Selected Articles from This Issue

Recently, innovations in genomic and molecular biology have set forth new possibilities for cancer detection that are not limited to a single anatomic site. This modeling analysis presented by Clarke and colleagues and conducted by GRAIL, Inc., projects the reductions in absolute cancer deaths that could occur from earlier cancer detection. The analysis utilizes real-world cancer statistics from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. The findings show that if all cancers currently diagnosed at stage IV could be diagnosed earlier, evenly distributed across stages I–III, cancer deaths could fall by 24%. These data support a potential significant public health benefit of multicancer early detection strategies.

Asian Americans are genetically, linguistically, and culturally heterogeneous but have generally been assessed collectively in prior studies. Huang and colleagues isolated the six largest Asian subgroup. by population in the United States using data from 13 regional U.S. cancer registries. The risk for gastric cancer varied by as much as 7-fold between the highest and the lowest subgroups, emphasizing the importance of not treating all Asians the same. Of great interest, all Asian subgroups demonstrated better survival from gastric cancer compared to non-Hispanic whites. These findings have critical public health implications, particularly when designing gastric cancer screening programs in the United States to target high-risk racial groups.

Visceral adipose tissue (VAT) may play a greater role than subcutaneous fat in increasing cancer risk but is poorly estimated in epidemiologic studies. Le Marchand and colleagues developed a score using circulating biomarkers to predict MRI-assessed VAT and showed the score to be positively associated with breast cancer risk independently of body mass index and other risk factors in the Multiethnic Cohort Study. These findings provide specific evidence for the importance of VAT in breast cancer. The score will also be useful for exploring the association of visceral fat with the risk of other chronic diseases in diverse populations.

Pancreatic cancer is the third-leading cause of cancer death in the United States. Most patients with pancreatic cancer are diagnosed with late-stage disease, as no population-based screening strategies are currently available. Kim and colleagues developed a pancreatic cancer risk model incorporating known epidemiologic risk factors, inherited genetic risk variants, and blood-based biomarkers. This model identified >3% of the population at >3 times the average risk of pancreatic cancer. These high-risk individuals from the general population could benefit from targeted screening.