Geographic variation in breast cancer screening may reflect persistent structural inequities in access to preventive care. Understanding whether historical redlining remains associated with screening, independent of contemporary social vulnerability, neighborhood conditions, and geographic access, is critical for targeting interventions within cancer center catchment areas.

To examine the association between historical redlining and breast cancer screening prevalence, accounting for social vulnerability, neighborhood characteristics, and geographic access, and to characterize spatiotemporal screening patterns.

This cohort study used Census tract-level data from 2016 to 2024 across the University of Kansas Cancer Center catchment area, including communities in Kansas and adjacent Missouri counties. The analytic sample included Census tracts with available Homeowners' Loan Corporation (HOLC) grades A (indicating the least redlining) to D (indicating the most redlining). Statistical analysis was performed from July to December 2025.

HOLC grades; Social Vulnerability Index quintiles (with the first quintile indicating the lowest vulnerability and the fifth quintile indicating the highest); Census tract-level socioeconomic, housing, and transportation indicators; and distance to the nearest mammography facility.

Census tract-level breast cancer screening prevalence from the Centers for Disease Control and Prevention's PLACES database, reported as odds ratios (ORs) with 95% credible intervals (CrIs).

A total of 1152 historically redlined Census tracts were analyzed. Tracts were categorized by HOLC grades A (n = 27), B (n = 99), C (n = 423), and D (n = 603). The median (IQR) screening prevalence was highest in grade A tracts (79.6% [79.0%-80.0%]) and lowest in grade D tracts (75.2% [71.7%-79.2%]). Models demonstrated substantial spatial and temporal dependence with geographic clustering and localized variability. Compared with grade A tracts, grade C (OR, 0.94; 95% CrI, 0.90-0.99) and grade D tracts (OR, 0.94; 95% CrI, 0.89-0.99) had lower screening prevalence after adjustment. The highest Social Vulnerability Index quintile was associated with increased screening odds (OR, 1.08; 95% CrI, 1.01-1.14). Lower educational attainment (OR, 0.94; 95% CrI, 0.92-0.96) and higher mobile home prevalence (OR, 0.98; 95% CrI, 0.97-1.00) were associated with lower screening odds. Residual spatial heterogeneity persisted (711 of 1152 tracts [61.7%] excluding the null). Screening peaked in 2018 to 2019, stabilized through 2023, and declined in 2024, with most areas remaining below the Healthy People 2030 target of 80.3%.

This study found that historical redlining was associated with lower breast cancer screening prevalence independent of contemporary social vulnerability, neighborhood conditions, and geographic access. These findings support sustained, place-based strategies addressing structural and socioeconomic barriers to improve screening uptake and progress toward national screening targets.

There are 3.5 million prostate cancer survivors in the US, with a need for evidence-based lifestyle recommendations that improve survivorship.

To assess whether consumption of specific dietary fats after diagnosis is associated with long-term survival among patients with nonmetastatic prostate cancer.

This study, nested in the Health Professionals Follow-Up Study, a cohort of male health professionals from across 50 US states ongoing since 1986, included participants with confirmed nonmetastatic prostate cancer between 1986 and January 2019, followed up through December 2022. Statistical analysis was conducted from July 2024 to May 2026.

Dietary data were collected every 4 years from validated food frequency questionnaires and used to estimate intake of saturated, polyunsaturated, monounsaturated, trans, plant, and animal fat after cancer diagnosis.

Main outcomes were all-cause mortality and death from prostate cancer, other cancers, cardiovascular disease, and other causes during a median 12.8 years (IQR, 8.1-16.8 years) of follow-up through 2022. Hazard ratios (HRs) and 95% CIs from multivariable Cox proportional hazards regression and multivariate nutrient-density models examined associations with mortality, adjusting for demographic, epidemiologic, and clinical factors.

Among 4884 patients with nonmetastatic prostate cancer, the mean (SD) age at diagnosis was 69.5 (6.9) years. During follow-up, 3040 deaths from any cause were confirmed. When comparing patients in the highest quintile of saturated fat consumption with those in the lowest quintile, higher postdiagnostic saturated fat intake was associated with greater all-cause (HR, 1.24 [95% CI, 1.05-1.47), cardiovascular (HR, 1.42 [95% CI, 1.02-1.98]), and other cancer mortality (HR, 1.42 [95% CI, 0.93-2.17]). Animal fat, a major source of saturated fats, was also positively associated with all-cause mortality (HR, 1.14 [95% CI, 0.97-1.33]), as well as deaths from other cancers (HR, 1.49 [95% CI, 1.00-2.21]). Replacing 10% of calories from animal fats with plant-based fats (HR, 0.84 [95% CI, 0.76-0.93]) and replacing 5% of calories from saturated fats with monounsaturated fats (HR, 0.80 [95% CI, 0.70-0.91]) was associated with a decrease in all-cause mortality. There were no associations between dietary fats and prostate cancer mortality.

