American Cancer Society Research Articles

Preliminary efficacy of VOICE, a decision support tool for older adults with advanced cancer: A pilot randomized trial.

11094 Background: Quality shared decision-making (SDM) requires integrating patient values into treatment decisions. Many older patients (pts) with cancer report that clinicians do not elicit their values when making treatment decisions. We developed a decision support tool for older adults with advanced cancer (called VOICE) with values elicitation, real-time feedback to patients, and tailored question prompt lists. Prior research suggests that variation in clinician behavior may impact the efficacy of SDM tools. Methods: We evaluated the preliminary efficacy of VOICE to improve SDM quality in a pilot double-blinded randomized trial. We enrolled pts ≥ 60 years with advanced solid cancers. Pts were randomized to receive VOICE or an American Cancer Society (ACS) educational document with general cancer-related question prompts. Pts completed 2 simulated consultations where they made a treatment decision for a fictional secondary cancer diagnosis: one values-based (VB), where clinicians initiated values elicitation, and one non-values-based (NVB), where clinicians did not. Logistic regression, Fisher’s exact and Mann-Whitney tests evaluated the relationship of trial arm and clinician behavior to pt reports of SDM quality (CollaboRATE) and perceived usefulness of intervention (PrepDM). Five medical students, trained in VB and NVB consultations, functioned as clinicians during consultations. All consultations were recorded and analyzed for fidelity. Results: Forty-four pts (ages 60-88; 50% female; 86% Caucasian, 7% Black, 7% other) with advanced cancer (34% prostate, 23% breast, 18% lung, 11% melanoma, 14% other) were randomized and completed 88 consultations. Pts were more likely to report quality SDM for VB over NVB consultations (Odds ratio [OR] 2.57, 95% Confidence Interval [CI] 1.09-6.25, p=0.03). Pts reported VOICE was more useful to inform SDM than ACS document (mean PrepDM score 65.1 v. 17.4, p<0.001). Pts in the VOICE arm were more likely to report quality SDM (OR 1.70, 95% CI 0.73-4.04) but this did not reach statistical significance (p=0.22). The difference in the percentage of patients reporting high-quality SDM between arms was larger for NVB (43% VOICE v. 22% ACS) than for VB consultations (57% VOICE v. 52% ACS) though not statistically significant. Conclusions: This study demonstrates the value of using simulated encounters for “early-phase” testing of SDM tools. In this pilot randomized trial using simulated clinical encounters, clinician initiation of a discussion of patient values resulted in the highest quality of SDM regardless of study arm. VOICE improved preparation for SDM and showed encouraging preliminary data for its potential to improve the quality of SDM for older adults with advanced cancer especially when clinicians did not engage in values elicitation. Further research is needed to improve values elicitation as part of treatment decision-making.

Recruitment strategies and enrollment for a virtually supervised exercise intervention for Hispanic/Latinx breast cancer survivors.

10601 Background: Hispanic and/or Latinx cancer survivors remain underrepresented in clinical trials, particularly in exercise oncology and energy balance research, with less than 1% of exercise oncology trials focused on this population. The purpose of this analysis was to describe recruitment strategies and enrollment rates among Hispanic and/or Latinx breast cancer survivors screened for and enrolled in an exercise intervention. Methods: The ROSA Trial was a culturally tailored, virtually supervised exercise intervention designed to mitigate metabolic dysregulation in sedentary, overweight/obese Hispanic and/or Latinx breast cancer survivors. Trial recruitment strategies at the Dana-Farber Cancer Institute (DFCI) involved screening pre-determined electronic medical records of breast cancer patient lists for the DFCI Boston location, direct referral from the DFCI Merrimack Valley satellite which is comprised of > 70% Hispanic patient population, recruitment letter mail outs the Massachusetts Department of Public Health (MDPH) cancer registry, American Cancer Society (ACS) Making Strides for Breast Cancer Boston events (2022-23), and media outlets. Descriptive statistics were used to determine frequency of recruitment strategies used and screening variables. Results: Trial recruitment occurred from September 2021-August 2024. The majority of women screened were identified at the DFCI Boston location (70%) followed by the MDPH (23%), DFCI Merrimack Valley (5%), and ACS events (2%). Out of 710 women screened, 396 were ineligible. Main reasons for ineligibility included did not identify as Hispanic/Latinx (n = 78; 19.7%), not sedentary (n = 60; 15.2%), and lived out of country/state (n = 56; 14.1%). Of the 314 women deemed eligible, 240 declined participation, with primary reasons including no communication response (i.e., never responded to voicemails or emails; n = 84; 35%), not interested (n = 46; 19.2%), and no time/scheduling issues (n = 42; 17.5%). There were 74 women who consented for the trial from the 314 deemed eligible, resulting in a 23.6% success rate. A total of 64 women were successfully randomized with 10 women unable to proceed to randomization due to no time (n = 4) or did not provide a specific reason/stopped responding to study staff (n = 6). Randomized participants were 55.47 ± 9.5 years old, overweight or obese (BMI = 30.33± 5.6), postmenopausal (71%), diagnosed primarily with stage I (37.1%) or stage II (37.1%) breast cancer. Conclusions: Multiple recruitment strategies with specific attention to consistent points of contact are necessary to recruit Hispanic and/or Latinx breast cancer survivors in the Greater Boston area. Unique situations such as residency out of the country is important to consider in the planning of future trials among said population. Clinical trial information: NCT04717050 .

