IntroductionPreoperative biopsy techniques, primarily core needle biopsy (CNB), and surgical excision, are routinely employed in clinical practice. Our study aimed to assess the impact of time to surgery (TTS) following different biopsy methods on the prognosis of early-stage breast cancer.MethodsWe retrospectively analyzed patients with early-stage breast cancer who underwent CNB or excision from 2009 to 2017 and were subsequently treated with standard surgical procedures. Survival outcomes were evaluated using Kaplan‒Meier analysis, Cox proportional hazards models, and propensity score matching (PSM).ResultsOur cohort comprised 2072 patients, categorized into a 15days_less group (n=1,707) and a 14days_more group (n=365),with a median follow-up of 8.79 years. The median waiting period between biopsy and surgery was 8 days for the CNB group. The majority of excision biopsies occurred on the same day as the standard surgical procedure (median 0 days). Both stratified multivariate and PSM analyses demonstrated that patients with a TTS less than 15 days had significantly better prognoses than those with a TTS more than 14 days. Furthermore, similar results were consistently observed within the respective CNB and excision subgroups.ConclusionsExcision biopsy was associated with a shorter TTS in the preoperative setting. Notably, reducing the surgical waiting period across all biopsy groups can potentially improve patient survival.

IntroductionOral squamous cell carcinoma (OSCC) represents a disproportionate cancer burden in South Asia, where advanced-stage presentation, limited radiotherapy infrastructure, and constrained chemotherapy resources necessitate pragmatic approaches to treatment selection. Platinum-based combinations remain the standard for induction chemotherapy; however, a substantial proportion of OSCC patients present with malnutrition, poor performance status, and limited financial resources that preclude these regimens. This is a hypothesis generating feasibility study which explores whether early response to single-agent low-dose methotrexate (MTX) can serve as a functional assay of tumour biology, predicting subsequent radiotherapy response in patients ineligible for conventional multi-agent induction chemotherapy.MethodsThis prospective, observational feasibility study was conducted at a comprehensive cancer centre in South India. Treatment-naïve patients (n=30) with histologically confirmed stage III-IV OSCC underwent three weekly intramuscular MTX cycles (20 mg/m[2] BSA); tumour response was evaluated by serial imaging and clinical assessment before and after MTX, and post-radiotherapy. Baseline demographics and clinical features were collected. Exploratory analysis using Youden's J index identified tumour size reduction thresholds associated with radiotherapy response.ResultsMTX administration was well tolerated with no severe toxicities observed in any participants during chemotherapy. Statistically significant reductions in tumour size occurred following MTX (mean = 0.90 cm, p < 0.001), with further reduction after definitive radiotherapy (mean = 3.50 cm, p < 0.001). An exploratory optimal cutoff of 21% tumour size reduction identified patients unlikely to achieve complete radiotherapy response (specificity 94.12%, sensitivity 46.1%).ConclusionThis feasibility study demonstrates proof-of-concept that early tumour response to low-cost, single-agent MTX correlates with subsequent radiotherapy outcomes in advanced OSCC patients. The strategy offers potential as a triage tool in South Asian resource-constrained settings, but the exploratory 21% cutoff requires external validation in independent cohorts before clinical application.

IntroductionMultidisciplinary team meetings (MTMs) integrate expertise from different specialties to support individualized treatment planning. However, their association with short-term postoperative outcomes in high-risk patients with gastrointestinal malignancies remains unclear. This study evaluated the implementation of preoperative MTM discussion and its association with postoperative outcomes in patients with gastric cancer (GC) or colorectal cancer (CRC) complicated by diabetes mellitus and/or coronary heart disease.MethodsThis single-center retrospective cohort study included consecutive patients with histologically confirmed gastric or colorectal adenocarcinoma and concomitant diabetes mellitus and/or coronary heart disease who underwent radical resection between January 2020 and January 2024. Patients were divided into MTM and no-MTM groups according to whether they received preoperative MTM discussion. The primary outcome was the severity of postoperative complications during the hospitalization, categorized as no complication, Clavien-Dindo grade I-II, or grade III or higher. Multivariable ordinal logistic regression was used to estimate the association between the absence of preoperative MTM discussion and increasing complication severity. The secondary outcome was the occurrence of any postoperative complication and was analyzed using binary logistic regression. Firth penalized logistic regression for major postoperative complications was performed as a sensitivity analysis.ResultsA total of 477 patients were included, with 191 in the MTM group and 286 in the no-MTM group. The no-MTM group had a higher overall postoperative complication rate than the MTM group (19.2% vs. 12.0%, p=0.039), whereas ICU admission and hospitalization costs were higher in the MTM group. Multivariable ordinal logistic regression showed that absence of preoperative MTM discussion, longer operative time per 30-minute increase, and preoperative hypoalbuminemia were independently associated with increasing postoperative complication severity. Secondary analyses yielded generally consistent findings.ConclusionsPreoperative MTM discussion was associated with a lower occurrence and lower severity of postoperative complications during the hospitalization among high-risk patients with GC or CRC.

