Cancer Information Service Research Articles

Variation, precision and validity of 1-year survival estimates for lung, breast, colon and prostate cancer in South East England primary care trusts

English cancer policy has encouraged primary care trusts (PCTs) to consider their 1-year cancer survival estimates. This study quantifies variation in these estimates across 39 PCTs in the London and South East Coast strategic health authorities, and explores their precision, possible confounding by age and bias due to death certificate only (DCO) registrations. Retrospective observational study. One-year relative survival estimates and data on DCO registrations for patients diagnosed with lung, colorectal, breast and prostate cancers between 2002 and 2006 were extracted from the UK Cancer Information Service. Direct age standardization was performed with weightings derived from the standard cancer patient population for Europe. Pearson correlation coefficients between survival estimates and DCO proportions were calculated. Mean 1-year PCT survival estimates ranged from 6.9 to 19.4 percentage points, and the precision of individual estimates ranged from ±0.9 to ±6.5 percentage points (at 95% confidence level). Age standardization significantly changed the estimates of nine PCTs for breast cancer, five PCTs for lung cancer and three PCTs for colorectal cancer. None of the prostate cancer estimates were affected significantly. DCO proportions were positively associated with lung cancer survival and negatively associated with colorectal and breast cancer survival. PCT 1-year cancer survival estimates may be informative, but caveats relating to data quality and hence the validity of the estimates means that they require careful investigation before naïve use, as random variation, confounding due to age and bias due to DCO registrations may be significant.

Psychological distress and unmet supportive care needs in cancer patients and carers who contact cancer helplines

Cancer information services are a highly accessible source of support for people affected by cancer. To date the nature and extent of distress experienced by such callers and their unmet support needs have not been well described. A cross-sectional survey of 354 cancer patients and 336 carers who reported elevated distress on contact with a cancer information service assessed socio-demographic variables; anxiety, depression and somatization; unmet supportive care needs; cancer-specific distress; presenting problems; post-traumatic growth. Adjustment to cancer was most commonly reported; followed by anxiety. In all, 53.4% of patients and 45.2% of carers reached caseness in anxiety, depression or somatization. Carers had higher distress ratings and intrusive thinking compared to patients; whereas patients had higher somatization. For patients, most unmet supportive care needs were psychological; for carers unmet needs were related to health care services and information related to the person diagnosed with cancer. Being single, unemployed, in treatment, having higher initial distress scores, higher intrusion and avoidance predicted poorer outcomes. Information service frameworks should include distress screening and clear triage and referral processes for psychological care.

Assessing the Awareness of and Willingness to Participate in Cancer Clinical Trials Among Immigrant Latinos

Clinical trials are considered the gold standard of evidence about the efficacy of cancer prevention, early detection, and treatment interventions. A paucity of data exists on determinants of clinical trial participation in the growing US Latino population despite poor cancer outcomes in this group. This study seeks to describe correlates of awareness of and willingness to participate in clinical trials among largely Central, North, and South American Latinos using safety-net clinics. Between June 2007 and November 2008, we conducted an interviewer-administered, Spanish-language cross-sectional survey (n=944). Logistic regression was used to assess effects of health information sources and psychosocial variables on awareness of and intention to participate in clinical trials. Analyses were completed in spring 2010. While only 48% knew what a clinical trial was, when explained, 65% indicated a willingness to participate. Providers were the most common source of health information. Use of Internet for health information, trust in health information, and higher education each independently increased the odds of clinical trial awareness, but obtaining information from providers did not. Contacting the Cancer Information Service and psychosocial factors were each independently associated with intent to join a clinical trial, while demographic factors were not. Information channels such as the Internet may be effective in conveying clinical trial information to Latinos. Providers being cited as the most common source of health information but not being associated with knowledge about or intent to participate in trials suggests a missed opportunity for communication to this population.

