Awareness Of Cancer Screening Research Articles

Questionnaire survey on cervical cancer screening and human papillomavirus awareness among patients at a local cancer center in Japan

Questionnaire survey on cervical cancer screening and human papillomavirus awareness among patients at a local cancer center in Japan

Exploring Factors Influencing Cervical Cancer Screening Participation among Singaporean Women: A Social Ecological Approach

Background/Objectives: Cervical cancer screening uptake in Singapore remains suboptimal. This study employed the Social Ecological Model (SEM) to investigate factors influencing cervical cancer screening participation among Singaporean women. Methods: The study included 665 women, aged 25–69 years, who reported awareness of cancer screening and no personal cancer history. Data were collected through a previously described online survey. Hierarchical logistic regression analysis was conducted to identify significant factors influencing screening participation. Results: Only 30% of participants reported cervical cancer screening participation. Women aged 25–29 years (OR = 0.33; 95% CI = 0.12–0.77), Malay women (OR = 0.42; 95% CI = 0.20–0.83), and unmarried women (OR = 0.30; 95% CI = 0.18–0.48) were less likely to be screened. Positive associations with screening participation were observed with good cervical cancer screening knowledge (OR = 2.90; 95% CI = 1.96–4.32), awareness of primary care providers’ role in delivering screening services (OR = 1.94; 95% CI = 1.24–3.10), cancer information seeking behavior (OR = 1.59; 95% CI = 1.07–2.39), and acceptance of self-sampling options (OR = 1.81; 95% CI = 1.22–2.70). Conclusions: Our study highlights the cumulative impact of factors at various SEM levels on screening participation and underscores the necessity for more targeted and multi-pronged strategies to improve cervical cancer screening uptake in Singapore.

Creating scalable health equity and quality improvement frameworks: Evaluating the impact of a cancer screening awareness campaign for reducing disparities in Black and Hispanic women.

75 Background: Cancer disparities persist for Black and Hispanic women. Quantifiable learnings from early detection efforts may help inform future health equity initiatives and improve patient outcomes. This study describes survey results measuring the effectiveness of Love Letters for Cancer Screening for Women of Color, an awareness campaign using representative artwork and letters created “for the community, by the community,” within a quality improvement framework. Methods: Genentech and IQVIA deployed a survey at community health events hosted by partner organizations Weill Cornell Medicine and the American Cancer Society. The survey (fielded in English and Spanish) evaluated the impact of this health equity campaign on perceptions of cultural representation, cancer screening awareness, and motivation to act. In-person responses were compared with responses from an online control group in the broader NY metro area. Participants gave informed consent, and modest compensation was provided upon survey completion. This study was not powered for statistical significance. Results: Responses from 317 participants (117 in person; 200 online) showed that this campaign successfully resonated with target demographics of Black and Hispanic women both in person and online, demonstrating the positive impact of this community-based campaign. The campaign was effective at motivating Black and Hispanic respondents to act, with 74% reporting they would schedule a cancer screening, and 75% reporting they would talk to friends or family. Among respondents with self-reported low health literacy, 85% reported feeling more knowledgeable. Overall, in-person engagement was more meaningful than online engagement, highlighting the importance of partnering with community organizations for live events. Conclusions: Partnerships across patient, community, industry,and provider organizations are key to advancing cancer health equity and overcoming health disparities in historically marginalized, underserved populations. These survey results support cocreation and co-implementation of culturally tailored awareness campaigns with measurement frameworks to achieve quality improvement and health equity goals. Respondents who “agreed” or “completely agreed”. The campaign respects/reflects my culture and community Felt inspired to act around cancer screening for myself/my loved ones Will share information and/or materials about campaign with others Will talk to family and/or friends about cancer screenings Will speak to my HCP about cancer screenings Will schedule a cancer screening appointment for myself Black In-person (n=64) 75% 89% 77% 80% 77% 75% Online (n=20) 65% 75% 50% 70% 60% 60% Hispanic In-person (n=28) 82% 86% 79% 82% 75% 82% Online (n=20) 70% 70% 60% 70% 60% 65%

S463 The Role of Generative Language Systems in Increasing Patient Awareness of Colon Cancer Screening

S463 The Role of Generative Language Systems in Increasing Patient Awareness of Colon Cancer Screening

Cross-sectional study of assessment of lung cancer (LC) screening awareness in an underserved community in the Bronx, New York.

