Search Results (528)

Background/Objectives: Bladder cancer is a common malignancy with a high rate of recurrence and progression. Recent studies have identified that the urinary microbiome can be a key factor in tumor pathogenesis, progression, and outcomes. This narrative review is designed to summarize current evidence regarding the urobiome and explore its diagnostic and therapeutic potential. Methods: Studies between 2019 and 2024 were identified through the PubMed/MEDLINE and Google Scholar databases. Case reports and non-English-language articles were excluded. Results: The main findings revealed that specific bacteria, viruses, and taxa are linked to bladder cancer presence, progression, and response to immunotherapy treatment. Urinary microbiota differ by tumor type, sex, smoking status, and occupational exposure to toxins. Conclusions: Urinary microbiome and certain types of viruses present in urine may serve as promising tools to enhance bladder cancer diagnosis and predict treatment response. However, larger longitudinal studies are needed to confirm and establish these findings. Furthermore, integration of the urinary microbiome in clinical practice and public health strategies may reduce disease-related burden. Full article

Background: Patients diagnosed with melanoma are at increased risk of developing multiple primary melanomas (MPMs). Identifying clinical and genetic factors associated with MPM is critical for implementing personalized surveillance strategies. This study aims to describe the clinical, histopathological, and genetic characteristics of patients with MPM managed in a tertiary hospital and to contextualize findings within the current literature. Methods: We conducted a retrospective review of patients diagnosed with two or more primary melanomas between 2010 and 2023 at a tertiary dermatology unit. Demographic data, personal and family cancer history, phototype, melanoma characteristics, genetic testing, staging, treatments, and outcomes were collected. These data were compared with findings from the recent literature. Results: Thirteen patients (ten males, three females; median age: 59 years) were found to have a total of 33 melanomas. Most patients had Fitzpatrick phototype II and no immunosuppression. The number of melanomas per patient ranged from two to five. Synchronous lesions were observed in two patients. Common locations included the trunk and extremities. Histologically, 57% were in situ melanomas, and subsequent melanomas were generally thinner than the index lesion. Two patients showed progression to advanced disease. One patient was positive for MC1R mutation; the rest were negative or inconclusive. Additional phenotypic and environmental risk factors were extracted from patient records and are summarized as follows: Ten patients (76.9%) had Fitzpatrick skin phototype II, and three (23.1%) had phototype III. Chronic occupational sun exposure was reported in four patients (30.8%), while five (38.5%) recalled having suffered multiple sunburns during childhood or adolescence. Eight patients (61.5%) presented with a total nevus count exceeding 50, and five (38.5%) exhibited clinically atypical nevi. None of the patients reported use of tanning beds. Conclusions: Our findings are consistent with the existing literature indicating that patients with MPM often present with thinner subsequent melanomas and require long-term dermatologic follow-up. The inclusion of genetic testing and phenotypic risk factors enables stratified surveillance and supports the application of personalized medicine in melanoma management. Full article

Cancer disparities in low- and middle-income countries (LMICs) arise from multifaceted interactions between environmental exposures, infectious agents, and systemic inequities, such as limited access to care. The exposome, a framework encompassing the totality of non-genetic exposures throughout life, offers a powerful lens for understanding these disparities. In LMICs, populations are disproportionately affected by air and water pollution, occupational hazards, and oncogenic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), Helicobacter pylori (H. pylori), human immunodeficiency virus (HIV), and neglected tropical diseases, such as schistosomiasis. These infectious agents contribute to increased cancer susceptibility and poor outcomes, particularly in immunocompromised individuals. Moreover, climate change, food insecurity, and barriers to healthcare access exacerbate these risks. This review adopts a population-level exposome approach to explore how environmental and infectious exposures intersect with genetic, epigenetic, and immune mechanisms to influence cancer incidence and progression in LMICs. We highlight the critical pathways linking chronic exposure and inflammation to tumor development and evaluate strategies such as HPV and HBV vaccination, antiretroviral therapy, and environmental regulation. Special attention is given to tools such as exposome-wide association studies (ExWASs), which offer promise for exposure surveillance, early detection, and public health policy. By integrating exposomic insights into national health systems, especially in regions such as sub-Saharan Africa (SSA) and South Asia, LMICs can advance equitable cancer prevention and control strategies. A holistic, exposome-informed strategy is essential for reducing global cancer disparities and improving outcomes in vulnerable populations. Full article

