Zouiouich et al. Page 305

This investigation compared microbial data from fecal samples obtained by different collection methods used in ongoing colorectal cancer screening programs from around the world. The study showed that microbial data obtained from fecal immune test (FIT) tubes and specimen collection cards may be appropriate methods to collect fecal samples for microbiome research in population-based cohorts. Furthermore, the opportunistic collection of fecal samples after colorectal cancer screening is feasible, thereby permitting the potential establishment of cohorts within such screening programs. This study has generated important methodological data on the impact of fecal sample collection tools on microbial measurements that is needed for future epidemiological research on the microbiome and cancer.

Charvat et al. Page 325

In this study, Charvat and colleagues explored the association between excess weight during early to mid-adulthood and survival in patients diagnosed with breast and colorectal cancer, using a pooled analysis of five cohort studies and study participants from 11 countries. The authors found a significant dose-response relationship between the average BMI during early and mid-adulthood and death from breast cancer. These results emphasize the importance of public health policies aimed at reducing overweight during adulthood and inform future studies on the relationship between excess weight and cancer outcomes.

Liu et al. Page 362

Cancer survivors are developing more subsequent tumors. Liu and colleagues sought to comprehensively characterize the clinical and genetic features of patients with multiple primary cancers (MPCs) who underwent parallel sequencing. The authors utilized epidemiologic methodologies to define significant co-incidence patterns of Mp. and informed these findings with germline and somatic DNA sequencing for known cancer predisposition genes. In addition to informing clinical and preventive management, this approach sets the stage for deeper sequencing and computational approaches to facilitate gene discovery. The study identified tumor pairs without known predisposing mutations that merit confirmation and will require novel strategies to elucidate genetic mechanisms of shared susceptibilities. If verified, MPC patients with novel phenotypes may benefit from targeted cancer surveillance.

Kleinstern et al. Page 461

Vaccinations have been hypothesized to play a role in the etiology of lymphoma, a cancer of the immune system. However, relatively few epidemiologic studies have assessed vaccinations and lymphoma risk overall or by lymphoma subtype. In the largest study to date, Kleinstern and colleagues, found that lymphoma risk was inversely associated with ever receiving influenza, hepatitis A, yellow fever, and perhaps more recent hepatitis B vaccinations, with heterogeneity by time since last vaccination and for selected lymphoma subtypes. Identifying the biologic mechanisms underlying these observations may lead to novel lymphoma prevention strategies.