Importantly, the findings suggest that maintaining a healthy lifestyle, including not smoking, getting sufficient physical activity, lowering red meat consumption, and having a healthy weight may prevent over a quarter of healthy years lost to illness and premature death due to breast cancer worldwide.

“Breast cancer continues to take a profound toll on women’s lives and communities,” said lead author Kayleigh Bhangdia from the Institute for Health Metrics and Evaluation (IHME), University of Washington, USA. “While those in high-income countries typically benefit from screening and more timely diagnosis and comprehensive treatment strategies, the mounting burden of breast cancer is shifting to low- and lower middle-income countries where individuals often face later-stage diagnosis, more limited access to quality care, and higher death rates that are threatening to eclipse progress in women’s health.”

Using data from population-based cancer registries, vital registration systems, and interviews with family members or caregivers of women who have died from breast cancer, the new analysis provides an updated global, regional, and national analysis of the female breast cancer burden and risk factor estimates from 1990 to 2023 in 204 countries and territories, with forecasts up to 2050. Importantly, the study also estimates the number of years of healthy life that women with breast cancer have lost to illness, disability, and premature death.

Rates of new cases remain highest in HICs, but growing fastest in LICs

Breast cancer remains the most common cancer among women worldwide, with an estimated 2.3 million new breast cancers diagnosed worldwide in women in 2023 (with 73% or 1.67 million cases occurring in high- and upper-middle-income countries) and 764,000 resulting deaths (with 39% or 300,000 deaths occurring in low- and lower-middle-income countries).

When global cases and death rates are adjusted to account for differences in age (to allow comparisons between countries and over time), the study reveals striking inequalities in the burden of breast cancer. For example, in 2023, breast cancer age-standardised incidence rates were on average highest in high-income countries (HICs), including Monaco, Andorra, France, Germany and Ireland (100 new cases per 100,000 women or higher), and lower in low- and middle-income countries (LMICs), including Afghanistan, Somalia, and Mozambique (13 new cases per 100,000 women or lower) in 2023.

However, age-standardised rates of new cases have risen sharply (up 147% on average) since 1990 in low-income countries (LICs), but remained stable in HICs, highlighting the disproportionate growth occurring in settings with lower resources (see table 1 in the paper).

Moreover, between 1990 and 2023, age-standardised death rates from breast cancer in HICs fell on average 30% to 16 deaths per 100,000 women, but almost doubled in LICs to 24 deaths per 100,000 women, exposing likely disparities in timely diagnosis and access to quality treatment.

Globally, the number of years of healthy life lost due to poor health and early death more than doubled from 11.7 million years in 1990 to 24 million years in 2023. However, although women in low- and lower-middle-countries account for 27% (around 628,000) of new cases globally, they contribute to more than 45% of all the ill-health and early deaths from breast cancer globally (nearly 11 million years of healthy life lost).

“LMICs are hit hardest by escalating breast cancer burden as many of these nations grapple with lifestyle and demographic changes alongside health systems that are less equipped than ideal to respond, with shortages of radiotherapy machines, chemotherapy drugs, and pathology labs, and standard treatments that can be quite costly,” explained co-author Dr Olayinka Ilesanmi, a physician and epidemiologist from Nigeria working for the Africa CDC. “Although survival continues to improve in HICs, reflecting success in breast cancer screening, diagnosis, and treatment, even within HICs, outcomes can still depend on where a woman lives.”

Rise in pre-menopausal breast cancer

Globally, three times as many new breast cancer cases were diagnosed in women aged 55 or older in 2023 (161 vs 50 new cases per 100,000 women) compared to women aged 20-54 years. However, rates of new cases have risen in women aged 20-54 years old (up 29%) since 1990, with rates in older women not changing substantially—these differences may reflect changing age patterns as well as changes in risk factors, which vary between pre- and post-menopausal women.