Enhancing breast cancer awareness through artificial intelligence: Bridging the gap for low-literacy populations.

e13519 Background: Breast cancer poses a significant threat to women's health, as evidenced by the alarming statistics that it is the second most common form of cancer among females. It is responsible for a staggering 30% of all female cancers, according to data from the American Cancer Society. Furthermore, the incidence of breast cancer is projected to rise by 1% annually by 2025. This can be attributed to various factors, including low literacy levels and lack of health care awareness. In this project, we explore how Chat Generated Pre-Trained Transform (ChatGPT), an emerging artificial intelligence, can be leveraged to simplify the abundant data about breast cancer available on the National Breast Cancer Foundation website, making it more accessible to low-literacy populations. Methods: We aimed to examine the readability of the 17 breast cancer-related questions and answers provided by the National Breast Cancer Foundation on their website. Additionally, we investigated the effectiveness of using ChatGPT in simplifying the content to ensure it is easily understood by individuals with a sixth-grade reading level. To compare the original text and the readability of ChatGPT-generated text, we used the Flesch-Kincaid scoring criteria to understand the education and reading levels needed to interpret this text. We then employed STATA BE 18.5 software using a paired t-test to statistically analyze the Flesch-Kincaid grade level and readability ease score of the original text and ChatGPT-generated text. Results: The results of the paired t-test analysis revealed a significant difference between the mean values of original and ChatGPT-modified text, with a standard error of 0.54 and a standard deviation of 2.23. The 95% confidence interval for the mean difference ranged from 1.38 to 3.67, with the mean difference being 2.523 and a corresponding p-value of 0.0003, which is statistically significant (p < 0.05). Conclusions: Breast cancer continues to be a major public health concern, particularly among women, and there is a pressing need to develop innovative approaches to enhance awareness and encourage early detection. Emerging research suggests that artificial intelligence technologies, such as chatbots, may provide a promising solution to address the barriers faced by individuals with low literacy rates in accessing and comprehending crucial health information.

Inconsistent housing support for oncologic patients at NCI–Designated Cancer Centers.

e13520 Background: Affordable housing accommodations during cancer care is critical for reducing financial toxicity and improving patient outcomes. 1 However, the availability and accessibility of housing resources at National Cancer Institute (NCI)-designated cancer centers is not uniform. For patients and families who travel for cancer care, or who may be admitted, housing costs may exacerbate financial challenges. Our study investigates the availability and limitations of supportive housing programs at NCI cancer centers. Methods: We conducted a cross-sectional analysis of 67 NCI-designated cancer center websites assessing institutional housing programs, charity-supported accommodations, and discounted hotel programs. Non-NCI-treatment centers were excluded. Housing programs were categorized as free or subsidized, and cost-of-living indices were derived from Census 2021 data. Statistical analysis was completed using Python V3.12.1 (2024). Results: Among 67 NCI cancer centers, 52 (78%) provided housing program information online. Of these, 15 (22%) listed institutional housing programs, 32 (48%) listed charity-supported accommodations, and 36 (54%) listed discounted hotel options. Free housing options were available at 35 centers (67%). Centers offering free housing were in regions with a lower average cost-of-living index (52.45) compared to those without free housing (56.90), though this trend was not significant (t-test, p = 0.30). Notably, cancer centers with institutional housing programs were significantly more likely to offer free housing (chi-square = 4.93, p = 0.026). Charity housing programs included the Ronald McDonald House (n = 20) and the American Cancer Society (n = 12). The most likely census region to have free housing was East South Central, with 100% of institutions. The least likely census region to have free housing was Middle Atlantic, with only 36.36% of institutions. Nine programs imposed restrictions, predominantly limiting eligibility to families with pediatric patients or those residing greater than 40 miles. Conclusions: This study examines the current state of housing resources as a component of comprehensive cancer care. Nearly a quarter (22%) of NCI centers lacked online housing information, which may represent a barrier to planning treatment logistics for patients and families. Centers without free housing options highlight disparities in care accessibility, potentially exacerbating financial toxicity for vulnerable families. Increasing visibility and expanding institutional housing programs is needed to promote equitable access and alleviate financial toxicity for patients and their families.

