Breast Cancer Awareness Month Research Articles

To Close the Gap of Survivorship Education: A Series of Breast Cancer Webinars in Collaboration with Wellspring

Background and Aims: Breast cancer survivors face uncertainties post-treatment, requiring ongoing support and education. Digital media online training courses may be used to disseminate evidence-based cancer information. In this study, we hosted a series of webinars which aimed to empower survivors with evidence-based survivorship information. Materials and Methods: A four-part weekly online webinar series (1 hour each) including expert presentations, survivor insights, and interactive question-and-answer sessions, was held in October 2023 during Breast Cancer Awareness Month, via the Zoom digital platform. Topics covered included surveillance, mental health, adjuvant antihormonal therapy, and sexual health. After the webinar series, participants completed a post-webinar survey electronically. The post-webinar survey assessed participant satisfaction, understanding of topics, and suggestions for improvement. Likert scales were used to measure self-reported changes in understanding of the discussed topics. Results: 99 participants took part in the Breast Survivorship and Surveillance webinar, 97 participated in the Mental Health in Breast Survivorship webinar, 108 participated in the Adjuvant Antihormonal Therapy for Breast Cancer webinar, and 74 participated in the Sexual Health after Breast Cancer webinar. 25 participants completed the post-webinar survey, administered after the final webinar (sexual health). Among the 25 survey participants, 96% (24/25) expressed that the information presented in the series of webinars was very useful or extremely useful. Furthermore, 80% (20/25) noted significant knowledge improvement. Conclusions: This breast cancer webinar series effectively bridges the knowledge gap in survivorship, offering valuable insights, emotional support, and practical guidance. The results emphasize the importance of ongoing education and support for breast cancer survivors.

Influence of Breast Cancer Awareness Month on Public Interest of Breast Cancer in High-Income Countries Between 2012 and 2022: Google Trends Analysis.

Breast cancer is the most common cancer among women worldwide. High-income countries have a greater incidence and mortality rate of breast cancer than low-income countries. As a result, raising awareness about breast cancer is crucial in increasing the chances of early detection and treatment. Social media has evolved into an essential tool for Breast Cancer Awareness Month campaigns, allowing people to share their breast cancer stories and experiences while also providing a venue for education and support. The aim of this study was to assess the level of public interest in searches linked to breast cancer among a sample of high-income nations with a sizable internet user base from 2012 to 2022. We also sought to compare the proportional search volume for breast cancer during Breast Cancer Awareness Month with that during other months of the year. Google Trends was used to retrieve data on internet user search behaviors in the context of breast cancer from 2012 to 2022. Seven countries were evaluated in this study: Australia, Canada, Ireland, New Zealand, the United Kingdom, Saudi Arabia, and the United States, in addition to global data. Breast cancer relative search volume trends were analyzed annually, monthly, and weekly from 2012 to 2022. The annual percent change (APC) was calculated for each country and worldwide. Monthly and weekly data were used to identify potential trends. A fluctuating pattern in APC rates was observed, with a notable increase in 2018 and a significant decrease in 2020, particularly in Saudi Arabia. Monthly analysis revealed a consistent peak in search volume during October (Breast Cancer Awareness Month) each year. Weekly trends over a 20-year period indicated significant decreases in Australia, Canada, New Zealand, and the United States, while increases were noted in Ireland. Heatmap analysis further highlighted a consistent elevation in median search volume during October across all countries. These findings underscore the impact of Breast Cancer Awareness Month and suggest potential influences of governmental COVID-19 pandemic control measures in 2020 on internet search behavior.

Women’s health on social media: a corpus stylistic study of Pink October campaigns

Women’s health on social media: a corpus stylistic study of Pink October campaigns

Representation of skin carcinomas in public awareness - Awareness worldwide and in Germany.