In this cohort study of patients with nonmetastatic prostate cancer, saturated fats, including animal fats, were associated with greater all-cause mortality owing to deaths from cardiovascular disease and other cancers. Diets rich in monounsaturated and polyunsaturated fats and plant-based fats after prostate cancer diagnosis were associated with improved survival outcomes for patients. These findings support evidence-based recommendations for patients and clinicians around dietary fat consumption to improve survivorship outcomes in the clinical setting of nonmetastatic prostate cancer.

Although modern radiotherapy (RT) techniques have reduced cardiac exposure, concerns regarding RT-induced heart disease persist. Identifying which patients are most vulnerable to cardiac toxic effects is crucial for personalized survivorship care.

To evaluate whether the association between tumor laterality and ischemic heart disease (IHD) risk varies by cumulative baseline cardiovascular risk burden.

This retrospective nationwide cohort study used data on 23 305 women in the Korean National Health Insurance Service database who underwent postoperative RT for breast cancer without prior IHD from January 1, 2002, to December 31, 2018. The median follow-up was 4.3 years (IQR, 2.5-6.5 years); data analysis was completed in March 2023.

Treatment laterality (left-sided vs right-sided RT) and baseline cardiovascular risk burden (defined as a count of 6 factors: age ≥55 years, obesity, smoking, hypertension, diabetes, and dyslipidemia).

The cumulative incidence of IHD was estimated using competing-risk analysis. Subdistribution hazard ratios (sHRs) were calculated using Fine-Gray models.

Of 23 305 patients (mean [SD] age, 51.7 [9.2] years), 11 723 (50.3%) received left-sided RT and 11 582 (49.7%) received right-sided RT. Left-sided RT was associated with a statistically significant increase in IHD risk (sHR, 1.11; 95% CI, 1.01-1.22; P = .04). No statistically significant difference in IHD risk between left- and right-sided RT was observed among patients with 0 to 2 cardiovascular risk factors, whereas left-sided RT was associated with significantly higher IHD risk among patients with 3 risk factors (adjusted sHR, 1.37; 95% CI, 1.10-1.71; Gray test P = .004).

In this cohort study of 23 305 women with breast cancer, excess cardiac risk associated with left-sided RT was concentrated among patients with 3 cardiovascular risk factors. These findings suggest that among patients with low baseline risk profiles, the difference in IHD risk between left- and right-sided treatment may be small, whereas those with high cardiovascular burden warrant prioritized access to advanced heart-sparing modalities and aggressive risk factor management.

Triple-negative breast cancer (TNBC) is an aggressive subtype characterized by the absence of estrogen, progesterone, and HER2 receptors, limiting effective targeted therapies. Increasing evidence suggests that metabolic reprogramming, a hallmark of TNBC progression, is driven by underlying epigenetic mechanisms such as DNA methylation. The represented study performed an integrative analysis of transcriptomic (RNA-seq) and methylome data to uncover the metabolic-epigenetic interplay in TNBC. Differential gene expression analysis using DESeq2 revealed significant dysregulation of key metabolic genes, including upregulation of genes encoding glycolytic and serine biosynthesis enzymes and downregulation of metabolic tumor suppressors. Genome-wide methylation profiling identified extensive cytosine-phosphate-guanine (CpG) hypermethylation events associated with transcriptional repression, particularly in promoter regions. Integrative analysis pinpointed a subset of metabolism-related genes exhibiting both differential expression and methylation, such as FBP1, RASSF1A, and PHGDH. Pathway enrichment analysis highlighted aberrations in glycolysis/gluconeogenesis, fatty acid metabolism, and one-carbon pathways (adjusted p < 0.01). Importantly, TNBC patients with hypermethylated metabolic gene signatures displayed significantly shorter overall survival (log-rank p < 0.05). These findings reveal that DNA methylation-driven metabolic dysregulation contributes to TNBC aggressiveness and may provide novel biomarkers and therapeutic targets at the metabolic-epigenetic interface.

