OBJECTIVE: In this study, we aimed to validate the performance of the PAX1 and JAM3 methylation (PAX1m/JAM3m) test as a triage tool for detecting cervical intraepithelial neoplasia grade 3 or worse (CIN3 +) in non-16/18 high-risk human papillomavirus-positive patients (non-16/18 hrHPV +).
METHODS: The triage performance of liquid-based cytology (LBC) and the PAX1m/JAM3m test for detecting CIN3 + were compared.
RESULTS: In total, 1851 participants had cervical histological outcomes and were included in the analysis. The sensitivity/specificity of the LBC test results with atypical squamous cells of undetermined significance or worse (LBC ≥ ASCUS) and the PAX1m/JAM3m test were 90.1%/26.7% and 84.8%/88.5%, respectively. PAX1m/JAM3m( +) had the highest diagnostic AUC (0.866, 95% confidence interval (CI) 0.837-0.896) in the whole cohort. All cancers (n = 20) were detected by PAX1m/JAM3m(+). Compared with LBC ≥ ASCUS, PAX1m/JAM3m(+) reduced the number of patients who needed referral for colposcopy by 57.21% (74.66% vs. 17.45%). The odds ratios for detecting CIN3 + by LBC ≥ ASCUS and PAX1m/JAM3m(+) were 3.3 (95% CI 2.0-5.9) and 42.6 (27.1-69.6), respectively (p < 0.001). The combination of LBC ≥ ASCUS or PAX1m/JAM3m(+) slightly increased the diagnostic sensitivity (98.0%, 95% CI: 95.8-100%) and referral rate (77.09%) but reduced the diagnostic specificity (24.8%, 22.7-26.8%).
CONCLUSIONS: In non-16/18 hrHPV(+) women, PAX1m/JAM3m was superior to cytology for detecting CIN3 + . Compared with LBC ≥ ASCUS, PAX1m/JAM3m(+) reduced the number of significant referrals to colposcopy without compromising diagnostic sensitivity.

Nursing and physical examination early screening of multiple tumors is helpful to find tumors early, so as to improve the cure rate. Studying its molecular mechanisms is urgent. By logging into gene expression omnibus database, we found laryngeal cancer dataset GSE127165, bladder cancer dataset GSE65635, oral cancer dataset GSE146483, obtain differentially expressed genes, subsequently, weighted gene co-expression network analysis, protein-protein interaction networks, functional enrichment analysis, immune infiltration analysis, survival analysis, comparative toxicogenomics database analysis were conducted. Draw a heatmap of gene expression. Use targetScan to search for miRNA information about core DEG. Got 53 differentially expressed genes. In GOKEGG analysis, they were clustered in cell cycle processes, spindle poles, and protein serine/threonine/tyrosine kinase activity cell cycle, transcriptional dysregulation in cancer, RIG-I-like receptor signaling pathway, P53 signaling pathway. Protein-protein interaction analysis screened out 5 genes (NEK2, BUB1, HMMR, TTK, CCNB2). Cyclin B2 (CCNB2) and budding uninhibited by benzimidazole 1 (BUB1) were highly expressed in laryngeal cancer, bladder cancer, oral cancer. Comparative toxicogenomics database analysis found that core genes (CCNB2, BUB1) are associated with tumors, necrosis, and inflammation. Related miRNA of CCNB2 gene is hsa-miR-670-3p; related miRNAs of BUB1 gene are hsa-miR-5688, hsa-miR-495-3p. CCNB2 and BUB1 exhibit high expression in laryngeal cancer, bladder cancer, and oral cancer, suggesting their potential as molecular targets for precision therapy in these cancers.