155 Background: LC remains the second most diagnosed cancer but is the leading cause of cancer death in the USA, accounting for 21% of all cancer deaths. Despite advances in screening and treatment, it remains the principal cause of cancer mortality worldwide. Notably, survival rates have improved from 21% to 25% over the past 5 years. However, LC screening with low-dose computed tomography (LDCT) is underutilized, with only 5.8% of eligible individuals screened in 2021. Methods: A prospective 29-question survey was conducted at St. Barnabas Health Care System in the Bronx, NY, from February to April 2024. The survey included patients aged 50-80, both former and active smokers. Data on demographics, social determinants, and knowledge of LC and LDCT screening were collected and processed using JASP Version 0.18.3. The study aimed to assess the community's knowledge of lung cancer screening, with demographic characteristics as secondary outcomes. Results: From all the surveys collected, 115 met the inclusion criteria, 53% male (61) and 47% female (54), with no significant difference between proportions (p=0.576). The median age was 63 years. Race: 73% were Hispanic, 22% Black, and 5% White, with significant differences from an equal distribution (p< 0.001). Legal Status, citizens (74%), followed by green card holders (17%). Most of the patients lived in the USA for over 20 years (90%), with very few having lived for less than five years (1%), indicating a long-term residency trend (p < 0.001). Education Level: high school education was the most common (58%), followed by middle school (17%) and elementary school (15%). Doctorate and graduate degrees were less common (7%). 91% of patients were aware of the relationship between cigarette smoking and LC, while 9% did not (p<0.001). On the other hand, 66% believed there was a relationship between e-cigarette use and LC, while 44% believed there was not. Patients with an income greater than $50,000 have significantly more knowledge of the screening tool for LC (STLC), as indicated by a Chi-square value of 50.87 (p < 0.05, with a critical value of 5.99). Patients with low education levels have less knowledge of the existing STLC, with a Chi-square of 143.587 (p<0.05 and a critical value of 9.488). Conclusions: Our study highlights critical disparities in LC awareness and knowledge of screening tools among different demographic groups. There is a clear need for targeted educational initiatives, especially for lower-income and less-educated populations, to improve understanding of LC risks associated with both traditional and electronic cigarette use. The significant presence of long-term Hispanic residents suggests that culturally tailored interventions could be particularly effective. Addressing these gaps is essential for enhancing lung cancer prevention and early detection efforts across diverse communities.

S544 Short-Form Videos for Colorectal Cancer Screening Awareness

S544 Short-Form Videos for Colorectal Cancer Screening Awareness

S521 Community Speaks: Engagement of Community Members Is an Important Component to Increasing Colon Cancer Screening Awareness

S521 Community Speaks: Engagement of Community Members Is an Important Component to Increasing Colon Cancer Screening Awareness

Abstract A144: Insight into cervical cancer screening and HPV self-sampling among Vietnamese immigrants in Southern California