In recent years, there has been an increase in skin cancer. The aim of this study was therefore to investigate the representation of skin cancer in public awareness worldwide and in Germany, and to determine whether Skin Cancer Awareness Month is represented in the search interests of the Internet-using population in the same way as Breast Cancer Awareness Month worldwide. In this study, Google Trends data were used to track levels of public awareness for different tumor entities and skin cancer types worldwide and for Germany. The results of this analysis clearly showed a high level of relative public search interest in breast cancer worldwide in the awareness month of October. Worldwide and in Germany, there was a certain increase in search interest and a certain seasonal effect around the May awareness month for skin cancer. For example, the analysis showed a search interest in May and during the summer months in Germany. It is likely that the population, for example in Germany, may benefit further from an even greater emphasis on the topic of skin cancer.

October Breast Cancer Awareness Month: Emphasizing Equity in Access to Early Detection

As October draws near, the annual Breast Cancer Awareness Month comes to the forefront, shedding light on the significant impact of breast cancer on people’s lives, it may be appropriate to consider the unequal access to care. Especially since, alarmingly, breast cancer continues to affect a significant number of individuals in the US, making it a prevalent health concern.

Impact of COVID-19 on Public Interest in Breast Cancer Screening and Related Symptoms: A Google Trends Analysis.

The COVID-19 Pandemic has led to a decrease in cancer screening due to redeployment of healthcare resources and public avoidance of healthcare facilities. Breast Cancer is the most common cancer diagnosed in women, with improved survival rates with early detection. An avoidance of screening, resulting in late detection, greatly affects survival and increases healthcare resource burden and costs. To evaluate if a sustained decrease in public interest in screening occurred, and to evaluate other search terms, and hence interest, associated with that. This study utilized Google Trends to analyze public interest in breast cancer screening and symptoms. We queried search data for four keyword terms ("mammogram", "breast pain", "breast lump", and "nipple discharge") from 2019-01-01 to 2022-01-01. The relative search frequency (RSF) metric was used to assess interest in these terms, and related queries were retrieved for each keyword to evaluate trends in search patterns. Despite an initial drastic drop in interest in mammography from March-April 2020, this quickly recovered by July 2020. After this period, alongside recovery of interest in screening there was a rapid increase in interest for arranging for mammography. Relative search frequencies of perceived Breast Cancer related symptoms such as Breast Lump, Nipple Discharge and Breast Pain remained stable. There was increase public interest in natural and alternative therapy of breast lumps despite recovery of interest in mammography and breast biopsy. There was a significant correlation between search activity and Breast Cancer Awareness Month (BCAM) in October. Online search interest in breast cancer screening experienced a sharp decline at the beginning of the COVID-19 pandemic, with a subsequent return to baseline interest in arranging mammography followed this short period of decreased interest.

Cervical cancer risk factors, knowledge and attitudes towards HPV vaccine among coastal Kenyan women: A prospective cross-sectional survey.

e22515 Background: Cervical cancer is the leading cause of death among women in Sub-Saharan Africa (SSA) despite being a preventable disease. Currently, there is a global rolling out of the human papillomavirus (HPV) vaccine among young girls. However, the knowledge and attitude of Cervical Cancer and the HPV vaccine remain unknown among women in SSA. Methods: We conducted a voluntary cross-sectional survey among adult women attending the cervical and breast cancer screening during Breast Cancer Awareness month in October 2022 at the Coast General Teaching Referral Hospital Regional Cancer Center, Kenya. The demographic, cervical cancer risk factors, knowledge, and attitudes to the HPV vaccine data were collected and analyzed using descriptive analysis. Results: Two hundred and fifty women participated in the survey, of which 48% were native coastal people. Their mean age was 39.3 ±12.4, and the majority (61%) of the participants were married. The most common age onset of sexual intercourse was 21-30 years (50%), followed by 16-20 years (41%), while 7% were virgins, and a quarter (n = 67) reported having multiple sexual partners. Most (90%) of the participants knew screening and early detection of cervical cancer are associated with better survival. Nevertheless, only a third had been screened previously for cervical cancer. Concerning the cause of cervical cancer, half of the patients (n = 126) knew cervical cancer is caused by HPV, and only 45% (n = 111) were aware of the free national HPV vaccination program, with only 5 participants having been vaccinated against HPV. The most commonly sighted reason for not being vaccinated was lack of knowledge of the HPV vaccine's existence (50%), a third was afraid of the vaccine’s side effects, 10% was due to lack of access, and 3%- were due to the vaccine’s age limit. With regards to the willingness to be vaccinated if they had qualified and the HPV vaccine is available for free, only two-thirds were willing to be vaccinated. However, most (90%) would recommend it to young girls. The few who would not recommend the vaccine to young girls were due to fear and lack of knowledge about the vaccine (73%). Conclusions: There is an unmet need for awareness and understanding of the HPV vaccine, and sensitization is needed to improve its uptake. In addition, it will be worth reviewing the age limit of HPV vaccination among Kenyan women as most women are sexually active after 20 years.