UNASSIGNED: Persistent human papillomavirus (HPV) infection remains a key risk factor for cervical cancer. HPV-based primary screening is widely recommended in clinical guidelines, and further longitudinal studies are needed to optimize strategies for detecting high-grade cervical lesions compared to cytology.
UNASSIGNED: From November 2015 to December 2023, 31,942 participants were included in the real-world observational study. Among those, 4,219 participants underwent at least two rounds of HPV tests, and 397 completed three rounds of HPV tests. All participants were tested for high-risk types of HPV 16/18/31/33/35/39/45/51/52/56/58/59/66/68 (hrHPV) and low-risk types of HPV6/11 genotyping. Some participants also received cytology or colposcopy with pathology.
UNASSIGNED: In the cross-sectional cohort, the prevalence of hrHPV and all HPV subtypes was 6.6% (2,108/31,942) and 6.8% (2,177/31,942), respectively. The three top hrHPV genotypes were HPV52 (1.9%), HPV58 (0.9%), and HPV16 (0.9%). Age distributions showed two peaks at 45-49 and 60-65 years. For the primary screening cohort, the hrHPV prevalence rate increased from 4.8% in 2015-2017 to 7.0% in 2020-2020 and finally reached 7.2% in 2023. For the longitudinal cohort study, the hrHPV prevalence rates in the repeated population (3.9, 5.3, and 6.0%) were lower than the primary hrHPV screening rates (6.6%), which indicated that repeated screening might decrease the prevalence rate. Methodologically, the hrHPV (89.5%) and the screening group of 16 subtypes (92.3%) demonstrated superior sensitivity than the cytology group (54.4%). Moreover, the longitudinal study indicated that the persistent hrHPV subgroup had a significantly higher (p = 0.04) incidence of high-grade squamous intraepithelial lesions and more histology progression events (7/17 vs. 0/5) than the reinfection group.
UNASSIGNED: The study indicates a rising high-risk HPV prevalence in Dongguan, with repeated screening reducing this trend. The findings support HPV-based primary screening and might guide HPV vaccination and cervical cancer prevention in South China.

BACKGROUND: At present, conventional endoscopy and chromoendoscopy using indigo carmine (IC) is a very useful method to determine the demarcation line (DL) of early gastric cancer lesions, but it is not suitable for all lesions.
OBJECTIVE: This study aimed to determine the applicable conditions for IC chromoendoscopy.
METHODS: We retrospectively evaluated 187 lesions in 181 patients who had an endoscopic diagnosis of EGC and were treated with endoscopic submucosal dissection (ESD). According to the existence of the DL between the lesion mucosa and normal mucosa with IC chromoendoscopy, the lesions were divided into two groups: clear group and unclear group. Clinicopathological characteristics were evaluated in each group. From January 2022 to March 2023, the postoperative pathological sections of 19 lesions (81 slices) in the clear group and 19 lesions (80 slices) in unclear group were scanned with high definition, and the crypt structure between the two groups was evaluated.
RESULTS: There was no significant difference in clinical factors between the clear group and unclear group. There were significant differences in crypt area, crypt length, and crypt opening diameter between the two groups. In the clear group, there were significant differences in crypt area, crypt length, and crypt opening diameter between the normal area and cancer area, but there was no significant difference in the unclear group.
CONCLUSIONS: The margins of lesions with fused or absent crypt structures, a small crypt area, a short crypt length, and a short crypt opening diameter can be easily determined with IC chromoendoscopy.

Objective: To analyze the detection of colorectal advanced neoplasms in the population who underwent colonoscopy screening in Henan Province as part of the Urban China Cancer Screening Program and its influencing factors. Methods: A cross-sectional study design was employed. Based on the Cancer Screening Program conducted in Henan Province, the study enrolled 7 454 urban residents who manifested no symptoms and were recruited from eight cities in the province, including Zhengzhou, Zhumadian, Anyang, Luoyang, Nanyang, Jiaozuo, Xinxiang, and Puyang from October 2013 to October 2019, and participated in colonoscopy screening. The χ2 test was used to compare the detection rates of colorectal advanced neoplasms among participants with different characteristics, and a multivariate logistic stepwise regression model was used to analyze the factors affecting the detection rates. Results: A total of 7 454 subjects underwent colonoscopy screening, and 112 cases of colorectal advanced neoplasms were detected. Multivariate logistic regression analysis suggested that older age, smoking, higher meat intake, history of diabetes, and family history of colorectal cancer in a first-degree relative were risk factors for colorectal advanced neoplasms. The detection rate was significantly higher in people aged 60-74 years compared with those aged 40-49 years, with an odds ratio (OR) of 2.04 (95% CI: 1.23-3.38).The rates were higher in people who smoked than those who did not smoke, with an OR of 2.21 (95% CI: 1.48-3.31), and in people who consumed more meat than those who consumed less, with an OR of 1.53 (95% CI: 1.04-2.26). Those with diabetes had a higher detection rate compared with those without, with an OR of 1.69 (95% CI: 1.07-2.69), and those with a first-degree family history of colorectal cancer had a higher detection rate than those without, with an OR of 1.64 (95% CI: 1.09-2.46). Conclusion: The detection rate of colorectal advanced neoplasms through colonoscopy screening in Henan Province covered by the Urban China Cancer Screening Program is 1.50%. Older age, smoking, higher meat intake, history of diabetes, and family history of colorectal cancer in a first-degree relative are identified as risk factors for colorectal advanced neoplasms.
目的： 探讨河南省城市癌症早诊早治项目中结肠镜筛查人群结直肠进展期肿瘤检出情况及其影响因素。 方法： 采用横断面研究设计，依托河南省城市癌症早诊早治项目，以2013年10月至2019年10月在河南省郑州市、驻马店市、安阳市、洛阳市、南阳市、焦作市、新乡市和濮阳市招募的无症状参与结肠镜筛查的7 454名城市居民为研究对象，采用χ2检验比较不同特征人群的结直肠进展期肿瘤检出率，采用多因素logistic回归模型分析结直肠进展期肿瘤检出的影响因素。 结果： 接受结肠镜筛查的7 454人中共检出进展期肿瘤112例，检出率为1.50%。多因素logistic回归分析显示，年龄、吸烟史、肉类摄入量、糖尿病史和一级亲属结直肠癌家族史是结直肠进展期肿瘤检出的独立影响因素。与40～49岁组相比，60～74岁组检出结直肠进展期肿瘤的风险增高（OR=2.04，95% CI：1.23～3.38）；与不吸烟人群相比，正在吸烟的人群检出结直肠进展期肿瘤的风险增高（OR=2.21，95% CI：1.48～3.31）；与肉类摄入量较少的人群相比，肉类摄入量较多的人群检出结直肠进展期肿瘤的风险增高（OR=1.53，95% CI：1.04～2.26）；与无糖尿病史的人群相比，有糖尿病史的人群检出结直肠进展期肿瘤的风险增高（OR=1.69，95% CI：1.07～2.69）；与无一级亲属结直肠癌家族史的人群相比，有一级亲属结直肠癌家族史的人群检出结直肠进展期肿瘤的风险增高（OR=1.64，95% CI：1.09～2.46）。 结论： 河南省城市癌症早诊早治项目中结肠镜筛查结直肠进展期肿瘤的检出率为1.50%，高龄、吸烟、肉类摄入较多、糖尿病史、结直肠癌一级亲属家族史是结直肠进展期肿瘤的危险因素。.