IntroductionSexual dysfunction is a common consequence of cancer that affects survivors' body image, social relationships, and quality of life more often than in the general population, yet it remains frequently overlooked in cancer care. This scoping review aimed to describe nurse-led interventions for sexual dysfunction and their outcomes among people with cancer and cancer survivors.MethodsA scoping review was conducted and reported following the PRISMA-ScR guidelines. Six databases and grey literature were searched for primary studies (2015-2025) focusing on nurse-led interventions for sexual dysfunction or related outcomes in adults with cancer or cancer survivors. Twenty-four eligible studies were identified, and the findings were narratively synthesized.ResultsMost studies used quasi-experimental or single-group designs, with few randomized controlled or mixed-method studies. The studies were geographically concentrated in Asia, Europe, and the Middle East. The interventions were mostly multicomponent psychoeducational or psychosexual programs combining tailored education, counselling, skills training, and strategies such as pelvic-floor exercises, relaxation techniques, and guidance on lubricants or vaginal dilators. Many interventions improved pain during intercourse, lubrication, sexual distress, and sexual satisfaction. In some culturally adapted or theory-based programs, sexual function scores moved from severe dysfunction towards normal ranges. Larger pragmatic trials in settings with enhanced usual care showed modest or domain-specific benefits and no clear advantage in terms of overall sexual function.ConclusionsNurse-led interventions are beneficial and can ameliorate pain during intercourse, lubrication problems, and sexual distress, especially in patients with gynecological cancers. The size and durability of these benefits remain uncertain. Future work should focus on testing culturally adapted and partner-inclusive interventions, using designs that ensure longitudinal follow-up. Integration of nurse-led sexual care in routine care for male and other cancer patients is also needed to ensure comprehensive cancer rehabilitation.

IntroductionPancreatic cancer is associated with substantial symptom burden, but access to supportive care medications (SCMs) may vary by socioeconomic context. We examined associations between neighborhood socioeconomic status (SES) and the receipt and timing of SCMs among older adults with pancreatic cancer in the United States.MethodsWe conducted a retrospective cohort study using SEER-Medicare data (from 2005-2020). The cohort included beneficiaries aged 65 years or older with incident pancreatic cancer and Part D coverage. SCMs included psychotropics, pain medications, anti-nausea agents, appetite stimulants, and sleep aids. Neighborhood SES was measured using Yost Index quintiles (with Q5 representing the highest SES). Multivariable logistic regression estimated associations with medication receipt, and Fine-Gray competing risk models estimated associations with the cumulative incidence of medication initiation, treating death as a competing event.ResultsAmong 81,535 beneficiaries, 69% received at least one SCM after diagnosis. Compared with beneficiaries in Q5, those in Q1 had lower adjusted odds of receiving antipsychotics (aOR 0.81; 95% CI 0.68-0.96), antidepressants (aOR 0.80; 95% CI 0.73-0.88), anxiolytics (aOR 0.87; 95% CI 0.78-0.97), anti-nausea agents (aOR 0.77; 95% CI 0.71-0.83), appetite stimulants (aOR 0.78; 95% CI 0.72-0.85), and sleep aids (aOR 0.67; 95% CI 0.60-0.76). Lower neighborhood SES was also associated with lower cumulative incidence of psychotropic, anti-nausea, appetite stimulant, and sleep aid initiation. Associations with pain medication receipt and initiation were smaller and less consistent.ConclusionLower neighborhood SES was associated with lower receipt and cumulative incidence of several SCM classes among older adults with pancreatic cancer. Because SEER-Medicare does not capture symptom burden or clinical indication, these findings describe medications dispensed through Part D rather than the adequacy of supportive care received and identify targets for research on the mechanisms underlying these differences and on interventions to improve equitable symptom management.

