Life | Special Issue : Cancer Epidemiology

Research

18 pages, 1054 KB

Open AccessArticle

Vulvar Squamous Cell Carcinoma: A Retrospective Analysis of Epidemiologic Characteristics, HPV Status, and Surgical Outcomes in 35 Cases

by Daniela Marinescu, Laurențiu Augustus Barbu, Tiberiu Stefăniță Țenea Cojan, Ștefania Tudorache, Dominic Iliescu, Răzvan Alexandru Marinescu, Lucian George Zorilă and Valeriu Șurlin

Life 2025, 15(11), 1781; https://doi.org/10.3390/life15111781 - 20 Nov 2025

Cited by 1 | Viewed by 1192

Abstract

Background: Vulvar squamous cell carcinoma (VSCC) is an uncommon yet increasingly relevant malignancy characterized by two distinct etiopathogenetic pathways: HPV-associated and HPV-independent. Data from Eastern Europe remain scarce, where demographic and diagnostic variability may influence disease presentation and outcomes. Purpose: This study aimed [...] Read more.

Background: Vulvar squamous cell carcinoma (VSCC) is an uncommon yet increasingly relevant malignancy characterized by two distinct etiopathogenetic pathways: HPV-associated and HPV-independent. Data from Eastern Europe remain scarce, where demographic and diagnostic variability may influence disease presentation and outcomes. Purpose: This study aimed to assess the epidemiologic characteristics, HPV status, surgical management, and postoperative morbidity of VSCC in a Romanian single-center cohort, providing real-world evidence from an underrepresented region. Methods: A retrospective analysis was conducted on all 35 consecutive patients with histologically confirmed vulvar squamous cell carcinoma (VSCC) diagnosed and treated between January 2017 and December 2024 at the Department of Obstetrics and Gynecology, County Emergency Clinical Hospital of Craiova, Romania. Demographic, histopathologic, and surgical data were reviewed. HPV genotyping was performed on formalin-fixed paraffin-embedded (FFPE) tissue using PCR-based methods. Results: HPV DNA was detected in 31.4% of cases, predominantly genotypes 16, 18, and 33. HPV-positive patients were significantly younger than HPV-negative ones (median 58 vs. 72.5 years, p < 0.001), supporting the dual-pathway model of carcinogenesis. Early postoperative complications occurred in 65.7% of patients and late morbidity in 71.4%, secondary lymphedema. Surgical radicality was not significantly associated with early complications or length of hospitalization. Conclusions: This study highlights the epidemiologic and surgical patterns of VSCC in an Eastern European population, showing that conservative surgical strategies can maintain oncologic safety while reducing morbidity. These findings emphasize the need for standardized HPV testing, optimized perioperative care, and improved surveillance programs to enhance outcomes and survivorship. Full article

(This article belongs to the Special Issue Cancer Epidemiology)

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11 pages, 528 KB

Open AccessArticle

Disparities in Colorectal Cancer Mortality and Survival Trends Among Hispanics Living in Puerto Rico (2000–2021): A Comparison Between Early-Onset and Average-Onset Disease

by Camille Montalvo-Pacheco, Carlos R. Torres-Cintrón, Marilyn Moró-Carrión, Hilmaris Centeno-Girona, Luis D. Borrero-García and María González-Pons

Life 2025, 15(11), 1742; https://doi.org/10.3390/life15111742 - 13 Nov 2025

Viewed by 1216

Abstract

Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, a U.S. territory with noted disparities in CRC incidence, particularly among those with early-onset disease (EOCRC). Although EOCRC incidence has been consistently increasing in the U.S. mainland, and a disparate [...] Read more.

Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, a U.S. territory with noted disparities in CRC incidence, particularly among those with early-onset disease (EOCRC). Although EOCRC incidence has been consistently increasing in the U.S. mainland, and a disparate burden has been reported among Hispanics, EOCRC mortality and survival are yet to be assessed among Hispanics living in Puerto Rico (PRH). In this study, we analyzed EOCRC mortality and survival trends in PRH and compared these to those of other U.S. populations. Mortality data were obtained from the Puerto Rico Central Cancer Registry and the Surveillance, Epidemiology, and End Results (SEER) program. Descriptive characteristics and temporal trends were derived via SEER*Stat software (version 9.0.42) and Joinpoint regression models, respectively. Relative survival was estimated using the Actuarial method and the Ederer II approach. Overall, CRC mortality trends showed a decline, but an increase in EOCRC mortality among Hispanics. PRH exhibited the lowest 5-year survival in regional cancers (54.10%), with NHB having the lowest survival among younger individuals. This study highlights significant disparities in EOCRC mortality trends and underscores an urgent need for targeted public health strategies and research efforts to address the disproportionate burden of EOCRC among PRH. Full article