Changes in plasma and fecal metabolomes in colorectal cancer (CRC) progression (normal-adenoma-CRC) remain unclear. Here, plasma and fecal samples were collected from four independent cohorts of 1,251 individuals (422 CRC, 399 colorectal adenoma [CRA], and 430 normal controls [NC]). By metabolomic profiling, signature plasma and fecal metabolites with consistent shift across NC, CRA, and CRC are identified, including CRC-enriched oleic acid and CRC-depleted allocholic acid. Oleic acid exhibits pro-tumorigenic effects in CRC cells, patient-derived organoids, and two murine CRC models, whereas allocholic acid has opposing effects. By integrative analysis, we found that oleic acid or allocholic acid directly binds to α-enolase or farnesoid X receptor-1 in CRC cells, respectively, to modulate cancer-associated pathways. Clinically, we establish a panel of 17 plasma metabolites that accurately diagnoses CRC in a discovery and three validation cohorts (AUC = 0.848-0.987). Overall, we characterize metabolite signatures, mechanistic significance, and diagnostic potential of plasma and fecal metabolomes in CRC.

BACKGROUND: Breast and cervical cancer are the most common cancers in women, and are associated with high morbidity and mortality rates. Cancer screening can facilitate early diagnosis, reduce mortality, and ease the burden of cancer. Social support and self-efficacy are strongly associated with cancer screening behavior. The present study aimed to explore the mediating effect of self-efficacy on social support and cancer screening behavior.
METHODS: In this cross-sectional survey study conducted from June to October 2023, 312 women aged 35-65 years were recruited from the East Coast area of China. A general information questionnaire, cancer screening behavior questionnaire, social support scale and self-efficacy scale were used to collect data. Descriptive statistics were used to analyze the general characteristics of participants; one-way analysis of variance was used to test for differences in the measured variables; and Pearson\'s correlation analyses were used to describe the relationship among social support, self-efficacy, and cancer screening behavior. A mediation model was constructed and analyzed using the PROCESS macro for SPSS.
RESULTS: The mean (standard deviation) screening behavior score for breast cancer and cervical cancer was 3.98 (2.79), representing an intermediate level. Self-efficacy was closely related to social support and cancer screening behavior. Social support showed a significant positive correlation with self-efficacy (r = 0.37, p < 0.01) and cancer screening behavior (r = 0.18, p < 0.01). Self-efficacy was also significantly positively correlated with cancer screening behavior (r = 0.19, p < 0.05). Self-efficacy showed a full mediating effect between social support and cancer screening behavior, with an explanatory power of 32%.
CONCLUSIONS: The findings emphasize the need to increase women\'s level of social support and self-efficacy, which in turn can increase women\'s participation in breast and cervical cancer screening.