Impact of uncontrolled risk factors

In 2023, 28% of the global breast cancer burden (6.8 million years of healthy life lost to disability, illness and early death) was linked to six potentially modifiable risk factors. High red meat consumption had the biggest impact (linked to nearly 11% of all healthy life lost), followed by tobacco use (including second-hand smoke; 8%), high blood sugar (6%), high body mass index (BMI; 4%), and high alcohol use and low physically activity (both 2%).

Substantial progress has been made in reducing the global breast cancer burden linked to high alcohol use and tobacco between 1990 and 2023, which declined by 47% and 28%, respectively, while the breast cancer burden linked to other risk factors did not indicate the same progress over time.

“With more than a quarter of the global breast cancer burden linked to six modifiable lifestyle changes there are tremendous opportunities to alter the trajectory of breast cancer risk for the next generation,” said co-senior author Dr Marie Ng, Affiliate Associate Professor at IHME and Associate Professor at National University of Singapore. “Targeting known risk factors through public health policies and making healthier choices more accessible, while working with individuals to take action to reduce obesity and high blood sugar, is crucial to halting the rise in breast cancers worldwide.”

Ensuring all women have an equal chance to survive breast cancer

Even with the best prevention policies, millions of women will still develop breast cancer, which makes closing the care gap an urgent priority. The authors stress that with fair access to care in low-resource settings, investment in innovative therapies, and strong political will, there is an opportunity to ensure that all women have an equal chance to overcome breast cancer.

As Dr Lisa Force, co-senior author from IHME explained, “Collaborative efforts are needed to ensure well-functioning health systems capable of early diagnosis and comprehensive treatment of breast cancer in all countries. Reducing the cost of breast cancer therapies and ensuring that universal health coverage includes breast cancer care essentials would also be valuable in protecting patients from catastrophic costs and improving outcomes.”

While the study uses the best available data, the authors note that the estimates are constrained by a lack of high-quality cancer registry data, particularly in countries with limited resources, highlighting the need to increase investments in cancer surveillance systems. They also note that information on cancer stage at diagnosis and subtype are not included in the analysis despite their distinct survival patterns and resource implications due to data limitations, and the analysis does not analyse the impact of the COVID-19 pandemic or recent conflicts on the disease burden.

Writing in a linked Comment, Professor Yeon Hee Park from Sungkyunkwan University School of Medicine, Seoul, South Korea (who was not involved with the study) noted that, “Without ethnic or genetic ancestry data, the study cannot distinguish whether observed regional differences reflect genetic predisposition, environmental exposures, health-care disparities, or combinations thereof…Despite these limitations, this study provides a necessary foundation for global health planning…With appropriate refinements, particularly ethnic and genetic ancestry stratification that acknowledges the distinctive molecular signatures of African, Asian, and other ethnic and genetic ancestry populations, this study can achieve its goal of informing evidence-based cancer control strategies worldwide.”

Summary tables of findings:

Table 1

Global breast cancer rates:

Table 2

Country breast cancer rates (for more country-level data, see https://cloud.ihme.washington.edu/s/iDnqW7jaPz7ENcB):


UI = Uncertainty Interval

ASIR = Age-Standardised Incidence Rate

ASMR = Age-Standardised Mortality Rate

The findings were published on Feb. 23, 2026 in CANCER, a journal of the American Cancer Society.

“Over the past several years, we’ve had an increasing appreciation for the important relationship between cancer, its treatment, and mental health,” said lead author Julian Hong, MD, MS, of the University of California, San Francisco. “This study reproduces our prior work by leveraging the shared experience across the University of California system, reinforcing a relationship between mental health conditions and mortality for patients with cancer and highlighting the need to prioritize and manage mental health.”

The researchers used The University of California Data Discovery Platform, in which data on all patients at University of California–affiliated hospitals are recorded.

They identified adult patients with a cancer diagnosis and no documented mental health disorder prior to cancer diagnosis between 2013 and 2023.