(This article belongs to the Special Issue Cancer Epidemiology)

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19 pages, 683 KB

Open AccessArticle

Colorectal Cancer in Romania: Surgical Strategies, Survival, and Historical Trends in a 302-Patient Cohort

by Laurențiu Augustus Barbu, Liliana Cercelaru, Valeriu Șurlin, Stelian-Stefaniță Mogoantă, Tiberiu Stefăniță Țenea Cojan, Nicolae-Dragoș Mărgăritescu, Ana-Maria Țenea Cojan, Valentina Căluianu, Gabriel Florin Răzvan Mogoș and Liviu Vasile

Life 2025, 15(11), 1686; https://doi.org/10.3390/life15111686 - 30 Oct 2025

Cited by 8 | Viewed by 1883

Abstract

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, with Romania reporting among the highest rates in the European Union. Regional outcome data remain scarce. Methods: We performed a retrospective cohort study of 302 patients with surgically treated [...] Read more.

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, with Romania reporting among the highest rates in the European Union. Regional outcome data remain scarce. Methods: We performed a retrospective cohort study of 302 patients with surgically treated colorectal adenocarcinoma at a Romanian tertiary hospital between 2003 and 2005, with a median follow-up of 60 months. Survival was analyzed using Kaplan–Meier and Cox regression. Results: Radical resection with R0 margins was achieved in 72% of cases. The overall 5-year survival was 38%, with significantly lower outcomes in advanced stages. Independent predictors of poor prognosis included advanced stage, emergency surgery, incomplete resection, and older age. Conclusions: Survival outcomes in this Romanian cohort were substantially lower than those reported in Western Europe, reflecting the burden of late-stage presentation. These findings emphasize the urgent need for nationwide CRC screening programs and wider access to modern multimodal therapies. Full article

(This article belongs to the Special Issue Cancer Epidemiology)

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10 pages, 642 KB

Open AccessArticle

Survival Outcomes in Hepatocellular Carcinoma: Experience from a Multidisciplinary Committee in Ecuador

by Enrique Carrera, Jaysoom Abarca, Johana Acuña, Mercedes Almagro, David Armas, Cinthya Borja, Wendy Calderón, Diana Chamorro, Daniel Garzon, Melina Gonzalez, Andrea Moreno, Mónica Proaño, Darwin Quevedo, Maritza Quishpe, Juan Fernando Salazar, Fabian Tulcanazo, Cecilia Trujillo and Gabriela Velalcazar

Life 2025, 15(10), 1565; https://doi.org/10.3390/life15101565 - 8 Oct 2025

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Abstract

Hepatic cancer is a world health concern due to its high lethality. The main risk factor worldwide is having hepatic cirrhosis. The etiology of hepatic cirrhosis has changed in recent years, with metabolic-associated steatotic liver disease (MASLD) becoming the leading cause, displacing hepatitis [...] Read more.

Hepatic cancer is a world health concern due to its high lethality. The main risk factor worldwide is having hepatic cirrhosis. The etiology of hepatic cirrhosis has changed in recent years, with metabolic-associated steatotic liver disease (MASLD) becoming the leading cause, displacing hepatitis C and B viruses and alcoholic liver disease. It is of the utmost importance to develop screening programs in at-risk populations for early detection. The survival rate of HCC, as determined by a group of specialists or an interdisciplinary committee, is a challenge we have taken on in a public health hospital in Ecuador. This retrospective study identified 71 patients diagnosed with hepatocellular carcinoma, mostly middle-aged men with a history of liver cirrhosis. No significant association was found between the presence of cirrhosis, laboratory abnormalities, and survival. However, the identification by imaging vascular invasion and extrahepatic extension were associated. This study highlights that patients with liver lesions identified through HCC screening have a higher survival rate over a one-year follow-up period. Full article

(This article belongs to the Special Issue Cancer Epidemiology)

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9 pages, 456 KB

Open AccessArticle

The Prevalence of Human Papillomavirus Genotypes in Women with Precancerous Lesions and Cervical Cancer in Arequipa, Peru

by Gonzalo Arturo Medina Bueno, Deyné Maribel Ticona Ramos, Claudia Amparo Mares Cuadros and Rocio Mary Quequezana Guevara

Life 2025, 15(2), 267; https://doi.org/10.3390/life15020267 - 10 Feb 2025

Viewed by 2613

Abstract

The objective of this study was to determine the relationship between the prevalence of high-risk human papillomavirus (HRHPV) and age in women with cervical neoplasia or cervical cancer. This retrospective study involved 470 women referred for abnormal cervical cytology between January 2021 and [...] Read more.

