bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emerging Evidence on Induction Chemotherapy and Implications for Care of Cervical Cancer Patients in Low Resource Settings
Authors: Lawal Ishak , Olayiwola Ololade Kehinde , Faurk Halima , Abdullahi Habiba Ibrahim , Ahmadu Oiza Tessy , Yaqub Habeebu Mohammed , Folasire Ayorinde , Kwis Samuel , Musa Ali Gombe , Otene Samuel A. 
Published: July 2024

PURPOSE Induction chemotherapy followed by chemoradiation was found to further improve both overall survival (OS) and progression free survival (PFS) for locally advance cervical cancer in a phase 3 INTERLACE trial. This is a significant improvement in the care of cervical cancer since the 1999 clinical announcement of chemoradiation as the standard of care by National Institute of Health (NIH). We hereby propose exploration of the application of the study to improve cervical cancer care in low resource settings. METHODS We constructed a typical clinical course for a cervical cancer patient in low resource settings based on interactions with our patients needing radiotherapy services. We then conducted a desktop review of literature to broaden our understanding of interventions employed by other healthcare providers in low resource settings to provide care for cervical cancer patients needing radiotherapy services. Those interventions involving use of chemotherapy were further explored in the light of the findings of the INTERLACE trials for possible extrapolation of evidence. RESULTS The challenges of access to radiotherapy services in low resource settings is multifactorial including availability, affordability, accessibility, acceptability and sustainability factors. There are robust multinational collaborative efforts to address the availability factors with little or no considerations for the other factors. Chemotherapy similar to the protocol used in the INTERLACE trial has been innovatively used in various settings to provide some care for cervical cancer patients needing but not able to receive radiotherapy services due to various factors. There is however no documented evidence on impact of such innovations on the burden of cervical cancer in settings where they are applied. CONCLUSION The INTERLACE trial has opened a new frontier on the role of chemotherapy in the management of locally advanced cervical cancer that can be further explored to improve the outcome of care in resource constraints settings with limited access to radiotherapy services.
Epidemiological Analysis of Deaths for Malignant Bladder Neoplasia in Adults in the Last 4 Years in Brazilian Territory
Authors: Loureiro Yasmin Marques , Cruz Guihherme Ferreira , Borsa Eduarda Paica , Rodrigues Heitor Vieira , Paesi Dutra Pedro Henrique 
Published: July 2024

PURPOSE Bladder cancer represents a significant public health concern worldwide, with its incidence and socioeconomic impact standing out as persistent challenges. The objectives of this study were to analyze deaths related to malignant bladder neoplasms in Brazil between 2019 and 2022, conducting an analysis in relation to the age group, sex, and color/race of the patients, with the aim of providing an overview of mortality during this period. METHODS This is a cross-sectional, retrospective, descriptive study about deaths related to malignant bladder neoplasms in Brazil from 2019 to 2022. The data were gathered from the Brazilian Unified Health System (DATASUS) in the “Tabnet” section, selecting those that addressed the age group, sex, and color/race of the patient. The information was grouped in the four years in question based on the three variables mentioned and subsequently analyzed to establish an overview of mortality in the period. RESULTS The period and detailed age group accounted for a total of 10,073 deaths in Brazil. The highest number of deaths occurred in 2022 (26.92%), followed by 2021 (25.68%). There was an increase in total prevalence during the studied period, with the highest rate of increase between the years 2020 and 2021 (6.54%), followed by 4.83% between the years 2021-2022. Comparing 2019 with 2022, there was an increase of 15.60%, with the number of deaths in 2022 equivalent to 26.92% of the entire period studied. There were more deaths among male patients, with more than a 100% difference in prevalence between sexes throughout the entire period. The Caucasian population was the most affected, corresponding to 64.57% of deaths during this period. CONCLUSION Therefore, it is possible to understand, based on the epidemiological profile constructed, how deaths related to malignant bladder neoplasms in adults have been established in recent years. Thus, it is noted that mortality has increased, emphasizing the relevance of the problem. It was also possible to outline the most prevalent patient profile, which corresponds to male and Caucasian patients. Therefore, the broad development of measures to mitigate this alarming public health problem becomes relevant in Brazil.
Expansion of Cancer Diagnostics Reimbursement in Tbilisi, Georgia, Driven by Evidence-Based Economic Forecast Model
Authors: Verdzadze Natia , Mallafré-Larrosa Meritxell , Polo Alfredo , Morand Mathieu , Khizanishvili Gvantsa 
Published: July 2024