National Cancer Information Service in Italy: An information points network as a new model for providing information for cancer patients

The international literature data report that good information and communication are fundamental components of a therapeutic process. They contribute to improve the patient-health care professional relationship, to facilitate doctor-patient relationships, therapeutic compliance and adherence, and to the informed consent in innovative clinical trials. We report the results of a multicentric national initiative that developed a 17-information-structure network: 16 Information Points located in the major state-funded certified cancer centers and general hospitals across Italy and a national Help-line at the nonprofit organization AIMaC (the Italian oncologic patients, families and friends association), and updated the already existing services with the aim to create the National Cancer Information Service (SION). The project is the result of a series of pilot and research projects funded by the Italian Ministry of Health. The Information Service model proposed is based on some fundamental elements: 1) human interaction with experienced operators, adequately trained in communication and information, complemented with 2) virtual interaction (Help line, Internet, blog, forum and social network); 3) informative material adequate for both scientific accuracy and communicative style; 4) adequate locations for appropriate positioning and privacy (adequate visibility); 5) appropriate advertising. First results coming from these initiatives contributed to introduce issues related to "Communication and Information to patients" as a "Public Health Instrument" to the National Cancer Plan approved by the Ministry of Health for the years 2010-2012.

Rural–urban differences in discussions of cancer treatment clinical trials

ObjectiveCompare the characteristics of rural and urban callers to NCI's Cancer Information Service (CIS), and explore the association of geographic location and discussion of cancer clinical trials. MethodsUsing CIS call data from 2006 to 2008, we assigned a rural or urban designation to caller ZIP codes using Rural–Urban Commuting Area Codes. Calls which discussed clinical trials were analyzed using univariate and multivariate analyses. ResultsThe CIS received 227,579 calls from 2006 to 2008 where geographic location could be determined. Overall, 10.3% of calls included a discussion of clinical trials; there were significantly more discussions among urban dwellers than rural individuals (10.5% versus 9.4%, respectively). Multivariate regression analyses supported the univariate findings. In addition, compared to other callers, patients (OR 5.58 [95% CI: 4.88, 6.39]) and family and friends (6.26 [5.48, 71.5]) were significantly more likely to discuss clinical trials. ConclusionUrban callers were more likely than their rural counterparts to discuss cancer treatment trials, placing individuals living in rural areas at a disadvantage in learning about and communicating with their providers about possible participation in clinical trials. Practice implicationsThrough its multiple access points, the CIS can serve as an important source of clinical trials information for rural cancer patients, family members, and providers.

Cancer Information Seeking and Awareness of Cancer Information Sources among Korean Americans

Many Korean Americans (KAs) suffer high cancer incidence levels and have low cancer screening rates. A significant number of KAs lack adequate information about cancer screening tests. However, little is known about the health information seeking behaviors of KAs. This study examines the types of cancer information searched for, the cancer information seeking experiences, and the awareness of major cancer information sources, such as the National Cancer Institutes (NCI) and the NCI's Cancer Information Service, among KAs. It also examines associations with demographic characteristics and media use influencing variations in the awareness of cancer information sources. Data for this study were gathered with a cross-sectional, community-based survey (254 KAs). The survey results indicated that KA's involvement in cancer information seeking is relatively low, and they have somewhat negative experiences in seeking cancer information. In addition, their awareness of cancer information sources was limited. Despite of the heavy use of Korean ethnic media, it did not connect to cancer information source awareness. Rather, use of US mainstream media was significantly related with awareness. Campaigns using the Korean language through partnerships with Korean ethnic media to inform KAs about credible sources of health information appear to be warranted by our findings.