The objective of this study was to determine the relationship between the prevalence of high-risk human papillomavirus (HRHPV) and age in women with cervical neoplasia or cervical cancer. This retrospective study involved 470 women referred for abnormal cervical cytology between January 2021 and December 2023. The Cobas 4800 test was used to identify HRHPV genotypes; it specifically identified genotypes 16 and 18 and grouped the other high-risk genotypes into another category. The Cobas 4800 test was performed together with colposcopy and biopsies of cervical lesions. From the analysis, we selected 470 women who underwent cervical biopsies and HPV testing. Of them, 208 (44.3%) were HPV-negative. Among the 262 women positive for HPV, 13.0% were positive for genotype 16 only, 1.3% for genotype 18 only, and 35.1% for other HPV genotypes. HPV-16 was found in 58.3% of cases of cervical intraepithelial neoplasia grade 3 (CIN 3) in women under 35 years of age and in 20.9% of cases in women over 35 years of age. Furthermore, 51.9% of patients with cervical cancer tested positive for other high-risk HPV types, whereas 30.8% had HPV-16. Although other HPV genotypes were more frequent than HPV-16 and HPV-18 in individuals with cervical cancer, HPV-16 was the most common individual high-risk genotype in women ≥ 35 years of age with CIN-3. Full article

(This article belongs to the Special Issue Cancer Epidemiology)

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15 pages, 889 KB

Open AccessArticle

The Relevance of Sex and Age as Non-Modifiable Risk Factors in Relation to Clinical-Pathological Parameters in Colorectal Cancer

by Robert Barna, Alis Dema, Aura Jurescu, Adrian Ovidiu Văduva, Dorela-Codruța Lăzureanu, Octavia Vița, Bianca Natarâș, Ioana Hurmuz, Adelina Vidac, Sorina Tăban and Sorin Dema

Life 2025, 15(2), 156; https://doi.org/10.3390/life15020156 - 23 Jan 2025

Cited by 5 | Viewed by 2788

Abstract

Background and objectives: We aimed to assess the significance of sex and age compared to other clinical-pathological parameters in colorectal cancer (CRC). Materials and methods: Our study included a retrospective approach to CRC patients who underwent surgery at the ‘Pius Brinzeu’ County Clinical [...] Read more.

Background and objectives: We aimed to assess the significance of sex and age compared to other clinical-pathological parameters in colorectal cancer (CRC). Materials and methods: Our study included a retrospective approach to CRC patients who underwent surgery at the ‘Pius Brinzeu’ County Clinical Emergency Hospital in Timisoara (PBECCHT), Romania. The analyzed parameters were: patient age and sex, tumor location, histological type, differentiation grade (G), extent of tumor (pT), lymph-node status (pN), distant metastasis status (pM), and lymphovascular invasion (LVI). The population was divided into three groups based on age, with those under 49 years old, 50 to 69 years old, and elderly (>70). Results: The study’s inclusion criteria were met by 1885 patients, with a male-to-female ratio of 1.39:1. There were significant differences between the sexes in the anatomical location of tumors (p < 0.0001). Younger patients were more likely to have deeply invasive tumors (p = 0.0096), LVI (p = 0.0332), lymph-node metastases (p = 0.0158), and metastatic disease (p = 0.0017). Conclusions: Over the ten-year period reviewed, the frequency of CRC cases has progressively increased, with males being diagnosed more often. In terms of patient age, the young population exhibits clinical features of aggressive evolution. Patient sex did not influence the analyzed parameters, except for tumor location, where right colon tumors are slightly more common in females. Full article

(This article belongs to the Special Issue Cancer Epidemiology)

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10 pages, 2122 KB

Open AccessArticle

Two Decades of Insights: Comprehensive Histopathological and Epidemiological Analysis of Conjunctival Tumors

by Dolika D. Vasović, Dejan M. Rašić, Zoran Latković, Bojana Dačić-Krnjaja, Jelena Vasilijević, Ivan Marjanović, Jelena Simonović, Anica Bobić Radovanović, Miodrag Karamarković, Milan Stojičić, Milica Mićović and Tanja Kalezić

Life 2024, 14(11), 1381; https://doi.org/10.3390/life14111381 - 27 Oct 2024

Viewed by 2549

Abstract

This study analyzed 2102 conjunctival lesions excised between 1981 and 2003 at a single tertiary center in Serbia, with the aim of evaluating their histopathological characteristics, anatomical localization, and demographic distribution. Of the total cases recorded, 55.1% were male, indicating a slight male [...] Read more.

