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1.
JAMA Netw Open ; 5(11): e2242354, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2119297

ABSTRACT

Importance: Cancer screening deficits during the first year of the COVID-19 pandemic were found to persist into 2021. Cancer-related deaths over the next decade are projected to increase if these deficits are not addressed. Objective: To assess whether participation in a nationwide quality improvement (QI) collaborative, Return-to-Screening, was associated with restoration of cancer screening. Design, Setting, and Participants: Accredited cancer programs electively enrolled in this QI study. Project-specific targets were established on the basis of differences in mean monthly screening test volumes (MTVs) between representative prepandemic (September 2019 and January 2020) and pandemic (September 2020 and January 2021) periods to restore prepandemic volumes and achieve a minimum of 10% increase in MTV. Local QI teams implemented evidence-based screening interventions from June to November 2021 (intervention period), iteratively adjusting interventions according to their MTVs and target. Interrupted time series analyses was used to identify the intervention effect. Data analysis was performed from January to April 2022. Exposures: Collaborative QI support included provision of a Return-to-Screening plan-do-study-act protocol, evidence-based screening interventions, QI education, programmatic coordination, and calculation of screening deficits and targets. Main Outcomes and Measures: The primary outcome was the proportion of QI projects reaching target MTV and counterfactual differences in the aggregate number of screening tests across time periods. Results: Of 859 cancer screening QI projects (452 for breast cancer, 134 for colorectal cancer, 244 for lung cancer, and 29 for cervical cancer) conducted by 786 accredited cancer programs, 676 projects (79%) reached their target MTV. There were no hospital characteristics associated with increased likelihood of reaching target MTV except for disease site (lung vs breast, odds ratio, 2.8; 95% CI, 1.7 to 4.7). During the preintervention period (April to May 2021), there was a decrease in the mean MTV (slope, -13.1 tests per month; 95% CI, -23.1 to -3.2 tests per month). Interventions were associated with a significant immediate (slope, 101.0 tests per month; 95% CI, 49.1 to 153.0 tests per month) and sustained (slope, 36.3 tests per month; 95% CI, 5.3 to 67.3 tests per month) increase in MTVs relative to the preintervention trends. Additional screening tests were performed during the intervention period compared with the prepandemic period (170 748 tests), the pandemic period (210 450 tests), and the preintervention period (722 427 tests). Conclusions and Relevance: In this QI study, participation in a national Return-to-Screening collaborative with a multifaceted QI intervention was associated with improvements in cancer screening. Future collaborative QI endeavors leveraging accreditation infrastructure may help address other gaps in cancer care.


Subject(s)
COVID-19 , Neoplasms , Humans , Quality Improvement , Early Detection of Cancer , Pandemics , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , Mass Screening , Neoplasms/diagnosis , Neoplasms/epidemiology , Neoplasms/prevention & control
2.
J Interferon Cytokine Res ; 42(11): 592-593, 2022 11.
Article in English | MEDLINE | ID: covidwho-2117093

ABSTRACT

Recently, messenger ribonucleic acid (mRNA) vaccine research and development became a hotspot in the field of prevention and treatment of Corona Virus Disease 2019 (COVID-19) and some other disorders. mRNA vaccine shows many advantages over other vaccines, including cost-effectiveness, safety, and rapid optimization of antigen-specific sequences and shorter development cycle. Cancer progression is significantly associated with immune response, and mRNA vaccine also shows obvious advantages for cancer immunotherapy. In this study, we briefly summarize the recent advances and discuss the perspectives on tumor mRNA vaccine development; particularly, these findings pave an avenue for effective cancer prevention and treatment.


Subject(s)
COVID-19 , Cancer Vaccines , Neoplasms , Humans , COVID-19/prevention & control , Cancer Vaccines/genetics , Neoplasms/genetics , Neoplasms/prevention & control , RNA, Messenger/genetics
3.
Front Biosci (Landmark Ed) ; 27(9): 253, 2022 08 31.
Article in English | MEDLINE | ID: covidwho-2067594

