Factors associated with anal cancer screening uptake in men who have sex with men living with HIV: a cross-sectional study Most western countries have guidelines on anal cancer screening for men who have sex with men (MSM) living with HIV. However, adherence to these guidelines has been studied poorly. This cross-sectional study reports anal cancer screening uptake and identifies the factors associated with a previous screening in MSM living with HIV in a Paris Hospital (France). A total of 410 outpatients completed a self-administered questionnaire on anal cancer screening. The median age was 50 years and the median time from HIV diagnosis was 14.2 years. Overall, 82.2% of patients were aware of anal cancer screening and, of these, 56.7% had already undergone a screening test. The absence of history of screening (43.3%) was most often explained by lack of time (31.3%) or information (28.2%). Among patients familiar with the anal screening procedure, those older than 50 years (adjusted odds ratio=2.4, 95% confidence interval=1.3–4.7, P=0.007) and informed by healthcare providers (adjusted odds ratio=8.2, 95% confidence interval=2.5–32.0, P=0.001) were more likely to have already been screened. To date, adherence to anal cancer screening in MSM living with HIV appears to be inadequate to enable diagnosis of cancer at its early stages. Encouraging physicians to inform MSM living with HIV about anal cancer screening, irrespective of their age, could be an effective strategy to improve anal cancer screening uptake.

Doneness preferences, meat and meat-derived heterocyclic amines intake, and N-acetyltransferase 2 polymorphisms: association with colorectal adenoma in Japanese Brazilians Intake of heterocyclic amines (HCAs) and other mutagenic compounds formed during cooking has been hypothesized to be responsible for the positive association observed between red meat and colorectal cancer. We evaluated whether well-done/very well-done preferences for various meat and fish items, higher intakes of meat and fish, and meat-derived and fish-derived HCA are associated with the risk of colorectal adenoma (CRA) in a Japanese–Brazilian population. We selected 302 patients with adenoma and 403 control individuals who underwent total colonoscopy between 2007 and 2013, and collected information on aspects of meat intake using a detailed questionnaire. We also estimated HCA intake of the study participants using an HCA database that matched the cooking methods of this population. Latent class analysis on the basis of response to doneness preferences for different cooking methods of commonly consumed meat and fish items identified four distinct subgroups. Compared with the subgroup characterized by a preference for rare/medium well-done cooking for most meat and fish items, the odds ratio of CRA for the well-done/very well-done preference subgroup was 1.19 (95% confidence interval: 0.51–2.75). High intake of mixed-meat dishes was suggestively associated inversely with CRA, whereas a high intake of poultry was associated positively with CRA. No clear association with intake of total or specific HCAs and no effect modification by N-acetyltransferase 2 acetylation genotype were observed. We found no statistically significant associations between meat and HCA intake and CRA. These findings do not support a positive association between meat and meat-derived HCA intake and the risk of CRA.

Physical activity and mortality in patients with colorectal cancer: a meta-analysis of prospective cohort studies The association between physical activity (PA) and colorectal cancer (CRC) patients’ survival is inconsistent. We conducted a systematic review and meta-analysis to summarize published articles on this issue. We performed a comprehensive search of the PubMed, Embase, and Web of Science databases for relevant articles through 28 February 2018. The summary hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a random-effects model. Eighteen prospective cohort studies were included in the meta-analysis, with a total of 9257 cases of total mortality (TM) and 4015 cases of colorectal cancer-specific mortality (CRCSM) among 31 873 CRC survivors and 557 150 general populations. Among CRC survivors, the highest versus the lowest levels of prediagnosis PA showed decreased risks of TM (summary HR = 0.81, 95% CI: 0.76–0.87, I2 = 1.8%) and CRCSM (summary HR = 0.85, 95% CI: 0.77–0.98, I2 = 0), respectively. Significant risk reductions for TM and CRCSM were also demonstrated for postdiagnosis PA (HR = 0.63, 95% CI: 0.54–0.74; and HR = 0.64, 95% CI: 0.47–0.88, respectively). The inverse association between prediagnosis PA and cancer mortality was more pronounced for colon cancer than that for rectal cancer (P = 0.08). The summary HRs (95% CIs) of TM were 0.89 (0.83–0.97) and 0.79 (0.69–0.90) per 10 metabolic equivalent task-h/week increase in prediagnosis and postdiagnosis PA, respectively. Our meta-analysis provides comprehensive evidence that PA performed before or after cancer diagnosis is related to reduced mortality risk among CRC survivors.

