CA: A Cancer Journal for Clinicians最新文献

McFarland D, Bergerot C, Bidstrup P, et al. Serious mental illness and cancer: a call to action for equitable care. CA Cancer J Clin. 2026;e70095. doi:10.3322/caac.70095

An author’s first name was misspelled in the original publication. The sixth author’s name should read Shahrzad Zamani.

The authors apologize for this error.

This article provides updated global cancer statistics for the year 2024 based on the GLOBOCAN estimates of the International Agency for Research on Cancer. The authors describe national cancer incidence and mortality by world region and the Human Development Index and predict the burden in 2050 based on demographic trends. In 2024, an estimated 20.6 million new cancer cases (19.5 million excluding nonmelanoma skin cancer) and 9.8 million deaths (9.7 million excluding nonmelanoma skin cancer) occurred worldwide, equivalent to one in five people developing cancer during their lifetime and one in nine men and one in 13 women dying from the disease. Lung cancer is the most frequently diagnosed cancer, responsible for almost 2.6 million new cases (12.8%), followed by female breast (11.8%), colorectal (9.9%), prostate (7.5%), and stomach (4.7%) cancer. Lung cancer is also the leading cause of cancer death, with an estimated 1.9 million deaths (19.1%), followed by colorectal (9.4%), liver (7.5%), female breast (7.1%), and stomach (6.6%) cancer. Incidence rates vary four- to five-fold across regions, with the highest rates found in Australia/New Zealand (men, 477 per 100,000; women, 396 per 100,000), whereas mortality rates differ two-fold, with elevated rates in Eastern Europe for men (158 per 100,000) and Melanesia for women (108 per 100,000). The incidence burden is predicted to reach 34.4 million by 2050, up 67% from 2024, with the largest proportional increases in lower Human Development Index countries. Although global variation in cancer profiles demands a nuanced approach to cancer control at national and regional levels, primary prevention must be at the forefront, including intensified efforts to reduce tobacco use, prevent infections, lower alcohol consumption and excess body weight, and increase physical activity.

Cancer advances are not distributed equitably among many segments of the population. Specifically, individuals with serious mental illness (SMI) face compounded disparities in cancer detection, treatment, and survival. SMI, characterized by conditions such as schizophrenia, bipolar disorder, and severe major depression, is associated with significant functional impairment and a two-to-three-decade reduction in life expectancy. Patients with SMI encounter unique challenges when navigating cancer care, including fragmented care pathways, less access to cancer therapeutics, limited psychosocial support, stigma, heightened vulnerability to diagnostic overshadowing where symptoms are attributed to their psychiatric rather than a medical or oncologic condition, and underrepresentation in therapeutic clinical trials. This review explores the intersection of SMI and cancer care starting with the conceptual background and its importance related to cancer outcomes and the delivery of ethical care to highlight unmet needs and a multitude of barriers. The paper proposes practical recommendations to improve cancer care for individuals with SMI who develop cancer including adopting the collaborative care model, enhancing psychosocial and psychiatric integration in oncology settings, and addressing biases inherent in clinician training. Interventions targeting individual, interpersonal, health system, and policy levels are essential to comprehensively mitigating disparities and developing durable cancer delivery strategies. Equitable cancer care for patients with SMI is both a moral imperative and a cornerstone of advancing social justice in oncology. Thus, there is a critical need to prioritize the translation of research advances, to close the gap in cancer outcomes and mortality, and to improve patient outcomes and wellbeing.

Extranodal natural killer (NK)/T-cell lymphoma (ENKTCL) is one of the most aggressive non-Hodgkin lymphomas characterized by NK-cell or T-cell origins, a geographic prevalence in Asian and South American populations, and Epstein–Barr virus (EBV) infection. ENKTCL used to be a fatal disease upon treatment with anthracycline-containing chemotherapies. However, the treatment paradigms for ENKTCL have evolved; consequently, patients have achieved significantly improved clinical outcomes. Today, combined-modality therapies co-targeting genomic instability and metabolic vulnerability comprise the standard of care for early stage ENKTCL, whereas therapies that include targeting of immune and metabolic dysregulation are the backbone of treatment for advanced-stage ENKTCL. New agents targeting surface antigens, oncogenic signaling pathways, and EBV are under investigation and have demonstrated promising responses. Hematopoietic stem cell transplantation is beneficial when used in therapy-responsive, high-risk patients and ENKTCL-associated hemophagocytic lymphohistiocytosis, but it is not recommended for early stage ENKTCL. Although nearly 80% of patients with newly diagnosed ENKTCL achieve long-term survival, treatment of relapsed/refractory ENKTCL is critical. Because it is now understood that EBV infection has a major role in disease progression, a deeper understanding of EBV-associated oncogenesis and alterations in the tumor microenvironment foster the development of novel therapeutic strategies, such as cellular therapies and vaccines targeting EBV. Future multicenter collaborations worldwide will be needed to further optimize mechanism-based treatment in the era of precision medicine, paving a curative pathway for this once fatal disease.

Systemic immunoglobulin light-chain amyloidosis is a rare but life-threatening plasma cell disorder characterized by the production of misfolded monoclonal light chains that deposit as amyloid fibrils, leading to pathologic tissue remodeling and progressive multiorgan dysfunction. Despite substantial therapeutic advances, delayed diagnosis remains common because of nonspecific presentations and the need for coordinated hematologic, pathologic, and organ-specific evaluation. The introduction of daratumumab-based regimens has transformed frontline therapy, whereas advances in cytogenetic profiling, measurable residual disease assessment, and transplantation strategies have informed risk-adapted management. Emerging treatments, including BCL-2–targeted therapy, bispecific antibodies, chimeric antigen receptor T-cell therapy, and possibly fibril-directed approaches, further expand the therapeutic landscape. This review summarizes contemporary concepts in the pathobiology, diagnosis, and management of systemic light-chain amyloidosis, with an emphasis on practical diagnostic algorithms, evolving response assessment, and remaining challenges in achieving durable organ recovery and sustained survival.