IntroductionImmune checkpoint inhibitors (ICIs) were introduced at different times across cancer types, but whether early approvals coincided with cancer-specific changes in national mortality remains uncertain.MethodsWe conducted an ecological observational comparative time-series study using CDC WONDER United States Cancer Statistics mortality data from 1999-2019. We analyzed CDC-calculated age-adjusted mortality rates (AAMRs) for melanoma of the skin, lung and bronchus, kidney and renal pelvis, urinary bladder, and Hodgkin lymphoma. Cancer-specific synthetic-control models used each site's first major ICI approval year, preperiod-centered log AAMR trajectories, mutually exclusive solid or hematologic comparison sites, and a common 0-3-year postapproval estimand. Placebo analyses and staggered-adoption difference-in-differences (DiD) were robustness checks.ResultsObserved AAMRs averaged 3.44%, 13.05%, 4.73%, 3.60%, and 3.68% below synthetic estimates for melanoma, lung, kidney, bladder, and Hodgkin lymphoma, respectively. Conditional placebo-rank pseudo-P values were .40, .23, .25, .20, and 1.00. Temporal-placebo models showed earlier divergence for several sites. The balanced 0-3-year DiD estimate was -0.96 deaths per 100,000 (95% pointwise CI, -2.99 to 1.06).ConclusionCancer-specific mortality patterns were directionally compatible with lower mortality during early ICI approval eras, but placebo benchmarking, heterogeneous temporal specificity, and an imprecise DiD estimate precluded firm causal attribution. These ecological findings do not estimate individual treatment effectiveness or current ICI practice.

BackgroundThe widespread success of tobacco control policy and smoking cessation campaigns has led to considerable reductions in lung cancer mortality. However, it is currently not known how many more deaths might have occurred if not for the substantial progress made in lung cancer control.MethodsIn this retrospective study, we used age-specific population counts and lung cancer mortality rates from 1950 to 2019 (from 48 countries) from the Global Cancer Observatory. We estimated age-standardized mortality rates (ASMR), standardized to the WHO (2000-2025) Standard Population. Peak mortality was defined as the year when the maximum ASMR was reached for each country and sex. For each year in the period following peak mortality, the expected number of lung cancer deaths was estimated using peak-year age-specific mortality rates and age-specific population counts for that year. The number of avoided deaths was estimated as the difference between expected and observed lung cancer deaths in that period.ResultsLung cancer mortality peaked for males in all 48 countries but has yet to peak for females in 11 countries. There have been 3.08 million avoided lung cancer deaths since mortality rates peaked for many countries (2.93 million for males, 0.15 million for females). Across these countries, 21.4% and 4.3% of expected lung cancer mortality has been avoided since mortality peaked for males and females, respectively. Fourteen countries have reduced lung cancer mortality more than 25% for men, while only two countries have for women. There have been statistically significant reductions in lung cancer deaths for 46 out of 48 (96%) countries for men and 14 out of 48 (29%) countries for women.ConclusionThere has been a substantial number of lung cancer deaths avoided since mortality rates peaked for many countries, though the reduction in mortality has not been observed in all countries or equally for males and females.

IntroductionAsian Americans have lower colorectal cancer (CRC) screening rates compared with other racial/ethnic groups in the United States (U.S.). Moreover, individuals with limited English proficiency (LEP) face additional challenges in understanding and accessing healthcare. We examined the association between seven Asian origin groups and lifetime use of CRC screening [home fecal occult blood test (FOBT) and endoscopy], stratified by LEP status.MethodsData from the 2021-2022 California Health Interview Survey were analyzed (n=23,785 respondents aged 50-75 years). Asian origin groups (Chinese, Filipino, Japanese, Korean, South Asian, Vietnamese, Others) and LEP were exposures of interest. Ever having lifetime use of FOBT and endoscopy screening were outcomes of interest. Weighted multivariable logistic regression was performed.ResultsThe highest prevalence of FOBT screening use were observed in Vietnamese respondents with LEP (57.6%); however, the lowest prevalence of FOBT screening use was found among Filipino (16.6%) respondents with LEP (p-value=0.014). In adjusted analysis, Chinese and Filipino with LEP had 50% (OR, 0.50; 95%, 0.28-0.90) and 90% (OR, 0.10; 95%, 0.03-0.27) lower odds of having lifetime FOBT use, respectively. For those without LEP, South Asians had 46% (OR, 0.54; 95%, 0.38-0.77) lower odds of having lifetime FOBT use, and Chinese and Korean had 35% (OR, 0.65; 95%, 0.51-0.84) and 52% (OR, 0.48; 95%, 0.33-0.69) lower odds of having lifetime endoscopy use, respectively.ConclusionFOBT screening disparities are evident among Chinese and Filipino Americans with LEP. These findings highlight the complexity of CRC screening disparities across Asian origin groups and suggest the need for further investigation.