Abstract Background: Screening can effectively identify precancerous lesions for early treatment to prevent cervical cancer. However, only 69% of Vietnamese immigrants in the U.S. reported screening in the past 3 years compared to 84% of non-Hispanic White women. Human papillomavirus (HPV) self-sampling is a novel cervical cancer screening approach that does not require women to visit healthcare providers and has been shown to increase screening uptake in several minority populations. Understanding the attitudes towards cervical cancer screening, including HPV self-sampling, among Vietnamese immigrants could inform strategies to improve their screening rates. Methods: We conducted two online semi-structured focus groups with a total of nine Vietnam-born women aged 50-65 living in Southern California, which has the largest Vietnamese community outside of Vietnam, to understand their awareness of, attitudes towards, and experiences with cervical cancer screening. Participants also watched two short videos on two cervical cancer screening methods (Papanicolaou "Pap" test and HPV self-sampling) and shared their thoughts on each method. Each focus group was recorded, transcribed, translated into English, and coded and analyzed using NVivo 14. Results: Three main themes emerged from the focus groups. First, participants showed a strong acceptance of cervical cancer screening despite poor knowledge of the disease and its prevention as well as logistic and psychosocial barriers associated with visiting healthcare providers for screening. Second, participants found HPV self-sampling to be highly acceptable, mentioning advantages like its convenience and the lack of embarrassment compared to visiting healthcare providers. However, there were some concerns regarding the mailing of the self-collected samples and the cost of the test. Third, participants described circumstances that may be immigrant-specific, such as a shift from making gynecologic appointments themselves in Vietnam to relying on family doctors as gatekeepers for such appointments in the U.S., a strong preference for Vietnamese- speaking providers, and the use of English as a Second Language (ESL) centers, community organizations, radio stations, and newspapers targeting Vietnamese communities to obtain healthcare information. Conclusions: HPV self-sampling has the potential to improve cervical cancer screening uptake in Vietnamese immigrants since it can overcome barriers associated with visiting healthcare providers for a Pap test. Education campaigns are needed to increase awareness of cervical cancer screening and address concerns related to HPV self-sampling. Engagement with healthcare providers, organizations, and media channels that serve Vietnamese communities may be effective since Vietnamese immigrants often receive health-related information from these sources. It is necessary to explore the perceptions of younger immigrants and U.S.-born Vietnamese women to inform efforts that can improve screening uptake in all Vietnamese women; focus groups and interviews of these women are underway. Citation Format: Minh T. Phung, Ivy Nguyen, Bethany Nguyen, Hailey Nguyen, Becky Nguyen, Dung Hua, Celeste L. Pearce, Alice W. Lee. Insight into cervical cancer screening and HPV self-sampling among Vietnamese immigrants in Southern California [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A144.

Women’s empowerment and its influence on the uptake of breast cancer screening in Tanzania: an analysis of 2022 Tanzania demographic health survey data

BackgroundBreast cancer is the second most commonly diagnosed cancer worldwide, with a high mortality rate in developing countries, including sub-Saharan Africa. Screening is one way to ensure early detection and management of breast cancer, and it is influenced by several factors. Education and socio-economic status may also affect the utilization of breast cancer screening services as these impact decision-making. This study aimed to investigate women’s empowerment and its influence on the uptake of breast cancer screening among women in Tanzania.MethodsThis study utilized the 2022 Tanzania Demographic and Health Survey data, and included 4216 women aged 20 to 49 years. Women empowerment variables used include social independence, decision-making, ownership of assets, and attitude towards violence. Statistical Package for Social Sciences version 26 was used for data cleaning and analysis. Descriptive statistics and bivariate analysis were done, including a multivariate logistic regression to assess the level of association between independent variables with breast cancer screening.ResultsFindings indicate that the prevalence of breast cancer screening is 5.2%. Age, education level, literacy, ownership of assets, attitude towards violence, and decision making are associated with ever going for breast cancer screening. Women aged 45 to 49 years (AOR = 6.28, 95% CI = 6.27–6.28), those with secondary or higher education (AOR 1.1, 95% CI = 1.05–1.06), literate women (AOR = 1.13, 95% CI = 1.13–1.13), those who own a house (AOR = 3.08, 95% CI = 3.08–3.09), who jointly decide on their healthcare with partners on healthcare (AOR = 1.18, 95% CI = 1.18–1.19) had significantly higher odds of going for breast cancer screening.ConclusionWomen’s empowerment is significantly associated with the likelihood of engaging in breast cancer screening. Empowered women are more likely to undergo screening. Focus should be on empowering women through education, businesses, and community involvement. Country-specific interventions and breast cancer screening awareness campaigns should include empowerment initiatives to promote screening uptake.

The role of generative language systems in increasing patient awareness of colon cancer screening.