Background: The sensitivity and specificity of current breath biomarkers are often inadequate for effective cancer screening, particularly in colorectal cancer (CRC). While a few exhaled biomarkers in CRC exhibit high specificity, they lack the requisite sensitivity for early-stage detection, thereby limiting improvements in patient survival rates. Methods: In this study, we developed an advanced Mass Spectrometry-based volatilomics platform, complemented by an enhanced breath sampler. The platform integrates artificial intelligence (AI)-assisted algorithms to detect multiple volatile organic compounds (VOCs) biomarkers in human breath. Subsequently, we applied this platform to analyze 364 clinical CRC and normal exhaled samples. Results: The diagnostic signatures, including 2-methyl, octane, and butyric acid, generated by the platform effectively discriminated CRC patients from normal controls with high sensitivity (89.7%), specificity (86.8%), and accuracy (AUC = 0.91). Furthermore, the metastatic signature correctly identified over 50% of metastatic patients who tested negative for carcinoembryonic antigen (CEA). Fecal validation indicated that elevated breath biomarkers correlated with an inflammatory response guided by Bacteroides fragilis in CRC. Conclusion: This study introduces a sophisticated AI-aided Mass Spectrometry-based platform capable of identifying novel and feasible breath biomarkers for early-stage CRC detection. The promising results position the platform as an efficient noninvasive screening test for clinical applications, offering potential advancements in early detection and improved survival rates for CRC patients.

Early diagnosis of gastric cancer can improve the prognosis of patients, especially for those with early gastric cancer (EGC), but only 15% of patients, or less, are diagnosed with EGC and precancerous lesions. Magnifying endoscopy with narrow-band imaging (ME-NBI) can improve diagnostic accuracy. We assess the efficacy of ME-NBI in diagnosing ECG and precancerous lesions, especially some characteristics under NBI+ME. This was a retrospective analysis of 131 patients with EGC or gastric intraepithelial neoplasia (IN) who had undergone endoscopic submucosal dissection and were pathologically diagnosed with EGC or IN according to 2019 WHO criteria for gastrointestinal tract tumors. We studied the characteristics of lesions under ME-NBI ,compared the diagnostic efficacy of ME-NBI and white light endoscopy (WLI) plus biopsy, and investigated the effect of Helicobacter pylori infection on microvascular and microsurface pattern. The diagnostic accuracy of ME-NBI for EGC, high-grade IN (HGIN), and low-grade IN (LGIN) was 76.06%, 77.96%, and 77.06%, respectively. The accuracy of WLI plus biopsy in diagnosing the above lesions was 69.7%, 57.5%, and 60.53%, respectively. The rate of gyrus-like tubular pattern was highest in LGIN (60.46%), whereas the highest rate of papillary pattern was 57.14% in HGIN and villous tubular pattern was 52% in EGC. Demarcation lines have better sensitivity for differentiating EGC from IN (92.06%). The ME-NBI has higher diagnostic accuracy for EGC than WLI plus biopsy. Demarcation lines and villous and papillary-like microsurface patterns are more specific as EGC and HGIN characteristics. The cerebral gyrus-like microsurface pattern is more specific for LGIN.

BACKGROUND: Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is an efficient method that can reduce lung cancer mortality in high-risk individuals. However, few studies have attempted to measure the preferences for LDCT LCS service delivery. This study aimed to generate quantitative information on the Chinese population\'s preferences for LDCT LCS service delivery.
METHODS: The general population aged 40 to 74 in the Sichuan province of China was invited to complete an online discrete choice experiment (DCE). The DCE required participants to answer 14 discrete choice questions comprising five attributes: facility levels, facility ownership, travel mode, travel time, and out-of-pocket cost. Choice data were analyzed using mixed logit and latent class logit (LCL) models.
RESULTS: The study included 2529 respondents, with 746 (29.5%) identified as being at risk for lung cancer. Mixed logit model (MLM) analysis revealed that all five attributes significantly influenced respondents\' choices. Facility levels had the highest relative importance (44.4%), followed by facility ownership (28.1%), while out-of-pocket cost had the lowest importance (6.4%). The at-risk group placed relatively more importance on price and facility ownership compared to the non-risk group. LCL model identified five distinct classes with varying preferences.
CONCLUSIONS: This study revealed significant heterogeneity in preferences for LCS service attributes among the Chinese population, with facility level and facility ownership being the most important factors. The findings underscore the need for tailored strategies targeting different subgroup preferences to increase screening participation rates and improve early detection outcomes.