Supplementation with phytoestrogens and insoluble fibers reduces intestinal carcinogenesis and restores ER-β expression in Apc-driven colorectal carcinogenesis Supplementation with phytoestrogens and insoluble fibers has been reported to reduce duodenal polyps in colectomized familial adenomatous polyposis patients, with a mechanism involving, at least in part, upregulation of estrogen receptor-β subtype, whose expression is lowered during intestinal tumorigenesis. These data suggest a protective effect also in the colon, the main target organ for tumorigenesis in familial adenomatous polyposis and a major cancer type in non-familial (sporadic) cancers. Therefore, we tested whether a similar preparation might reduce tumorigenesis in the colon of Pirc rats (F344/NTac-Apcam1137) mutated in the Apc gene and thus, like familial adenomatous polyposis patients, spontaneously developing multiple tumors in the colon. We first demonstrate that estrogen receptor-β expression in Pirc rat colon is significantly down-regulated compared to age-matched wt rats. Then, Pirc rats aged 1 month were treated for 3 months with Adipol (Adi), a patented preparation containing phytoestrogens and insoluble fibers. Colon tumorigenesis was significantly reduced by Adi treatment (colon tumors/rat were 5.3 ± 0.8 and 2.9 ± 0.3, Mucin Depleted Foci/rat 127 ± 6.6 and 97.1 ± 8.6 in Controls and Adi-treated rats, respectively, means ± SE, P < 0.01). The treatment also normalized colon proliferation pattern along the crypt and significantly increased apoptosis in colon tumors. Estrogen receptor-β expression was increased by Adi treatment, especially in the tumors. These positive effects suggest that Adipol may be exploited as a chemopreventive agent to reduce cancer risk in familial adenomatous polyposis patients and to postpone prophylactic colectomy. Moreover, given the similarities between familial adenomatous polyposis and sporadic colorectal cancer, it might also be used as chemopreventive agent in colorectal cancer patients at risk.

The association of metabolic syndrome and its components with serum prostate-specific antigen levels Metabolic syndrome (MetS) can increase the risk of prostate cancer. Prostate-specific antigen (PSA) is the marker for prostate cancer puncture screening. The aim of our study was to investigate the association between MetS and its components with PSA levels. Data were obtained from 482 943 healthy men who underwent routine health check-ups from January 2010 to December 2017. We used linear regression analysis to evaluate the effects of MetS and its components on PSA levels. To explore the cumulative effect of MetS components, analysis of variance trend analysis was carried out. The PSA levels in the group with MetS were significantly lower than those without MetS (P = 0.001). In the multivariate regression model, age (P < 0.001) and hypertension (P < 0.001) were correlated positively with PSA levels; nevertheless, obesity (P < 0.001), hypertriglyceridemia (P < 0.001), hyperglycemia (P < 0.001), and low high-density lipoprotein cholesterol level (P < 0.001) had a negative correlation. In addition, after adjustment for age, increasing sums of positive MetS components were associated with a linear decrease in PSA levels (P<0.001). In conclusion, MetS, obesity, hypertriglyceridemia, hyperglycemia, and low high-density lipoprotein cholesterol levels are associated with decreased PSA levels. For patients with PSA levels at the critical value of prostate puncture, the effect of these diseases in reducing PSA levels should be taken into account.

Effect of metformin on the risk of prostate cancer in patients with type 2 diabetes by considering different confounding factors: a meta-analysis of observational studies Preclinical studies have suggested the antitumorigenic properties of metformin on prostate cancer; results from epidemiological studies remain contradictory. We aim to investigate the evidence of metformin and the risk of prostate cancer. PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies. Meta-analyses were carried out using the most fully adjusted hazard ratios and the corresponding 95% confidence intervals. Eighteen cohort studies and six case–control studies representing 2 009 504 male patients with type 2 diabetes mellitus were identified. The pooled HR of prostate cancer for metformin therapy was 0.97 (0.84–1.12) in case–control studies and 0.94 (0.79–1.12) in cohort studies, respectively. In cohort studies, we found that there was a modest association in studies with samples from Europe, but not in studies with samples from North America, Asia, and Oceania. In addition, metformin showed a slightly protective effect compared with sulfonylurea, but not insulin and other comparators. Meta-regression analyses found that obesity and prostate-specific antigen adjustment in statistical models may be the sources of heterogeneity. However, there were no significant differences in subgroups stratified by time-related biases, analytical approaches, types of risk estimates, study quality, publication year, and whether adjusted for smoking, alcohol abuse, hemoglobin A1c, diabetes duration, and other confounding factors. Our study showed that metformin therapy was not associated with the risk of prostate cancer in patients with type 2 diabetes mellitus. However, exploratory analyses suggest that metformin use may be protective in a certain subgroup of patients.

The impact of depression on adherence to organized and opportunistic breast cancer screening One in five women will experience depression over her lifetime, and one out of eight will develop breast cancer. We evaluated the effect of depression on adherence to mammography in Switzerland, where opportunistic and organized screening programs coexist. We analyzed data from 3206 women aged 50–69 who participated in the Swiss Health Survey 2012. We compared mammographic rates among women with no to mild versus moderate to severe depressive symptoms. The effect of the type of screening on the odds of undertaking a mammography was calculated using multivariable logistic regression analysis. Women with moderate to severe major depressive symptoms were more likely to have had a mammography in the previous 2 years than their nondepressed or less-depressed counterparts (51 vs. 39.2%, respectively, P = 0.005). In the multivariable analysis, women with no to mild major depression living in cantons with an organized screening program had an adjusted odds ratio of 2.7 (95% confidence interval: 2.30–3.17, P < 0.001) of having had a mammography within the past 24 months compared with those living in the regions with an opportunistic screening. The adjusted odds ratio for women with moderate to severe major depression was 4.21 (95% confidence interval: 2.13–8.33, P < 0.001). In Switzerland. adherence to mammographic screening among women with moderate to severe major depression is higher than among women with no or minimal major depressive symptoms. This increased adherence is even more pronounced in regions with organized screening.

