Selected Articles from This Issue

In the U.S., Hp. vaccination has been shown to decrease HPV infections, anogenital warts, and cervical precancers, but not invasive cancers. Using cancer registry data from 1999–2017, Mix and colleagues examined new cases of cancer among women aged 15–29 to assess the potential impact of vaccination. Decreasing trends were observed within 4 years of HPV vaccine introduction among women aged 15–19 and 21–24, but not among women 25–29 years. The largest decreases were among women aged 15–20 years for both squamous cell carcinomas and adenocarcinomas, an age group that was most likely to have been vaccinated and not screened, suggesting vaccine impact.

Cigarette filter ventilation, which was marketed by the tobacco industry as a means to reduce harm, has likely resulted in greater public harm than benefit. This study by Carroll and colleagues comprehensively examined relationships between filter ventilation in cigarettes and smokers' biomarkers of exposure (BOE) and potential harm (BOPH) and perceptions of harm. While more smokers of higher versus lower ventilated cigarettes perceived their cigarettes to be less harmful than other brands of cigarettes, greater ventilation was not associated with lower BOE or BOPH. This study raises the question of the impact of this persistent misperception and whether it fosters continued smoking or greater uptake of smoking.

Place-based measures of structural inequities are important contributors to health outcomes. Collin and colleagues leveraged resources from the Georgia Cancer Registry and the Housing Mortgage Disclosure Act to examine the associations between redlining (the systemic denial of mortgage based on place), lending bias (the systemic denial of mortgage based on the applicant's race), and breast cancer mortality in the metropolitan-Atlanta area. Breast cancer patients residing in redlined neighborhoods had an increased rate of breast cancer mortality, and patients residing in neighborhoods with pronounced lending bias had a decreased rate of breast cancer mortality. These findings highlight the importance of considering ecologic measures of structural racism to achieve health equity.

There is widespread interest in discriminating indolent from aggressive ductal carcinoma in situ (DCIS) to support management strategies that spare women unnecessary breast cancer treatments. Sprague and colleagues comprehensively characterized collagen structural organization in 90 human DCIS lesions within the population-based Vermont DCIS Cohort with up to 20 years of follow-up. The authors found that multiple aspects of collagen organization, including collagen fiber straightness, width, and density, were associated with risk of recurrence after DCIS. Collagen organization should be further considered in the development of biomarker signatures to distinguish indolent from aggressive DCIS.