Chronic atrophic gastritis (CAG), primarily driven by Helicobacter pylori infection, is a well-established precursor to gastric cancer. However, its association with extragastric malignancies remains poorly understood, especially in high-prevalence, resource-limited settings. We aimed to evaluate the risk of gastric and extragastric cancers in Thai patients with CAG.

This hospital-based prospective cohort study included 1,252 Thai adults with histologically confirmed CAG between 2012 and 2017. Participants were stratified by H. pylori status. Incident cancers were identified via linkage with the national cancer registry through 2023. Cancer risks were estimated using Kaplan-Meier survival analysis and Cox proportional hazards models, adjusting for demographic, behavioral, and familial factors.

Over a median follow‑up of 7.9 years (9,679 person‑years), 44 participants developed cancer, corresponding to an incidence of 455 per 100,000 person‑years. Gastric cancer (n = 14) and breast cancer (n = 16) were the most frequent malignancies. H. pylori-associated atrophic gastritis (HPAG) was significantly associated with increased risks of gastric cancer (HR 2.03; 95% CI: 1.25-3.26; p = 0.012) and breast cancer (HR 7.35; 95% CI: 2.08-17.13; p < 0.001) compared with non‑HPAG patients. No significant associations were observed for other cancer types.

HPAG is a primary driver of gastric cancer risk and is associated with a significantly elevated risk of breast cancer in this cohort. These findings underscore the importance of early detection and eradication of H. pylori before irreversible glandular loss. While the breast cancer association is exploratory, it suggests systemic oncogenic effects of chronic infection, warranting prioritized gastric surveillance and consideration for breast cancer screening in female HPAG patients.

In many routine pathology settings, particularly where resources are constrained, liver tumors are evaluated with an individualized, morphology-guided immunohistochemistry (IHC) strategy rather than fixed panels or molecular assays. Despite widespread use, the real-world diagnostic yield, stain utilization, and laboratory cost of this approach are not well defined.

We retrospectively reviewed consecutive malignant liver tumor diagnoses at a university-affiliated hospital from January 2020 to December 2023. Cases were classified as primary liver cancers or metastatic tumors. IHC was performed using a morphology-guided, case-based sequence. Primary outcomes were histologic subtype assignment among primary liver cancers and determination of the primary site among liver metastases. Secondary outcomes were IHC stain utilization and laboratory cost per case.

Among 279 malignant liver tumors, 144 (51.6%) were primary and 135 (48.4%) were metastatic. Hepatocellular carcinoma accounted for 80.6% of primary liver cancers. Among metastases, a likely primary site was identified in most cases; colorectal (31.1%), lung (9.6%), and pancreatic (8.1%) primaries were most common, while cancers of unknown primary comprised 14.8%. IHC utilization was lower in primary tumors than in metastases (median 2 stains/case [IQR 2-4] vs 4 stains/case [IQR 2-7]; p<0.001). Correspondingly, median laboratory IHC cost per case was lower for primary tumors than for metastases (USD 29.90 [IQR 21.73-51.00] vs USD 46.92 [IQR 21.73-92.57]; p<0.001).

An individualized, morphology-guided IHC strategy enabled reliable subtyping of primary liver cancers and identification of likely primary sites for most liver metastases while maintaining compact stain utilization and moderate laboratory costs. These data provide practical, real-world benchmarks for diagnostic performance and resource use and support targeted, hypothesis-driven IHC where broad fixed panels or molecular diagnostics are not routinely available.

Breast cancer continues to be a major cause of illness and mortality for women. Delayed detection remains a significant barrier to better health outcomes in many settings. This study explored the critical role of community health workers (CHW) in breast cancer prevention and identified practical strategies to enhance their effectiveness.