Alcohol abuse among adults with esophageal cancer and impact on outcomes of esophagectomy.

e16056 Background: Recent reports from the American Cancer Society confirmed a rising incidence, mortality rate, and burden of esophageal cancer in the United States. Although alcohol abuse is one of the key risk factors, its impact on the outcomes of esophageal cancer undergoing esophagectomy has not been well reported in the literature. Methods: This study relied on National Inpatient Sample records to evaluate patients with esophageal cancer admissions. We first estimated the prevalence of alcohol abuse among them(per 100,000 cases of esophageal cancer). Then, all patients undergoing esophagectomy were retained, and we explored the impact of alcohol abuse on their in-hospital outcomes. Results: Between 2016 and 2022, there were 283895 all-cause admissions involving esophageal cancer patients, with 19745(7.0%) having a history of alcohol abuse. The highest rate was noted in 2021(7.3%), with the lowest in 2016(6.5%). There were 21770 procedures of esophagectomy conducted during those calendar years, with 5.1%(1115) having a history of alcohol abuse. Those with alcohol abuse were younger (mean age of 61.37 vs. 64.31 years, p < 0.01), had a higher mean Charlson Comorbidity Index(CCI) score(4.02 vs. 3.65, p < 0.01), and contained more males (86.1% vs. 79.9%, p < 0.01), than the non-alcohol abuse group. Our cohort with alcohol abuse faced various in-hospital complications such as pneumonia (aOR 2.052, 95% CI 1.779-2.366, p < 0.01), postprocedural pneumothorax(aOR 1.776,95% CI1.370-2.302, p < 0.01), and sepsis(aOR 1.624, 95% CI 1.351-1.952, p < 0.01). Although bleeding events between the two groups were not different(aOR 1.516, 95% CI 0.938-2.449, p = 0.09), the need for blood transfusion was higher among the alcohol abuse patients (aOR 1.944, 95% CI 1.604-2.356, p < 0.01). Alcohol abuse also involved a heavier burden on healthcare, as the patients stayed on average for 16.66 days (vs. 13.45 days, p < 0.01) and also had higher odds of all-cause death (aOR 1.864, 95% CI 1.449-2.397, p < 0.01). Conclusions: Our findings confirm that esophageal cancer patients with alcohol abuse who were undergoing esophagectomy were younger, with a higher mortality burden, and experienced more complications. Such results underscore the need to address alcohol consumption as a modifiable risk factor and to evaluate adequate preoperative screening and targeted measures that can help improve surgical outcomes.

Predictors of preventive breast cancer screening: Findings from a national dataset.

e22500 Background: Breast cancer is a major health concern and is the most common cancer in women according to the American Cancer Society with 1 in 3 women diagnosed each year. Breast cancer screening with annual or biennial mammography for women 40 years and older has significantly decreased mortality. Our aim in this study is to assess factors predicting adherence to breast cancer screening in the United States. Methods: A retrospective analysis was conducted of adult women using the 2021 National Health Interview Survey (NHIS). Inclusion criteria were women 50-74 years of age who had a mammogram within 2 years as part of a routine exam and who didn’t have history of breast cancer. The US Preventive Screening Task Force guidelines were used. We analyzed demographic and behavioral variables in relation to reported breast cancer screening. SAS v9.4 was used to analyze the data in a manner that accounts for the NHIS complex sample survey design. Bivariate comparisons was performed using Chi-square test, all significance tests were two-sided, p-value < .05 for significance. This study has been approved by UND IRB. Results: Of the 6,334 women respondents, the 72.8% had a mammogram within the past two years. Women who reported having anxiety (p=.000), were underweight (p=.020), lacked health insurance (p=.000), were current smokers (p=.000), lived in rural areas (p=.003), and had poor general health (p=.000) were significantly less likely to have had a mammogram. Conclusions: We identified several modifiable risk factors for non-adherence to preventive breast cancer screening, particularly residing in rural areas gaining more interest in enhancing access to preventative cares. In North Dakota, most patients reside in rural areas, and there are ongoing efforts to provide high quality consistent preventive care. This creates a great opportunity to perform a quality improvement project to further optimize breast cancer screening in this population. Breast cancer remains a complex, heterogeneous disease. Serial screening with mammography is the most effective method to detect early-stage disease and decrease mortality. Promoting breast cancer screening among currently low screened women may reduce future health disparities.

Sex-based differences in outcomes following minimally invasive gastrectomy for gastric cancer: A nationwide study.

