{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T20:50:52Z","timestamp":1782334252412,"version":"3.54.5"},"reference-count":35,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Down syndrome (DS) (trisomy 21) presents a distinctive cancer profile requiring risk-adapted surveillance strategies. This study examined cancer prevalence and screening participation patterns in individuals with DS to inform clinical care protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This large-scale retrospective cross-sectional study analyzed German nationwide statutory health insurance outpatient data, comparing 46,362 individuals with DS (International Classification of Diseases [ICD]-10: Q90) with 463,620 matched controls without intellectual disability (including DS), stratified by age, sex, and residential district. Logistic regression analysis evaluated cancer occurrence and screening program participation between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Cancer prevalence was lower in the DS group compared with the matched control group (2.4%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      2.8%; odds ratios [OR], 0.85 [95% CI, 0.80 to 0.91];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .00001; corrected:\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .00002) and occurred at younger age. However, individuals with DS demonstrated markedly elevated odds for hematologic malignancies: unspecified cell type leukemia (OR, 10.32), lymphatic leukemia (OR, 6.12), and myeloid leukemia (OR, 6.32), and testicular cancer (OR, 4.25). Conversely, breast cancer (OR, 0.36), digestive system tumors (OR, 0.39), and malignant melanomas (OR, 0.52) were significantly less frequent. Notably, individuals with DS participated less frequently in cancer screening programs (17.03%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      26.17%; OR, 0.58 [95% CI, 0.56 to 0.59]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The distinctive cancer profile in DS reflects elevated leukemia and testicular cancer risks alongside protection against solid malignancies, consistent with the chromosomal biology of trisomy 21. Reduced screening participation may partially explain lower overall cancer prevalence and warrants future research. These findings underscore the need for syndrome-specific surveillance protocols targeting high-risk malignancies and further molecular characterization of cancer predisposition and protection mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00710","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T19:59:11Z","timestamp":1782331151000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Cancer Frequencies and Screening in Individuals With Down Syndrome: A Comprehensive Nationwide Cross-Sectional Analysis"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5904-1112","authenticated-orcid":true,"given":"Tanja","family":"Sappok","sequence":"first","affiliation":[{"name":"Medical School and University Medical Center OWL, Bielefeld University, University Clinic for People with Neurodevelopmental Disorders, Mara Hospital, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Krieg","sequence":"additional","affiliation":[{"name":"Medical School and University Medical Center OWL, Bielefeld University, University Clinic for People with Neurodevelopmental Disorders, Mara Hospital, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7691-5818","authenticated-orcid":true,"given":"Marie-Luise","family":"Rosenbusch","sequence":"additional","affiliation":[{"name":"Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Hering","sequence":"additional","affiliation":[{"name":"Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Schulz","sequence":"additional","affiliation":[{"name":"Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7438-4321","authenticated-orcid":true,"given":"Christoph","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, German Cancer Society, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6314-8158","authenticated-orcid":true,"given":"Nora Tabea","family":"Sibert","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, German Cancer Society, Berlin, Germany"},{"name":"Oncological Health Services Research, Department of Gynecology and Obstetrics, University Hospital Du\u0308sseldorf, Heinrich-Heine University Du\u0308sseldorf, Du\u0308sseldorf, Germany"},{"name":"Centre for Digital Medicine, Heinrich-Heine University D\u00fcsseldorf, D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3259-0810","authenticated-orcid":true,"given":"Thomas","family":"Seufferlein","sequence":"additional","affiliation":[{"name":"Ulm University Hospital, Department of Internal Medicine I, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas W.","family":"Berger","sequence":"additional","affiliation":[{"name":"Ulm University Hospital, Department of Internal Medicine I, Ulm, Germany"},{"name":"Evangelisches Krankenhaus K\u00f6nigin Elisabeth Herzberge, Clinic for Internal Medicine II - Gastroenterology and Gastrointestinal Oncology, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12987-X"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00057-9"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckl103"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-010-1253-0"},{"key":"e_1_3_4_6_2","first-page":"463909","article-title":"Age-related neurodegeneration and memory loss in Down syndrome","volume":"2012","author":"Lockrow JP","year":"2012","unstructured":"Lockrow JP, Fortress AM, Granholm A-C: Age-related neurodegeneration and memory loss in Down syndrome. 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