Acute leukemia is the most common cancer in children, highlighting the importance of early diagnosis. RECAF is an AFP receptor that is abnormally re-expressed in various malignant tumors, serving as a promising biomarker for tumors.

This study aimed to assess the clinical utility of RECAF expression by flow cytometry immunophenotyping in pediatric de novo acute leukemia patients.

Our study was conducted in 80 pediatric patients with acute leukemia, comprising 40 newly diagnosed ALL patients, 40 newly diagnosed AML patients, and 40 age- and sex-matched non-malignant control subjects. Flow cytometric analysis for the Acute Leukemia panel and RECAF expression was performed on all subjects, along with other laboratory and clinical parameters.

Our study revealed that RECAF expression was significantly higher in patients with acute leukemia than in controls. We also established a cutoff of ≥ 13.31% for positive RECAF expression by flow cytometry to distinguish RECAF-positive acute leukemia patients from FECAF-negative patients and normal controls.

Our findings suggest that RECAF could be an important biomarker for differentiating leukemic blasts and may become a useful tool for monitoring measurable residual disease in the future. Such advancements have the potential to improve clinical outcomes and enhance patient monitoring and management for this high-risk group.

Sentinel lymph node biopsy (SLNB) is standard for axillary staging in early breast cancer. While the combination of radioisotope and blue dye (e.g., patent blue V, PBV) remains the standard, it has limitations including logistics, variable identification rate (IR), and allergic potential. Indocyanine green (ICG) fluorescence is a promising alternative, but high-quality comparative evidence is needed.

This was a single-center, prospective, randomized controlled trial. Forty patients with early-stage, node-negative breast cancer were allocated to SLNB using either ICG (n = 20) or PBV (n = 20). All patients subsequently underwent completion level I-II axillary lymph node dissection (ALND) as the pathological reference standard for diagnostic performance assessment. Primary outcome was sentinel lymph node (SLN) IR. Secondary outcomes included detection time, number of SLNs retrieved, false-negative rate (FNR), and safety.

Baseline characteristics were comparable between groups. The SLN IR was significantly higher with ICG (100% [20/20]) than with PBV (75% [15/20], p = 0.047). ICG was associated with a significantly shorter median detection time (14.5 vs. 24.0 min, p < 0.001) and retrieved more SLNs (mean: 3.6 vs. 2.4, p = 0.002). Most critically, ICG demonstrated 100% sensitivity, specificity, negative predictive value (NPV), and overall diagnostic accuracy, with a 0% FNR. In contrast, PBV achieved a sensitivity of 75%, an overall diagnostic accuracy of 90%, and an FNR of 25%. No ICG-related adverse events occurred. PBV caused skin discoloration in 75% of patients and one (5%) allergic reaction.

ICG fluorescence achieved a higher SLN IR, shorter detection time, higher sensitivity, lower FNR, and fewer tracer-related adverse events than PBV as a single tracer for SLNB in patients with early-stage breast cancer. These findings suggest that ICG is a promising standalone tracer when radioisotope mapping is unavailable. Larger multicenter studies are required before widespread adoption can be recommended.

Candida bloodstream infections remain a significant complication of malignancies and their therapies.

To investigate the epidemiology of Candida species causing bloodstream infections in patients with malignancies.

We retrospectively reviewed bloodstream infections due to Candida from July 2008 to June 2023 in patients admitted under hematological, solid tumor and surgical services. Common species included C. albicans, Nakaseomyces glabratus (formerly C. glabrata), Pichia kudriavzevii (formerly C. krusei), C. parapsilosis complex and C. tropicalis. The rest were classified as uncommon.

Incidence of candidemia was 0.46 episodes per 1,000 patients-days of admission. Of 265 episodes of candidemia, 102 (38.5%) occurred in patients under hematological services, 59 (22.3%) under solid tumor and 104 (39.2%) under surgical services. Among 271 available isolates, C. albicans was the predominant species, accounting for 96 (35.4%). N. glabratus (formerly C. glabrata) was the dominant species in 15 (55.6%) episodes of candidemia following triazole exposure (p: 0.008) and C. parapsilosis the dominant in 15 (34.9%) following echinocandin exposure (p: < .001). Candidemia due to uncommon Candida species occurred in 22 (8.3%) episodes for the total cohort and in 17 (16.7%) in patients with hematological malignancies (p: < .001). Multivariable logistic regression analysis identified neutropenia (OR 4.5 [95% CI 1.7-11.9]) as independent predictor of candidemia caused by uncommon species.