ABSTRACT

SIRT1 was discovered in 1979 but growing interest in this protein occurred only 20 years later when its overexpression was reported to prolong the lifespan of yeast. Since then, several studies have shown the benefits of its increased expression in preventing or delaying of many diseases. SIRT1, as a histone deacetylase, is an epigenetic regulator but it has wide range of non-histone targets which are involved in metabolism, energy sensing pathways, circadian machinery and in inflammatory regulation. Disturbances in these interconnected processes cause different diseases, however it seems they have common roots in unbalanced inflammatory processes and lower level or inactivation of SIRT1. SIRT1 inactivation was implicated in coronavirus disease (COVID-19) severity as well and its low level counted as a predictor of uncontrolled COVID-19. Several other diseases such as metabolic disease, obesity, diabetes, Alzheimer's disease, cardiovascular disease or depression are related to chronic inflammation and similarly show decreased SIRT1 level. It has recently been known that SIRT1 is inducible by calorie restriction/proper diet, physical activity and appropriate emotional state. Indeed, a healthier metabolic state belongs to higher level of SIRT1 expression. These suggest that appropriate lifestyle as non-pharmacological treatment may be a beneficial tool in the prevention of inflammation or metabolic disturbance-related diseases as well as could be a part of the complementary therapy in medical practice to reach better therapeutic response and quality of life. We aimed in this review to link the beneficial effect of SIRT1 with those diseases, where its level decreased. Moreover, we aimed to collect evidences of interventions or treatments, which increase SIRT1 expression and thus, open the possibility to use them as preventive or complementary therapies in medical practice.


Subject(s)
Epigenesis, Genetic , Metabolic Diseases , Neoplasms , Sirtuin 1 , COVID-19 , Homeostasis , Humans , Inflammation , Metabolic Diseases/genetics , Metabolic Diseases/prevention & control , Neoplasms/genetics , Neoplasms/prevention & control , Quality of Life , Sirtuin 1/genetics , Sirtuin 1/metabolism
4.
Anticancer Res ; 42(10): 5027-5034, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2056773

ABSTRACT

Official public health pronouncements about sun exposure and vitamin D can be summarized as follows: First, there is no such thing as a safe tan. Therefore, avoid exposing the skin to sunshine. Second, in the absence of sunshine, a daily intake of 800 IU/day (20 mcg/d) vitamin D or less is sufficient for the health needs of almost all members of the population. However, exposure of the skin to sunlight induces multiple mechanisms that lower blood pressure, while also initiating production of vitamin D, which is needed to produce a hormone that regulates multiple systems including the cellular biology that affects cancer mortality. Disease-prevention relationships point to a beneficial threshold for serum 25-hydroxyvitamin D [25(OH)D; the index of vitamin D nutrition] that is at least 75 nmol/l (30 ng/ml). To ensure the threshold for all adults, an average per-day minimum total input of vitamin D3 from sunshine/UVB exposure, and/or from food (natural food like fish or fortified food like milk), and/or vitamin supplementation of at least 4,000 IU/d (100 mcg/d) is required. Strong, although not Level-1, evidence indicates that the maintenance of that threshold will lower mortality overall, lower mortality from cancer, and lower the risk of certain other diseases such as respiratory infection and COVID-19.


Subject(s)
COVID-19 , Neoplasms , Vitamin D Deficiency , Animals , Cholecalciferol , Dietary Supplements , Hormones , Neoplasms/prevention & control , Public Health , Sunlight/adverse effects , Triacetoneamine-N-Oxyl , Vitamin D/therapeutic use , Vitamins/therapeutic use
6.
Inflammopharmacology ; 30(3): 775-788, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-2003753

ABSTRACT

Metformin can suppress gluconeogenesis and reduce blood sugar by activating adenosine monophosphate-activated protein kinase (AMPK) and inducing small heterodimer partner (SHP) expression in the liver cells. The main mechanism of metformin's action is related to its activation of the AMPK enzyme and regulation of the energy balance. AMPK is a heterothermic serine/threonine kinase made of a catalytic alpha subunit and two subunits of beta and a gamma regulator. This enzyme can measure the intracellular ratio of AMP/ATP. If this ratio is high, the amino acid threonine 172 available in its alpha chain would be activated by the phosphorylated liver kinase B1 (LKB1), leading to AMPK activation. Several studies have indicated that apart from its significant role in the reduction of blood glucose level, metformin activates the AMPK enzyme that in turn has various efficient impacts on the regulation of various processes, including controlling inflammatory conditions, altering the differentiation pathway of immune and non-immune cell pathways, and the amelioration of various cancers, liver diseases, inflammatory bowel disease (IBD), kidney diseases, neurological disorders, etc. Metformin's activation of AMPK enables it to control inflammatory conditions, improve oxidative status, regulate the differentiation pathways of various cells, change the pathological process in various diseases, and finally have positive therapeutic effects on them. Due to the activation of AMPK and its role in regulating several subcellular signalling pathways, metformin can be effective in altering the cells' proliferation and differentiation pathways and eventually in the prevention and treatment of certain diseases.