Cadmium is widely recognized as an important environmental toxicant that may give rise to kidney dysfunction, bone disease, and cancer in humans and animals. Kidney dysfunction occurs at very low exposures and is often considered as the most sensitive or critical effect. Cadmium exposures of concern occur in many countries. In low- and middle-income countries with small-scale mining, excessive exposure to cadmium and other metals occurs in occupational and environmental settings. This is of particular importance in view of the growing demand for metals in global climate change mitigation. Since the 1970s, the present authors have contributed evidence concerning the role of metallothionein and other factors in influencing the toxicokinetics and toxicity of cadmium, particularly as it relates to the development of adverse effects on kidneys in humans and animals. The findings gave a background to the development of biomarkers employed in epidemiological studies, demonstrating the important role of metallothionein in protection against cadmium-induced kidney dysfunction in humans. Studies in cadmium-exposed population groups demonstrated how biomarkers of kidney dysfunction changed during 8 years after drastic lowering of environmental cadmium exposure. Other epidemiological studies showed the impact of a good zinc status in lowering the prevalence of cadmium-related kidney dysfunction. Increased susceptibility to Cd-induced kidney dysfunction was shown in a population with high exposure to inorganic arsenic when compared with a group with low such exposure. Several national and international organizations have used part of the reviewed information, but the metallothionein-related biomarkers and the interaction effects have not been fully considered. We hope that these data sets will also be included and improve risk assessments and preventive measures. Full article

(1) Background: Occupational exposure to asbestos remains a significant public health concern due to its association with pleural cancer and other cancers. This cohort study examines the incidence of asbestos-related diseases among railway carriage maintenance workers exposed to asbestos between 1960 and 1979 in Bologna, Italy. (2) Methods: A cohort of 2197 male workers was followed from 1960 onwards, with data collected on asbestos exposure, smoking habits, and mortality outcomes. The association of asbestos exposure and smoking with the risk of pleural cancer and lung cancer was assessed using Cox proportional hazards regression models. (3) Results: This study identified a substantial burden of asbestos-related pleural cancer, with an exponential increase in risk over time since the beginning of exposure. Our results suggest the lack of a multiplicative effect of asbestos exposure and smoking on lung cancer risk. The Cox models showed a significant association between smoking and lung cancer risk, with a hazard ratio of 3.26 (95% CI: 1.10–9.64, p = 0.03), less significant for asbestos exposure, with a hazard ratio of 1.42 (95% CI: 0.66–3.06). (4) Conclusions: This study provides valuable insights into the long-term health effects of occupational asbestos exposure and underscores the complex interaction between asbestos exposure and smoking in the development of lung cancer. Full article

Background/Objectives: Childhood cancer leads to significant physical, cognitive, and psychosocial consequences that adversely affect the development and quality of life. Occupational Therapy (OT) has the potential to mitigate these effects. However, its integration into pediatric oncology care in Spain remains limited and underexplored. This study aims to examine the availability, characteristics, and perceived impact of OT services within pediatric oncology units across Spain and to identify key barriers to their implementation. Methods: A descriptive, cross-sectional study using a mixed-methods approach was conducted. An online questionnaire was distributed to healthcare professionals working in pediatric oncology units nationwide. Quantitative data were analyzed using descriptive statistics, Fisher’s exact test, and odds ratios with 95% confidence intervals to explore associations. Effect sizes were calculated using Cramér’s V where applicable. Qualitative responses underwent inductive thematic analysis. Results: A total of 42 hospital centers from 12 autonomous communities participated. Only 16 reported having OT services in pediatric oncology, with notable regional disparities. A significant proportion of respondents were unaware of the integration of OT in their institutions. Identified barriers included lack of resources, insufficient specialized training, and limited institutional recognition of OT. Nonetheless, professionals familiar with OT interventions reported positive outcomes, particularly in improving patients’ functional autonomy, emotional well-being, and social participation. Conclusions: OT remains insufficiently integrated into pediatric oncology care in Spain. To optimize the quality of care, it is essential to address educational, structural, and institutional challenges and promote OT as a key component of multidisciplinary teams. Full article

