Colorectal cancer mortality is elevated among people with intellectual disabilities, potentially because of delayed diagnosis.

To compare colorectal cancer screening participation and completion among people with and without intellectual disabilities.

This nationwide, register-based cohort study was conducted in Denmark, where all residents aged 50 to 74 years are invited to biennial, free-of-charge colorectal cancer screening. People with and without intellectual disabilities born between 1940 and 1973 and invited to colorectal cancer screening at least once between 2014 and 2023 were included.

Intellectual disability, defined as being registered with an intellectual disability diagnosis or a diagnosis most likely leading to intellectual disability. Disability severity (mild, moderate, severe, and profound) was available for a subpopulation.

The primary outcomes were colorectal cancer screening participation and completion, including stool sample return, screening results, and diagnostic examination (mainly colonoscopy) following a positive screening test result. The pseudo-observations method was used to estimate cumulative incidence differences and cumulative incidence ratios between people with and without intellectual disability.

The study included 17 117 people with (median [IQR] age, 55.2 [50.2 to 63.2] years; 8445 female [49.3%]) and 149 162 without (median [IQR] age, 54.8 [50.2 to 62.5] years; 75 324 female [50.5%]) intellectual disabilities. Among those, 5170 people with intellectual disabilities (30.2%) and 83 709 people without (56.1%) returned a stool sample within 90 days of first invitation (adjusted cumulative incidence difference, -23.2 percentage points; 95% CI, -24.0 to -22.4 percentage points), with participation increasing with disability severity (range, 1453 of 5293 individuals with mild [27.5%] to 198 of 488 individuals with profound [40.6%] intellectual disabilities). Nonanalyzable samples were more common among people with vs without intellectual disabilities (105 individuals [1.8%] vs 330 individuals [0.4%]). Among those with a positive screening test result, 347 people (70.5%) with intellectual disabilities and 4724 (90.2%) without underwent diagnostic examination (mainly colonoscopy) within 60 days (adjusted cumulative incidence difference, -17.9 percentage points; 95% CI, -22.1 to -13.7 percentage points). The proportion who underwent diagnostic examination decreased with increasing disability severity (range, 127 of 165 individuals with mild [77.0%] to 50 of 100 individuals with moderate to profound [50.0%] intellectual disabilities). Colonoscopies were more often incomplete among people with vs those without intellectual disabilities (109 individuals [28.2%] vs 673 individuals [13.8%]).

In this cohort study of people with and without intellectual disabilities, those with intellectual disabilities were less likely to participate in colorectal cancer screening and, when they did participate, more often encountered challenges with stool sample collection and colonoscopy completion. These disparities call for tailored, decision-supportive strategies to ensure equitable access to colorectal cancer screening.

Transcervical radiofrequency ablation is a low-risk, uterus-preserving option for symptomatic fibroids in women with obesity with significant improvement of bleeding disorder, including ≥ 40 kg/m². Obesity should not preclude offering TFA.

To evaluate the safety and effectiveness of transcervical radiofrequency ablation (TFA) for uterine fibroids in women with obesity.

Retrospective multicenter cohort at two German Fibroid Centers. From 574 consecutive TFA cases, we included patients with BMI ≥ 30 kg/m² and ≥ 6-month follow-up; those with incomplete data were excluded. Fibroids were characterized by ultrasound. TFA (Sonata®) was performed per instructions for use. Outcomes were perioperative complications and patient-reported improvement in abnormal uterine bleeding (AUB).

Sixty patients were analyzed (age 43.59 ± 6.52 years; BMI 35.72 ± 6.72 kg/m²). Mean operative and ablation times were 33.65 and 9.91 min, respectively. One intraoperative bleeding event (1.7%) was controlled with a balloon catheter; no postoperative complications occurred. Mean follow-up was 17.08 months (6-54). Overall, 42/60 (70.0%) reported AUB improvement. By BMI category: 30-34.9 kg/m² 25/39 (64.1%), 35-39.9 kg/m² 5/7 (71.4%), ≥ 40 kg/m² 12/14 (85.7%) (p = 0.3168). Considering the initial assessment, 48/60 (80.0%) improved; six later recurred, yielding 42/60 (70.0%) at last follow-up.