This descriptive qualitative study, using an interpretivist paradigm, was conducted in the Kaliwates subdistrict, Jember, Indonesia, from May 2024 to January 2025. Purposive sampling was used, including 12 CHWs with ≥1 year of involvement in the cancer program and 5 Healthcare Professionals (HCPs) involved in community health worker programs. In-depth interviews, each lasting between 60 and 90 minutes within 2-3 sessions, were performed. Interviews were concluded once data saturation was reached. All sessions were audio-recorded, transcribed verbatim, and analyzed using the six steps of Braun and Clarke's thematic analysis with ATLAS.ti software. To ensure trustworthiness, member checking and triangulation were employed.

Analysis of data from all 17 participants generated three themes. Theme one positioned CHWs as catalysts for early breast cancer prevention through building community confidence in breast self-examination and guiding individuals to professional care. Theme two focused on capacity development, emphasizing skill and confidence building alongside trust-building communication strategies. Theme three highlighted health system support and collaboration, identifying the need for adequate resources and formal recognition of collaborative efforts.

CHWs have a pivotal role in early breast cancer prevention. Strengthening their capacity through targeted training and trust-based communication, supported by adequate resources and collaborative recognition within the health system, is essential for optimizing their impact. Future research should focus on designing targeted interventions grounded in empowerment models to enhance CHWs' early detection skills.

Cholangiocarcinoma (CCA) is a major public health issue in Southeast Asia and has the highest global incidence in Northeast Thailand. Thailand has implemented cholangiocarcinoma screening; nonetheless, public access to screening remains limited. This study aims to examine the impact of cost barriers on cholangiocarcinoma rescreening intention with a mediating effect of health literacy.

This cross-sectional study was conducted with participants who received cholangiocarcinoma screening in four community hospitals between November and December 2024. The association between costs, health literacy, and rescreening intention was investigated through causal mediation analysis.

This study examined 171 participants; most participants were female (57.9%). Participants' rescreening intention was 71.9% (95%CI: 65.2% to 78.7%). Males intend to rescreen 75% more than females (69.7%). When quantifying the effect of costs channeled through health literacy to rescreening intention, 1) direct non-medical costs in the natural indirect effect showed statistically significant results at the lower to moderate cost levels. The results showed a statistically significant negative indirect effect at 300 THB (probability difference = -0.118, 95% CI: -0.182 to -0.055) and 500 THB (probability difference -0.135, 95% CI: -0.244 to -0.027). 2) Indirect costs in the natural indirect effect showed statistically significant results at the lowest levels. A statistically significant negative indirect effect was observed at 300 THB (probability difference -0.059, 95% CI: -0.095 to -0.023).

Using health literacy as a mediator, direct non-medical costs and indirect cost expenses affect cholangiocarcinoma screening decisions. Expanding screening to communities, minimizing costs, and increasing health literacy on cholangiocarcinoma may increase screening.

Prostate cancer is one of the most common malignancies in men, and current diagnostic tools, such as prostate-specific antigen (PSA) and biopsy remain limited by low specificity and invasiveness. Urinary volatile organic compounds (VOCs) are increasingly recognized as promising non-invasive biomarkers reflecting tumor-associated metabolic changes. This study aimed to evaluate the diagnostic potential of urinary VOCs using a semiconductor-based gas-sensor platform.

Urine samples from patients with prostate cancer and non-cancer controls were analyzed using an array of five metal oxide semiconductor sensors (S1-S5), each tuned to specific VOC groups. Measurements were performed under six thermal cycles with sequential heater voltages (2000-5000 mV). Sensor signals were converted into characteristic parameters following a validated extraction protocol. Logistic regression was used to determine discriminatory performance.

Ten candidate VOC parameters were initially identified with significant intergroup separation. In the multivariate model, the resistance gap at 2500 mV targeting trimethylamine and methyl mercaptan remained independently associated with prostate cancer. When combined with PSA in the logistic regression model, this VOC-derived signal yielded an AUC of 0.88, with a 77% sensitivity and 88% specificity for distinguishing cancer from controls.