Among 371,189 patients, 39,687 (10.6%) developed a mental health disorder within the first year after cancer diagnosis.

After adjusting the data for factors which might affect the primary outcome, the researchers reported that a mental health disorder diagnosis was linked to a 51% higher risk of all-cause death in the initial 1–3 years after cancer diagnosis. This elevated risk decreased to a 17% higher risk after 3–5 years. Then it disappeared.

The authors concluded, “Patients with cancer who experience a mental health condition are at an increased risk of all-cause mortality. This reinforces and emphasizes existing recommendations for prompt screening and management of distress and mental health following a cancer diagnosis.

This finding should offer relief for patients needing long term proton pump inhibitor therapy and is valuable for clinical decision making in healthcare settings, say the researchers.

A fear that proton pump inhibitors could lead to stomach cancer has been ongoing since the 1980s. Recent research has linked their use to around a twofold increased risk, but the literature is hampered by several methodological limitations, making this possible association uncertain.

To help clarify whether long term use of proton pump inhibitors is associated with an increased risk of stomach cancer, researchers designed a study that made extensive efforts to avoid and assess these previous weaknesses.

Their findings are based on healthcare registry data in the five Nordic countries – Denmark, Finland, Iceland, Norway, and Sweden – over a 26-year period from 1994 to 2020.

They identified 17,232 patients with stomach cancer (cases) and randomly matched each one by age, sex, calendar year, and country with 10 healthy participants (controls) from each country’s entire population – a total of 172,297.

They then recorded long term (more than 1 year) use of proton pump inhibitors and histamine-2-receptor antagonists (another class of drugs used to reduce stomach acid) excluding the 12 months before the diagnosis date (cases) or study inclusion date (controls) to prevent the reporting of a potentially false association.

Other factors that may have influenced the results were also accounted for. These included age, sex, Helicobacter pylori eradication treatment (the bacteria implicated in the development of stomach cancer), peptic ulcer disease, smoking and alcohol related diseases, obesity or type 2 diabetes, and use of certain medications.

After adjusting for these factors, the researchers found no remaining association between long term use of proton pump inhibitors or histamine-2-receptor antagonists and increased risk of stomach cancer.

This is an observational study so no firm conclusions can be drawn about cause and effect. And despite extensive efforts, the authors can’t rule out the possibility that unmeasured factors, such as diet and family history of stomach cancer, may have affected the results.

However, they note that this multinational study based on up to 26 years of high quality registry data allowed them to mitigate many of the biases and other problems affecting previous research on this topic.

As such, they conclude: “The results of this study do not support the hypothesis that long term proton pump inhibitor use is associated with an increased risk of gastric adenocarcinoma.”

“This finding should offer relief for patients needing long term proton pump inhibitor therapy and is valuable for healthcare in clinical decision making,” they add.

Researchers found that between 2012 and 2020, 178,000 Medicare beneficiaries received early access to cancer drugs through the FDA’s accelerated approval pathway. While the pathway aims to give patients faster access to promising treatments, fewer than half of these drugs were later shown to help people live longer.

Key Findings:

• Limited Survival Gains: Only 45% of Medicare beneficiaries who received accelerated approval drugs were treated with drugs that ultimately improved survival.
• Life-Years Added: Early access to accelerated approval drugs delivered an estimated 76,000 extra years of life for Medicare beneficiaries.
• Concentrated Benefits: Just three drugs—for melanoma and lung cancer—accounted for over two-thirds of all extra life-years gained.
• High Cost: Medicare spent over $20 billion more on early access to cancer drugs than on alternative treatments, averaging $263,000 per additional year of life. Costs ranged from $26,000 per life-year for melanoma drugs to $4.5 million per life-year for some breast cancer drugs.

Huseyin Naci, Associate Professor of Health Policy at the London School of Economics, and lead author of the study, said: “Early access to new cancer drugs through FDA’s accelerated approval pathway can save lives, but our findings show that most offered little or no survival benefit while costing Medicare substantial sums. This raises important questions about how to balance rapid access to novel treatments with solid evidence of effectiveness.”