Google Trends in Breast and Cervical Cancer Searches From 2008 to 2021: An Infodemiology Study.

Breast and cervical cancer are the leading causes of cancer death among women worldwide. Given the growing concern, cervical cancer awareness month (CCAM) in January and Breast cancer awareness month (BCAM) in October occur annually as global health observances to raise public awareness. This infodemiology study aimed to assess trends in public online searches for breast cancer and cervical cancer following the annual BCAM and CCAM from 2008 to 2021. Google Trends (GT) was used to investigate online searches for "breast cancer" and "cervical cancer" from January 1, 2008, to December 31, 2021. (168 months). A joinpoint regression analysis was used to identify statistically significant weekly percentage changes (WPCs) and monthly percentage changes (MPCs) trends over time. Breast cancer searches increased in October (BCAM) every year, while cervical cancer searches increased in January (CCAM) in 2013, 2019, and 2020. Joinpoint regression analysis revealed a significant negative trend in "breast cancer" searches from 2008 to 2021 (MPC: -0.2%, 95% CI: -0.3 to -0.1) and an upward trend in "cervical cancer" searches from May 2017 to December 2021 (MPC: 0.5%, 95% CI: 0.2 to 0.7). Online searches on "breast cancer" remain consistently high only during BCAM, and "cervical cancer" has increased by 0.5% MPC since May 2017. Our findings can inform online interventions like event-based opportunities (BCAM and CCAM) and Google Ads to raise public awareness of breast and cervical cancer.

Pink October anxiety: Balancing breast self awareness and anxiety levels during October awareness

Pink October anxiety: Balancing breast self awareness and anxiety levels during October awareness

Abstract P6-05-48: Perceptions About Breast Cancer in North Africa: A Social Listening Project