Indoor radon constitutes a public health issue in various regions across the United States as the second leading cause of lung cancer following tobacco smoke. The U.S. Environmental Protection Agency advises radon mitigation interventions for residential buildings with indoor radon concentrations exceeding the threshold level of 4 pCi/L. Despite considerable research assessing the technical effectiveness of radon mitigation systems, there remains a gap in understanding their broader influence on occupant behavior and preferences in residential design. This study aims to investigate the impact of residing in radon-mitigated homes within the Commonwealth of Kentucky—an area known for elevated radon concentrations—on occupants’ preferences regarding healthy home design attributes. The objectives of this research are twofold: firstly to determine if living in radon-mitigated homes enhances occupant awareness and consequently influences their preferences toward health-related home attributes and secondly to quantitatively evaluate and compare the relative significance homeowners assign to health-related attributes such as indoor air quality, thermal comfort, and water quality relative to conventional attributes including home size, architectural style, and neighborhood quality. The overarching purpose is to explore the potential role radon mitigation initiatives may play in motivating occupants towards healthier home construction and renovation practices. Using choice-based conjoint (CBC) analysis, this paper compares preferences reported by homeowners from radon-mitigated homes against those from non-mitigated homes. While the findings suggest a relationship between radon mitigation and increased preference for indoor air quality, the cross-sectional design limits causal interpretation, and the possibility of reverse causation—where health-conscious individuals are more likely to seek mitigation—must be considered. The results provide novel insights into how radon mitigation efforts might effectively influence occupant priorities towards integrating healthier design elements in residential environments. Full article

Background/Objectives: Laryngeal cancer (LC) accounts for 1–3% of all malignant neoplasms. The aim of this study was to analyze temporal trends in the incidence and mortality of LC in Central Serbia over a 25-year period (1999–2023). Methods: Data on newly diagnosed cases and deaths, stratified by sex and age group, were obtained from the Serbian Cancer Registry. Crude, age-specific, and age-standardized incidence and mortality rates were calculated. Joinpoint regression analysis was used to estimate average annual percent changes (AAPCs) and assess their statistical significance. Results: The average annual age-standardized incidence rate (ASR-W) was 11.1 per 100,000 in men and 1.4 in women, with corresponding mortality rates of 5.4 and 0.5, respectively. The highest incidence was observed in the 60–69 age group for both sexes (61.1/100,000 in men; 7.4/100,000 in women), while the highest mortality was recorded in individuals aged ≥70 (35.7/100,000 in men; 3.8/100,000 in women). A statistically significant annual decline among men was observed in both incidence (ASR-W: −0.7%) and mortality (ASR-W: −2.0%). In contrast, trends among women were not statistically significant, indicating overall stability. Conclusions: Although the Cancer Registry in Serbia faces limitations primarily due to data quality issues, it is a key tool for understanding LC trends, guiding health policies, and effectively allocating resources. Given the substantially higher burden among men, it is essential to strengthen tobacco and alcohol control, improve occupational safety, and promote early detection and timely treatment to reduce the disease burden. Full article

Hypoxia is a hallmark of aggressive prostate cancer, but how it disrupts lineage-specific transcriptional programs to drive progression remains unclear. Here, we identify the HIF1α-PHD1-FOXA1 axis as a critical mediator of hypoxic adaptation and androgen signaling suppression. Using genome-wide profiling, we demonstrate that hypoxia reprograms HIF1α chromatin occupancy, shifting its cooperation from AR to FOXA1. Mechanistically, HIF1α physically interacts with FOXA1, destabilizing it via PHD1-mediated hydroxylation—a previously unrecognized post-translational regulatory node. Under hypoxia, loss of FOXA1 attenuates androgen-responsive transcription while activating hypoxia-inducible genes, demonstrating a dual role for this axis in hypoxia adaptation and prostate cancer progression. Genetic or pharmacological disruption of HIF1α-PHD1-FOXA1 impairs prostate cancer proliferation and migration, underscoring its translational relevance. Our findings establish oxygen-dependent FOXA1 degradation as a linchpin connecting microenvironmental stress to transcriptional plasticity in advanced prostate cancer, offering new therapeutic avenues. Full article

