The evolving landscape of sex-based differences in lung cancer: a distinct disease in women

In stark contrast to a few decades ago when lung cancer was predominantly a disease of men who smoke, incidence rates of lung cancer in women are now comparable to or higher than those in men and are rising alarmingly in many parts of the world. Women face a unique set of risk factors for lung cancer compared to men. These include exogenous exposures including radon, prior radiation, and fumes from indoor cooking materials such as coal, in addition to endogenous exposures such as oestrogen and distinct genetic polymorphisms. Current screening guidelines only address tobacco use and likely underrepresent lung cancer risk in women. Women were also not well represented in some of the landmark prospective studies that led to the development of current screening guidelines. Women diagnosed with lung cancer have a clear mortality benefit compared to men even when other clinical and demographic characteristics are accounted for. However, there may be sex-based differences in outcomes and side effects of systemic therapy, particularly with chemotherapy and immunotherapy. Ongoing research is needed to better investigate these differences to address the rapidly changing demographics of lung cancer worldwide.

Sociodemographic Factors Associated With HPV Awareness/Knowledge and Cervical Cancer Screening Behaviors Among Caregivers in the US

Background. Family caregivers may be at a higher risk for several chronic diseases including cancer. Cervical cancer is one of the most prevalent cancers among U.S. women. Despite family caregivers’ vulnerability, the status of their HPV awareness, knowledge, and preventive health behaviors, including cervical cancer screening, have been understudied. Thus, this study aimed to examine the sociodemographic factors associated with HPV awareness and knowledge, and adherence to the cervical cancer screening guidelines among caregivers in the U.S. Methods. Nationally representative cross-sectional survey data were obtained from the Health Information National Trends Survey (HINTS 5, 2017-2020). Only female caregivers, aged 21-65, were included (N= 834). Weighted multivariate logistic regression was performed to identify factors associated with HPV awareness, knowledge, and adherence to the United States Preventive Service Task Force cervical cancer screening guidelines (by age, race/ethnicity, education, household income, marital status, employment status, and health insurance type). Results. Caregivers who were older (aged 51-65 vs. 21-50), were less educated (high school graduate or less vs. some college or more) showed lower adherence to the cervical cancer screening guidelines (every 3 years) than their counterparts. Caregivers who were older and less educated showed lower HPV awareness (Heard of HPV).Conclusions. There are caregiving populations whose HPV awareness, knowledge and cervical cancer screening adherence are low. To improve their awareness and knowledge of HPV and support their cervical cancer screening behaviors, we need to consider interventions that target those specific populations.

Imaging to intervention: a review of what the Interventionalist needs to Know about Hereditary Hemorrhagic Telangiectasia

Hereditary hemorrhagic telangiectasia (HHT) is a disorder that affects 1 in 5000–10,000 people worldwide and can result in devastating complications such as cerebral abscess, stroke, massive hemorrhage, and even death. HHT is an autosomal dominant disorder that leads to the formation of abnormal communication between the arteries and veins with a resultant spectrum of vascular anomalies. The disorder affects many organ systems and thus requires a dedicated multidisciplinary approach. Interventional radiologists are vital members of this team providing expertise not only in disease management, but in complex embolotherapy, helping to maintain the health of these patients. This article reviews clinical manifestations, screening guidelines, diagnostic criteria, and endovascular management of HHT.

The impact of medical tourism on cervical cancer screening among immigrant women in the U.S.

Background Research on the relationship between medical tourism—traveling abroad for healthcare and cervical cancer screening is lacking. This study examines (1) the association between medical tourism and cervical cancer screening among immigrant women and (2) whether the association varies across years in the U.S. Methods We analyzed the New Immigrant Survey data of immigrant women aged 21–65 (n = 999). The outcome was having had a Pap smear since becoming a permanent resident, and the main predictor was medical tourism. Logistic regressions were conducted. Results Immigrant women who engaged in medical tourism had higher cervical cancer screening rates compared to those who did not engage in medical tourism (84.09% vs. 71.68%). This relationship was statistically significant only among women who have recently immigrated, after controlling for covariates. Conclusions Immigrant women who engaged in medical tourism had 2.18 higher odds of receiving a Pap smear than immigrant women who did not, after controlling for other covariates. Health educators should be aware of the practice of medical tourism and consider providing education on adherence to cancer screening guidelines and follow up abnormal results to ensure that immigrant women receive continuous cancer care.

A RARE CASE OF COLON CANCER IN A YOUNG PATIENT: A CASE REPORT AND LITERATURE REVIEW

Malignant neoplasms of the colon and rectum are often missed in patients younger than 45 years, the uncertainty of the diagnosis by the surgical team due to unavailability of clear screening guidelines in this population may be one of the reasons. The objective of this case report is to highlight the occurrence of colon cancer in a patient younger than 45 years to avoid the delay in management and the need for clear screening guidelines. Our patient, a 30 years old lady with an average risk of colon cancer demonstrated clinical symptoms and signs suggestive of partial bowel obstruction. After full radiological and laboratory investigations, she was initially diagnosed with inflammatory vs infectious cause of this obstruction. Colonoscopy showed a mass in the right hepatic flexure and sessile polyp in the transverse colon, Histopathology result showed moderately differentiated colon cancer. The patient was taken to the operation theater, right extended hemicolectomy was done, final histopathology result showed stage IIIc cancer, the patient was sent for oncology. In a conclusion, Colon cancer in patients younger than 45 years old requires a high index of suspicion by the surgeon and the managing team despite the unavailability of clear guidelines for screening at a young age.

Future incidence and mortality of colorectal carcinoma in the United States: an updated overview of risk factors and preventative measures

According to the Global Cancer Observatory (GLOBOCAN) 2020, colorectal carcinoma (CRC) was the second leading cause of cancer death globally. Current literature utilizes reported databases such as Surveillance, Epidemiology, and End Results (SEER) to better understand the epidemiology of CRC. The global cancer observatory’s “Cancer Tomorrow” data visualization tools was used to predict the future incidence and mortality of colorectal cancers until 2030 as a guided tool to look over ways to reduce incidence by controlling risk factors of CRC. The total number of CRC is expected to rise by 2030, with a percent change of 17.3%. The expected percent change in colon cancer is more than rectal cancer (19.8% vs. 11.6%). The estimated number of deaths secondary to CRC is expected to increase in 2030, an estimated percent change of 22.2%. The incidence and mortality rate was higher in men vs. women; however, the gap seems to be closing on trend analysis. Major risk factors for CRC include familial syndromes, family history, race, gender, obesity, diet, alcohol, and smoking. Risk can be reduced by exercise and dietary changes, fiber intake, vitamin D, calcium, and minerals. Individualized screening based on age, gender, and additional risk factors could be an option that needs further comparative data to propose a definitive benefit over established screening guidelines.