Abstract Background Social media platforms are a versatile platform used for exchange of information. It is increasingly being used by patients, caregivers, and physicians to interact and engage among themselves and with healthcare organizations. Breast cancer is the most commonly diagnosed cancer in the world, with ~2.3 million cases in 2020 alone. Hence, it is vital to understand the perceptions about breast cancer from a wider lookout to bridge the gaps in patient management. The objective of this study was to understand the trends in social media conversations and current perceptions about breast cancer in the North African countries. Methods Artificial Intelligence (AI) technologies hosted by Brandwatch (a social analytics tool) were used to scan 100M websites to analyze publicly visible online conversations about cancer between November 1, 2018 and October 31, 2021. Conversations from 6 North African countries i.e. Algeria, Egypt, Morocco, Sudan, Tunisia, and Western Sahara were analyzed in 3 languages (Arabic, English, and French). Conversations were filtered to isolate breast cancer and related mentions. To isolate the voice of breast cancer patients and their caregivers, manual review of all non-news content in which pronouns appeared within 7 words proximity of disease terms was carried out. Results A total volume of 53,354 conversations (43,785 Arabic, 6,161 English, and 3,408 French) on breast cancer were analyzed. Breast cancer was the most discussed cancer type, contributing to 63% of Arabic, 61% of English, and 66% of French conversations among total cancer related conversations. Egypt led the volume of breast cancer related conversations in Arabic and English, followed by Sudan. Morocco led the volume of conversations in French, followed by Tunisia. For all 3 languages, the proportion of male authors dominated the volume of conversations as compared to female authors (60% of Arabic, 54% of English, and 56% of French). A total volume of 590 (347 Arabic, 158 English, and 85 French) conversations about breast cancer were identified as patient related. Twitter was the most popular platform for Arabic and English-speaking populations. The most discussed topic about breast cancer was identified to be ‘Pink October’ or ‘Breast Cancer Awareness Month’. Across all languages, impact on mental health and financial security was a significant patient concern. Many people reached out directly to the online community for financial support. In Arabic conversations, female patients expressed concern about impact on their relationship with their spouse (or future spouse) due to their condition. Patient conversations about the BReast CAncer gene (BRCA) were also observed. However, there is little evidence about the extent of awareness among patients or their caregivers. There were scarce mentions about male/transgender breast cancer among conversations. Discussions about raising awareness, early detection, and self-checking of breast cancer were also identified. Conclusion Breast cancer was the most discussed type of cancer in North African countries. Patients and caregivers sought financial support on social media platforms. Based on types of conversations identified, it can be inferred that patients do not actively seek information about treatments and cancer management on social media. These insights can be utilized to engage patients, caregivers, patient advocacy groups, and influencers to address concerns and disseminate accurate and simplified information for mass consumption. Table 1. Types of Patient Conversations*. Citation Format: Amel Ladjeroud, Ahlem El Ghoul, Magdy Mohamed. Perceptions About Breast Cancer in North Africa: A Social Listening Project [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-48.

Comprehending the impact of #Breastcancer, #Breastsurgery and related hashtags on Twitter: A content and social network cross-sectional analysis #Breastcancer#Breastsurgery

BackgroundEarly detection along with improved locoregional and systemic therapies have decreased breast cancer mortality and allowed for the clinical implementation of breast conserving surgical options, in turn reducing the clinical and psychosocial impact of mastectomy. To what extend this has been successfully conveyed through social media for breast cancer awareness, has not been previously investigated. MethodsThis study presents a content and social network cross-sectional descriptive study of Twitter and Google trends data worldwide from platform launch (2006 and 2004 respectively) until May 15th, 2022, in agreement with the STROBE guidelines. Tweets associated with the hashtags #Breastcancer, #Breastsurgery, #Oncoplasticsurgery, #Mastectomy, #Breastreconstruction, #Breastconservingsurgery were licensed and downloaded through the Vincitas and Tweetbinder online platforms. Associated available demographics, namely username, biography, location, date and language of post, were extracted from the Twitter dataset while interest percentage, location and language of search were extracted from the Google trends dataset. ResultsA total of 390111 unique tweets were generated by 127284 unique users, with 2 users engaging with all six hashtags. Original tweets constituted on average 39.1% [Min 30.7% to max 47.2%] of the total. Hashtag frequency increased on Twitter for all six searches during October, the breast-cancer awareness month, but not on Google trends. Cancer survivors engaged much more often with the hashtag #Breastcancer and #Mastectomy, whereas #Breastsurgery, #Oncoplasticsurgery, #Breastconservingsurgery, #Breastreconstruction were mostly used by health professionals. ConclusionIn this large qualitative and quantitative dataset, geo-temporal oscillations on Twitter and Google trends for hashtags relevant with breast cancer provide preliminary insights on information flow and user engagement. Understanding the effective use of social media platforms may provide the niche for disseminating evidence and promoting education on the surgical options of patients with breast cancer.