PURPOSE In 2013, Georgia introduced a Universal Healthcare (UHC) program that has improved access to cancer care and reduced financial barriers for patients. While about 80% of the costs derived from cancer treatment are covered by the UHC insurance, diagnostics (including pathology and imaging) are not currently reimbursed. Thus, in Georgia a significant number of patients are diagnosed with advanced cancer. As part of the City Cancer Challenge (C/Can) initiative in Tbilisi operative as of 2019, a forecasting economic model was developed to provide the ministry of health (MoH) with robust evidence supportive of the inclusion of cancer diagnostics in the UHC program. METHODS A standard package of cancer diagnostic services was developed in accordance to local and international guidelines, including Tbilisi's local guidelines for the management of locally invasive breast carcinoma and invasive carcinoma of the cervix and those of the National Comprehensive Cancer Network (NCCN) and European Society for Medical Oncology (ESMO). Seven tertiary care clinics (5 in Tbilisi and 2 outside the capital) were randomly selected to obtain pricing information on diagnostic procedures. The forecasted 5-year incidence rate for each cancer type was obtained from the Global Cancer Observatory (GCO) database, and an interpolation method was used to fill in estimates for interim years. For cancer types with unavailable GCO data, it was retrieved from the NCDC database, and an extrapolation method was used to predict future 10-year incidence rates. A budget forecast model was developed to estimate the investment required for cancer diagnostics over the next 10 years using a Markov model. RESULTS It was forecasted that to reimburse cancer diagnostic services in Georgia, approximately 48,580,647 GEL would be needed for 2024, 50,760,753 GEL for 2025 and 52,982,449 GEL for 2026. CONCLUSION In November 2023, the MoH officially announced that cancer diagnostic tests will be reimbursed as part of the UHC program as of March 2024. This significant step is a remarkable improvement in accessibility to cancer care services for the Georgian population, proving the need for contextual and robust evidence to inform policy making.
Exploring the Therapeutic Role of CO-RMS: A Novel Perspective on Prostate Cancer Development
Authors: Pascual Gaston , Sabater Agustina , Sanchis Pablo , Seniuk Rocio , Cotignola Javier , Vazquez Elba , Motterlini Roberto , Toro Ayelén , Gueron Geraldine 
Published: July 2024

PURPOSE Carbon monoxide (CO) is recognized for its anti-inflammatory, anti-apoptotic, and anti-proliferative properties. The application of carbon monoxide-releasing molecules (CO-RMs) is thus a promising strategy for therapeutic interventions in various pathological conditions, particularly in the field of oncology. This study aims to evaluate the influence of CO-RMs on several key processes involved in the pathogenesis of prostate cancer (PCa). METHODS We assessed the effects of three water-soluble CO-RMs” CORM-3, CORM-401, and CORM-A1 (concentrations ranging from 25 to 150µM for 6 hours)” on two prostate adenocarcinoma cell lines: the androgen receptor-insensitive PC3 and the androgen receptor-dependent MDA PCa 2b. Cell viability was assessed using the MTS assay. The production of reactive oxygen species (ROS) was measured via the DCFH-DA probe by confocal microscopy. Additionally, we performed migration and cell adhesion assays and evaluated several metabolic parameters, including ATP levels by luciferase assay and lactate dehydrogenase (LDH) enzyme activity by kinetic assay. The expression of genes associated with oxidative stress, angiogenesis, and metabolism was quantified using real-time PCR. Statistical significance was predetermined at p<0.05. RESULTS Treatment with CO-RMs did not impact cell viability but notably decreased intracellular ROS levels (p<0.05). Moreover, this treatment was linked to increased cell adhesion and reduced migration, particularly following CORM-3 administration (p<0.05). Metabolic analysis revealed that CORM-401 treatment decreased ATP levels and LDH activity in the PC3 cell line (p<0.05), while increasing both ATP levels and LDH activity in the MDA PCa 2b cell line. Gene expression analysis confirmed a repressive effect of CO-RMs on markers of oxidative stress (SOD-2), metabolism (LDH), and angiogenesis (VEGF) (p<0.05). CONCLUSION Our findings suggest that CO-RMs can modulate key cellular processes relevant to PCa pathophysiology without affecting cell viability. These results underscore the potential of CO-RMs as modulators of oxidative stress, metabolism, and angiogenesis, presenting a novel avenue for therapeutic exploration in oncology.
Factors Affecting Cancer Diagnosis and Treatment Delays in Ukraine
Authors: Liakh Anastasiia , Dzhemiliev Ali , Antoniv Marta , Uzlova Anna , Matiushenko Inesa , Reutova Mila , Kopetskyi Viacheslav , Huivaniuk Inesa , Beznosenko Andriy , Melnitchouk Nelya , Kizub Darya 
Published: July 2024