Influences of two significant variants located in the ST6GAL1 3′-untranslated region on lung carcinoma susceptibility in the Chinese Han population The aim of this study was to identify the associations of the ST6GAL1 gene 3′-untranslated region polymorphisms with lung carcinoma risk in a Chinese Han population. Three single-nucleotide polymorphisms (SNPs; rs1042757, rs2284749, and rs2239611) in ST6GAL1 were genotyped in 322 lung carcinoma patients and 384 healthy controls. The relationships between these variants and lung cancer risk were examined by logistic regression analysis. Stratified analysis was conducted to detect the influence of these SNPs on lung carcinoma susceptibility among individuals aged younger or older than 50 years. In addition, bioinformatics analysis predicted the potential microRNAs that target the region containing the selected SNPs. We determined rs2284749 in the ST6GAL1 gene that was associated with a decreased risk of lung cancer in the Chinese Han population, based on the recessive model (odds ratio: 0.66; 95% confidence interval: 0.44–0.99, P = 0.045). Among individuals older than 50 years, we observed a protective effect of rs2284749 in the recessive model (P = 0.020) and log-additive model (P = 0.045), and rs2239611 associated with the decreased lung cancer risk under codominant (P = 0.037), dominant (P = 0.010), overdominant (P = 0.026) and log-additive (P = 0.015) models. Furthermore, bioinformatics analyses revealed distinct roles for rs2284749 and rs2239611 in the microRNA targeting sites. These findings suggested that rs2284749 and rs2239611 in the ST6GAL1 gene are associated with lung carcinoma risk in the Chinese Han population. Our results yield new insights into ST6GAL1 in lung cancer development.

Oral potentially malignant disorders: clinical diagnosis and current screening aids: a narrative review Around 300 000 patients are estimated to have oral cancer worldwide annually, and the incidence is higher in South Asian countries. In 2005, at the Congress of WHO, the term potentially malignant disorder (PMD)/lesion was suggested as a replacement for premalignant oral lesions and conditions. PMDs are those lesions of the oral mucosa that are at an increased risk of malignant transformation compared with the healthy mucosa. PMDs consist of leukoplakia, erythroplakia, oral lichen planus, oral submucous fibrosis, and other miscellaneous lesions. A literature search was performed using PubMed, Scopus, and Web of Science without any language restrictions. There is no standardized method for identifying a site for biopsy and various methods such as toluidine blue stain, methylene blue, Lugol’s iodine, and chemiluminescence have been proposed in the literature. Despite easy access to the oral cavity, there has been significant mortality associated with oral cancer as they are often diagnosed late because of the inability of healthcare professionals to identify them at early premalignant states. This article aims to provide healthcare professionals with the knowledge to identify potentially malignant disorders and to aid them in biopsy site identification.

Cytopathological tests for early detection of oral carcinogenesis The carcinogenesis in the oral cavity occurs as a multistep process and is often preceded by potentially malignant lesions. The main risk factors for the development of oral cancer are smoking and alcohol intake. The current challenge is to identify patients at greatest risk for the development of oral cancer using noninvasive and effective methods. The aim of this study is to evaluate the microsatellite mutations in the 9p21 locus, the cell proliferative activity, the pattern of epithelial desquamation, and the nucleus/cytoplasm ratio of exfoliated epithelial cells. Cytopathological samples were collected from 131 individuals divided into four groups: control (n = 26), alcohol-smoking (n = 32), leukoplakia (n = 38), and the oral squamous cell carcinoma group (OSCC, n = 35). From the cytological scraping, a slide was silver impregnated for Ag-stained nucleolar organizer region analysis and another slide was stained using the Papanicolaou technique. The remaining cells were used for DNA extraction, followed by PCR amplification and capillary electrophoresis. The cell proliferation velocity rate was higher in the leukoplakia and OSCC groups compared with the control group (P < 0.05). The leukoplakia group showed increased anucleated scales, whereas the nucleated superficial predominated in the control group and the parabasal cells in the OSCC group (P < 0.05). An increased nucleus/cytoplasm ratio was detected only in the OSCC group (P < 0.05). The 9p21 locus mutation frequency was higher in the alcohol-smoking and leukoplakia groups. 9p21 analysis and Ag-stained nucleolar organizer region methods are promising for the screening and monitoring of individuals at higher risk for the development of oral cancer.