of introducing confounding factors. This study used U.S. Optum claims data from 2019 to 2024 to characterize co-medication patterns in predominately non-small cell lung cancer (NSCLC) patients and map enzyme- and transporter-mediated liabilities across commonly used medications, chemotherapy agents, and biomarker-driven therapies. Potential DDI liabilities were further prioritized using a semi-quantitative clinical framework based on perpetrator strength, substrate sensitivity, narrow therapeutic index status, and available evidence. Frequently used medications included disease-specific supportive therapies such as ondansetron and dexamethasone, as well as treatments for common U.S. comorbidities such as cardiovascular and endocrine disorders. Many of the co-medications were substrates, inhibitors, and inducers of pathways critical for NSCLC treatments such as CYP3A, CYP2D6, P-gp, and OATP1B and additional risks were identified when giving treatments with acid-reducing agents or QT-prolonging drugs. These findings demonstrate how integrating real-world data (RWD) can strengthen DDI assessment by improving clinical trial design, informing risk-mitigation strategies, and supporting more patient-centric drug development.

To identify distinct dysphagia profiles among nasopharyngeal carcinoma (NPC) survivors and to examine the mediating roles of depression and anxiety in the relationship between these profiles and broader symptom clusters. This study hypothesized that subgroup membership would have differential effects on symptom clusters through psychological mediating pathways. The study aimed to provide evidence for the development of precision symptom management interventions.

In this cross-sectional study, 271 survivors recruited from a tertiary cancer hospital in Guangzhou (January 2023-December 2024) completed standardized assessments of dysphagia, psychological status, and symptoms. Latent profile analysis (LPA) identified subgroups of survivors with distinct dysphagia profiles; exploratory factor analysis extracted symptom clusters, multivariable linear regression examined associated factors, and parallel mediation analysis with bootstrap resampling tested the mediating effects.

Dysphagia prevalence among NPC survivors was 57.2%, with the highest prevalence (72.7%) observed among survivors within 6 months post-treatment. LPA identified two survivor subgroups with distinct dysphagia profiles: a high dysphagia burden subgroup (51.0%) and a low dysphagia burden subgroup (49.0%). Three symptom clusters were extracted: Systemic/Psychological, Oral/Swallowing, and Gastrointestinal/Neuropathic. Membership in the high dysphagia burden subgroup and anxiety significantly predicted all clusters (p < 0.05). Mediation analyses revealed that dysphagia subgroup membership had significant total effects on all clusters (p < 0.001). Depression showed statistical mediation for the Systemic/Psychological and Oral/Swallowing clusters, whereas anxiety showed statistical mediation for the Systemic/Psychological and Gastrointestinal/Neuropathic clusters.

NPC survivors exhibit distinct dysphagia burden profiles, including high- and low-burden subgroups. A high dysphagia burden profile is directly associated with a greater overall symptom burden and indirectly contributes to more severe symptom clusters via depression and anxiety. These findings highlight the need for early identification of survivors within this high-risk subgroup, and the integration of swallowing rehabilitation with psychological interventions for comprehensive symptom management.