Knowledge of HPV Among United States Hispanic Women: Opportunities and Challenges for Cancer Prevention

In the United States, Hispanic women contribute disproportionately to cervical cancer incidence and mortality. This disparity, which primarily reflects lack of access to, and underutilization of, routine Pap smear screening may improve with increased availability of vaccines to prevent Human Papillomavirus (HPV) infection, the principal cause of cervical cancer. However, limited research has explored known determinants of HPV vaccine acceptability among Hispanic women. The current study examines two such determinants, HPV awareness and knowledge, using data from the 2007 Health Interview National Trends Survey (HINTS) and a cross-section of callers to the National Cancer Institute's (NCI) Cancer Information Service (CIS). Study data indicate that HPV awareness was high in both samples (69.5% and 63.8% had heard of the virus) but that knowledge of the virus and its association with cervical cancer varied between the two groups of women. The CIS sample, which was more impoverished and less acculturated than their HINTS counterparts, were less able to correctly identify that HPV causes cervical cancer (67.1% vs. 78.7%) and that it is a prevalent sexually transmitted infection (STI; 66.8% vs. 70.4%). Such findings imply that future research may benefit from disaggregating data collected with Hispanics to reflect important heterogeneity in this population subgroup's ancestries, levels of income, educational attainment, and acculturation. Failing to do so may preclude opportunity to understand, as well as to attenuate, cancer disparity.

Exploring and comparing the experience and coping behaviour of men and women with colorectal cancer after chemotherapy treatment: a qualitative longitudinal study

Men have higher incidence and mortality rates for nearly all cancers. They are less likely than women to utilise cancer information services and other social support services. The aim of this study was to explore and compare the experience and coping behaviour of men and women after treatment for colorectal cancer (CRC). A longitudinal qualitative study was conducted involving 38 individuals (24 men and 14 women) with CRC. Data were generated using semi-structured interviews at four time points over an 18-month period, post-diagnosis. Interviews focused on participant's experience of CRC and on how gender affected their coping. This paper reports the findings of interviews 3 and 4 which examined the participant's experience after chemotherapy. Three themes emerged from the interviews ('new normal', living with uncertainty and support needs). Many men and women reacted similarly; however, there was some variation evident between and within sexes. The main difference was with regard to the long-term physical side effects of the illness. Many women admitted to still experiencing side effects, whereas many men indicated that they had no problems. These men engaged in practices that aligned with their gender identity and view of masculinity. It must be noted that some men and women were still experiencing an impact. Recovery from the physical and psychological effects of CRC does not occur simultaneously. Healthcare professionals should be aware that not all men (or women) conform to the social stereotypes of masculinity (or femininity).

Doctor—I want to do more! German Cancer patients’ use of dietary supplements and non-prescription drugs—An evaluation of the German Cancer Information Service, German Cancer Research Center, Heidelberg

Doctor—I want to do more! German Cancer patients’ use of dietary supplements and non-prescription drugs—An evaluation of the German Cancer Information Service, German Cancer Research Center, Heidelberg

Some Things I Learned at the AACE/EACE/CPEN Meeting

I came home from the AACE/EACE/CPEN Meeting with a head brimming with ideas. I must admit I couldn’t tell which presentation was from a CPEN member and which was from an AACE member! I couldn’t tell which were the best hula dancers at the Luau either! We heard a nice synopsis report regarding Dr Varmus’ priorities at the NCI. He wants to ramp up clinical trials. It takes too long to get from concept to accrual and more than 60% of trials have less than 6 participants. I had a nice talk with the NCI’s (and our) editorial board member Rose Mary Padberg and she’ll write a paper on initiatives they have at NCI on clinical trials education. Our groups and this journal can help in this arena. Dr Varmus also wants to foster the application of personalized (he likes the term genomic) medicine. He’ll be pushing for the cancer genomic atlas project. Global Health will be a big issue—that’s the theme for next year’s conference! I heard great presentations from the international cancer information service group (www.icsisg.org) and was amazed at their reach into so many countries. I also heard from Carolyn Messner (who constantly reminds me of the reach that telephones can have) about all of her programs at CancerCare, which are now available across the globe, and the awesome (the only word to describe it) St Jude program, Cure4kids, which brings pediatric oncology information to the world (www.Cure4Kids.org). Global research will help this country and Canada learn to deal better with ethnic minority populations (see the NCI’s Office of Latin American Cancer Projects, for example). Tobacco control remains big on the NCI’s screen. Another priority is stimulating the next generation of scientists, and our organizations can play a big part (the US Science and Engineering Festival was taking place on the National Mall at the same time as our meeting, and was attended by President Obama). And finally, the NCI will try to foster “comparative effectiveness research.” One special presentation of many was that of Kathy Blazer and her colleagues at City of Hope, who spoke about how their wonderful genetics education program was sprouting seeds whereever their trainees were working. Kathy used the apt business analogy “communities of practice.” I think that image describes exactly what we want—widely dispersed but connected sites of excellence, pushing the mission to understand and control cancer forward! This important image depicts what we all should be and can be doing to spread and connect and use education to decrease the burden of suffering from cancer across the globe. Read the abstracts! Presenters, send in papers! Submit something for next year’s meeting in Buffalo, which will take place September 8–10, 2011. We CAN change the world by working together in effective communities of practice. Let’s do it!