e16058 Background: Gastric cancer is projected to affect 17,720 men and 12,580 women in 2025, according to the American Cancer Society. Minimally invasive gastrectomy(MIG) has rapidly gained popularity as a safe alternative to open surgery—unfortunately, no gender-based studies comparing postoperative outcomes between males and females after MIG were available. Therefore, we aim to investigate these differences and develop an understanding of the sex-specific outcomes of this procedure, which refers to outcomes unique to each biological sex due to physiological and anatomical differences. Methods: Between 2016 and 2022, we performed a retrospective analysis using the National Inpatient Sample(NIS) database, which includes information on many inpatient stays, to identify gastric cancer patients who underwent MIG. We utilized multivariable regression models to analyze in-hospital complications and any sex-based differences. Results: There were 13,315 MIG procedures, including 8,620 (64.7%) in males and 4,695 (35.3%) in females. Both groups were similar in age (mean age 65.33 years for males vs. 64.71 years for females, p = 0.618) and Charlson Comorbidity Index (CCI) scores (mean CCI 4.06 for males vs. 3.84 for females, p = 0.219). Malnutrition was present in 15.2% of females and 17.6% of males (p < 0.01), while 22.8% of females and 24.8% of males had metastasis (p = 0.011). The multivariable regression revealed that males had higher odds of complications, including surgical wound disruption (aOR 1.843, 95% CI 1.316-2.580, p < 0.01), sepsis (aOR 1.557, 95% CI 1.280-1.894, p < 0.01), pneumothorax (aOR 1.580, 95% CI 1.263-1.977, p < 0.01), and acute kidney injury (AKI) (aOR 1.517, 95% CI 1.305-1.763, p < 0.01). Additionally, males had a higher risk of bleeding (aOR 1.328, 95% CI 1.031-1.711, p < 0.01) but no significant difference in blood transfusion rates (aOR 0.942, 95% CI 0.818-1.084, p = 0.405). Both sexes had similar mortality odds (aOR 1.021, 95% CI 0.753-1.385, p = 0.894). Length of hospital stay was significantly shorter for females (mean 8.04 days) compared to males (mean 8.91 days, p < 0.01). Conclusions: In our study, 64.7% of MIG procedures were performed in males. Males had higher odds of several postoperative complications, including surgical wound disruption, sepsis, pneumothorax, bleeding, and AKI, but no significant differences in blood transfusion rates or mortality. These findings underscore the importance of considering sex-based disparities in postoperative outcomes, as they can inform the development of more effective clinical guidelines for both sexes. Additionally, the limitations of the National Inpatient Sample, including a lack of post-discharge data, indicate the need for future research addressing long-term outcomes and follow-up.

US population-level costs and cost-savings associated with long-term follow-up (LTFU) screening for survivors of childhood cancer.

10059 Background: Children’s Oncology Group’s (COG) LTFU Guideline adherence is poor. We evaluated the impact of universal payer coverage on patient costs associated with adherence to COG-directed cardiomyopathy (CM), breast (BC), and colorectal cancer (CRC) screening. Methods: We reviewed coverage guidelines for Medicare, Medicaid, and commercial plans for COG screening for exposure-based CM (echocardiogram [echo] every 2-5 yrs based on cumulative chest radiation (RT) and anthracyclines), BC (yearly mammography [MAM] and magnetic resonance imaging [MRI] beginning at age 25 or 8 yrs from chest RT), and CRC (colonoscopy [COL] every 5 yrs or multitarget stool DNA [MTSD] every 3 yrs, starting 5 yrs from abdominopelvic RT or age 30). The eligible US population was estimated from SEER and American Cancer Society cancer survival rates. Cost of screening was derived from the Center for Medicare & Medicaid Services (CMS) and of lifetime treatment from published data. Net costs vs. benefits (in US $) were calculated, assuming 100% adherence, as the sum of cost-savings (i.e., treatment costs averted) and monetary value of quality-adjusted life-yrs (QALYs) gained minus costs (e.g., screening, false positives). Results: Screening coverage varied by payer (Table). BC screening for all US survivors with prior chest RT (n = 42,847) yielded a net benefit ranging from $0.5 to $3.4 billion, with patients paying 19.3% of costs. Among 138,702 survivors at-risk of CRC, net benefit from COL and MTSD was $5.7 and 5.0 billion. Patients nationally bore 0% of MTSD but 60% of COL costs. Among 218,322 at-risk of CM, costs exceeded cost-savings by $1.7 billion when using the median echo cost by payer but yielded a $400 million benefit when using the average cost of CMS and the lowest commercial plan. Patients bore 90% of CM costs. Conclusions: Screening for CM, BC, and CRC per the COG guidelines results in substantial cost savings and benefits. However, as adherence is < 100% due to copay, inadequate coverage, and low provider awareness, interventions and policies focused on boosting adherence could yield cost savings to the health system and reduce disease burden in this population. COG Screening By Payer (Subset) Cost Bearer, % (Aggregated across Payers) Value of Cases Averted Value of QALYs Gained Total Cost Net Costs (-) or Benefit (+) Medicare Medicaid Commercial Patient (Pt) Payer Billion US $, Range BCMAM & MRI Coverage Full, at physician’s discretion MAM: Full MRI: None Full 19.3 80.7 NA* 2.6 - 5.9 2.1 - 2.5 0.5 - 3.4 Pt Cost 20% copay after Part B deductible 20% copay MAM: 0% MRI: 15-30% copay after deductible CRCCOL or MTSD Coverage COL: None MTSD: Full NoneFull NoneFull COL: 60 40 3.7 4.4 2.4 5.7 Pt Cost COL: 100% MTSD: 0% 100% 0% 100% 0% MTSD: 0 100 2.9 4.0 1.9 5.0 CMEcho Coverage None None ≤2 covered after age 18 90.3 9.7 0.01 0.74 0.36 - 2.5 -1.7 - 0.4 Pt Cost 100% 100% 15%-30% copay after deductible *Not available in published models.