Clinical Profile and Findings in a Breast Cancer Screening Campaign in a Brazilian State

Objectives: To describe the sociodemographic characteristics and the findings in the BC screening tests of women who signed up for a Breast Cancer Awareness Month campaign in the Brazilian state of Santa Catarina. Methods: In this descriptive, retrospective, observational study, 638 women volunteered to participate. Sociodemographic and clinical data collection occurred between February 2020 and June 2021. Participants had mammograms and were referred to additional ultrasound exams when necessary. All participants with BI-RADS® of 4 or 5 were referred to core biopsy. Results: In our sample, 31.2% had had a mammography longer than 5 years or had never had it. The most frequent findings in the performed mammograms were: dense breasts (37.1%), microcalcifications (12.0%) and breast lumps (10.4%).

Does Pink October really impact breast cancer screening?

ObjectiveThis study aims to evaluate the impact of the Pink October Campaign on the increase in mammographic screening in Brazil. Study designEcological observational study, based on retrospective data. MethodsBrazilian national screening database (DATASUS/SISMAMA/Information System on Breast Cancer) was used as a data source and is publicly available for download and analysis. We report screening numbers and outcome rates from January 2017 to December 2021 comparing statistically (ANOVA test, post-Tukey test), age groups, regions of Brazil, and the four quarters of the year. ResultsDuring the study period, the average number of exams performed monthly over the five years was 137,400.117. An increase in the number of mammograms performed in October was identified, as well as in the two following months, respectively 33%, 39%, and 22%, with statistical significance (p = 0.000) in relation to the three quarters of the year. In addition, in the other months, we found values below the monthly average. Statistical difference was not found in the increase in mammograms considering age groups (p = 0.5) and different regions of the country (p = 0.6). ConclusionsThis study showed an increase in mammographic screening in the three months following the Pink October Campaign, so we should intensify similar actions throughout the year and not just in October.

Insights and Strategies to Revive Brachytherapy Using Social Media: A Google Trends Analysis.

Introduction: The utilization and public awareness of brachytherapy are both declining. Social media has an increasing presence in health promotions. As regards cancer care, social media has been successfully used as a platform for information dissemination, psychosocial support, and patient engagement and empowerment.Methods and materials: Using Google Trends (Google LLC, Mountain View, CA, USA), we analyzed the impacts on the public interest of three brachytherapy-related social media campaigns/publicity events and compared and contrasted them with three other campaigns/publicity events. We used descriptive statistics (mean ± standard deviation (SD)) to describe the search results, independent t-tests to compare means before and after campaigns/announcements for short-term effects, and one-way ANOVA (or Kruskal-Wallis test when appropriate) to compare mean values across distinct time periods for long-term effects.Results: We identified three major types of social media campaigns/events: those that have a short-term impact but little long-term impact, those that have both short-term and long-term impacts, and those with little short-term or long-term impact. We examined campaigns with significant and lasting impacts and noticed that they tend to be celebrity-related/celebrity-endorsed, focused on sharing personal experiences, and occur with regular frequency.Conclusions: To increase public awareness of brachytherapy, the American Brachytherapy Society (ABS) can consider tie-ins with events and people with high search traffic (such as Breast Cancer Awareness Month), having celebrities/influencers who were treated with brachytherapy to provide testimonials, encouraging patient engagement and sharing of their experiences with brachytherapy on social media, and setting up recurring brachytherapy publicity events.

Impact of Breast Cancer Awareness Month on Public Interest in the United States between 2012 and 2021: A Google Trends Analysis.