PURPOSE Prompt diagnosis is a key step in starting effective cancer treatment. The earlier the disease is detected, the more opportunities for successful treatment and improved prognosis. We explored perceived factors affecting cancer screening and treatment in Ukraine, which faced multiple challenges following Russia's invasion. METHODS Online surveys assessing cancer diagnosis and treatment delays in Ukraine were distributed to patients in Ukraine through cancer-focused social media in April 2023. For patients who reported experiencing delays in either diagnosis or treatment, the survey included open-ended questions inquiring about details of this and suggestions for improvement. Data was analyzed using thematic analysis and descriptive statistics. RESULTS Overall, 307 patients from all regions of Ukraine were surveyed. Out of them, 225 were women (73.29%), while men accounted for 26.71% of all cases. Breast cancer comprised 102 cases (33.22%), another type - 89 (29.10%), lymphoma 22 (7.17%), rectal cancer 17 (5.54%), head and neck cancer 15 (4.78%). Notably, 143 (46.59%) were diagnosed before the large-scale invasion, while the remaining 164 (53.42%) were diagnosed after. Of 307, 66 (21.5%) reported experiencing diagnostic delays. For these 66, primary reasons for delays included physician negligence for 17 (25.8%), expensive diagnostic tests 14 (21.2%), long waiting time for results 12 (18.2%), Russia's full-scale invasion for 8 (12,1%), incorrect initial diagnosis for 6 (9.1%), misinterpretation of test results for 4 (6.1%), difficulty organizing logistics from the initial visit to diagnosis 2 (3%), with incorrect sample collection, coronavirus infection, and physician refusing to provide treatment cited by 1 (1.5%) patient each. Of 307, 63 participants (20.5%) reported experiencing treatment delays. For the 53, reasons included the war situation for 13 (20.6%), high cost of treatment for 12 (19%), unavailability of prescribed medications for purchase in Ukraine for 12 (19%), suboptimal doctor-patient relationship for 9 (14.3%), long treatment waiting lists for 9 (14.3%), corruption cited by 5 (7.9%), and incomplete understanding of the treatment plan by the patients cited by 3 (4.8%). CONCLUSION Both diagnostic and treatment delays were fairly common among our respondents. Opportunities for improvement include strategies to enhance the doctor-patient relationship, improve affordability and accessibility of cancer therapy.
Global Landscape of Phase III Interventional Clinical Trials in Colorectal Cancer
Authors: Adeoye Oluwatayo , Falade Ayo , Paciorek Alan , Buckle Geoffrey 
Published: July 2024

