{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:59:52Z","timestamp":1790859592451,"version":"4.1.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000646","name":"JSPS","doi-asserted-by":"publisher","award":["JP22K06972, JP25K10293"],"award-info":[{"award-number":["JP22K06972, JP25K10293"]}],"id":[{"id":"10.13039\/501100000646","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent advancements in immunotherapy have revolutionized microsatellite instability-high (MSI-H) tumor management. Given the higher prevalence of MSI-H\/deficient mismatch repair (dMMR) in older and female patients, characterizing these specific populations is clinically essential. We aimed to elucidate MSI-H\/dMMR prevalence and predictive factors in older patients with gastric, colorectal, and endometrial cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using molecular and immunohistochemical analysis, we evaluated MSI status and MMR protein expression in 429, 647, and 54 patients with gastric, colorectal, and endometrial cancers, respectively (median age: 78\u00a0years for each group). Multivariable logistic regression analysis was performed to identify independent factors associated with dMMR status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MSI-H was identified in 17.0% and 9.8% of gastric and colorectal cancer cases, respectively, and dMMR was identified in 17.0%, 9.1%, and 18.5% of gastric, colorectal, and endometrial cancer cases, respectively. dMMR prevalence was significantly higher in patients aged \u226580\u00a0years than in those &amp;lt;80\u00a0years for gastric (28.5% vs. 8.1%) and colorectal (13.5% vs. 5.9%) cancers, while endometrial cancers showed a non-significant increase with age (24.0% vs. 13.8%). Multivariable analysis identified primary site (adjusted odds ratio [aOR]\u00a0=\u00a04.20), age (aOR\u00a0=\u00a03.89), and female sex (aOR\u00a0=\u00a02.73) as independent predictors of dMMR in gastric cancer. For colorectal cancer, primary site (aOR\u00a0=\u00a016.88) and age (aOR\u00a0=\u00a01.91) were independently associated with dMMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Advanced age, sex, and primary tumor site are strong independent predictors of dMMR status. These findings underscore the value of routine MSI\/MMR testing, particularly in older individuals, to optimize immunotherapy candidate selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyag172","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:29:19Z","timestamp":1790335759000},"source":"Crossref","is-referenced-by-count":0,"title":["Age- and sex-specific prevalence of deficient mismatch repair protein expression in gastric, colorectal, and endometrial cancers: a center-based study of older Japanese patients"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4583-8301","authenticated-orcid":false,"given":"Tomio","family":"Arai","sequence":"first","affiliation":[{"name":"Department of Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology , 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015 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Tokyo Metropolitan Institute for Geriatrics and Gerontology , 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4172-4892","authenticated-orcid":false,"given":"Hirofumi","family":"Rokutan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology , 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9486-3795","authenticated-orcid":false,"given":"Keisuke","family":"Nonaka","sequence":"additional","affiliation":[{"name":"Research Team for Geriatric Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology , 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015 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