This study aims to evaluate the effectiveness of ChatGPT (Chat Generative Pretrained Transformer) in answering patients' questions about colorectal cancer (CRC) screening, with the ultimate goal of enhancing patients' awareness and adherence to national screening programs. 15 questions on CRC screening were posed to ChatGPT4. The answers were rated by 20 gastroenterology experts and 20 non-experts in three domains (accuracy, completeness, and comprehensibility), and by 100 patients in three dichotomic domains (completeness, comprehensibility and trustability). According to expert rating, the mean accuracy score was 4.8±1.1 on a scale ranging from 1 to 6. Men completeness score was 2.1±0.7 and mean comprehensibility score was 2.8±0.4 on a scale ranging from 1 to 3. Overall, accuracy (4.8±1.1 vs 5.6±0.7, P<0.001) and completeness (2.1±0.7 vs 2.7±0.4, P<0.001) scores were significantly lower for expert compared to non-expert, while comprehensibility was comparable among the two groups (2.7±0.4 vs 2.8±0.3, P=0.546). Patients rated all questions as complete, comprehensible and trustable in 97 to 100% of cases. ChatGPT shows good performance with the potential to enhance awareness about CRC and improve screening outcomes. Generative language systems may be further improved after proper training in accordance with scientific evidence and current guidelines.

Awareness Regarding Screening Programs in General Population to Improve Health Indicators: Genetic Counselors as Facilitators

Public health screening programs are crucial for early disease detection, but limited awareness hinders their effectiveness in India, regardless of literacy. This study assessed awareness levels for key programs among 294 literate and illiterate individuals via an online survey. Results showed high awareness for antenatal care (96%). Newborn screening (NBS) and thalassemia screening awareness were higher in females, particularly regarding thalassemia's hereditary nature (73% vs 61% and 73% vs 57%). Cervical cancer awareness increased with education (83% for graduates). Interestingly, even those with no education displayed some awareness of breast cancer screening. Prostate cancer awareness was similar across genders, with limited knowledge even among highly educated individuals (66% for Ph.Ds). These findings highlight a critical gap in public health education. Genetic counselors can bridge this gap by implementing targeted campaigns, partnering with schools and communities, and collaborating with healthcare professionals. Empowering individuals with knowledge is essential for improved population health outcomes in India.

Male support for cervical cancer screening in Debre Berhan City Ethiopia a community based cross sectional survey

Male partner involvement strongly influences a woman's decision to undergo cervical cancer screening. Women of low socioeconomic status are disproportionately affected by cervical cancer. Women living in low-and middle-income countries often encounter resistance from their partners regarding participation in cervical cancer screening. The lack of men's support for sexual and reproductive health programs, including cervical cancer screening, creates a barrier to women's utilization of health services. To assess Ethiopian men's awareness, knowledge, perceptions, and attitudes toward cervical cancer screening and their support to their female partners during screening. A community-based cross-sectional survey was conducted from June 20, 2023, to August 04, 2023. A multistage sampling procedure was used to recruit 614 male survey participants. Descriptive statistics were used to summarize sociodemographic data. Univariate and multivariate regression analyses were performed to measure the associations between the dependent and independent variables. A p-value of less than 0.05 was considered statistically significant. In this survey, 58.5% (359) of participants supported their partners for cervical cancer screening. More than half 55.9% (343) of the participants had an awareness of cervical cancer disease and 47.2% (290) participants knew the risk factors associated with the development of cervical cancer. In addition to that, 66.8% (410) of men have a positive attitude towards screening and encourage their wives to get screened if they notice symptoms of cervical cancer. Regarding the perceptions of cervical cancer, 37.0% (227) of male participants believed that their female partners were at risk of developing the disease, while 38.3% (235) of men believed that cervical cancer screening was only necessary if the woman showed symptoms. Completion of higher education (AOR = 3.75, 95% CI 1.60–8.79, p = 0.002), living with other people (AOR = 0.09, 95% CI 0.03–0.29, p < 0.0001), not being tested for HIV (AOR = 0.26, 95% CI 0.10–0.74, p = 0.011), and having information about cervical cancer (AOR = 3.33, 95% CI 1.36–8.15, p = 0.009) were statistically significantly associated with men’s support for their partners in cervical cancer screening. Men’s awareness, knowledge, and perceptions of cervical cancer screening were low. On the other hand, men have a positive attitude towards screening and encourage their wives to get screened if they notice symptoms of cervical cancer. This survey will serve as a basis for the development of further strategies and action plans to promote and support male participation in cervical cancer screening in Ethiopia. This can be achieved through the development of strategic plans, including public campaigns, raising awareness among social and community leaders, involving non-governmental organizations focusing on women's health, and community education.

