The treatment of locally advanced rectal cancer has been transformed over the last century with nearly 40% of patients achieving complete eradication of their tumor with total neoadjuvant therapy alone. Nonoperative management with a watch-and-wait approach has now allowed a subset of patients the chance to avoid surgery altogether with 50% of watch-and-wait patients achieving long-term organ preservation. However, the other half of patients develop either local regrowth, which requires expeditious surgical intervention, or distant recurrence. Watch-and-wait is a reasonable option for select patients in a protocolized environment that can successfully deliver the recommended surveillance protocol, which ensures its safety.

Timely access to curative-intent colorectal cancer (CRC) surgery is a central component of surgical quality. Yet contemporary evidence challenges historical assumptions that shorter wait times always confer better outcomes. Drawing on population-based studies which offer the most robust and generalizable data this article synthesizes what is known about the relationship between surgical delay and oncologic outcomes in CRC. We outline key conceptual considerations in defining wait-time intervals, discuss lessons from the coronavirus disease 2019 pandemic, and identify gaps for future research. Ultimately, wait times should be applied as flexible, evidence-informed quality indicators that support patient-centered, biologically sound, and operationally feasible cancer care.

The dramatic rise in thyroid cancer incidence in recent decades is driven primarily by the detection of small, biologically indolent papillary microcarcinomas rather than a true increase in clinically significant disease. Robust long-term data now show that active surveillance is a safe and effective initial strategy for appropriately selected low-risk patients, with very low rates of progression and oncologic outcomes comparable to immediate surgery. Reflecting this evidence, contemporary guidelines endorse active surveillance as an alternative to upfront resection, emphasizing shared decision-making, structured ultrasound monitoring, and clearly defined triggers for intervention, shifting modern thyroid cancer care toward individualized care minimizing overtreatment.

The potential of image-based deep learning (DL) in the diagnosis of oral squamous cell carcinoma has been investigated recently. This review aims to evaluate its effectiveness to provide an evidence base for future development.

Cochrane Library, Embase, PubMed, and Web of Science were systematically searched up to June 3, 2025. The QUADAS-2 tool was utilized for the risk of bias assessment. Subgroup analyses were conducted by the classification type (binary classification and multiclass classification) and image type (histopathological images, oral photographs, and Raman spectral images).

Fifty-two studies were included. For binary classification, DL demonstrated strong performance. Four studies developed DL based on Raman spectral images, yielding a pooled sensitivity of 0.99 (95% CI 0.98-0.99) and a specificity of 0.98 (95% CI 0.96-0.99), with an area under the summary receiver operating characteristic value (AUC) of 0.99 (95% CI 0.20-1.00). Eight studies developed DL based on oral photographs, yielding a pooled sensitivity of 0.97 (95% CI 0.91-0.99) and a specificity of 0.93 (95% CI 0.85-0.97), with an AUC of 0.99 (95% CI 0.85-1.00). DL was developed based on histopathological images in 31 studies, which had a pooled sensitivity of 0.98 (95% CI 0.97-0.98) and a specificity of 0.97 (95% CI 0.96-0.98), with an AUC of 0.99 (95% CI 0.50-1.00).

Image-based DL has demonstrated promising diagnostic performance and advantages across multiple imaging modalities including histopathological images, oral photographs, and Raman spectral images, suggesting that it is a promising direction for the development of intelligent diagnostic tools for oral squamous cell carcinoma diagnosis. DL may become an effective adjunct to diagnosis.

The incidence of oral squamous cell carcinoma (OSCC) has been rising in recent years, substantially affecting patients' quality of life and psychological well-being. Identifying effective prognostic indicators is critical for guiding clinical decision-making. Currently, the predictive value of the neutrophil-to-lymphocyte ratio (NLR) in OSCC remains controversial. This meta-analysis aimed to systematically examine the relationship between preoperative NLR and postoperative survival outcomes among individuals with OSCC.

Studies on the association between preoperative NLR and postoperative overall survival (OS), disease-free survival (DFS), and other survival outcomes in OSCC patients were systematically searched from the Cochrane Library, Web of Science, Embase, and PubMed from inception to March 1, 2025. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias. Stata 15 was utilized to perform statistical analyses.

In total, 30 studies were included, all of which had a Newcastle-Ottawa Scale score of 7 or higher. Among them, 21 studies reported OS, 10 reported disease-specific survival (DSS), 3 reported progression-free survival, and 11 reported DFS. The meta-analysis results suggested that a higher preoperative NLR was significantly associated with poorer postoperative OS (hazard ratio [HR] = 1.79, 95% confidence interval [CI]: 1.48-2.16; P < .001), DFS (HR = 1.70, 95% CI: 1.48-1.94; P < .001), and DSS (HR = 2.10, 95% CI: 1.72-2.57; P < .001) in individuals with OSCC. No significant association was found between NLR and progression-free survival (HR = 1.24; 95% CI: 0.78-1.99; P = .367). Sensitivity analyses revealed that the pooled effect sizes for OS, DSS, and DFS did not significantly change. The publication bias assessment results showed that significant publication bias was found for OS, DFS, and DSS (P < .05). After the trim and filling method, the direction of the pooled effect size did not reverse, and the 95% CI of the effect estimates remained statistically stable, indicating that the study results were relatively robust.