FDA’s accelerated pathway allows new drugs to enter the market based on interim measures rather than waiting for long-term results like overall survival. Pharmaceutical companies are required to run follow-up studies after initial approval to confirm the benefits, but these studies are not always completed. From 1992 to 2020, nearly half of the drugs approved through this pathway were still missing these follow-up studies.

Joseph Ross, Professor of Medicine and Public Health at Yale University and co-author of the study, said: “Treatments which have been approved for use must be followed up with trials measuring overall survival and then appropriate regulatory actions put in place. This will help direct Medicare funds towards treatments with proven clinical benefits.”

Anita Wagner, Associate Professor of Population Medicine at Harvard Medical School, and senior author of the study, added “Importantly, FDA should also clearly communicate the degree of uncertainty about drugs which have had accelerated approvals. This will help clinicians and patients be more informed as they make important health decisions.”

Bladder cancer remains a major clinical challenge as it is one of the most common and deadliest urological cancers with a high recurrence rate. Yet its diagnosis still relies heavily on invasive and costly procedures like cystoscopy (inserting a thin, tube-like instrument through the urethra) or cytology, a noninvasive test that can identify tumor cells shed in urine but has limited sensitivity.

Investigators of the current study were motivated to find a simpler, more comfortable way to detect and monitor bladder cancer. They analyzed urine samples from 156 patients with bladder cancer and 79 matched controls and using real-time PCR, measured the concentration and integrity (long-short size distribution) of cfDNA fragments from five genes (ACTB, AR, MYC, BCAS1, and STOX1).

“Our most significant finding was that the small fragment of the MYC gene may represent a valuable tool to diagnose bladder cancer, as it exhibited excellent specificity (97%) and predictive value (88%) for identifying muscle-invasive bladder cancer,“ explains lead investigator Pilar Medina, PhD, Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.

MYC produces a transcription factor crucial for regulating cell growth, proliferation, and metabolism.

Additionally, researchers found that the ratio of large to small fragments of the housekeeping gene ACTB and the small fragment of the AR gene increased with disease severity, suggesting these could be reliable staging biomarkers. The integrity of these genes may be useful to identify bladder cancer relapse.

Lead author Raquel Herranz, MS, Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain, notes, “With growing interest in liquid biopsies and personalized medicine, our study offers a timely and practical alternative to invasive diagnostics. This study is one of the first to comprehensively evaluate urine cfDNA fragmentation and integrity across most bladder cancer stages, bringing us closer to a future in which bladder cancer can be diagnosed and monitored through a simple urine test, improving patient comfort and care.”

Dr. Medina concludes, “Our findings show that urine can tell us much more than we thought; it holds the potential to transform how we detect and manage bladder cancer.”

He recently earned his PhD in medical science at Lund University and is a senior consultant at the dermatology clinic in Landskrona, Sweden. In one of the studies included in his dissertation, he investigated the links between common blood pressure medications and cases of basal cell carcinoma, a form of skin cancer. This cancer type is very common, with 70,000 newly discovered cases per year in Sweden. It often appears on skin that has been exposed to intense sun.

“Basal cell carcinoma is a rather mild form of cancer, with a low risk of spreading and low mortality. Treatment usually involves surgically removing the tumour, but it’s often also possible to freeze or scrape it away,” says Johan Kappelin.

Previous studies, both Swedish and international, have shown a likely increased risk of various skin cancers in connection with antihypertensive medications. When focusing specifically on basal cell carcinoma, Johan Kappelin used several large Swedish registries to identify possible statistical associations between the disease and blood pressure medication.