TFA showed a very low complication rate and clinically meaningful bleeding improvement in women with obesity, with comparable outcomes across BMI strata, including ≥ 40 kg/m². Obesity is not a barrier to safe, effective TFA. Prospective, BMI-stratified studies with validated bleeding measures and objective endpoints are warranted.

Cellular senescence is a double-edged sword in cancer biology, initially acting as a tumor-suppressive mechanism but later contributing to cancer progression and therapy resistance. Senescent cells, characterized by stable cell cycle arrest, secrete a complex array of bioactive molecules known as the senescence-associated secretory phenotype (SASP), which fosters chronic inflammation, disrupts tissue architecture, and promotes tumorigenesis through paracrine signaling. Accumulation of these cells in the tumor microenvironment can enhance malignancy, drive metastasis, and impair treatment outcomes. Senotherapeutics, have emerged as promising strategies for targeting senescent cells in cancer therapy. These agents selectively induce apoptosis in senescent cells while preserving normal tissues, representing a paradigm shift in oncology. Senotherapeutics can function as standalone treatments by clearing senescent tumor cells or as adjuvants to chemotherapy and radiotherapy, effectively eliminating residual therapy-induced senescent cells that may contribute to relapse. This dual approach allows for reduced treatment toxicity, improved therapeutic efficacy, and decreased tumor recurrence. Furthermore, targeting non-cancerous senescent cells may help suppress inflammation-driven tumorigenesis, slow disease progression, and enhance patient outcomes. Despite their promise, challenges remain in optimizing senotherapeutic strategies, identifying precise biomarkers, and minimizing off-target effects. This review explores the mechanisms of cellular senescence, its role in tumor dynamics, and the potential of senotherapeutics as a novel adjunct in cancer treatment. By integrating senotherapeutics with existing modalities, the field moves closer to more effective, personalized cancer interventions, warranting further preclinical and clinical investigation.

The study aims to develop and validate a predictive tool for assessing the risk of in-breast tumor recurrence (IBTR) in breast cancer patients considered candidates for intraoperative radiotherapy using electrons (IOERT).

This study included 3397 breast cancer patients treated with IOERT at a single institution between 2000 and 2016. The primary endpoint was IBTR, with or without nodal or distant metastasis. Fine and Gray regression models were used to identify predictors of IBTR. A nomogram predicting the 5- and 10-year probability of IBTR was developed based on the multivariable model and was validated both internally and externally using data from the IOERT arm of the ELIOT phase III trial (585 patients).

With a median follow-up of 6.1 years (interquartile range 4.3-8.0), 265 IBTRs (7.8%) were observed, resulting in an IBTR cumulative incidence of 4.4% (95% CI 3.7-5.2) at 5 years and 13.5% (95% CI 11.7-15.5) at 10 years. Multivariable analysis revealed that age under 60, certain histologic subtypes, positive axillary nodes, and intermediate/high tumor grade were key risk factors for IBTR. The overall Harrell's concordance statistic was 0.69 (95% CI 0.66-0.73) in the internal and 0.64 (95% CI 0.57-0.71) in the external validation.

The nomogram has demonstrated moderate discriminative ability in predicting IBTR in the internal validation set and may be a useful tool to support treatment decision-making in breast cancer patients eligible for IOERT.

Physical prehabilitation is a key element of multimodal preoperative care, but there is a lack of standardized, home-based exercise protocols, particularly in gynecological oncology. This gap, together with organizational barriers to supervised programs, may limit the feasibility and implementation of prehabilitation in many centers. The aim of this study was to present an original set of home-based physical exercises developed for patients with gynecological cancer undergoing cytoreductive surgery and to compare it with existing recommendations from the literature.

A structured literature search was conducted in PubMed, Medline, EMBASE, and PsycINFO using predefined terms related to prehabilitation, cancer, and physical exercise. Eligible studies were reviewed by two independent investigators. Based on this review and clinical experience, we developed a set of aerobic and resistance exercises tailored to the needs of gynecological oncology patients, designed to be safe, feasible, and performed at home without specialized equipment.