Community Awareness of Lung Cancer Screening: A Cross-sectional Survey

BackgroundLung cancer remains the leading cause of cancer mortality in the United States, but only 4.5% of eligible people undergo recommended screening. We hypothesize that low community awareness remains a barrier to lung cancer screening. MethodsA cross-sectional survey was conducted in a convenience sample of attendees at our institution’s community health fair. Survey topics included demographics, smoking history, cancer history, lung cancer screening knowledge, and perceptions of screening risks and benefits. ResultsOf 214 survey participants, 139 (65%) were women, and there were 98 (46%) Asian and 86 (40%) White participants. Almost a third of the sample had worked in health care, and just more than a half had completed some graduate school. There were only 6 (2.8%) current smokers and 28 (13%) former smokers. Most participants (71%) did not know there was a way to screen for lung cancer. Most participants (66%) knew that cigarette smoking was the risk factor considered for lung cancer screening, but very few knew the screening criteria. More than 75% of participants chose “strongly agree” or “agree” that several benefits of lung cancer screening are important to consider, but only 50.0% to 66.3% for several risks. Most participants (71%) responded that they are “very likely” or “likely” to undergo screening if eligible. ConclusionsIn a survey study at a community health fair, community awareness of lung cancer screening was very low, but most participants said they would be willing to be screened if eligible. Community education is critical in increasing our lung cancer screening rates.

Questionnaire survey on cervical cancer screening and HPV awareness among patients at a local cancer center in Japan

BackgroundThe incidence of cervical intraepithelial neoplasia is increasing in Japan. Although human papillomavirus (HPV) vaccination and cancer screening are crucial in preventing cancer-related mortality, the cervical cancer screening rate in Japan was only approximately 43.6% in 2022. This study aimed to conduct an epidemiological analysis of cervical cancer by collecting data from individual patients.MethodsA questionnaire survey was administered to patients who visited our hospital between January 2017 and July 2023 owing to abnormal cervical cytological findings or a cancer diagnosis. Patients answered questions regarding their history of cervical cancer screening as well as their knowledge of HPV and cervical cancer.ResultsDuring the study period, 471 patients participated in the survey, with 35 declining to participate. Patients with Stage 1b1–4b primarily sought medical attention due to self-reported symptoms (P < 0.001); however, they were less likely to have undergone cervical cancer screening (P < 0.001). Additionally, older patients were less likely to be aware of the association of HPV with cervical and other cancers. Notably, 28 of the 129 patients with stage 1b1–4b cancer underwent cervical cancer screening within 2 years. The tumor location within the endocervical canal emerged as a significant factor contributing to the difficulty for an accurate diagnosis of precancerous or cervical cancer during cervical screening. Furthermore, non- squamous cell carcinoma (SCC) histology was another possible factor.ConclusionsOur findings suggest the need to widely disseminate information regarding the significance of cancer screening to increase cancer screening rates. Moreover, establishing strategies for improving the accuracy of detecting lesions during screening for non-SCC and endocervical canal tumors is crucial.

Barriers to and facilitators of breast, cervical and colorectal cancer screening and cancer screening histories of Métis people in Alberta, Canada

ABSTRACT Comprehensive evaluation of cancer screening activities based on individual experiences is urgently needed to address the burden of cancer among Métis people. In this co-designed and co-led study, a cancer screening questionnaire developed for Métis people to evaluate their cancer screening histories and to explore barriers and facilitators to cancer screening was used. Adult Métis Albertans were invited to participate in the anonymous survey through a multi-modal strategy used for community consultations. Descriptive analyses compared responses between regions, age groups and geographic locations. In total, 370 participants who identified as Métis consented and contributed responses between 12 September and 2 December 2022. Female respondents reported higher rates of cervical and breast cancer screening (>94%) and lower rates of colorectal cancer screening (67–78%). Most of the barriers and facilitators were rated as very important, especially access to reliable and accurate information on screening, risks and benefits of cancer screening, explanation of the test results or procedures, trust in their health care provider(s) and health care system and access to a primary health care provider. This study fills a crucial gap that can inform targeted interventions to increase cancer screening awareness and rates among Métis Albertans and reduce their cancer burden.