The impact of sociodemographic factors on thyroid cancer trends in the United States: A retrospective study using SEER database.

e18163 Background: Thyroid cancer remains a significant cause of morbidity and mortality in the US. The American Cancer Society reports approximately 44,000 new cases and about 2,300 deaths annually. Overall, there has been a plateau in its incidence, for a cancer that was until recently the fastest growing than any other cancer in the US. In this study, we looked at the contribution of demographic and economic factors on the trend of thyroid cancer incidence using the SEER database. Methods: Using the SEER Stat software, we gathered data from seventeen (17) registries of the Surveillance, Epidemiology, and End Results (SEER) database (2000-2021). Joinpoint regression software was utilized in analyzing the secular trend of age-adjusted incidence of thyroid cancer in the United States from 2000-2021 which we stratified according to age, sex and median household income. The annual percentage changes (APC) and graphic trends were determined from data obtained. Results: Thyroid cancer incidences were similar among both sexes. Trends show a steep rise between 2000-2009 with APC of 6.78 and 6.13 respectively (p<0.05), a much slower incidence from 2009-2015 and significant decline in incidence from 2015-2021. The rate of decline in females -3.22 versus males -2.30. We looked at thyroid cancer with regard to income. For patients with median household income <$40,000 yearly, APC from 2000-2005 was 12.10, 2.64 from 2005-2019 and -10.81 from 2019-2021 (p<0.05). For patients with median household income $40,000-$80,000 yearly, APC from 2000-2010 was 6.51 (p<0.05), 2.48 from 2010- 2015 (p>0.05)and -3.54 from 2015-2021(p<0.05). For patients with median household income > $80,000 yearly, APC from 2000-2011 was 6.51, and -2.19 from 2011-2021 (p<0.05). We also studied thyroid cancer based on race. Among White population, APC from 2000-2009 was 6.84, 1.96 from 2009-2015 and -3.33 from 2015-2021 (p<0.05). For African Americans, APC from 2000-2014 was 5.24, and -4.08 from 2014-2021 (p<0.05). Among American Indian/Alaska natives, APC from 2000-2015 was 5.09, and -4.07 from 2015-2021 (p<0.05). For the Asian or Pacific Islander population, APC from 2000-2012 was 4.99, and -1.44 from 2012-2021 (p<0.05). Conclusions: Race, sex and income have all influenced recent trends in thyroid cancer across the nation over the past two decades. Median household income had the greatest impact, with the highest incidence and slowest decline noted among poorer patient populations. Underlying factors need to be addressed to maintain continuous decline and prevent resurgence in thyroid cancer incidence across the country.

Co-designing a smartphone-based navigation system for cancer patients.

e13727 Background: Kentucky ranks 1st among states for the worst overall cancer incidence and mortality in the U.S., with significant geographic, socioeconomic, and racial disparities affecting the access to quality cancer care. To address these cancer patients’ Social Drivers of Health (SDOH) concerns, we are engaging stakeholders from communities to co-design a new, smartphone-based patient navigation system that offers cancer patients and their families the timely access to support services. We will share our experiences in co-designing this digital SDOH navigation system, called MyPathKY, currently under testing at three cancer centers in Kentucky. Methods: From December 2022 to 2024, a co-design studio was conducted at each of three participating sites: University of Kentucky Markey Cancer Center (UKMCC) in Lexington, KY, Saint Elizabeth Healthcare Cancer Center in Edgewood, KY, and Med Center Health Cancer Treatment Center in Bowling Green, KY, to solicit design ideas from cancer patients, family caregivers, healthcare providers, patient navigators, community-based organizations. Other co-design activities include three patient advisory group meetings at the UKMCC, and the following meetings conducted at each site: quarterly clinical collaborator meetings, usability testing, and a quasi-experimental trial. This study was funded by the Merck Foundation as part of its Alliance for Equity in Cancer Care and the American Cancer Society navigation capacity building grant and was approved by the Institutional Review Boards. Results: Co-design ideas were carefully reviewed with stakeholders and incorporated into the MyPathKY system, including a patient-facing smartphone app for both iOS and Android devices and a web-based dashboard for patient navigators at the sites. The patient app offers tools to report cancer related concerns using the built-in NCCN Distress Thermometer tool. Based on patients’ reported concerns and their locations, the app recommends relevant nearby community services as well as provides guidance and follow-ups to ensure that patients receive services to close the loop. Patients can also access personalized patient education in this app. Site navigators receive email alerts about patients’ high-level distress and can review patients distress reports and their status of contacting community services. They can also proactively suggest services and help connect patients with services. The feedback from stakeholders is mostly positive with suggestions for improvement. The initial testing of the patient app shows acceptable usability with a mean system usability score at 73.7, higher than the suggested threshold at 68. Conclusions: Co-designing a new cancer navigation program with community stakeholders ensured the program’s acceptability and integration with the existing workflow, and in turn will likely maximize its effects and adoption. We will share project updates at the meeting. Clinical trial information: NCT06326567 .