Urinary VOCs demonstrate strong potential as non-invasive biomarkers for prostate cancer detection. The diagnostic performance of the combined VOC-PSA model (AUC 0.88) exceeded that of PSA alone, underscoring the feasibility of gas-sensor platforms in urologic cancer diagnostics and supporting validation in larger, prospective cohorts.

Cholangiocarcinoma (CCA) is an aggressive biliary malignancy with poor prognosis, largely due to delayed diagnosis. In endemic regions, abdominal ultrasonography is a rapid, inexpensive, and widely available surveillance tool that may support earlier detection. However, some lesions are missed at initial screening and detected only on follow-up. This study aimed to characterize the sonographic features and anatomical distribution of previously undetected or newly identified CCAs detected through an ultrasound-based surveillance program.

We retrospectively reviewed patients diagnosed with CCA through an abdominal ultrasound surveillance program in Nan Province, Thailand, between 2011 and 2017. Ultrasound findings and lesion locations were analyzed. All patients underwent confirmatory computed tomography or magnetic resonance imaging at Chulabhorn Hospital, with pathological confirmation of CCA. Descriptive and comparative analyses were performed.

Thirty-nine patients with 41 lesions were identified after a negative ultrasound examination 6 months earlier. Sonographic patterns included isolated hepatic masses, hepatic masses with bile duct dilatation, focal segmental bile duct dilatation, diffuse bile duct dilatation, and intraductal nodules. The most common presentations were isolated liver masses, liver masses with bile duct dilatation, and focal peripheral bile duct dilatation. Lesions were predominantly located in the peripheral intrahepatic bile ducts, especially second-order branches in hepatic segments VI and VII.

Previously undetected or newly identified CCAs during ultrasound surveillance most commonly appear as small hepatic nodules or focal bile duct abnormalities arising from peripheral and second-order intrahepatic bile ducts, particularly in posterior right hepatic segments VI-VII. These patterns may reflect both liver fluke-associated cholangiocarcinogenesis and technical limitations of ultrasonography in hepatic blind areas. Careful evaluation of these high-risk regions and awareness of subtle signs, including small hyperechoic nodules and focal ductal dilatation, may improve early detection and optimize surveillance in endemic populations.

The growing dependence on digital platforms for health-related information has positioned YouTube as a key provider of vaccine-related content in India. Nonetheless, the quality, reliability, and completeness of the information accessible on this platform are still questionable. This study sought to assess the content, quality, and reliability of YouTube videos pertaining to HPV vaccination within the Indian context.

Search terms "Cervical Cancer Vaccination" and "HPV Vaccine" were used to cross-sectionally analyze YouTube videos. Screening the first 200 videos yielded 81 suitable English or Hindi videos. Data on video attributes and engagement was captured. Audio-Visual Quality (AVQ), Global Quality Score (GQS), modified Quality Criteria for Consumer Health Information (mDISCERN), and Video Information and Quality Index assessed quality and dependability. The new Content Score for Cervical Cancer Vaccination (CSCCV) was developed based on national and international guidelines to assess content completeness.

A total of 81 videos were analyzed and median duration of the videos 169 seconds, Health-related channels accounted for 51(63.0%) of uploads, and doctors or medical experts serving as speakers in 46(56.8%) of cases. Although none of the videos depicted HPV vaccination unfavourably, engagement metrics did not align with the level of information presented. Videos involving medical professionals exhibited markedly higher mDISCERN scores (p = 0.001), signifying enhanced reliability. The overall content completeness was moderate, exhibiting notable deficiencies in guideline-based information.

YouTube videos regarding HPV vaccination in India are predominantly favourable, although they exhibit variability in dependability and comprehensiveness. Enhancing expert-driven, guideline-compliant, and multilingual digital resources is crucial for promoting HPV vaccine adoption and advancing cervical cancer prevention initiatives in India.

To evaluate the prognostic performance of lymphovascular space invasion (LVSI) quantification in patients with endometrial carcinoma (EC).