IntroductionPublic awareness of modifiable cancer risk factors remains limited, and fatalistic prevention beliefs and cancer information overload may hinder information seeking and engagement in preventive behaviors. Brief communication interventions may help address these barriers, but evidence comparing different communication strategies in cancer prevention remains scarce. This randomized study evaluated the effects of four theory-based intervention materials on cancer prevention beliefs, cancer information overload, and prevention-related intentions.MethodsIn a population-based online study, 1,191 adults from Stuttgart, Germany, were randomly assigned to one of four intervention conditions that varied by presentation modality (audiovisual animation vs. text) and mode (narrative vs. non-narrative) or to a control condition. Interventions were self-developed based on the Protection Motivation Theory, addressing modifiable cancer prevention behaviors, particularly physical activity and healthy diet. Cancer prevention beliefs and cancer information overload were assessed pre- and post-intervention using items from the Health Information National Trends Survey; behavioral intentions were assessed post-intervention. Baseline-adjusted ANCOVAs and robust linear models were used.ResultsAudiovisual and narrative materials showed small advantages over text-based and non-narrative materials for the belief that cancer risk can be reduced (F(1,892)=7.33, p=.007, ηp[2]=.007; F(1,892)=6.71, p=.010, ηp[2]=.005, respectively). Narrative materials were associated with comparatively higher perceived cancer information overload than non-narrative materials (F(1,856)=11.90, p<.001, ηp[2]=.02). Compared with the control condition, all four intervention conditions were associated with stronger behavioral intentions (all p ≤ .009), with no significant differences between the intervention conditions.ConclusionBrief theory-based cancer prevention materials can positively influence prevention-related beliefs, perceived information overload, and behavioral intentions. The findings suggest a trade-off in cancer prevention communication: audiovisual and narrative materials showed advantages in strengthening prevention-related beliefs, whereas non-narrative materials were associated with lower perceived cancer information overload. All intervention conditions were associated with stronger intentions, highlighting the potential of diverse theory-based communication strategies to promote cancer-preventive behaviors.

IntroductionHospitalized patients with advanced cancer frequently experience high symptom burden, prognostic uncertainty, and complex decision-making needs. Although specialty palliative care improves patient-centered outcomes, access remains limited in many inpatient settings. Oncology hospitalists may be uniquely positioned to deliver elements of primary palliative care during acute hospitalizations. Communication is a core clinical skill in hospital medicine, yet many oncology hospitalists feel underprepared for breaking bad news, discussing prognosis and leading goals-of-care conversations. As providers of primary palliative care, oncology hospitalists help patients and families understand serious illness, explore personal values, and make decisions that align with what matters most to them. However, despite engaging in these conversations routinely, communication training and educational resources specifically tailored to the oncology hospitalist role remain limited.MethodsDrawing on published literature and established communication frameworks, this narrative review examines the role of oncology hospitalists in delivering primary palliative care communication. Evidence-based frameworks, including SPIKES, NURSE, and Ask-Tell-Ask, are illustrated through representative inpatient oncology case vignettes.ResultsOncology hospitalists are often the clinicians most consistently present during hospitalization and are therefore well positioned to initiate and revisit goals-of-care discussions, clarify prognosis, and align treatment decisions with patient values. Integrating structured communication approaches into inpatient oncology practice may enhance patient understanding, promote goal-concordant care, and reduce fragmentation. Successful implementation requires formal training, institutional support, and clear role delineation alongside specialty palliative services.ConclusionEmbedding primary palliative care competencies within the oncology hospitalist model represents a scalable strategy to strengthen inpatient cancer care delivery. As oncology hospitalist programs continue to expand, integrating structured complementary, well-established, frameworks into routine inpatient practice may improve patient-centered care and promote goal-concordant treatment decisions.