Hematopoietic stem cell transplant in multiple myeloma: An analysis of mortality, costs, and patient characteristics.

e19556 Background: Multiple myeloma (MM) is a clonal plasma cell neoplasm projected to affect approximately 36,000 people and result in 12,000 deaths in the United States in 2025, according to the American Cancer Society. While advancements in treatment options have revolutionized care in recent years, hematopoietic stem cell transplant (HSCT) remains a cornerstone of therapy. This study aimed to analyze differences in patient characteristics, in-hospital mortality rates, comorbidity prevalence, hospital length of stay, and total charges between multiple myeloma patients with and without HSCT. Methods: We used the 2019–2020 National Inpatient Sample (NIS) database to identify all patients admitted with a primary diagnosis of Multiple myeloma (based on relevant ICD-10 codes), categorizing them by receiving HSCT to analyze their epidemiological differences, demographic characteristics, mortality rates, and associated healthcare burdens. Results: The epidemiological characteristics of the patient populations are summarized in the table below. A total of 41,280 patients met the inclusion criteria, of which 18,076 (43.79%) were female, and 10,260 (24.85%) underwent HSCT. The transplant group had significantly longer hospital stays (12.94 vs. 10.76 days, p < 0.001) and higher total charges ($170,529 vs. $138,484, p < 0.001). In-hospital mortality rates were also higher in the HSCT group (5.95% vs. 4.25%, p = 0.0022). However, multivariate regression analysis adjusting for confounding factors did not find HSCT to be a significant risk factor for mortality (OR: 1.14, p = 0.270). Regional trends showed that most MM patients undergoing HSCT were hospitalized in the South (38.4%) and Northeast (28.51%), whereas patients not receiving HSCT were predominantly hospitalized in the South (37.89%) and Midwest (24.55%). Conclusions: While HSCT is a complex procedure associated with high risks of infection and significant costs in the treatment of MM, our study did not demonstrate a statistically significant increase in in-hospital mortality for transplant patients after adjusting for confounding factors. The mean ages between the transplant and non-transplant groups were comparable, suggesting that age was not a primary determinant for undergoing HSCT. Despite the longer hospital stays and higher total charges observed in the HSCT group, the findings underscore the need for further research to optimize patient selection criteria and improve cost-effectiveness in MM management. Variables MM patients with HSCT (24.85%) MM patients without HSCT (75.15%) p values Total number of patients 10, 260 31, 020 Age (years) 65.92 65.68 0.4542 Gender (Female) 45.32% 43.28% 0.0944 Race < 0.001 -White 52.58% 60.56% -Black 26.75% 21.71% -Hispanic 10.09% 9.72% -Asian/Native American and others 10.58% 8.01% Primary Insurance 0.2648 -Medicare 52.12% 52.73% -Medicaid 9.26% 8.26% -Private insurance 34.28% 33.47% -Other 4.34% 5.54% Household income(quartile) 0.0908 -1 st 26.16% 26.49% -2 nd 23.15% 23.7% -3 rd 24.04% 26.01% -4 th 26.66% 23.8% Obesity 12.77% 12.99% 0.8157 DM 24.12% 21.86% 0.0490 COPD 7.31% 6.33% 0.1456 CHF 15.64% 12.52% 0.0007 Smoking 21.3% 23.66% 0.0317 CKD 34.26% 29.11% 0.0001 Age> 80 11.11% 11.9% 0.3892 Sepsis 7.6% 5.3% 0.0020

Efficacy and Safety of Adavosertib in Platinum-Resistant and Recurrent Ovarian Cancer: A Systematic Review and A Meta-Analysis

Introduction: Ovarian cancer is a leading cause of mortality among gynaecological malignancies. According to estimates from the American Cancer Society for 2024, approximately 19,680 women in the United States will be newly diagnosed with ovarian cancer, and about 12,740 women will succumb to the disease. Advanced-stage ovarian cancers frequently develop resistance to treatment, resulting in a poor overall prognosis for this patient population. This article presents a systematic review and meta-analysis examining the efficacy and safety profile of adavosertib in treating platinum-resistant or recurrent ovarian cancers. Methodology: The research question was framed using the PICO framework before initiating the review. A comprehensive literature search was conducted across PubMed, Google Scholar, Scopus, HINARI, and ScienceDirect databases, covering publications up to August 2023. Inclusion and exclusion criteria were defined, and appropriate tools were utilized to assess the risk of bias in the included studies. Descriptive and summary statistics were employed to characterize the sociodemographic features of the study cohort and the adverse effects associated with adavosertib. A random-effects model meta-analysis was performed to evaluate the association between adavosertib and the overall median survival of patients. Results: In the meta-analysis using a random-effects model, the pooled estimate for the overall survival of patients given adavosertib is 14.71 months (95% CI: 9.01 to 20.41 months). The estimate is statistically significant (p < 0.0001), indicating a positive effect of adavosertib on overall survival. The amount of total heterogeneity (variability between studies) is estimated to be 18.97 (SE = 26.19), with a corresponding tau value of 4.35. The I² statistic is 77.36%, indicating a high level of heterogeneity among the studies. The most common adverse effects were nausea (69.3%), anemia (60.3%), diarrhea (56.8%), thrombocytopenia (55.0%), neutropenia (54%), vomiting (52.7%), lymphopenia (35.6%), hypomagnesemia (9.0%), and hypokalemia (5.4%). Conclusion: The meta-analysis suggests that adavosertib has a significant positive effect on overall survival in ovarian cancer patients, with an estimated pooled median survival of 14.71 months. However, the results should be interpreted cautiously due to the high heterogeneity observed among the studies. The top three most common adverse effects were nausea, anemia, and diarrhea. Larger studies are recommended to provide more comprehensive information on this topic.