Clinical and pathological data from EC patients who underwent primary surgical treatment between January 2008 and December 2020 were analyzed. Five-year progression-free survival (PFS) and overall survival (OS) were compared across LVSI categories (absent, focal, substantial) using previously proposed thresholds for substantial LVSI (≥3, ≥4, or ≥5 involved spaces).

A total of 843 patients were included (mean follow-up, 9.5 years). All three thresholds (3, 4, or 5 spaces) yielded significant differences in PFS and OS across LVSI categories (absent, focal, and substantial; p < 0.001). After adjustment for established clinicopathologic prognostic factors, substantial LVSI remained independently associated with worse PFS and OS compared with absent LVSI (PFS: p = 0.005-0.007; OS: p = 0.002-0.006). Focal LVSI, defined as <4 or <5 spaces, showed a trend toward lower adjusted PFS compared with absent LVSI, although the difference did not reach statistical significance (p = 0.052-0.059). For OS, focal LVSI showed worse adjusted outcomes than absent LVSI when using the <5-space definition (p = 0.024). No significant adjusted differences in PFS or OS were observed between focal and substantial LVSI.

Substantial LVSI (at least 3 involved spaces) is strongly associated with poorer prognosis in EC. Additionally, focal LVSI may be linked to decreased survival. These findings underscore the prognostic value of LVSI quantification and support further investigation into the clinical relevance of focal LVSI.

Cervical cancer is a major public health issue in Indonesia due to limited screening reach. Identifying the factors influencing screening uptake is critical for enhancing screening uptake strategies.

This cross-sectional study utilised data from the 2023 Indonesian Health Survey (IHS) to explore the predictors of cervical cancer screening uptake among women aged 15-49 years. Bivariate and multivariate logistic regression analyses were performed to assess associations.

This study included 163,433 women, with only 8.7% (n = 14,184) reporting participation in cervical cancer screening. Age, education, occupation, health insurance ownership, information exposure, and parity were significantly associated with cervical cancer screening. Among these, exposure to cervical cancer information showed the strongest effect, with informed women having more than twice the odds of screening (OR = 2.252, 95% CI: 1.992-2.545).

Cervical cancer screening uptake is low in Indonesia and is predicted by age, education, health insurance coverage, and exposure to cervical cancer information. Targeted interventions to improve these factors are essential for enhancing screening uptake and reducing the burden of cervical cancer. Future research should explore longitudinal studies to establish causal relationships between the identified factors and cervical cancer screening uptake.

The objective of the present study was to explore the prevalence, risk and prognostic factors for bone metastases (BM) developement in patients with initial gastric cancer (GC).

A total of 30,817 patients with GC in the Surveillance, Epidemiology and End Results (SEER) database, diagnosed from 2010 to 2016, were used to investigate the incidence and associated risk factors for BM developments using multivariate logistic regression. Among those, 1397 and 1121 BM patients were selected to identify independent prognostic factors for BM overall survival (OS) and cancer-specific survival (CSS) using multivariate Cox regression respectively.

A total of 1397 (4.53%) GC patients were diagnosed with BM at initial diagnosis. Younger age (<60 years), white race, cardia cancer, signet ring cell, higher grade, tumor size between 2.1 and 4.0 cm, the presence of regional lymph nodes (RLN) metastases, brain metastases, liver metastases, and lung metastases were positively associated with BM development. Conversely, a lower T stage was negatively associated with BM development compared to the T4 stage. The median survival time for GC patients with BM decreased dramatically to 5 months. The presence of RLN metastases was an independent predictor of worse overall survival and cancer-specific survival. Conversely, T2 stage and chemotherapy were associated with better overall survival and cancer-specific survival. Additionally, patients with cardia cancer had favorable cancer-specific survival.

The prognosis of gastric cancer patients with BM was dismal. Our findings of several risk factors for BM development and prognostic factors for BM patients could be useful for clinical surveillance and individualized treatment.