Enhancing Cancer Screening Awareness in Diabetic and Non-Diabetic Populations

Dear Editor, I would like to share my opinions on the article “Exploring Perspectives on Cancer Screening in People Aged 30-70: A Comparative Study of Those with and Without Type 2 Diabetes,” published in the Konuralp Medical Journal (2024;16(1):26-31). First and foremost, I commend the authors for their significant contributions to the field, addressing a topic of critical importance to physicians engaged in cancer research. This study, which investigates attitudes and behaviors towards cancer screening in individuals with and without type 2 diabetes mellitus (T2DM), is particularly notable for its potential public health implications given the increased cancer risk associated with diabetes (1).

Awareness, Acceptability and Uptake of Cervical Cancer Screening among Pregnant Women in Ekiti State, Nigeria.

Background: Cervical cancer is a significant global public health concern, particularly in developing countries. Antenatal care visits provide a unique opportunity to educate and screen women for cervical cancer. This study was undertaken to explore the awareness and acceptability of cervical cancer screening among antenatal attendees. Methods: This study was a descriptive cross-sectional survey of 422 pregnant women attending antenatal clinics at the Ekiti State University Teaching Hospital using a self-administered structured questionnaire. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26 software. Results: Of the 410 respondents who returned completed questionnaires, 61.7% had heard about cervical cancer, and only 40.3% reported awareness of the screening modalities. Healthcare providers were the primary source of information about screening methods in 59.0%. Approximately half agreed that information about cervical cancer screening during antenatal care would be beneficial. 90.5% had never undergone cervical cancer screening. Multivariate analysis shows that 32.4% of our clients who were aware of the cervical screening modalities before the current pregnancy had never been screened. OR 0.578, CI (0.036-9.321), p-value 0.699. 3.20% and 4.40.0% were aware and had done cervical cancer screening once and twice respectively before the current pregnancy. OR 1.444, CI(0.080-26.230); p-value 0.804 and OR 4.667, CI (0.223-97.497); p-value 0.321 respectively. Conclusion: The study highlights a concerning gap between awareness and practice of cervical cancer screening among pregnant women in Ekiti State, Nigeria.

Patterns of cancer screening practice and mutational status of cancer-predisposing genes among individuals at high risk for cancer.

10557 Background: Research on cancer screening practice and prevention strategies among individuals at high risk for cancer is limited. We explored the patterns of screening practice of seven cancer types in high-risk patients (pts) at a single institution. Methods: Between June-September 2023, we conducted a follow-up survey on pts enrolled in the University of Chicago Cancer Prone Study, a longitudinal cohort of high-risk families initiated in 1992. We assessed breast, cervical, colorectal, prostate (PSA), ovarian, skin (full-body skin exam [FBSE]), and lung cancer screening by mutational status. Results: Of 912 respondents, 80.4% were female. 81.6% were White, followed by 10.6% Black, 4.0% other/multi-racial, and 3.8% Hispanic. Overall, 35.2% reported having cancer-predisposing gene mutations. Mutation carriers were younger than those non-carriers (54.8 [SD 13.7] vs 60.3 [SD 12.8] years). After adjusting for age, carriers were more likely than non-carriers to have had breast MRI ( p&lt;.001), colorectal cancer screening ( p=.039), ovarian cancer screening ( p=.043), and an FBSE ( p=.007) (Table). No statistically significant differences in mammogram (OR=1.50, 95% CI=0.55-2.30; p=.13), cervical cancer (OR=0.92, 95% CI=0.54-1.59; p=.77), PSA (OR=0.70, 95% CI: 0.26-1.88; p=.48), or lung cancer (OR=1.18, 95% CI=0.72-1.92; p=.51) screening between carriers and non-carriers. By race/ethnicity, cervical cancer screening (Hispanic 92%, White 90.6%, other/multiracial 80.7% and Black 76%; p=.002) and colorectal cancer screening (White 83.3%, other/multiracial 71.8%, Black 71.4% and Hispanic 66.6%; p=.004) differed significantly. Conclusions: In this diverse cohort of individuals at high risk for cancer, findings highlight an increased awareness and uptake of cancer screening, though varying by race/ethnicity. Cancer risk assessment clinics can be great avenues to provide comprehensive cancer screening and prevention strategies while addressing racial/ethnic screening disparities. [Table: see text]