Elevated preoperative NLR may be an effective predictor of poor survival prognosis among individuals with OSCC and may be applied as a low-cost prognostic biomarker to assist in prognostic prediction. However, due to the limited number of included studies, high-quality research is warranted in the future to validate these findings.

Cancer is the most common cause of disease-related mortality in children, highlighting the urgent need for improved care in this population. It is estimated that >15% of children diagnosed with cancer harbour a germline pathogenic variant in a cancer predisposition gene which confers an increased risk to develop cancer. There are over 100 genes associated with cancer predisposition syndromes (CPSs) and greater availability and acceptability of genetic testing in the last decade has facilitated their recognition in childhood. However, individually, each of these CPSs is rare, impeding robust research and advancement of clinical care. Once a specific CPS is diagnosed, current recommendations for clinical care are based primarily on expert consensus with a 'one size fits all' approach to management. Detailed knowledge of genotype-phenotype associations and the impact of genetic modifiers is lacking, and due to strong ascertainment bias of children already diagnosed with cancer predominantly being tested for a CPS, the true cancer risk is likely overestimated.

The Childhood Cancer Predisposition Study (CCPS) is a multi-centre registry and biorepository for children and adolescents aged 0-21 years with a clinical or molecularly confirmed CPS and their family members (NCT04511806). The study objectives are to characterise the natural history of each CPS, correlate the natural history phenotype with CPS genotype, evaluate the efficacy of standard surveillance strategies and allow future investigation into the feasibility and effectiveness of novel surveillance strategies. The principal study question is whether adherence to recommended tumour surveillance guidelines is associated with earlier detection of tumours and/or improved survival. We will also address what barriers exist that prevent adherence to surveillance guidelines. Data collected from primary subjects includes detail about the CPS, genomic data, cancer history and family cancer history, as well as information about tumour surveillance. Required biospecimen collection includes germline DNA samples, with optional collection of serial blood and stool samples. Planned enrolment is 1050 primary subjects.

CCPS was reviewed and approved by a central IRB (WCG IRB 2020P002450) and the Research Ethics Board at The Hospital for Sick Children in Toronto (1000072286). Written informed consent is obtained from all participants. Data and specimens are available to qualified investigators by request to address specific research questions through a standardised research application process. In addition, de-identified data are available through the Pediatric Cancer Data Commons for exploration. Analysed data will be disseminated in peer-reviewed publications and at conferences including meetings inclusive of patient and family advocacy groups.

NCT04511806.

To evaluate associations of a newly developed trajectory-based trauma index (TTI) and tumor-related pleural infiltration with pneumothorax after CT-guided lung cryoablation.

This retrospective single-center observational cohort included procedures from May 2017 through January 2026. Eligible procedures involved transpulmonary cryoablation of primary or metastatic lung malignancy in adults. Exclusions were extrapleural access, ipsilateral pleural effusion or drainage, concomitant ipsilateral microwave ablation, and incomplete data. Ablation was indicated after multidisciplinary assessment; contraindications included uncorrectable coagulopathy, active infection, anesthesia intolerance, or no safe access. The primary endpoint was pneumothorax on immediate CT or 2-hour radiography; chest tube placement before discharge was secondary. TTI, the primary exposure, summed contributions from cryoprobes and biopsy needles based on diameter, aerated-lung traversal, and pleural entry angle. Pleural infiltration was a prespecified co-exposure and relative entry height a covariate. Associations were evaluated with logistic regression.

Ninety procedures in 69 patients were analyzed. Across 230 pleural punctures, median diameter was 2.1 mm (IQR, 2.1-2.1), aerated-lung traversal 25.0 mm (IQR, 8.9-38.7), and entry angle 52.8° (IQR, 38.8-69.9). Pneumothorax occurred in 56/90 procedures (62%; 95% CI, 51%-72%); 34/90 (38%) required chest tubes. Higher TTI was associated with pneumothorax (OR, 21.87; 95% CI, 4.47-106.99; P<.001), whereas greater pleural infiltration was associated with lower odds (OR, 0.56; 95% CI, 0.40-0.78; P<.001). TTI was associated with chest tube placement (OR, 5.02; 95% CI, 1.60-15.78; P=.006).

In this retrospective single-center cohort, higher TTI and less extensive pleural infiltration were associated with pneumothorax.

Invasive cervical cancer (ICC) is a key outcome for evaluating cervical cancer screening (CCS) programs. Monitoring ICC trends and distinguishing cancers detected within and outside the organized screening program are essential for assessing program impact, particularly during transitions such as the introduction of human papillomavirus (HPV) based primary screening.

We conducted a retrospective population-based study in Portugal's Central Region (2014 - 2023). Deterministic linkage was performed between the organized CCS database and hospital morbidity records. Invasive cervical cancer cases were classified as screen-detected or non-screen-detected based on prior screening history. Incidence rates were calculated using population denominators. Poisson regression models with log link and log-transformed population offsets were fitted to estimate incidence rate ratios (IRR) comparing cytology-based (2014 - 2019) and HPV-based (2020 - 2023) periods, adjusting for temporal trends.