Skin Disease Detection using Machine Learning

Cancer is a serious illness due to someone’s abnormal cell growth that can spread throughout the body. Although skin cancer is uncommon, it is still quite dangerous. Basal cell carcinoma, squamous cell carcinoma, and melanoma are the three main skin cancer types. In the U.S., melanoma is 1% of skin cancer cases, but it is the reason for the most skin cancer deaths. The American Cancer Society estimated that about 8,430 melanoma deaths will occur in 2025, 5470 of whom are men and 2960 are women. Fortunately, the death rates from melanoma are decreasing much more thanks to better treatments from 2013 to 2022. To effectively treat skin cancer, it should be detected early. When necessary, the diagnostic process usually begins with a clinical examination by a dermatologist, followed by a dermoscopy, then a biopsy, and a histopathological evaluation. These diagnostic steps can take several weeks in total. Many healthcare professionals argue that early diagnosis brings greater success. Machine learning algorithms can help detect skin cancer quickly, which can ultimately improve the prognosis of the patient.

Cancer treatment and survivorship statistics, 2025

AbstractThe number of people living with a history of cancer in the United States continues to rise because of the growth and aging of the population as well as improved survival through advances in early detection and treatment. To assist the public health community serve the needs of these survivors, the American Cancer Society and the National Cancer Institute collaborate triennially to estimate cancer prevalence in the United States using data from the Surveillance, Epidemiology, and End Results cancer registries, the Centers for Disease Control and Prevention's National Center for Health Statistics, and the United States Census Bureau. In addition, cancer treatment patterns are presented from the National Cancer Database along with a brief overview of treatment‐related side effects. As of January 1, 2025, about 18.6 million people were living in the United States with a history of cancer, and this number is projected to exceed 22 million by 2035. The three most prevalent cancers are prostate (3,552,460), melanoma of the skin (816,580), and colorectum (729,550) among males and breast (4,305,570), uterine corpus (945,540), and thyroid (859,890) among females. About one half (51%) of survivors were diagnosed within the past 10 years, and nearly four fifths (79%) were aged 60 years and older. Racial differences in treatment in 2021 were common across disease stage; for example, Black people with stage I‐II lung cancer were less likely to undergo surgery than their White counterparts (47% vs. 52%). Larger disparities exist for rectal cancer, for which 39% of Black people with stage I disease undergo proctectomy or proctocolectomy compared to 64% of their White counterparts. Targeted, multi‐level efforts to expand access to high‐quality care and survivorship resources are vital to reducing disparities and advancing support for all survivors of cancer.

Cervical Cancer Screening After Menopause.

About 14,000 women develop cervical cancer each year in the United States. Human Papillomavirus (HPV) vaccination is an effective primary prevention measure for HPV infections and cervical cancer among adolescents and young adults. For middle-aged and older women, they rely on secondary prevention (i.e., cancer screening) for early detection of cervical cancer. The average age at which women receive a cervical cancer diagnosis is around 50, when most women are in the middle of perimenopause. In this study, we use data from a longitudinal survey to examine whether going through menopause is associated with cervical cancer screening behavior four or eight years later. Data were taken from 2012, 2016, and 2020 waves of the Health and Retirement Study (HRS), a longitudinal survey of middle-aged and older adults in America. Using the 2012 and 2016 waves as baselines, two four-year (n = 1011 and n = 1263) and one eight-year (n = 823) longitudinal analyses were conducted. The lost follow-ups and those who have had a hysterectomy were excluded. Hierarchical logistic regression models were used to compare women who had gone through menopause to those who were premenopausal or perimenopausal at each of the baselines in terms of their likelihood of having a pap smear test four or eight years later. Results show that the women who had gone through menopause were less likely to have a pap smear test four or eight years later when compared to those who were still premenopausal or perimenopausal at baseline. Women who had gone through menopause at the baseline of 2016 were less likely to have a pap smear test by 2020 (Odds Ratio = 0.76, p < 0.05). A similar association was found among women who had gone through menopause at the baseline of 2012 after controlling for their previous pap smear behavior and other covariates. The American Cancer Society and other professional organizations recommend that women have cervical cancer screenings regularly until age 65. Our findings suggest that women seem less likely to have a pap smear test after menopause. More research is needed to have a comprehensive understanding of cervical screening behavior in this age group of women.

Do people prefer AI-generated patient educational materials over traditional ones?