There are many different blood pressure medications, grouped by their active substances. These types were included in Johan Kappelin’s study:

• Thiazides (diuretics)
• ACE inhibitors (angiotensin-converting enzyme inhibitors)
• Angiotensin II receptor blockers (ARBs)
• Calcium channel blockers
• Beta blockers

Among those who used thiazides, ARBs, and calcium channel blockers, the risk of basal cell carcinoma appeared to increase by nine percent. For the thiazide group, however, this only applied to medications containing multiple active substances (so-called combination therapy). For beta blockers, the results showed a seven percent increased risk. For ACE inhibitors, on the other hand, no increased risk was found; according to these study results, the risk even appeared to decrease slightly.

Johan Kappelin is somewhat surprised that such similar risk increases were seen across several medication types.

“It’s also a bit surprising that medications containing only thiazides as the active substance did not appear to increase the risk of basal cell carcinoma. At the same time, an increased occurrence of basal cell carcinoma was seen in people who received thiazides as combination therapy. Is the risk found in the other agent, or is it the combination itself that creates the risk?” he wonders.

Other questions requiring further research include whether factors such as skin type and/or certain lifestyle factors contribute to the risk of basal cell carcinoma during blood pressure treatment.

“The increase in basal cell carcinoma risk with these medications is quite small in our study, and at present we see no reason to change any recommendations regarding the use of these drugs. However, there may be reason to be extra careful with sun protection when undergoing blood pressure treatment,” recommends Johan Kappelin.

How the Registry Study Was Conducted

To determine possible statistical associations, researchers compare people with basal cell carcinoma to people without such a diagnosed disease.

The approximately 130,000 patient cases come from the national Basal Cell Carcinoma Registry. The control group consists of roughly twice as many individuals, drawn from the Swedish Population Register. Data on prescriptions for antihypertensive medications come from the Prescribed Drug Register. Researchers also collected registry data on other ongoing medications and other diseases among the included individuals.

Many other factors were not examined in the study, such as skin type or lifestyle factors. Therefore, the researchers emphasize, it cannot be definitively determined that it is the blood pressure medications that cause the increased risk of basal cell carcinoma.

“The use of glucagon-like peptide-1 receptor agonists—or GLP-1RAs—has increased dramatically, but recommendations suggest their discontinuation before pregnancy because there’s not enough information about their safety for unborn babies,” said lead author Jacqueline Maya, MD, a pediatric endocrinologist at Mass General Brigham for Children. “We sought to assess how such discontinuation affects weight gain and outcomes during pregnancy.”

For the study, the team analyzed electronic health records for 1,792 pregnancies delivered within the Mass General Brigham healthcare system between 2016–2025, primarily among women with obesity. Each woman with a GLP-1RA prescription within three years before and up to 90 days after conception was matched to three similar pregnancies where the mother did not use GLP-1RAs.

Individuals who stopped GLP-1RAs before or in early pregnancy gained an average of 7.2 pounds more weight during pregnancy than those who did not use the weight loss drugs. The GLP-1RA group also had a 32% higher risk of excess weight gain (gaining more than recommended), a 30% higher risk of diabetes during pregnancy, a 29% higher risk of hypertensive disorders during pregnancy, and a 34% higher risk of preterm delivery. There were no differences in risk of high or low birth weight, birth length, or Cesarean delivery.

“Additional studies are needed on the balance of pre-pregnancy benefits of GLP-1s with the risks associated with interrupting them for pregnancy,” said senior author Camille E. Powe, MD, a Mass General Brigham endocrinologist and co-director of the Diabetes in Pregnancy Program at Massachusetts General Hospital. “We need to do more research to find ways to help manage weight gain and reduce risks during pregnancy when stopping GLP-1 medications.”

Authorship: In addition to Maya and Powe, Mass General Brigham authors include Deepti Pant, Yiran Fu, Kaitlyn James, Carolina Batlle, Sarah Hsu, Diana C. Soria-Contreras, Lydia Shook, Christopher Mow, Marie-France Hivert, and Tanayott Thaweethai.

