Cigarette smoking is clearly the most important head and neck cancer risk factor in this population. The reduced cancer risk due to physical activity was consistent with results from a pooled analysis of case-control studies.

As part of efforts throughout China to improve the outcomes of individuals with disabilities, the Shanghai government has launched a campaign to screen at least 95 percent of newborns. To assist in meeting this goal, the Ages & Stages Questionnaires (ASQ), Third Edition, was translated into Chinese and the feasibility of a screening system using the ASQ-Chinese translation (ASQ-C) was investigated in Shanghai. Twenty-nine primary children’s healthcare clinics and several district-wide children’s healthcare institutes participated. Validity and reliability of the ASQ-C were studied as well as utility in pediatric clinics as part of well child visits. Using a sample of more than 8000 caregivers and children from 3 to 66 months of age, screening cutoff scores for each of the 19 ASQ-C intervals were determined, based on two standard deviations below the mean domain score. Inter-rater agreement between ASQ-C completed by 519 parents and a professional assessor was .89. Test-retest reliability for 651 caregivers who completed two ASQ-C at a 1–4 week interval was .91. Cronbach’s coefficient alpha measuring internal consistency ranged from .37 to .79. Convergent validity, measuring agreement between Bayley Scales of Infant Development, 2nd edition, and Denver II outcome categories (i.e. risk, typical) and ASQ-C outcomes (i.e. risk, typical), ranged from .57 to .94. Results from this pilot study suggest the ASQ-C is a promising screening instrument for identification of developmental problems in the Shanghai region. Implementation of a universal screening system in pediatric clinics has the potential to assist in early identification of developmental delays, referral to rehabilitative services, and improvement of developmental outcomes for young children and their families.

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer address all aspects of management for breast cancer. The treatment landscape of metastatic breast cancer is evolving constantly. The therapeutic strategy takes into consideration tumor biology, biomarkers, and other clinical factors. Due to the growing number of treatment options, if one option fails, there is usually another line of therapy available, providing meaningful improvements in survival. This NCCN Guidelines Insights report focuses on recent updates specific to systemic therapy recommendations for patients with stage IV (M1) disease.