This study analyzed 2102 conjunctival lesions excised between 1981 and 2003 at a single tertiary center in Serbia, with the aim of evaluating their histopathological characteristics, anatomical localization, and demographic distribution. Of the total cases recorded, 55.1% were male, indicating a slight male predominance. The bulbar conjunctiva was the most commonly affected site (34.5%), with 39.3% of tumors extended to multiple regions of the conjunctiva, including areas such as the plica and caruncula. The most common benign lesion was compound conjunctival nevus (16.7%), while squamous cell carcinoma (SCC) (11.4%) and melanoma (11.3%) were the most prevalent malignant tumors. Tumor incidence peaked in the 61–70 and 51–60 year age groups, with malignant tumors such as SCC being more frequent in males. Comparisons with similar global studies reveal that our findings align with worldwide trends, such as the predominance of SCC, which has been linked to UV exposure, and the frequency of melanoma in fair-skinned populations. However, the lower prevalence of fibrodegenerative lesions like pterygia and pinguecula in our cohort likely reflects Serbia’s cooler climate compared to regions with higher UV exposure. These findings underscore the diverse nature of conjunctival tumors, the critical role of histopathological examination for diagnosis, and the influence of environmental factors. This study provides valuable insights into the epidemiology of conjunctival tumors, contributing to global understanding and guiding future diagnostic and therapeutic approaches. Full article

(This article belongs to the Special Issue Cancer Epidemiology)

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13 pages, 1549 KB

Open AccessArticle

An Artificial Neural Network Prediction Model of Depressive Symptoms among Women with Abnormal Papanicolaou Smear Results before and after Diagnostic Procedures

by Irena Ilic, Goran Babic, Aleksandra Dimitrijevic, Sandra Sipetic Grujicic and Milena Ilic

Life 2024, 14(9), 1130; https://doi.org/10.3390/life14091130 - 7 Sep 2024

Cited by 2 | Viewed by 1677

Abstract

(1) Background: Cervical screening and additional diagnostic procedures often lead to depression. This research aimed to develop a prediction model for depression in women who received an abnormal Papanicolaou screening test, prior to and following the diagnostic procedures. (2) Methods: The study included [...] Read more.

(1) Background: Cervical screening and additional diagnostic procedures often lead to depression. This research aimed to develop a prediction model for depression in women who received an abnormal Papanicolaou screening test, prior to and following the diagnostic procedures. (2) Methods: The study included women who had a positive Papanicolaou screening test (N = 172) and attended the Clinical Center of Kragujevac in Serbia for additional diagnostic procedures (colposcopy/biopsy/endocervical curettage). Women filled out a sociodemographic survey and the Center for Epidemiologic Studies Depression questionnaire (CES-D scale) before and after diagnostic procedures. A prediction model was built with multilayer perceptron neural networks. (3) Results: A correlation-based filter method of feature selection indicated four variables that correlated with depression both prior to and following the diagnostic procedures—anxiety, depression, worry, and concern about health consequences. In addition, the use of sedatives and a history of both induced and spontaneous abortion correlated with pre-diagnostic depression. Important attributes for predicting post-diagnostic depression were scores for the domains ‘Tension/discomfort’ and ‘Embarrassment’ and depression in personal medical history. The accuracy of the pre-diagnostic procedures model was 70.6%, and the area under the receiver operating characteristic curve (AUROC) was 0.668. The model for post-diagnostic depression prediction showed an accuracy of 70.6%, and an AUROC = 0.836. (4) Conclusions: This study helps provide means to predict the occurrence of depression in women with an abnormal Papanicolaou screening result prior to and following diagnostic procedures, which can aid healthcare professionals in successfully providing timely psychological support to those women who are referred to further diagnostics. Full article

(This article belongs to the Special Issue Cancer Epidemiology)

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