Expansion of outreach to native Hawaii and Pacific Islander communities to increase breast cancer screening and clinical trial awareness in underserved and rural Oahu.

e13725 Background: Multiple barriers exist in the enrollment of racial and ethnic minority groups into breast cancer screening and clinical trials. Such barriers include the lack of knowledge, mistrust, and access. To increase participation of rural-dwelling Native Hawaiian/Pacific Islanders (NHPI) and other underserved minority groups in breast cancer screening and clinical trials, a pilot project was developed to augment community engagement, provide education, and gain insights into the cancer screening/clinical trial process. Our objective was to engage rural Oahu's underserved communities in breast cancer screening and facilitate enrollment into the Digital Tomosynthesis Mammography and Digital Mammography in Screening Patients of Breast Cancer Trial (TMIST) utilizing a team comprising of a cultural congruent and gender concordant Community Health Educator (CHE) and medical oncology health care provider. Methods: We reviewed the community activities over the course of a year. The CHE facilitated outreach by speaking at numerous church events and other community gatherings. Results: Participants did not respond favorably to surveys on social determinants of health. Common reasons for their reluctance included lack of perceived importance and medical mistrust. When discussing verbiage that was intimidating or confusing such as clinical trial protocol consent language, TMIST study participants conveyed a strong sense of dehumanization. Conclusions: A total of 93 women were screened for the TMIST clinical trial. Of those, 13 were enrolled in TMIST and 31 participants received mammograms. Participant insight highlighted the importance of education using culturally sensitive language and community engagement to combat the lack of knowledge and mistrust. Continued development of education materials centered around community involvement will improve the accrual of NHPI participation in breast cancer screening/clinical trials. We hope this project established a basis for equity in communities with low breast cancer screening and clinical trial participation rates. We intend to build upon the community partnerships forged during this pilot project.

Results of Lung Cancer Screening with Low-dose Computed Tomography and Exploration of Risk Factors in Guangzhou

Both of lung cancer incidence and mortality rank first among all cancers in China. Previous lung cancer screening trials were mostly selective screening for high-risk groups such as smokers. Non-smoking women accounted for a considerable proportion of lung cancer cases in Asia. This study aimed to evaluate the outcome of community-based mass screening in Guangzhou and identify the high-risk factors for lung cancer. Residents aged 40-74 years in Guangzhou were screened with low-dose computed tomography (LDCT) for lung cancer and the pulmonary nodules were classified and managed according to China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2018 version). The detection rate of positive nodules was calculated. Before the LDCT examination, residents were required to complete a "lung cancer risk factors questionnaire". The risk factors of the questionnaire were analyzed by least absolute shrinkage and selection operator (LASSO) penalized Logistic regression analysis. A total of 6256 residents were included in this study. 1228 positive nodules (19.63%) and 117 lung cancers were confirmed, including 6 cases of Tis, 103 cases of stage I (accounting for 88.03% of lung cancer). The results of LASSO penalized Logistic regression analysis indicated that age ≥50 yr (OR=1.07, 95%CI: 1.06-1.07), history of cancer (OR=3.29, 95%CI: 3.22-3.37), textile industry (OR=1.10, 95%CI: 1.08-1.13), use coal for cooking in childhood (OR=1.14, 95%CI: 1.13-1.16) and food allergy (OR=1.10, 95%CI: 1.07-1.13) were risk factors of lung cancer for female in this district. This study highlighted that numerous early stages of lung cancer cases were detected by LDCT, which could be applied to screening of lung cancer in women. Besides, age ≥50 yr, personal history of cancer, textile industry and use coal for cooking in childhood are risk factors for women in this district, which suggested that it's high time to raise the awareness of early lung cancer screening in this group.