Candidemia due to uncommon species occurred with higher frequency in patients with malignancies, with the highest rates observed among those with hematological malignancies.

Tumour recurrence after oncolytic virotherapy is a critical clinical challenge, as solid cancers tend to persist and spread after such therapies alone. Often, mathematical models consider tumour growth without taking possible cooperative cell behaviours into account. Instead, the well-known Allee effect has the ability to drive low-density tumour dynamics and affect therapeutic outcomes. For this reason, we here explore the contribution of Allee effects into two of the most common cancer growth paradigms, e.g. the logistic and the Gompertz frameworks. Our analysis reveals that density-dependent cooperation fundamentally alters virotherapy efficacy. Weak effects can enable pseudo-extinction states where tumour populations collapse to undetectable levels, whilst strong effects can interestingly create non trivial, bistable outcomes. Initial tumour burden seems to be determinant: bifurcation analysis shows scenarios where modest increase in infection or decrease in clearance rates can shift outcomes dramatically. Notably, the Gompertz model exhibits multistability under marginal Allee thresholds, pointing at a possible explanation for spontaneous remission that have been clinically observed. Overall, these findings suggest that Allee effects may be an important factor in the future to adjust dosing schedules, reduce viral loads, lower recurrence risk and shorten therapeutic times. Our framework may also offer quantitative guidance for patient-specific regimes for virotherapy and combination therapies.

Nutrition often becomes a prominent concern for patients living with metastatic cancer. While patients frequently seek nutritional information to support their health and manage treatment-related challenges, they may encounter inconsistent advice from different sources. This study aimed to explore how patients with metastatic cancer perceive and navigate nutritional information, and to identify their experiences and needs regarding nutritional support during systemic therapy.

A qualitative study using semi-structured interviews was conducted among patients with metastatic cancer receiving systemic therapy. Interviews were audio-recorded, transcribed verbatim and analyzed using reflexive thematic analysis.

Twenty-four patients (median age 55 y; 15 men; 9 women) with various tumor types participated. Three overarching themes were identified. First, nutrition became a more prominent concern after diagnosis, with patients reflecting on the role of nutrition during and after cancer treatment while adapting to treatment-related eating difficulties. Second, patients actively navigated nutrition-related information and advice from multiple sources, often encountering uncertainty and conflicting messages. Third, patients expressed a need for personalized, trustworthy and coordinated nutritional support. Respondents valued practical guidance tailored to their individual circumstances and preferred greater consistency between healthcare professionals.

For many patients with metastatic cancer the challenge is not only obtaining nutritional information but also navigating and applying information from multiple sources in daily life. Nutritional support should therefore extend beyond information provision alone and include personalized, coordinated guidance that helps patients make informed decisions and manage nutritional concerns throughout treatment.

Lynch syndrome-associated urothelial carcinoma (LS-UC) is a rare and undercharacterized clinical entity. While FGFR3 alterations are well described in sporadic urothelial carcinoma, their prevalence and clinical implications in LS-UC remain unclear. We aimed to provide a comprehensive clinical and molecular characterization of LS-UC. We conducted a retrospective single-center study including patients with Lynch syndrome (LS) and histologically confirmed urothelial carcinoma (UC). Clinical, pathological, treatment, and follow-up data were collected. Targeted next-generation sequencing was performed on available tumor samples to assess genomic alterations, with particular attention to FGFR3 mutations. A total of 27 patients with LS-UC were identified, with a predominance of upper urinary tract involvement (70%). Most tumors were diagnosed at an early stage and initially managed with local treatment. During a median follow-up of 92 months, 48% of patients experienced recurrence, with a median time to recurrence of 37 months. Recurrences were predominantly local and were mainly managed with additional surgical or intravesical treatments. No deaths were attributable to UC at last follow-up. Molecular analysis was feasible in 9 cases. FGFR3 mutations were detected in 67% of evaluable samples, with the recurrent p.Arg248Cys hotspot identified in 55% of cases. Additional alterations involved TP53, SWI/SNF complex genes, and PIK3CA, which co-occurred with FGFR3 p.Arg248Cys. No gene fusions were identified. This study expands the limited molecular and clinical evidence on Lynch syndrome-associated urothelial carcinoma. Beyond confirming the recurrent role of FGFR3 (notably p.Arg248Cys), our comprehensive multigene profiling enriches the current genomic knowledge for this rare population. Multi-center collaborative efforts remain essential to aggregate larger datasets and ultimately guide personalized patient management.