Simple SummaryIn this study, we quantified public awareness regarding breast cancer associated with Breast Cancer Awareness Month (BCAM) in October using Google Trends data and a joinpoint regression analysis. We analyzed the impact of BCAM, Lung Cancer Awareness Month (LCAM), and Prostate Cancer Awareness Month (PCAM) on public awareness of the top three most common cancers in the U.S. from 2012 to 2021 using the relative search volume of Google Trends. The results imply that BCAM has successfully improved the public awareness of breast cancer in the U.S., while LCAM and PCAM had no impact on the awareness of lung and prostate cancers. BCAM could serve as a good example for organizations working on health observances or awareness campaigns.Breast Cancer Awareness Month (BCAM) has a long history of over 30 years, established in 1985 to occur every October, and the National Breast Cancer Foundation now leads the operation. There have been no studies to evaluate the impact of the BCAM on public awareness of breast cancer. We analyzed the impact of BCAM on public awareness of breast cancer in the U.S. from 2012 to 2021 using the relative search volume (RSV) of Google Trends as a surrogate. We also analyzed the impact of Lung Cancer Awareness Month (LCAM) and Prostate Cancer Awareness Month (PCAM) on public awareness of lung and prostate cancer, respectively, to see differences in their effectiveness among the health observances for the top three most common cancers in the U.S. We performed a joinpoint regression analysis to identify statistically significant time points of a change in trend. There were joinpoints around BCAM for “Breast cancer” every year from 2012 to 2021, with a significant increase in the weekly RSVs from 21.9% to 46.7%. Except for 2013 and 2015 for “Lung cancer”, when significant increases in the RSV at 1.8% and 1.2% per week were observed around LCAM, no joinpoints were noted around LCAM or PCAM. These results imply that BCAM has successfully improved the public awareness of breast cancer in the U.S. compared to other representative health observances, likely due to the effective involvement of non-medical industries, influencers affected by breast cancer, and an awareness symbol.

Lessons Learnt From the First Year of a First-of-Its-Kind Breast Cancer Patient Psychosocial Support Group in Ethiopia and Promising Practices for Initiation and Implementation of Survivor Support Programs in Low-Resource Settings

PURPOSE Psychosocial support helps cancer patients adjust to diagnosis and treatment and improve their overall well-being. With few resources committed to cancer prevention and treatment in Ethiopia, patients’ and survivors’ mental health needs are frequently disregarded, resulting in low quality of life. In October 2020, a support group for breast cancer (BC) patients was formed at Adama Hospital Medical College (AHMC), the first of its kind in Ethiopia. Here, we reflect on lessons learnt from the first year of implementation and share promising practices for establishing such groups in low-resource settings. METHODS The founder and facilitators of the AHMC BC patient and survivor support group describe the program and critically reflect on its impact, challenges to implementation, lessons learned, and ideas for further improvement. Ng and Colombani’s framework for selecting best practices in public health (2015) is used to organize key themes. RESULTS One Saturday each month, 20-30 patients and survivors gather with a traditional Ethiopian coffee ceremony. Participants report feelings of empowerment, hope, and confidence, a stronger sense of interconnectedness with others, and increased engagement in social activities. One notable success was the advocacy opportunity for the women to speak with hospital administrators and Ministry of Health officials at a BC Awareness Month celebration this year. Implementation challenges include a lack of funding, lack of a trained psychologist, and ethical uncertainty about distress caused when members die (not uncommon as patients typically present with advanced stage disease). Clinicians have learned important lessons about patients’ lay beliefs and consequently, patient counseling has been improved to incorporate topics of diet, sexuality, and pregnancy. CONCLUSION A first-of-its-kind BC patient and survivor support group improves perceived psychosocial well-being and quality of life for women in Ethiopia. The low-cost program shares promising practices for survivor support groups and patient-centered cancer treatment in low-resource contexts.

Breast Cancer Stage Migration in Saudi Arabia: Examining the Influence of Screening.

Breast Cancer Stage Migration in Saudi Arabia: Examining the Influence of Screening.

Abstract PO-062: Flipping the switch to virtual community engagement: Strategies and future directions for online cancer education