Eight studies describing prehabilitation exercise interventions were identified, of which only one addressed gynecological oncology specifically. Most existing programs relied on supervised or hybrid interventions and rarely provided detailed descriptions of exercises. In contrast, our proposed set includes structured aerobic activity and five resistance exercises focusing on abdominal, core, and paraspinal muscles, illustrated with infographics and supplemented with educational materials to ensure patient adherence at home.

Evidence regarding home-based prehabilitation exercise programs in gynecological oncology remains scarce. Our proposed exercise set is, to our knowledge, the first detailed, practical, and reproducible home-based protocol for this patient population and may facilitate broader implementation of prehabilitation across oncological centers.

Purpose To evaluate the performance of a CT-based model combining two-dimensional (2D) and two-and-a-half-dimensional (2.5D) deep learning (DL) with radiomic features in predicting neoadjuvant chemoimmunotherapy response in patients with esophageal squamous cell carcinoma (ESCC). Materials and Methods In this retrospective study, patients with ESCC from Sun Yat-sen Cancer Center between May 2020 and January 2023 were divided into training (80%) and internal validation (20%) groups, while an external testing group was obtained from Nanfang Hospital between January 2021 and March 2023. Radiomic features were extracted manually, while 2D and 2.5D deep transfer learning (DTL) features were derived from pretrained DL networks. The optimal model was selected based on a comparison of the areas under the receiver operating characteristic curves (AUCs). Results In total, 251 patients (mean age, 59.91 years ± 7.63; 209 male and 42 female) were included in the study, with 157 and 94 patients from centers 1 and 2, respectively. The support vector machine (SVM) model outperformed the other radiomic and DL models, while ResNet18 had the best predictive performance among the 2D and 2.5D DL models. The SVM model with ResNet18-based DTL features showed the best performance, achieving AUC values of 0.85 (95% CI: 0.76, 0.91) for 2D DTL and 0.84 (95% CI: 0.75, 0.91) for 2.5D DTL in the external testing group. Conclusion A fusion model integrating 2D and 2.5D DTL and radiomic features effectively predicted the neoadjuvant chemoimmunotherapy response in patients with ESCC. Keywords: Deep Learning, Artificial Intelligence, Prognosis & Prediction, Esophagus, CT Supplemental material is available for this article. © RSNA 2026.

Germline pathogenic variants can inform targeted therapy for metastatic prostate cancer (mPC), and improve cancer early detection and risk reduction for family members. Guidelines recommend germline genetic testing be offered to all men with mPC, yet uptake of testing is only 10%-12%.

This prospective study enrolled veterans participating in the VA Million Veteran Program (MVP) with a diagnosis of mPC. Veterans were contacted by mail with option to opt-out of future contact. Eligible veterans who did not opt-out were mailed study information and received a follow-up phone call to establish interest in germline testing. Participants provided verbal consent and were mailed a saliva collection kit for a CLIA-level multigene cancer predisposition gene panel test. Results were disclosed to the patient and oncology provider. All steps were performed with genetic counseling support.

Of 2104 eligible patients, 1952 veterans with mPC did not opt out. Of these, 681 (35%) provided consent and 459 (24%) completed testing. Of those who were approached 63% were White and 25% were Black. Fifty-nine (13%) of those completing testing carried a germline pathogenic variant in a cancer risk gene. Of the 37 eligible for targeted therapy, 14 received targeted therapy, 18 did not yet have an indication for that therapy, and five were deceased without having received targeted therapy.

Participant completion of remote germline testing was facilitated at rates higher than the 10% previously reported. Remote genetic testing can augment uptake of testing in large, integrated health care systems.

Solid organ transplant (SOT) recipients face increased colorectal cancer (CRC) risk due to chronic immunosuppression and comorbidities such as primary sclerosing cholangitis, inflammatory bowel disease, and cystic fibrosis. Despite this elevated risk, CRC screening and treatment guidelines specific to transplant recipients remain limited. This systematic review and meta-analysis evaluated the prevalence, clinical characteristics, risk factors, and outcomes of CRC in SOT recipients.

A comprehensive search across major databases identified studies reporting CRC incidence and outcomes in kidney, liver, heart, and lung transplant recipients. Study quality was assessed using validated risk-of-bias tools. Pooled estimates were calculated using a random-effects model; heterogeneity and organ-specific subgroup analyses were also conducted.