A total of 654 ICC cases were included. Screening participation remained broadly stable over time. The HPV-based period was associated with a significantly higher rate of screen-detected ICC (IRR = 1.94; 95% CI 1.11 - 3.40) compared with the cytology period. In contrast, ICC incidence outside the organized screening program did not differ significantly between periods (IRR = 0.94; 95% CI 0.65 - 1.35).

The transition to HPV-based primary screening was associated with a shift in ICC detection towards the organized screening program, without evidence of a corresponding increase in incidence among women diagnosed outside the organized screening program. These findings should, however, be interpreted with caution in light of the early phase of implementation and potential external factors influencing access to diagnosis. Overall, the results support a shift in detection within the screening pathway rather than changes in underlying disease occurrence. Strengthening integration between screening, hospital, and cancer registry data remains essential for robust evaluation of cervical cancer screening policies.

Routine monitoring of patient-reported outcomes (PROs) during cancer treatment improves symptom control and quality of life, yet real-world uptake and sustained engagement with PRO monitoring remain suboptimal. Gamification has been shown to improve engagement with digital health interventions. User-centered design approaches are needed to ensure that gamified PRO tools are acceptable, usable, and responsive to patient and clinician needs, especially for older adult users.

This study aimed to develop a gamified symptom monitoring web application for older adult patients with cancer using a multiphase, iterative, and user-centered approach.

The overall study design was a mixed-methods user-centered design study involving 3 phases. From 2022 to 2026, participants were recruited across online and clinical settings using multiple strategies, including ResearchMatch (Vanderbilt University Medical Center), clinician referrals, professional networks, and outreach through the electronic health record at an academic medical center. Phase 1 was a survey of older adults with chronic health conditions. They reported on symptom severity, mobile health (mHealth) preferences, and gamification preferences, which were analyzed descriptively. Phases 2 and 3 involved semistructured interviews with older adult cancer survivors and clinicians, respectively, to identify actionable feedback, followed by iterative usability testing with older adult cancer survivors.

In Phase 1, older adults (n=216) with chronic conditions reported high frequency of mobile phone use (across 11 mobile phone behaviors, mean 6.1, SD 1.63 where 6 indicates daily use) and generally favorable attitudes toward gamification (across 18 gameful design elements, means ranged from 2.8-4.3 on a 1-5 scale and SDs ranged from 0.75-1.12), with learning elements rated most appealing (mean 4.3/5, SD 0.75). Concerns about a gamified mHealth app included data privacy and perceived trivialization of health. Phase 2 interviews (n=7) demonstrated strong interest in longitudinal symptom visualization and clinician-sharable reports; gamified content was viewed as engaging by most participants but was preferred as optional. In Phase 3, iterative clinician interviews (n=5) and patient usability testing (n=9) led to substantial refinements, including simplified navigation, enhanced visual accessibility, further guidance on score interpretation with embedded educational videos, and de-emphasis of the gamified travel learning component. Across usability testing rounds, the number of user experience problems per interview decreased from 17 to 4, indicating improved usability.

Using a multiphase, mixed methods, user-centered design process, we developed AthenaCompanion (Northwestern University with The Ohio State University), a gamified web application for PRO monitoring tailored to older adults undergoing cancer treatment. Across surveys and interviews, patients emphasized the importance of clinical utility, clarity of symptom feedback, and low-pressure, optional gamification elements. This work demonstrates the feasibility of integrating gamification into PRO monitoring and provides a foundation for future work evaluating long-term usability, engagement, and clinical effectiveness in real-world oncology care.

Outdoor workers receive significantly more UV radiation exposure than indoor workers, increasing their skin cancer risk. Hispanic individuals comprise a large proportion of the outdoor workforce in the United States, but have limited access to culturally tailored prevention resources.

This exploratory study assessed the perceptions of a culturally tailored narrative video to promote skin cancer prevention among Spanish-speaking Hispanic outdoor workers.

A qualitative study was conducted using two focus groups with Hispanic outdoor workers. Prior to viewing the video, participants completed surveys assessing sociodemographic factors, sun exposure, and protective behaviors. Focus group discussions explored video comprehension, cultural relevance, emotional engagement, and dissemination strategies. Quantitative data were summarized descriptively, and qualitative data were analyzed using rapid qualitative analysis.

Among 19 participants, the mean age was 46.5 (SD 15.5) years, and 94.7% (18/19) identified as male. While 47.4% (9/19) reported 6-9 hours of outdoor work per day, more than half (10/19, 52.6%) reported not engaging in sun protection. Participants described the video as culturally resonant, realistic, and engaging. Identification with characters and family-centered themes increased perceived relevance and message credibility. Many participants reported increased awareness of skin cancer risk and greater confidence in adopting sun-protective behaviors. Dissemination recommendations included workplaces, social media, schools, daycares, clinics, and other community settings.

Our video shows promise in improving skin cancer awareness and prevention, reflecting strong acceptability among participants. Future randomized controlled studies are needed to assess its effectiveness in enhancing long-term sun-protective behaviors.