Abstract A28: Reaching vulnerable populations: A process-oriented approach to breast screening

Abstract This community-based project evolved out of relationships established through the Detroit CNP for Older, Underserved African-Americans (NIH# U01-CA114583-04) to address the unmet needs of the clientele of three partnering community agencies. The need for breast cancer screening among older women from lower socioeconomic groups, the mentally ill, and the disabled has been well-documented. However, mammography among these special populations is low. This project brought together five organizations (three community service agencies, the NCI's Cancer Information Service Partnership Program, and the Karmanos Cancer Institute's Community Network Program) to provide breast health awareness, mammography screening, and navigation to underserved African American women. The five agencies collaborated to address the needs of the homebound, developmentally disabled, homeless, nursing home residents, grandparents raising grandchildren, and others. All groups were identified through a community assessment to identify significant barriers to accessing preventive health care services. Through community-based participatory research (CBPR), the members of the partner organizations worked with community health education professionals to define: 1) community-level needs; 2) assess how best to integrate screening messages and health service navigation into existing service provision; and 3) identify ways to obtain external funding for program implementation. The CBPR process yielded an intervention that consisted of staff training, improved screening needs assessment and procedures for case management referral and follow-up that increased agency capacity to address breast health disparities. A total of 490 women participated in this “high-touch” breast health education and screening intervention. Of those, 170 women received screening mammography and six women were diagnosed and received subsequent treatment and follow-up. The project was recently recognized by the Michigan Cancer Consortium, receiving their highest recognition, the Spirit of Collaboration Award. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A28.

The Cancer Information Service: Using CBPR in Building Community Capacity

The National Cancer Institute's (NCIs) Cancer Information Service (CIS) Partnership Program followed many of the key principles of community-based participatory research in providing technical assistance to partner organizations. Using five case studies, this article describes how the CIS Partnership Program served to identify community needs and leaders, bringing resources together to build capacity and increase knowledge, and facilitate further dissemination of findings. CIS Partnership Program staff transcended the traditional health education role by building the capacity of community partners to bring cancer information in culturally appropriate ways to their own communities. The lessons learned by the CIS Partnership Program are useful for both academics and service organizations that would benefit from working with medically underserved communities.

SACA: Software Assisted Call Analysis – An interactive tool supporting content exploration, online guidance and quality improvement of counseling dialogues

Objective Nearly 30,000 individual inquiries are answered annually by the telephone cancer information service (CIS, KID) of the German Cancer Research Center (DKFZ). The aim was to develop a tool for evaluating these calls, and to support the complete counseling process interactively. Methods A novel software tool is introduced, based on a structure similar to a music score. Treating the interaction as a “duet”, guided by the CIS counselor, the essential contents of the dialogue are extracted automatically. For this, “trained speech recognition” is applied to the (known) counselor's part, and “keyword spotting” is used on the (unknown) client's part to pick out specific items from the “word streams”. The outcomes fill an abstract score representing the dialogue. Results Pilot tests performed on a prototype of SACA (Software Assisted Call Analysis) resulted in a basic proof of concept: Demographic data as well as information regarding the situation of the caller could be identified. Conclusion The study encourages following up on the vision of an integrated SACA tool for supporting calls online and performing statistics on its knowledge database offline. Practice implications Further research perspectives are to check SACA's potential in comparison with established interaction analysis systems like RIAS.