Subject(s)
Metformin , Neoplasms , AMP-Activated Protein Kinases/metabolism , Cell Proliferation , Hepatocytes , Humans , Hypoglycemic Agents/metabolism , Hypoglycemic Agents/pharmacology , Metformin/pharmacology , Metformin/therapeutic use , Neoplasms/drug therapy , Neoplasms/prevention & control
7.
Cancer Cell ; 40(6): 559-564, 2022 06 13.
Article in English | MEDLINE | ID: covidwho-1944424

ABSTRACT

Given the renewed interest in vaccine development sparked by the COVID-19 pandemic, we are revisiting the current state of vaccine development for cancer prevention and treatment. Experts discuss different vaccine types, their antigens and modes of action, and where we stand on their clinical development, plus the challenges we need to overcome for their broad implementation.


Subject(s)
COVID-19 , Cancer Vaccines , Neoplasms , COVID-19/prevention & control , Cancer Vaccines/therapeutic use , Humans , Neoplasms/prevention & control , Pandemics/prevention & control
9.
Cancer Prev Res (Phila) ; 14(12): 1053-1054, 2021 12.
Article in English | MEDLINE | ID: covidwho-1938104

ABSTRACT

On October 20, 2021, I had the privilege of testifying before the House Energy and Commerce Committee, Subcommittee on Health Hearing on Enhancing Public Health: Legislation to Protect Children and Families. This commentary is based on the written testimony I provided to the Subcommittee on issues related to cancer screening and early detection. It highlights the research progress, updated guidelines, and new challenges in this field, emphasizing the importance of screening asymptomatic, at-risk population to detect precancerous lesions or cancer at an early stage.


Subject(s)
Early Detection of Cancer , Neoplasms , Child , Humans , Mass Screening , Neoplasms/diagnosis , Neoplasms/epidemiology , Neoplasms/prevention & control , Public Health
10.
J Community Health ; 47(5): 862-870, 2022 10.
Article in English | MEDLINE | ID: covidwho-1930477

ABSTRACT

Coronavirus disease of 2019 (COVD-19) continues to disrupt cancer care delivery efforts and exacerbate existing health inequities. Here we describe the impact of COVID-19 on community outreach organizations partnering with a National Cancer Institute-designated Community Outreach and Engagement (COE) office in New York City (NYC) and lessons learned from these experiences. Between July and September of 2020, we conducted 16 semi-structured interviews with community key-informants to validate and inform efforts to support community organizations in response to COVID-19. Key-informants represented organizations performing a broad range of health and cancer care activities serving historically underserved, low-income, marginalized communities of color in NYC. All interviews were recorded, transcribed, and analyzed using rapid qualitative approaches. We summarize our response to challenges raised by partnering organizations. Themes included the impact of COVID-19 on communities served, challenges faced by organizations, and solutions to address COVID-19 related challenges. The COE and community organizations had to shift priorities and adapt engagement efforts to address the more urgent needs of the community (e.g., emotional distress, food insecurity). COVID-19 disrupted traditional community engagement activities for cancer outreach-calling for creativity and innovation in the community engagement process and shift in priorities. The COE responded by maintaining ongoing dialogue with community partners, by being flexible in scope/priorities beyond cancer prevention and control, and by providing education, outreach, fundraising and other resources, and developing new partnerships to meet needs of community organizations and the populations they serve.


Subject(s)
COVID-19 , Neoplasms , COVID-19/epidemiology , Community-Institutional Relations , Food Insecurity , Humans , National Cancer Institute (U.S.) , Neoplasms/prevention & control , Pandemics , United States/epidemiology
12.
Cancer Epidemiol Biomarkers Prev ; 31(6): 1243-1246, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1874909

ABSTRACT

As leaders with the American Society of Preventive Oncology (ASPO) Cancer Health Disparities Special Interest Group, we describe the role of structural racism in perpetuating cancer health inequity historically, and potential implications of COVID-19 in exacerbating the effects of structural racism on patients with cancer seeking screening, diagnostic care, treatment, and survivorship support. As a strategy to reduce cancer inequities in the United States, we provide the following calls to action for cancer researchers to help alleviate the burden of structural racism: (i) identify and name structural racism while describing its operation within all aspects of scientific research; (ii) comprehensively integrate discussions on structural racism into teaching, mentoring, and service activities; and (iii) understand and support community actions to address structural racism.