The use of licensed ready-to-use (RTU) gemcitabine in polypropylene infusion bags (Sun Pharma) is associated with fewer carbon emissions than in-house compounding from glass vials, according to Dorian Protzenko (Centre Hospitalier Intercommunal des Alpes du Sud).

The researchers conducted a “cradle-to-grave” analysis of the carbon emissions associated with each product, taking into account the active pharmaceutical ingredient (API), excipients, packaging, upstream and downstream transport, formulation losses, consumables and disposal.  Carbon emissions were calculated using standard methods – Ecovamed© 2025, Carebone© v2.3 and in-house hospital data.

The results showed that RTU gemcitabine bags were associated with carbon savings of 40-60% per dose compared with traditional in-house preparation of doses. Major factors in the carbon savings were the switch to lightweight plastic containers (~42%), the elimination of sterile consumable devices (~19%) and lower quantities of clinical waste incinerated (~14%).

The researchers concluded that replacing glass vials of gemcitabine with the RTU bags reduced the environmental impact with up to 1.7 Kg of exhaust gas carbon dioxide (EGCO₂) avoided per dose administered. This corresponds to the emissions generated by a 15-minute car journey in an average petrol vehicle.

Protzenko D & Plan A. licensed ready-to-use gemcitabine bags cut carbon emissions versus in-house vial compounding. Short communication. GERPAC Congress 2025

Photo: Dorian Protzenko. Photo – courtesy of GERPAC

A near-infrared (NIR) spectroscopic method for analytical checks of compounded anti-cancer drugs could replace the current double visual checks in future, according Julie Evrard (Groupe Hospitalier Artois-Ternois). The major advantage of the NIR method is that the measurements are carried out through the final container – a bag, syringe or elastomeric pump – and no sample is required.

An evaluation of a NIR device (Ayna Analytics) was undertaken to evaluate its performance under real-life conditions. During a three-month period 10 commonly-prepared drugs – five cytotoxic drugs and five monoclonal antibodies – were included. For each molecule, diluents and final containers were identified in order to establish the calibration curves. Up to 50 data points for each molecule are required for calibration. During the study double visual checks (“four eyes”) were continued.

Ms Evrard said that the analytical procedure took just two minutes. So far, this analytical procedure has been validated for routine use for daratumumab SC, rituximab SC and fluorouracil Neopump 48h. have been validated for routine use. The next step will be to finalise calibrations for the remaining molecules before extending the project to include other molecules and containers.

During the discussion one member of the audience said that in a department that prepares 70 doses a day, this technology could eliminate the need for a someone to perform the visual checks (second checks).

Evrard J. et al. Analytical control of anticancer agents via sample-free near infrared spectroscopy: first feedback. Short communication. GERPAC Congress 2025

Photo – Julie Evrard

With the unenviable record of the highest melanoma rates in the world – two in three people are diagnosed with skin cancer by the age of 70 – a new approach is needed to reverse this trend, say University of South Australia (UniSA) researchers in the nursing journal Collegian.

Launched in February 2023, the model utilises primary care nurses trained in dermoscopy and artificial intelligence (AI) software to detect suspicious skin lesions. This has been rolled out across 13 South Australian regional and rural mobile clinics with great impact.

More than 1200 people have been screened and hundreds of suspicious lesions identified, including 96 suspected melanoma cases.

The initiative has demonstrated that primary care nurses can detect suspected skin cancer early and consumers overwhelmingly accept this model of care, according to lead author Dr Kim Gibson, from UniSA’s Rosemary Bryant AO Research Centre (RBRC).

“The current reliance on opportunistic, GP-led skin checks leaves significant healthcare gaps for Australians, particularly those living in rural and regional areas who face major barriers in accessing skin cancer screening,” Dr Gibson says.

Each year, more than 2200 Australians lose their lives to skin cancer, with 1400 of these deaths caused by melanoma. The national economic burden is expected to reach $8.7 billion by 2030 if urgent reforms are not introduced.

“In country areas there are serious GP shortages, long waiting times, out-of-pocket costs, and limited access to dermatologists.