Trends in the incidence rates of tonsil and base of tongue cancer in England, 1985–2006

The aim of this study was to investigate whether incidence rates of tonsil and base of tongue cancer in England are increasing using data from the UK cancer registry. Cancer registrations for oral cavity and oropharynx cancer from 1985-2006 in England were obtained from the National Cancer Information Service. Population estimates were obtained from the Office for National Statistics. Age-adjusted incidence rates and age-specific incidence rates were calculated. The sexes were considered separately as incidence rates are known to differ significantly between men and women. Linear regression was performed to establish whether there was a relationship between incidence rates and time. There has been an increase in all oral cavity and oropharyngeal cancer in the study period. Linear regression analysis suggests that approximately 90% of the variance in age-adjusted incidence rates for men and women for tonsil, base of tongue and other oral cavity cancer is explained by the passage of time. For other oropharyngeal cancer, the variance is 62% and 46% in men and women, respectively. The estimated annual percentage change from 1985 to 2006 in age-adjusted incidence rates for tonsil and base of tongue cancer is 5.7% and 6.7% for men, and 4.3% and 6.5% for women, respectively. This study confirms a wide-spread clinical impression that there has been an increase in age-adjusted incidence rates, between 1985 and 2006, in all oral cavity cancer in England. The age range 40-69 years has seen the biggest increases in age-specific incidence rates for tonsil and base of tongue cancer. This reflects the findings of similar studies in other countries.

Low Awareness of and Referral to National Cancer Information Resources Among Physicians

There are currently more than 11 million cancer survivors in the United States (1). With improvements in cancer screening technology and treatment, this number is likely to increase. The information needs of cancer patients and survivors could strain an already burdened health-care system, underscoring the need for reliable cancer information from credible sources (2–4). Although many quality cancer information resources are available, recent data (5) indicate that health-care professionals are the most trusted source for health information, followed by US government health agencies that produce and scientifically vet materials for patients and health-care professionals, such as the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). The National Cancer Institute's Web site (www.cancer.gov) and the Cancer Information Service (1-800-4-CANCER) serve as NIH's primary cancer information resources. The CDC Web site (www.cdc.gov) also serves as a cancer information resource. To assess the awareness of and referral to national cancer information resources among primary care physicians, we analyzed data from the National Survey of Primary Care Physicians’ Recommendations and Practice for Breast, Cervical, Colorectal, and Lung Cancer Screening. The survey was fielded in 2006 and 2007 as a mailed questionnaire. The sample was drawn from the American Medical Association Physician Masterfile by using a systematic sample design that was stratified by medical specialty type. Eligible respondents were nonfederal office-based family physicians, general practitioners, general internists, and obstetricians and gynecologists aged 75 years or younger. A total of 1212 physicians completed the survey for a 73.4% cooperation rate and a 67.5% response rate. Details about sampling and survey methodology are published elsewhere (6). Respondents were asked “Are you aware of, and have you ever referred a patient to, any of the following services for cancer information: 1-800-4-CANCER; www.cancer.gov; and www.cdc.gov?” Response options were “aware and referred,” “aware of it, never referred,” and “not aware of it.” Awareness and referral were assessed by physician and practice characteristics. SUDAAN software, version 10 (Research Triangle Institute, Research Triangle Park, NC), was used to calculate weighted percentages and 95% confidence intervals (CIs). Cross tabulations with two-sided χ2 and t tests and a multinomial regression analysis were conducted to discern physician and practice characteristics associated with awareness and referral. Awareness and referral to national information resources was low: 6.2% of physicians reported awareness and referral to 1-800-4CANCER, 14.0% reported awareness and referral to www.cancer.gov, and 23.1% reported awareness and referral to www.cdc.gov (Table 1). Greater awareness of and referral to at least one of these resources was associated with more time spent teaching (P = .046 [t test]) and conducting administrative duties (P = .046 [t test]). Lower awareness and referral was observed among physicians who were in private practice (P = .001 [χ2 test]), had larger patient loads (P = .015 [χ2 test]), or had a higher percentage of uninsured patients (P = .015 [χ2 test]). A multinomial logistic regression analysis revealed that compared with physicians in university settings, those in private practice were less likely to be aware of and refer to national cancer information resources (odds ratio = 0.50, 95% CI = 0.34 to 0.74) and less likely to report awareness and no referral (odds ratio = 0.49, 95% CI = 0.32 to 0.74). Table 1 Physician awareness of and referral to national cancer information resources Low levels of awareness of and referral to national cancer information resources were observed across physician and practice characteristics. Efforts to raise awareness and use of these resources could improve informational support to health-care providers, cancer patients, and survivors.