The pooled incidence of CRC in SOT recipients was 0.95% (95% CI: 0.35%-1.55%). Incidence was highest in heart transplant recipients (1.27%), followed by kidney (1.12%), lung (0.56%), and liver (0.53%) recipients. The mean time to CRC diagnosis was 8.8 years (95% CI: 5.94-11.82). A total of 41.13% of patients presented with stage III/IV or metastatic disease, and right-sided tumors predominated (46.34%). Surgical resection was performed in 62.74% of patients. The mortality rate among CRC patients post-transplant was 61.13% (95% CI: 39.55%-82.7%).

CRC in SOT recipients is associated with increased incidence, delayed diagnosis, and poor prognosis. The predominance of right-sided tumors and late-stage presentation underscore the need for tailored screening and surveillance protocols. Future clinical guidelines should incorporate organ-specific risk stratification and long-term monitoring to optimize outcomes in this high-risk population.

Non-melanoma skin cancer (NMSC) is a frequent long-term complication in transplant recipients, mainly due to chronic immunosuppression. Its incidence varies by transplant type and regimen, but existing evidence is often fragmented.

To assess long-term incidence and risk factors for NMSC, comparing transplant types, immunosuppressive regimens, and tumor subtypes.

This retrospective cohort comprised 901 transplant recipients (1975-2024) who were under long-term dermatologic follow-up. Data on transplant type, immunosuppressive regimen/duration, and tumor subtype were analyzed. NMSC-free survival was evaluated with Kaplan-Meier curves; Cox regression assessed predictors.

Among 901 transplant recipients, 191 (21.2%) developed at least one NMSC during long-term follow-up. Crude incidence rates ranged between 1.88 and 2.68 per 100 person-years across immunosuppressive drug classes and agents. In multivariable Cox models, older age at first transplant was independently associated with higher NMSC risk (HR 1.07 per year, 95% CI 1.06-1.09, p < 0.001). Sex, transplant group, and ever-use of individual immunosuppressive agents were not significantly associated with NMSC risk after adjustment.

In this long-term cohort, NMSC risk increased with age at first transplant, whereas transplant organ and ever-use of major immunosuppressive agents were not independently associated in adjusted models. Over an extended follow-up, NMSC accumulated steadily, with crude incidence rates around 1.88-2.68 cases per 100 person-years across immunosuppressive classes and agents, underscoring the cumulative nature of skin cancer risk under chronic immunosuppression. Our results reinforce the need for sustained, long-term dermatologic surveillance, particularly in older patients undergoing transplantation.

This study evaluated the clinical relevance of EBI3 polymorphisms, along with tumor Epstein-Barr virus (EBV) and Human Cytomegalovirus (HCMV) status, in prognostically adverse HPV-negative OSCCs.

EBI3 (rs4740, rs4905, rs428253) genotyping was performed by qPCR in 95 HPV-negative OSCC patients and 108 age- and sex-matched controls. Tumor HPV, EBV, and HCMV status were assessed by qPCR. EBV viral load was calculated by exponential approach and a relative estimate of EBV copies per 105 cells. Associations with overall survival (OS) and recurrence-free survival (RFS) were evaluated by Kaplan-Meier and Cox regression analyses.

EBV-positive tumors showed a significant association with increasing nodal stage (P=0.020). EBV viral load stratification (negative, low, high) presented a non-significant trend toward association with advanced tumor stage (P=0.060). Notably, EBI3 rs428253 predicted worse OS in EBV-positive patients, whereas rs4740 and rs4905 variants were associated with advanced tumor stage (P=0.024 and P=0.018). rs4740 and rs4905 variants were inversely associated with OSCC risk in dominant and overdominant models. Analysis detected HCMV in 7.4% of tumors but was not clinically relevant.

EBI3 genetic variants and EBV status may have prognostic relevance in HPV-negative OSCC. EBV may interact with the host genetics to influence nodal metastases and outcomes, suggesting a potential EBV-EBI3 axis, which warrants further investigation. Future precision oncology approaches may incorporate host and viral genetic markers to identify and stratify high-risk HPV-negative OSCC patients.