“Nurses represent the largest health workforce in regional areas and are ideally placed to bridge this gap. By empowering and equipping them to lead skin cancer detection, we can save lives.”

Since February 2023, the Rosemary Bryant AO Research Centre has trained 51 nurses in dermoscopy (the use of a specialised tool) and AI to identify suspicious lesions and refer for follow-up care. The aim is to educate 600 primary care nurses nationally.

Co-author and RBRC Director, Professor Marion Eckert, says that with additional training, nurse practitioners will also be able to perform biopsies and excisions, further reducing pressure on overstretched medical services.

“This approach is all about reducing inequities. Rural Australians are not only more likely to develop melanoma due to predominately being outdoor workers but are also more likely to die from it. This model tackles that inequity by bringing services to communities and using nurses’ expertise to detect skin cancer earlier,” Prof Eckert says.

The timing of the proposal is significant, given that Australia is currently developing a National Targeted Skin Cancer Screening Program that will focus on high-risk groups, such as those in rural and regional areas.

The UniSA team advocates for nurses to play a central role in this national strategy.

“By embedding nurses into the frontline of melanoma detection, the national program can be more efficient, accessible and cost-effective,” Prof Eckert says.

“Nurse-led models are already improving other areas of healthcare such as breast cancer screening, and skin cancer is a natural next step.”

The research was supported by The Hospital Research Foundation, Preventative Health SA, Skin Check Champions, and Country SA Primary Health Network, with training support from Skin Smart Australia.

‘A nurse-led model of care in response to Australia’s skin cancer crisis: A discussion paper’ is published in Collegian, the official journal of the Australian College of Nursing. DOI: 10.1016/j.colegn.2025.07.002

Most patients encountered the misinformation — defined as unproven or disproven cancer treatments and myths or misconceptions — even when they weren’t looking for it.

The findings have major implications for cancer treatment decision-making. Specifically, doctors should assume the patient has seen or heard misinformation.

“Clinicians should assume when their patients are coming to them for a treatment discussion that they have been exposed to different types of information about cancer treatment, whether or not they went online and looked it up themselves,” said senior author Carma Bylund, Ph.D., a professor and associate chair of education in the UF Department of Health Outcomes and Biomedical Informatics. “One way or another, people are being exposed to a lot of misinformation.”

Working with oncologists, Bylund and study first author Naomi Parker, Ph.D., an assistant scientist in the UF Department of Health Outcomes and Biomedical Informatics, are piloting an “information prescription” to steer patients to sources of evidence-based information like the American Cancer Society. The study paves the way for other similar strategies.

Most notably, the study found the most common way patients were exposed to misinformation was second hand.

“Your algorithms pick up on your diagnosis, your friends and family pick up on it, and then you’re on Facebook and you become exposed to this media,” Parker said. “You’re not necessarily seeking out if vitamin C may be a cure for cancer, but you start being fed that content.”

And no, vitamin C does not cure cancer.

Health misinformation can prevent people from getting treatment that has evidence behind it, negatively affect relationships between patients and physicians, and increase the risk of death, research has shown. People with cancer are particularly vulnerable to misinformation because of the anxiety and fear that comes with a serious diagnosis, not to mention the overwhelming amount of new information they have to suddenly absorb.

While past research has studied misinformation by going directly to the source — for instance, studying what percentage of content on a platform like TikTok is nonsense — little research has looked at its prevalence or how it affects people.

The team first developed a way to identify the percentage of cancer patients exposed to misinformation. UF researchers collaborated with Skyler Johnson, M.D., at Huntsman Cancer Institute, an internationally known researcher in the field.

The survey questions were based on five categories of unproven or disproven cancer treatments — vitamins and minerals, herbs and supplements, special diets, mind-body interventions and miscellaneous treatments — and treatment misconceptions. The myths and misconceptions were adapted from National Cancer Institute materials and included statements like “Will eating sugar make my cancer worse?”