IntroductionImmune checkpoint inhibitor (ICI)-associated myasthenia and myositis are rare, potentially life-threatening neuromuscular immune-related adverse events, but their serological spectrum remains incompletely characterized. This study aimed to elucidate their autoantibody profiles and explore associations with severe clinical features.MethodsThis retrospective, multicenter, serum-repository-based observational cohort study included 50 patients with ICI-associated myasthenia and myositis referred from institutions throughout Japan. Clinical data and serum samples were analyzed using conventional autoantibody assays, cytometric cell-based assays, RNA immunoprecipitation, and immunohistochemistry. Antibody-outcome associations were evaluated exploratorily using Firth logistic regression.ResultsAmong 50 patients, the median age was 71.5 years, and 35 (70%) were male. Two patients had preexisting thymoma-associated myasthenia. Underlying malignancies were diverse and included thoracic, gastrointestinal, urological, and other cancers. All but one patient received programmed cell death protein-1 inhibitors. The median interval from the first ICI administration to symptom onset was 31.5 days, although 7 patients showed delayed onset beyond 62 days. Severe toxicity, defined as Common Terminology Criteria for Adverse Events (CTCAE) grade 4 or 5, occurred in 15 patients, respiratory insufficiency in 12, and myocarditis in 9. Anti-acetylcholine receptor (AChR) antibodies were detected in 9 patients (18%) and showed exploratory associations with severe toxicity and respiratory insufficiency, although anti-muscle-specific kinase antibodies were not detected. Among striational antibodies, anti-titin and anti-Kv1.4 antibodies were detected in 21 and 22 patients, respectively. Anti-Kv1.4 antibodies showed an exploratory association with myocarditis. All 7 weak myositis-specific immunodot reactivities involved RNA-associated targets and lacked corresponding RNA immunoprecipitates. Reactivity on commercial paraneoplastic neurological syndrome (PNS) immunodot assays, accompanied by supportive neuronal tissue reactivity, was observed in 5 patients without classical PNS manifestations.ConclusionIn this retrospective referral cohort, anti-AChR and anti-Kv1.4 reactivities showed exploratory associations with selected severe clinical features. These findings require prospective external validation.

IntroductionBlinatumomab (BLINA) has improved event-free survival (EFS) and overall survival (OS) in pediatric patients with high-risk B-cell acute lymphoblastic leukemia (ALL) and has become an effective bridging therapy to hematopoietic cell transplantation. However, the prognostic significance of end-of-consolidation (EoC) measurable residual disease (MRD) in the current BLINA-incorporated treatment era remains unclear.MethodsWe retrospectively enrolled pediatric patients diagnosed with high-risk B-cell ALL between February 2022 and December 2024 at Chang Gung Memorial Hospital. Patients were categorized into EoC MRD-negative and EoC MRD-positive groups. EoC MRD was assessed by multiparameter flow cytometry, with real-time quantitative polymerase chain reaction used as a complementary molecular method when applicable. Outcomes of interest included EFS, OS, and BLINA-related adverse events (AEs).ResultsThe cohort consisted of 15 patients. With a median follow-up of 24 months, the observed 2-year EFS and OS rates were 71.5% and 86.7%, respectively. The EoC MRD-positive group demonstrated significantly higher relapse rates (57.1% vs. 0%, P = 0.0256) and numerically higher mortality rates (28.6% vs. 0%, P = 0.2). The 2-year EFS was significantly higher in the EoC MRD-negative group (100% vs. 42.9%, P = 0.02). Although the EoC MRD-negative group demonstrated a numerically higher 2-year OS (100% vs. 71.9%, P = 0.12), the difference did not reach statistical significance. Regarding safety, no high-grade short-term or long-term BLINA-related AEs were observed in either group.ConclusionIn this preliminary retrospective study, EoC MRD negativity was associated with sustained disease control during short-term follow-up and favorable survival outcomes in pediatric patients with high-risk B-cell ALL treated with BLINA-based therapy. These findings suggest that EoC MRD assessment might provide additional prognostic information in the contemporary BLINA treatment era. Further prospective studies with larger cohorts are warranted to validate these observations.

