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Article History

Received: 22 January 2026

Accepted: 7 June 2026

First Online: 16 June 2026

Declarations

:

: The All of Us protocol was reviewed and approved by the All of Us Institutional Review Board (IRB) of the All of Us Research Program (2021–02-TN-001). The All of Us IRB follows the regulations and guidance of the NIH Office for Human Research Protections for all studies, ensuring that the rights and welfare of research participants are overseen and protected uniformly. Participant rights and welfare are uniformly protected in accordance with the Declaration of Helsinki, with informed consent and withdrawal options provided. Privacy is ensured through de-identification, data storage on protected computers, limited researcher access, and contractual agreements. The present study did not directly involve participants, only their data; and the data available in the Researcher Workbench has been carefully checked and altered to remove identifying information while preserving its scientific utility. The Researcher Workbench employs a data passport model, through which authorized users do not need IRB review for each research project. As such, this research is considered non-human subjects research, and project-specific IRB approvals or waivers are not required. Prior to data access, the authors were trained on the All of Us data use policies that safeguard the ethical, confidential, and unbiased use of the All of Us data. In compliance with the All of Us Data and Statistics Dissemination Policy, counts ≤ 20 are withheld to prevent reidentification. Electronic health records (EHR) data were retrieved only if participants provided Health Insurance Portability and Accountability (HIPAA) authorization.

: The authors declare no competing interests.

: The findings and conclusions in this article are those of the authors and do not necessarily represent the official positions of the American Cancer Society.