Night shift work (NSW), has been associated with adverse health outcomes in women, including increased risks of metabolic disorders, cardiovascular diseases, and reproductive dysfunctions. However, the specific effects of NSW during the climacteric period remain underexplored. This narrative review aimed to examine original studies evaluating the health impacts of NSW on women in their climacteric, with a focus on menopausal timing, hormonal balance, and related symptoms. Relevant studies published in PubMed, Embase, and Scopus were reviewed in January 2025. Of 664 articles screened, 15 met the inclusion criteria. Results indicate that NSW may lead to circadian rhythm disruption, which in turn affects hormonal regulation, the timing of menopause, and the intensity of climacteric symptoms. Prolonged exposure to night shift work appears to increase the risk of metabolic and cardiovascular conditions, and certain cancers. These findings underscore the need to consider NSW as a potential modifiable risk factor for adverse health outcomes during midlife in women. They also highlight the importance of developing targeted occupational health policies and workplace interventions to mitigate these risks and promote healthier aging and quality of life. Full article

Background/Objectives: To correlate blood lead (Pb) levels with cancer risk in a prospective cohort of healthy women with non-occupational exposure to lead. We hypothesize that blood Pb levels can predict the risk of cancer in healthy women. Methods: The study was performed with women registered at the Hereditary Cancer Centre, Szczecin, aged 40 years and above between September 2010 and March 2024. A total of 2927 unaffected women were included in the study. Exclusion criteria were BRCA1 gene mutation, women with diagnosed cancer, and women with occupational exposures to Pb. All patients were asked about their occupational exposure and tested for the three Polish BRCA1 founder mutations (c.5266dupC/5382insC; c.181T > G/300T > G; c.4035delA/4153delA). Inductively coupled plasma mass spectrometry was used to measure blood Pb levels. The study was blinded to all scientists involved, and all samples were assayed in the absence of any knowledge about the clinical status of each participant. Results: There were 239 incident cancers diagnosed in the cohort after an average follow-up of 6 years. Compared to women with the lowest blood Pb concentration, women with higher blood Pb levels had a significantly increased risk of developing any cancer (HR = 1.46; (95% CI: 1.006–2.13; p = 0.046)). The association was stronger for women below the age of 50 years at study entry (HR = 2.59; (95% CI: 1.37–4.89; p = 0.003)). For women over 50 years of age, the results were statistically insignificant. Conclusions: This study suggests that blood Pb levels have the potential to be used as a marker of cancer risk in women under 50 years of age who have no known occupational exposure to this heavy metal. Further investigations using additional groups of women from Poland and other countries are needed for validate these findings. Full article

Background: There is substantial evidence supporting the role of genetic alterations in chemically induced carcinogenesis. We analyzed the existing literature to gather data on genetic alterations linked to human carcinogens and their possible connection to genotoxic outcomes. The review emphasizes carcinogenic substances and occupational exposures identified as “carcinogenic to humans”. In particular, we searched for studies describing genotoxic alterations linked to agents and occupational exposures for which the International Agency for Research on Cancer has found sufficient evidence of an association with bladder cancer. Methods: The review was carried out in compliance with the PRISMA standards. A comprehensive search of the PubMed database was conducted to identify studies published through March 2024. Results: We identified 60 studies that evaluated genetic alterations for 16 carcinogenic agents and occupations (such as aluminum production, 4-aminobiphenyl, auramine production, benzidine, chlornaphazine, cyclophosphamide, firefighters, magenta production, 2-naphthylamine, opium consumption, ortho-toluidine, painters, the rubber manufacturing industry, Schistosoma haematobium infection, X-radiation, gamma-radiation) in healthy humans. Conclusions: The genotoxic effects of chemical agents in healthy individuals have been well studied and characterized. Additionally, this review presents numerous studies concerning occupational exposure but not exclusively. Genotoxicity assessments have mainly been conducted on biological materials such as blood, peripheral blood lymphocytes, urine, and buccal epithelial cells. The most frequently examined genotoxic effects were DNA damage, chromosomal abnormalities, and micronuclei. Standardized data to clearly define a dose–response relationship for predicting delayed health effects are still lacking. Full article