Do people prefer AI-generated patient educational materials over traditional ones?

Prostate cancer screening guidelines and their alignment with recent literature.

A prostate-specific antigen (PSA) test is a simple blood test that is used to screen for prostate cancer. Over the last 30 years, the benefit of screening with a PSA test has been a matter of significant debate because of its association with overscreening, overdiagnosis, and overtreatment of prostate cancer. Although most prostate cancer screening guidelines recommend a shared decision-making approach between the patient and provider, these recommendations are contradictory in terms of screening initiation, frequency, and discontinuation as well as screening recommendations for high-risk populations. This article describes a literature review comparing screening guidelines with newer research in order to determine which guideline aligns most closely with the latest findings. Results show that the related American Urological Association and National Comprehensive Cancer Network guidelines, for example, may lead to over- or underscreening, whereas the American Cancer Society (ACS) guideline seems most closely in alignment with recent research. By following the ACS guideline, most clinically significant prostate cancer should be captured with less risk of overscreening and overdiagnosis.

Dietary-Lifestyle Patterns and Colorectal Cancer Risk: Global Cancer Update Programme (CUP Global) Systematic Literature Review.

Dietary-Lifestyle Patterns and Colorectal Cancer Risk: Global Cancer Update Programme (CUP Global) Systematic Literature Review.

Evaluation of Artificial Intelligence Models for Nutritional Symptom Management in Breast Cancer Patients Undergoing Chemotherapy

The purpose of the study is to determine if artificial intelligence (AI) models could provide dietary recommendations to manage chemotherapy-induced nutritional symptoms in breast cancer (BC) patients that are on comparable levels with the American Cancer Society, National Cancer Institute and World Cancer Research Fund guidelines which were used as evidence-based recommendation. The AI models—ChatGPT, ChatGPT 4.0, Gemini, Gemini Advanced, Copilot, and Copilot Pro—were evaluated based on their adherence to the guidelines. Specific queries were posed to each model, and the generated responses were rated by two experienced dietitians using a 5-point likert scale. Gemini provided the most adherent recommendations for metallic taste in mouth, while Gemini Advanced excelled in managing dehydration. ChatGPT and Gemini Advanced were the most effective in addressing heartburn, and Copilot Pro consistently showed the lowest performance across most symptoms. Overall, ChatGPT 4.0 attained the highest total score, followed by Copilot and Gemini, indicating a general trend where certain models were better suited for specific symptoms. Various AI models (e.g. ChatGPT 4.0) show potential in addressing certain chemotherapy-induced symptoms, but they do not consistently align with evidence-based recommendations. Improvement of AI models is necessary for their adherence to evidence-based recommendations.

Abstract 4908: Exploring the role of algorithms in accessing culturally tailored nutrition information to improve survivorship in women with reproductive cancers

Abstract Background/Significance: African American/Black (AA/B) women experience a 46 percent higher mortality rate from reproductive cancers compared to White women. While dietary interventions have shown effectiveness in improving survivorship, barriers such as limited access to culturally and linguistically relevant nutrition information hinder healthy dietary behaviors. Digital platforms are key sources of cancer nutrition information for AA/B women, yet algorithmic biases often limit the visibility of culturally relevant, reliable resources in underserved communities. Optimizing algorithmic frameworks to prioritize culturally tailored content could enhance survivorship outcomes for AA/B women. Methods: An environmental scan of 25 sources evaluated the accessibility and cultural alignment of online cancer nutrition information for AA/B women. Focus groups with reproductive cancer survivors explored trust in digital health platforms and barriers to accessing culturally adapted nutrition resources. Interviews with SEO specialists, bio-nutritionists, and food industry leaders examined how algorithms impact access to culturally specific cancer nutrition information. Results: The environmental scan revealed a gap in culturally adapted cancer nutrition content for AA/B women in national guidelines. Focus groups emphasized the reliance on digital platforms for dietary guidance but noted challenges in accessing trustworthy, culturally relevant information. Interviews revealed algorithmic biases that limit visibility of culturally tailored content, particularly in underserved areas. These findings stress the need for culturally competent nutrition education to address disparities and improve cancer survivorship outcomes. Conclusion: Optimizing search engine algorithms and integrating trustworthy, credible, and culturally relevant nutrition content into digital platforms are essential to addressing access barriers for AA/B cancer survivors. By advancing algorithmic design and promoting reliable, culturally tailored online resources, technology can build trust and improve survivorship outcomes. This research stresses the critical role of digital innovation and health equity-focused strategies in promoting equitable access to cancer nutrition information, supporting the continuum of innovation in cancer care. Acknowledgement of Funding: The project described was supported by Award Number CHERC-MSI-21-166-01-CHERC-MSI. from the American Cancer Society (ACS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the ACS. Citation Format: Zakirah L. Abdul-Hameed, Gabrielle Ford, Amirah Burton-Obanla, Desiree Rivers. Exploring the role of algorithms in accessing culturally tailored nutrition information to improve survivorship in women with reproductive cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4908.