Abstract History The University of Chicago Comprehensive Cancer Center's HealthyU program started as a health education initiative to reach University of Chicago Medicine employees from across a variety of sections and departments. HealthyU consisted of weekly workshops, called Workshop Wednesdays and pledge cards for cancer screenings. HealthyU programming was only done during awareness months for the “screenable” cancers: breast, cervix, colon, and lung. Attendance at our workshops was sporadic and completed pledge cards usually did not meet programmatic goals. Making the Switch to Virtual Programming Beginning in October 2020, in the wake of the COVID-19 pandemic, we took the HealthyU program online for Breast Cancer Awareness Month. Our breast cancer programming consisted of four educational webinars to encourage breast cancer screening, a digital screening pledge card, and a mammogram toolkit with printable resources to promote mammography. We had 50% more webinar participants and 23% more pledge cards signed virtually than we did in October of 2019 during our in-person programming. The success of our virtual Breast Cancer Awareness Month programming prompted us to expand HealthyU dramatically. Cutting out the logistics of on-campus programming has allowed us to broaden the scope of the HealthyU program in the following ways: 1. The target audience has grown beyond UChicago Medicine employees to include a variety of community partners across greater geographic areas both within and outside of our catchment area. 2. We host webinars on a weekly basis and for a wide range of cancer-related topics. 3. Our physical pledge cards are virtual and have grown to include pledge cards for other cancer screenings and risk-associated behaviors. 4. We created online toolkits to share with our community and UCM partners with information and shareable resources that can be used online or printed and distributed. 5. We have incorporated virtual contests to encourage cancer screening advocacy and awareness. 6. We designed self-guided cancer education modules and an online video library to supplement our programming. 7. We leveraged our social media presence to engage in real-time cancer-focused conversations online. 8. We developed other online webinar series, including documentary short screenings, survivorship storytelling, researcher/survivor summits, and singular webinars on public health topics. Outcomes & Future Directions Through the HealthyU program, we've connected over 100 UCM employees and community partners with 64 different University of Chicago faculty experts and 26 community experts. We plan to use the techniques and outreach strategies learned to expand our reach in other areas, including an online training course for cancer investigators and community members on the principles of community-based participatory research, and a community-scientist virtual summit on Cancer and the Microbiome. We have leveraged the success of this program to secure device donations to expand our outreach to communities with inadequate technology access. Citation Format: Alia Poulos, Gina Curry. Flipping the switch to virtual community engagement: Strategies and future directions for online cancer education [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-062.

Moving towards a strategy to accelerate cervical cancer elimination in a high-burden city-Lessons learned from the Amazon city of Manaus, Brazil.

The World Health Organization Call to Eliminate Cervical Cancer resonates in cities like Manaus, Brazil, where the burden is among the world's highest. Manaus has offered free cytology-based screening since 1990 and HPV immunization since 2013, but the public system is constrained by many challenges and performance is not well-defined. We obtained cervical cancer prevention activities within Manaus public health records for 2019 to evaluate immunization and screening coverage, screening by region and neighborhood, and the annual Pink October screening campaign. We estimated that among girls and boys age 14-18, 85.9% and 64.9% had 1+ doses of HPV vaccine, higher than rates for age 9-13 (73.4% and 43.3%, respectively). Of the 90,209 cytology tests performed, 24.9% were outside the target age and the remaining 72,230 corresponded to 40.1% of the target population (one-third of women age 25-64). The East zone had highest screening coverage (49.1%), highest high-grade cytology rate (2.5%) and lowest estimated cancers (38.1/100,000) compared with the South zone (32.9%, 1.8% and 48.5/100,000, respectively). Largest neighborhoods had fewer per capita screening locations, resulting in lower coverage. During October, some clinics successfully achieved higher screening volumes and high-grade cytology rates (up to 15.4%). Although we found evidence of some follow-up within 10 months post-screening for 51/70 women (72.9%) with high-grade or worse cytology, only 18 had complete work-up confirmed. Manaus has successfully initiated HPV vaccination, forecasting substantial cervical cancer reductions by 2050. With concerted efforts during campaigns, some clinics improved screening coverage and reached high-risk women. Screening campaigns in community locations in high-risk neighborhoods using self-collected HPV testing can achieve widespread coverage. Simplifying triage and treatment with fewer visits closer to communities would greatly improve follow-up and program effectiveness. Achieving WHO Cervical Cancer Elimination goals in high-burden cities will require major reforms for screening and simpler follow-up and treatment.

Pink October and Breast Cancer in Brazil.

Pink October and Breast Cancer in Brazil.