The rising global burden of chronic diseases and cancer in the workplace has intensified the need for accessible, rapid diagnostic strategies within workplace settings. Point-of-care testing (POCT) offers a decentralized solution, providing timely diagnostic insights without the need for centralized laboratory facilities. In the workplace, POCT offers significant advantages for early detection and management of cancer and chronic diseases, improving employee health outcomes and reducing absenteeism. Concurrently, the development of digital health passports has created secure, dynamic platforms for managing and sharing personal health data. This review explores the technological innovations underpinning POCT, examines its application in workplace health screening, and analyzes how integration with the Internet of Things (IoT) and digital health passports can enhance early detection and chronic disease management. The discussion extends to the ethical, regulatory and practical challenges associated with implementation. Furthermore, emerging trends such as artificial intelligence-driven diagnostics, blockchain-enabled data security and wearable biosensors are considered as potential future directions. Together, POCT and digital health passports represent a significant evolution towards proactive, personalized workplace healthcare systems. Full article

Purpose: The aim of this retrospective study was to analyse the compensation procedures concerning patients presenting with work-related lung cancer (LC), hospitalised in a French university hospital, and to assess the benefit of systematic specialised occupational disease (OD) consultations in improving procedures for reporting and recognising OD. Methods: Patient exposure to occupational lung carcinogens was assessed via an analysis of a standardised questionnaire, completed between 1 January 2009 and 24 April 2023. Among the 2024 patients who completed the questionnaire, 621 patients with probable exposure to occupational lung carcinogens were included. Among these patients, two groups were compiled: group 1, consisting of the 392 subjects who did not benefit from specialised OD consultations, and group 2, consisting of the 229 subjects who benefited from such consultations since 2014 and to whom a medical certificate to claim for compensation was issued by a physician. During the second phase of our study, we determined the outcome of the compensation procedure for OD. Uni- and multivariate logistic regressions were performed according to descending logistic regression methods. Results: Multivariate analyses, including smoking status, sex, age and claim for compensation, confirm the significant relationship between specialised OD consultation and claim for compensation (OR 18.13, 95% CI [11.47–28.64]). Furthermore, the rate of occupational disease recognition has multiplied by 1.5 since 2014. Conclusion: This study confirms the importance of specialised OD consultations in helping patients with LC to obtain compensation and to reduce under-recognition. Full article

Interventional radiology offers minimally invasive procedures guided by real-time imaging, reducing surgical risks and enhancing patient recovery. While beneficial to patients, these advancements increase occupational hazards for physicians due to chronic exposure to ionizing radiation. This exposure raises health risks like radiation-induced cataracts, cardiovascular disease, and cancer. Despite regulations like the European Council Directive 2013/59/EURATOM, which sets limits on whole-body and eye lens doses, no dose limits exist for the brain and meninges, since the brain has traditionally been considered a radioresistant organ. Recent studies, however, have highlighted radiation-induced brain damage, suggesting that meningeal exposure in interventional radiology may be underestimated. This study evaluates the entrance air Cumulative mean annual entrance air kerma to the skullull during interventional radiology procedures, using thermoluminescent dosimeters and controlled exposure simulations. Data were collected by varying the exposure time and analyzing the contribution to the entrance air kerma on each side of the head. The results indicate that, considering the attenuation of the cranial bone, the absorbed dose to the brain, obtained by averaging the head entrance air kerma for the right, front, and left sides of the operator’s head, could represent 0.81% to 2.18% of the annual regulatory limit in Italy of 20 mSv for the average annual effective dose of exposed workers (LD 101/2020). These results provide an assessment of brain exposure, highlighting the relatively low but non-negligible contribution of brain irradiation to the overall occupational dose constraint. Additionally, a correlation between entrance air kerma and the Kerma-Area Product was observed, providing a potential method for improved dose estimation and enhanced radiation safety for interventional radiologists. Full article