IntroductionAerobic exercise improves disease-free and overall survival in patients with colorectal cancer. This study tested the hypothesis that a key mechanism of action underpinning these survival benefits relates to exercise-induced improvements in inflammation and immunity in colorectal cancer survivors.MethodsThis trial randomized 60 survivors of stage I-III colorectal cancer to 12 weeks of home-based aerobic exercise or control. Endpoints included plasma sCD30, sGP130, IL-1β, and IL-2 measured using bead-based magnetic immunoassays, and the frequencies of circulating T-cell [CD4+ and CD8+ naïve, central memory, effector memory, and terminally differentiated effector memory (TEMRA)] and NK-cell subsets quantified by flow cytometry.ResultsExercise training reduced sCD30 [-153.1 pg/mL (95% CI: -249.5, -56.7); p=0.014] but did not reduce sGP130, IL-1β, or IL-2 compared to control. Exercise training increased the proportions of resting NKG2D-/NKG2C+ NK-cells [2.75% (95% CI: 0.34, 5.15); p=0.03] and CD56+ bright KLRG1-/NKG2C+ NK-cells [4.46% (95% CI: 1.32, 7.60); p=0.006] compared to control. In the control group, sCD30 inversely correlated with naive CD8+ T-cells [r=-0.51 (95% CI: -0.82, 0.03); p=0.04], whereas sGP130 [r=0.46 (95% CI: -0.09, 0.72); p=0.01] and IL-2 positively correlated with CD8+ TEMRA frequencies [r=0.50 (95% CI: 0.06, 0.78); p=0.02]; these associations were not statistically significant in the exercise group.ConclusionIn this secondary, exploratory analysis of a randomized trial, aerobic exercise reshaped aspects of the inflammatory-immune axis in colorectal cancer survivors. These findings refine our understanding of the biological mechanisms by which exercise may improve disease-free and overall survival in colon cancer survivors.

IntroductionAdolescent and young adult (AYA) cancer survivors (ages 15-39 at diagnosis) who identify as sexual and gender minorities [SGM] and/or Black, Indigenous, and Persons of Color [BIPOC]) experience survivorship challenges compounded by discrimination, mistrust, and culturally incongruent care. These factors contribute to inequities in health outcomes and research participation. This qualitative study explored the experiences of underrepresented AYA cancer survivors and key stakeholders in research engagement.MethodsParticipants were recruited through five US-based academic cancer centers and five community-based organizations. Interviews were conducted via two-way video conferencing, and transcripts were analyzed using inductive thematic analysis. A Community Advisory Panel (CAP) consisting of 10 underrepresented AYAs co-developed semi-structured interview guides and contributed to study interpretation.ResultsTwenty-eight participants completed interviews (n=22 survivors, n=5 healthcare professionals, n=1 caregiver). Participants identified as BIPOC (64.3%), SGM (46.4%), and both (23.1%). Four themes shaped research engagement: (1) Awareness (visibility and pathways to research opportunities); (2) Accessibility (emotional, logistical, and institutional feasibility); (3) Authenticity (trust and perceived legitimacy); and (4) Appropriateness (alignment with identity and lived context).ConclusionResearch engagement among underrepresented AYA cancer survivors is shaped by interconnected multilevel factors. Advancing equity requires moving beyond recruitment to redesign research approaches that enhance visibility, reduce structural barriers, build trust, and align participation with AYAs' identities and lived experiences.

IntroductionVarious industrial pollutants have been implicated in tumorigenesis. However, the cancer risk associated with microplastics, a pervasive environmental pollutant, remains poorly understood. This study aimed to evaluate the association between basin-level environmental microplastic contamination and cancer incidence.MethodsIn this secondary analysis of a prospective UK Biobank cohort, 378,985 participants were linked to basin-level river microplastic measurements using residential coordinates. The 2019 measurements were treated as an ecological proxy for regional environmental microplastic contamination. Participants were categorized into low, moderate, or high exposure groups, and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring a mean follow-up of 12.39 years, 37,322 participants developed at least one of the 24 cancer outcomes. Compared with participants in low-exposure basins, participants in high-exposure basins had increased risks of liver cancer (HR, 1.252; 95% CI, 1.031-1.520), colon cancer (HR, 1.167; 95% CI, 1.088-1.252), and lung cancer (HR, 1.198; 95% CI, 1.095-1.309). These estimates represent modest relative increases and should be interpreted alongside absolute event counts and confidence intervals.ConclusionsHigher basin-level river microplastic contamination was associated with modestly higher incidence of selected digestive and respiratory cancers.Patient or Public ContributionThis study was a secondary analysis of de-identified data from the prospective UK Biobank cohort. Patients, service users, and members of the public were not directly involved in the design, analysis, interpretation, or preparation of this study.