The team surveyed 110 UF Health patients diagnosed with prostate, breast, colorectal or lung cancer within the past six months, a time when patients typically make initial treatment decisions.

Most had heard of a potential cancer treatment beyond the standard of care, and most reported they had heard of at least one myth or misconception. The most common sources were close friends or family and websites, distant friends/associates or relatives, social media and news media.

The findings mark a shift in misinformation research, with major implications for the doctor-patient relationship, said Bylund, a member of the Cancer Control and Population Sciences research program at the UF Health Cancer Center.

“I still think media and the internet are the source and why misinformation can spread so rapidly, but it might come to a cancer patient interpersonally, from family or friends,” she said.

Most patients rarely discussed the potential cancer treatments they had heard about with an oncologist, the study also found.

Next, the researchers plan to survey a wider pool of patients, then study the outcomes of interventions designed to decrease misinformation exposure, like the information prescription.

It’s responsible for almost all cervical cancer cases. HPV now causes the majority of oropharyngeal (throat) cancers. It can also cause anal, vaginal, vulvar and penile cancers.

Yet new analysis from researchers at MUSC Hollings Cancer Center shows that most people are unaware of the connection between HPV and all of these cancers.

That awareness is critical, said lead researcher Kalyani Sonawane, Ph.D., because it informs people’s decisions about whether to have their children vaccinated against HPV.

“When people make decisions about whether they want to get vaccinated or whether they want to get their child vaccinated, they are doing a risk-versus-benefit assessment. So it’s important for them to understand what can happen when someone gets HPV infection,” she said.

Sonawane and colleagues used data from the Health Information National Trends Survey (HINTS), a survey conducted by the National Cancer Institute. They published their findings this week in JAMA Oncology.

They found that about a third of people, nationally, aren’t aware of either HPV or the HPV vaccine. The lack of awareness tended to be clustered in states in the Midwest and South.

For example, more than 40% of people in 13 states – including South Carolina – are unaware that there is a vaccine against HPV.

The vaccine is the first and best defense against HPV-caused cancers. Research from Europe and the U.S., including research at Hollings, is showing a significant reduction in cervical cancer cases in young women.

The young women of today were children when the vaccine was first introduced and, therefore, the first group to be vaccinated. As they get older and enter the decades of life when cancer is most common, scientists expect to see even greater reductions in HPV cancers.

Cervical cancer is the bellwether because that type of cancer most commonly shows up when people are in their 30s or 40s. Oropharyngeal cancers, on the other hand, most often are diagnosed when people are in their 50s or 60s, so it will be some time before the first group that was vaccinated reaches this age.

Sonawane noted that the biggest knowledge gap is in relation to oropharyngeal cancer. Across the nation, 70% of those who have heard about HPV didn’t know it causes oropharyngeal cancer.

“HPV is linked with six different types of cancers, but cervical cancer seems to be the one that people are most aware of,” she said. That probably goes back to the original introduction of the vaccine in 2006. “It was first approved for girls and heavily marketed toward girls. Even the packaging was pink.”

The vaccine has since been approved for boys, but rates of vaccination for boys remain lower than for girls.

“People think, ‘Oh, cervical cancer. I don’t need to get my boys vaccinated,’” Sonawane said. “Anecdotally, when we speak with pediatricians, they always tell us that when they ask a parent of a male child about HPV vaccination, the parents always say, ‘Oh, but he’s a boy.’”

The pandemic interrupted many measures of preventive care, including HPV vaccination and screening for cervical, breast and colon cancers. A recent report from the American Cancer Society showed that screening for breast and colon cancers has since rebounded. Cervical cancer screening and HPV vaccination, however, have not.

“It just worries me how this is going to translate five years, 10 years down the line,” Sonawane said. “We are losing that critical opportunity of being able to vaccinate kids, being able to screen women at the right time and being able to catch these cancers early. Both primary and secondary prevention are suffering.”