Post-diagnosis smoking cessation and survival of patients with head and neck cancer: a systematic review and meta-analysis.

Cigarette smoking is the main risk factor for head and neck cancer (HNC) and many HNC patients are active smokers at diagnosis. We conducted a systematic literature review and meta-analysis to quantify the survival impact of smoking cessation at or around the time of HNC diagnosis. We searched studies published until December 31, 2021, and used random-effects meta-analysis to pool study-specific estimates into summary hazard ratio (SHR) and corresponding 95% confidence intervals (CI). Sixteen studies were published between 1983 and 2021, and over 2300 HNC patients were included. Studies were diverse in terms of design, patients, tumours and treatment characteristics, and criteria used to discriminate quitters from continued smokers. HNC patients who quit smoking at or around diagnosis had significantly better overall survival than continued smokers (SHR 0.80, 95% CI 0.70-0.91, n studies = 10). A beneficial effect of post-diagnosis smoking cessation was suggested for other survival endpoints as well, but the results were based on fewer studies (n = 5) and affected by publication bias. Cessation counselling should be offered to all smokers who start a diagnostic workup for HNC and should be considered standard multidisciplinary oncological care for HNC patients. PROSPERO registration number CRD42021245560.

The Same-Up-Down Staging System for Recurrent Early Glottic Cancer.

(1) Background: The treatment of recurrent early glottic cancer (rEGC) remains challenging. We wanted to investigate how the oncological outcomes are affected by the initial and recurrent stages, in order to propose our newly developed Same-Up-Down (SUD) staging system. (2) Methods: In our cohort of 258 rEGC patients, we retrospectively assessed the prognostic performances of the rTNM (the TNM staging system for recurrence), CLRSS, CLRSS-2, and SUD staging systems by univariate and multivariate Cox analysis, comparing their predictive capability using Harrell's C-index. (3) Results: The SUD classification satisfactorily predicted both overall survival (p = 0.022) and second-recurrence-free survival (p = 0.024, as same + down vs. upstage) in our cohort. It also outperformed the other three systems in terms of prediction of survival, with an improvement of 1.52%, 1.18%, and 3.96% in the predictive capacity of overall survival, disease-specific survival, and second-recurrence-free survival, respectively. (4) Conclusions: The SUD staging system can efficiently predict survival in rEGC patients, whose prognosis heavily depends on both the initial and recurrent locoregional extension.

Serum heavy metals and breast cancer risk: A case-control study nested in the Florence cohort of the EPIC (European Prospective Investigation into Cancer and nutrition) study.

BACKGROUND: Chronic exposure to heavy metals is of concern for its potential carcinogenic effect. An association with increased breast cancer (BC) risk was hypothesized, but literature data are conflicting and the question remains unresolved. We aimed to investigate the association between heavy metals and BC risk in a case-control study nested within the Florence section of the EPIC (European Prospective Investigation into Cancer and nutrition) cohort. METHODS: We included 150 BC cases and an equal number of controls individually matched to cases by age and year of enrolment. In order to avoid confounding by smoking, the study was restricted to never smokers. Serum levels of six heavy metals (Cd, Co, Cr, Mn, Pb, and Tl) were quantified in pre-diagnostic samples using inductively coupled plasma mass spectrometry. Odds ratios (ORs) and corresponding 95 % confidence intervals (CI) were calculated via multivariable conditional logistic regression models. RESULTS: Serum levels of cobalt were inversely associated with BC risk (OR for the comparison of 3rd vs. 1st tertiles: 0.33, 95 % CI 0.12-0.91, p-value 0.033). None of the other heavy metals under study was significantly associated with BC risk in multivariable models. For Cd, Cr, and Tl, over half of the study participants had serum levels below the limit of quantitation. CONCLUSIONS: Our results do not support the hypothesis that exposure to heavy metals is associated with an increased BC risk among never smokers from the general population. The inverse association between cobalt serum levels and BC risk requires confirmation in future studies.

Prevalência de risco de sobrepeso e sobrepeso em escolares de 10 a 13 anos da cidade de Säo Paulo / Prevalence of overweight and obesity in 10 to 13-years-old school children in Säo PAulo

A obesidade em adultos vem apresentando crescimento nítido nas últimas décadas. No Brasil, a prevalência atual de sobrepeso somada com a de obesidade é de cerca de 40 porcento. Os dados em crianças ainda näo estäo totalmente esclarecidos. Contudo, sobrepeso e obesidade na infância têm sido associados com morbimortalidade na vida adulta. Neste sentido, foi estudada a prevalência de risco de sobrepeso e sobrepeso em 194 escolares de 10 a 13 anos de escolas públicas e particulares, os quais foram classificados de acordo com dois parâmetros: IMC (tabela HIMES e DIETZ, 1994) e Gráfico de adequaçäo ponderal (NCHS). Através destas classificaçöes, concluiu-se que a prevalência de risco de sobrepeso e sobrepeso é alta (cerca de 30 porcento), quer em escolas particulares, quer em escolas públicas.(au)