Siegel et al. Page 1151

Although colorectal cancer death rates in the U.S. have declined, large geographic disparities persist and identification of high-risk areas can facilitate targeted screening interventions. Siegel and colleagues identified colorectal cancer “hotspots” based on county-level mortality data from the national vital statistics system. The largest hotspot encompassed 94 counties in the Lower Mississippi Delta, where rates were 40% higher than in non-hotspot areas. This spatial analysis revealed large pockets of the U.S. with excessive colorectal cancer death rates that warrant prioritized screening intervention.

Marcus et al. Page 1167

To compare cancer prognosis by human immunodeficiency virus (HIV) status, Marcus and colleagues conducted a cohort study of HIV-infected and HIV-uninfected adults with Hodgkin lymphoma (HL) or anal, prostate, colorectal, or lung cancers. Five-year cancer-related survival was reduced for HIV-infected compared with HIV-uninfected subjects, reaching statistical significance for lung and prostate cancer but not HL, anal, or colorectal cancers. These findings emphasize the need for a focus on prevention, early detection, and adequate treatment of cancer among HIV-infected individuals.

Sisti et al. Page 1174

Studies have found weak inverse associations between breast cancer and caffeine and coffee intake, possibly mediated through their effects on sex hormones. Sisti and colleagues used high-performance liquid chromatography/tandem mass spectrometry to quantify levels of 15 individual estrogens and estrogen metabolites among 587 premenopausal women in the Nurses' Health Study II. These levels were correlated with caffeine, coffee, and/or tea intakes from self-reported food frequency questionnaires. Compared with women in the lowest quartile of caffeine consumption, those in the top quartile had higher urinary concentrations of several estrogen metabolites, indicating that consumption of caffeine and coffee may alter patterns of premenopausal estrogen metabolism.

Crump et al. Page 1184

High birth weight has been associated with subsequent increased risk of breast cancer in the infant's mother. Crump and colleagues conducted a national cohort study of 1,838,509 mothers who delivered 3,590,523 babies in Sweden in 1973–2008, and followed up for colorectal cancer incidence through 2009. The authors found that high fetal growth was associated with a subsequent increased risk of colorectal cancer in the mother. These findings may help identify subgroups of women at high risk of colorectal cancer.