Subject(s)
COVID-19 , Neoplasms , Racism , Humans , Neoplasms/prevention & control , Racial Groups , Racism/prevention & control , Systemic Racism , United States/epidemiology
14.
Cancer Prev Res (Phila) ; 15(5): 279-284, 2022 05 03.
Article in English | MEDLINE | ID: covidwho-1832720

ABSTRACT

The COVID-19 pandemic overloaded health care systems around the globe and brought travel restrictions and other mandates. These effects critically impacted cancer care and conduct of clinical trials, and required medical and research communities to incorporate changes and novel flexible workflows within clinical trials and regulations to improve efficiency. We report the impact of the pandemic on cancer prevention clinical trials managed by the Division of Cancer Prevention within the NCI, focusing on participant-centric, study staff-centric and regulatory elements. Learning lessons from this challenging period, the cancer prevention community has the opportunity to incorporate many of these necessitated novel approaches to future design of clinical trials, to streamline and improve clinical trial efficiency and impact.


Subject(s)
COVID-19 , Clinical Trials as Topic , Neoplasms , COVID-19/epidemiology , Delivery of Health Care , Humans , National Cancer Institute (U.S.) , Neoplasms/prevention & control , Pandemics , Research Design , United States/epidemiology
15.
Oncol Nurs Forum ; 49(3): 189-190, 2022 05 01.
Article in English | MEDLINE | ID: covidwho-1808480

ABSTRACT

The COVID-19 pandemic continues into spring 2022. Vaccination levels are relatively flat, and movement toward recommending a second booster is occurring. Many are now acknowledging that the pandemic is likely to continue for years to come. Waiting for the end of the pandemic to return to "normal" life and assume prepandemic activities is a less viable strategy as the virus continues to mutate and infect individuals across the world. A burgeoning literature is examining short- and long-term societal changes resulting from the pandemic.


Subject(s)
COVID-19 , Neoplasms , COVID-19/prevention & control , Early Detection of Cancer , Humans , Neoplasms/epidemiology , Neoplasms/prevention & control , Pandemics/prevention & control , Research
16.
Int J Oncol ; 60(4)2022 04.
Article in English | MEDLINE | ID: covidwho-1726131

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) is highly infectious and pathogenic. Among patients with severe SARS­CoV­2­caused by corona virus disease 2019 (COVID­19), those complicated with malignant tumor are vulnerable to COVID­19 due to compromised immune function caused by tumor depletion, malnutrition and anti­tumor treatment. Cancer is closely related to the risk of severe illness and mortality in patients with COVID­19. SARS­CoV­2 could promote tumor progression and stimulate metabolism switching in tumor cells to initiate tumor metabolic modes with higher productivity efficiency, such as glycolysis, for facilitating the massive replication of SARS­CoV­2. However, it has been shown that infection with SARS­CoV­2 leads to a delay in tumor progression of patients with natural killer cell (NK cell) lymphoma and Hodgkin's lymphoma, while SARS­CoV­2 elicited anti­tumor immune response may exert a potential oncolytic role in lymphoma patients. The present review briefly summarized potential carcinogenicity and oncolytic characteristics of SARS­CoV­2 as well as strategies to protect patients with cancer during the COVID­19 pandemic.


Subject(s)
COVID-19/complications , Neoplasms/etiology , SARS-CoV-2 , Androgen Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , COVID-19 Vaccines/immunology , Humans , Neoplasms/prevention & control , Neoplasms/therapy , Probiotics/administration & dosage , Tumor Virus Infections/complications
19.
Molecules ; 27(3)2022 Jan 25.
Article in English | MEDLINE | ID: covidwho-1686895

ABSTRACT

Oxidative stress is involved in the onset and development of several human diseases, such as cardiovascular diseases, diabetes, ageing, cancer, and neurodegenerative diseases [...].


Subject(s)
Food Analysis , Phenols/analysis , Antioxidants/analysis , Cardiovascular Diseases/prevention & control , Diabetes Mellitus/prevention & control , Humans , Neoplasms/prevention & control , Neurodegenerative Diseases/prevention & control
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