PURPOSE This study aims to examine the global landscape of phase III interventional trials for colorectal cancer (CRC). Our analysis leverages the ClinicalTrials.gov database to evaluate trial characteristics, geographic distribution of trial sites, as well as predictors of premature trial termination. METHODS We queried the ClinicalTrials.gov database on 1/20/2023 to identify all phase III studies evaluating interventions among patients diagnosed with colorectal cancers since ClinicalTrials.gov's inception. Trial characteristics and reasons for termination were summarized using descriptive analyses. Pearson's chi-square and Kruskal-Wallis tests were used to compare characteristics between completed and terminated trials. A multivariate logistic regression model was fit using stepwise variable selection and fit statistics were used to identify independent predictors of premature termination. RESULTS A total of 431 trials were identified. Most were randomized (94%), parallel assignment (88%), and open label (74%). Sixty-two percent reported systemic therapy as primary intervention. A total of 281 trials were completed or terminated. Of these, 49% recruited in Europe, 36% North America, and 35% Asia; only 6% recruited in Africa. A total of 62% recruited exclusively in high-income countries (HIC). Only 20% recruited exclusively in non-HIC countries. A total of 17% (n=47) terminated prematurely, 36% of these due to accrual difficulties. Comparisons of completed vs. terminated studies showed similarity in study populations, trial design, sponsors, and number of sites. Completed trials were less likely to have US-based recruitment sites (27% vs. 51%, p-value 0.001). In multivariate modeling, trials recruiting in the US and funded by the NIH were more likely to terminate (adjusted Odds Radio (aOR) 5.58 [95% CI 2.11-14.74] and aOR 3.86 [95% CI 1.09-13.61], respectively). CONCLUSION Analysis of the geographic distribution of clinical trials in CRC demonstrated major gaps in the trial activity globally. Most therapeutic trials in CRC take place in HICs, with strikingly few trials in Africa. Few factors emerged as significant predictors of termination: trials that were funded by the NIH and that recruited in the US were associated with premature termination. Further research into these factors could help inform stakeholders for future clinical trial planning.
Growth in the Brazilian Mortality Rate From Prostate Cancer Between the Years of 2011 and 2021
Authors: Afonso Mariana , Pires Rafaela , Loureiro Yasmin 
Published: July 2024

PURPOSE Compare the Brazilian mortality rate from prostate cancer with the global rate from 2011 to 2021. Propose a possible justification for the difference between Brazilian and global values. METHODS Cross-sectional, descriptive epidemiological study based on data collected from the Brazilian Mortality Atlas Online platform of the National Cancer Institute. The selected variable was the prostate cancer mortality rate in both the Brazilian population and the world population between 2011 and 2021. In addition, a secondary variable was used to verify the number of deaths by age group. RESULTS During the period from 2011 to 2021, Brazil recorded 162,918 deaths from prostate cancer, as well as a standard mortality rate of 14.76. In contrast, the global standard rate during this same period was 12.2, a relevant difference for a developing country. When analyzing mortality rates in detail, it is noted that, in 2011, the Brazilian value was 13.63, while the world value was 12.98. In 2016, the Brazilian rate had increased to 14.87, but the world rate decreased to 12.43. In 2021, the Brazilian value was 15.63, while the global value was 11.19. Furthermore, 43.75% of deaths refer to men aged 80 or over, while 34.20% of total deaths from prostate cancer refer to the age group of 70 to 79 years. CONCLUSION Therefore, the increase in deaths in Brazil due to the primary cause of prostate cancer per 100,000 men stands out, while, worldwide, there is a tendency towards a lower rate. A possible justification is the disparity of social and environmental factors in Brazilian territory, such as unequal access to treatment, indiscriminate use of substances that increase the incidence of cancer (tobacco, alcohol and obesity) and Brazilian conservatism in relation to body care on the part of men. Furthermore, it is important to highlight that, during the last decade, the existing prejudice surrounding the prevention of diseases in the male reproductive system has continued and, consequently, the majority of Brazilians refuse to have routine consultations with a urologist. Consequently, the difficulty of treating and curing prostate cancer increases when this diagnosis occurs at a more advanced stage of life, as the highest percentage of deaths occurs in old age.
Highlighting Interventions of Priority for Cervical Cancer Elimination in Nigeria
Authors: Lawal Ishak , Lawal Qudus , Otene Samuel A. , Alhassan Adamu U. , Ahmadu Tessy , Ogunmola Olajumoke M. , Suleiman Sharon Abrazado , Amure Ifeoluwa Alice , Omoladun Rachel 
Published: July 2024

PURPOSE The World Health Organization's Cervical Cancer Elimination Initiative (CCEI) proposed a roadmap for the world to eliminate cervical cancer by the turn of the century. While most developed countries have a demonstrable pathway to attain the cervical cancer elimination targets, most developing countries on the other hand don't have a clear path to attain the targets. The Stakeholders' Summit for Cervical Cancer Elimination in Nigeria was conceptualized to provide a platform for cross fertilization of ideas amongst stakeholders whose activities can impact Nigeria's ability to attain the targets. We hereby present the report of the first summit. METHODS This is a narrative review of the implementation process of the first Stakeholders' Summit on Cervical Cancer Elimination in Nigeria and report of interventions of priority towards achieving the cervical cancer elimination targets highlighted by the stakeholders. The organizing committee applied Delphi technique to identify the interventions of priority to be highlighted while the stakeholders at the summit discussed barriers and facilitators to implementation of the highlighted interventions. RESULTS The organizing committee of the summit was made up of 11 members and a total of 98 stakeholders attended the summit. Effective communication strategies to mitigate misinformation was highlighted as intervention of priority towards achieving the 90% HPV vaccination coverage. Integrated services was highlighted as a priority strategy towards achieving 70% screening coverage. Health system strengthening for equitable access to treatment was highlighted as priority intervention towards achieving 90% coverage. And lastly, development of a robust database was highlighted as a priority intervention. The summit also laid the ground for formation of various collaborations for cervical cancer elimination. CONCLUSION There are a number of isolated interventions on cervical cancer prevention in Nigeria that can be leveraged to provide a path to cervical cancer elimination. Coordinating and synergizing these activities should be the immediate priority for cervical cancer prevention and control.
Human Papillomavirus Genotype Distribution in Ethiopia: A Systematic Review
Authors: Derbie Awoke , Mekonnen Daniel , Nibret Endalkachew , Maier Melanie , Woldeamanuel Yimtubezinash , Abebe Tamrat 
Published: July 2024

PURPOSE Etiologically associated with infection by high-risk Human papillomaviruses (HR-HPVs), cervical cancer is one of the leading causes of cancer-related deaths globally and this is also true in among Ethiopian women. To develop efficient vaccination and HPV-based cervical cancer screening approaches, data on genotype distribution of HPVs is vital. Hence, the study was aimed to review HPV genotype distribution in Ethiopia. METHODS Research articles were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. Besides, Google Scholar was searched manually for grey literature. The last search was conducted on 18 August 2021. The first two authors independently appraised the studies for scientific quality and extracted the data using Excel sheet. The pooled HPV genotype distribution was presented with descriptive statistics. RESULTS We have included ten studies that were reported from different parts of the country during the period of 2005 and 2019. These studies included a total of 3,633 women presented with different kinds of cervical abnormalities, from whom, 29 different HPV genotypes with a sum of 1,926 sequences were reported. The proportion of high-risk, possible/probable high-risk and low-risk HPVs were at 1,493 (77.5%), 182 (9.4%) and 195 (10.1%), respectively. Of the reported genotypes, the top five were HPV 16 (37.3% 95% CI: 35.2.1-39.5%), HPV 52 (6.8% 95% CI: 5.8-8.0%), HPV 35 (4.8% 95% CI: 3.9-5.8%), HPV 18 (4.4% 95% CI: 3.5-5.3%) and HPV 56 (3.9%: 95% CI: 3.1-4.9%). Some of other HR-HPV groups include HPV 31 (3.8%), HPV 45 (3.5%), HPV 58 (3.1%), HPV 59(2.3%), and HPV 68 (2.3%). Among the high-risk types, the combined prevalence of HPV 16/18 was at 53.7% (95% CI: 51.2-56.3%). HPV 11 (2.7%: 95% CI: 2.1-3.5%), HPV 42 (2.1%: 95% CI: 1.5-2.8%) and HPV 6 (2.1%: 95% CI: 1.4-2.7%) were the most common low-risk HPV types. CONCLUSION We noted that the proportion of HR-HPV types was higher and HPV 16 in particular, but also HPV 52 and 35, warrant special attention in Ethiopian’s vaccination and HPV based cervical screening programs of Ethiopia. Additional data from other parts of the country where there is no previous report are needed to better map the national HPV genotypes distribution of Ethiopia.