Patient-Centered Communication in Cancer Care: The Role of the NCI’s Cancer Information Service

While patient-centered care and the reduction of suffering due to cancer are primary goals of the NCI, improvement in the delivery of patient-centered communication has been identified as a key NCI research priority. As research on patient-centered communication evolves, the potential contributions of programs such as the National Cancer Institute's (NCI) Cancer Information Service (CIS) cannot be overlooked. The purpose of this paper is to describe how the six core functions of patient-clinician communication described in the literature (fostering healing relationships, exchanging information, responding to emotions, managing uncertainty, making decisions and enabling patient-self management) are embedded in the work of the CIS. The communication process used by the CIS to extend the patient-centered communication role of the clinician will be discussed. CIS training and quality management systems will be described. Lastly, suggestions for the role of CIS in future health information delivery and research will be explored.

Requests for Cancer Prevention Information: The Cancer Information Service (2002–2006)

Prevention is crucial to reducing cancer burden. Awareness of prevention information is critical to engaging the public in prevention activities. We examined 106,610 information requests from the general public to the Cancer Information Service from 2002 to 2006. The percent of requests related to primary prevention decreased in 2003, but otherwise remained stable around 19%. The percent of requests related to secondary prevention decreased over time, from 38% (2003) to 14% (2006). Demographic characteristics were associated with patterns of change across time. Results suggest that efforts are needed to increase public awareness of cancer prevention, particularly among certain populations.

Acculturative and neighborhood influences on subjective social status among Spanish-speaking Latino immigrant smokers.

Subjective social status (SSS) reflects an individual's perception of her/his relative position in the social hierarchy. However, little is known about culturally-relevant, multilevel predictors of low SSS among low socioeconomic status (SES), minority populations. The goal of this study was to identify individual- and neighborhood-level variables predicting SSS among 297 Spanish-speaking Latino immigrant smokers living in several locations in Texas, with an emphasis on the association of SSS with acculturative and socioeconomic variables. Participants were recruited and enrolled through the National Cancer Institute's Cancer Information Service from August 2002 to March 2004. Determinants of SSS were explored using a series of linear regressions. In analyses adjusting for demographics (including objective indicators of SES), speaking Spanish at home and work and living in economically disadvantaged neighborhoods, respectively, were associated with low SSS. However, in analyses including demographics, acculturation, and neighborhood characteristics, only income, education, and acculturation remained associated with SSS. Consistent with results from a previous study in the area (Franzini & Fernandez-Esquer, 2006), less acculturation predicted low SSS among immigrant Latino smokers. However, unlike previous research, these associations were maintained after controlling for SES. Results suggest that the density of less acculturated Latinos within economically deprived neighborhoods might account for the disappearance of neighborhood effects in the final model.

Using the word ‘cancer’ in communication about an abnormal Pap test: Finding common ground with patient–provider communication

Objective To investigate provider and patient views about communication regarding cervical cancer screening follow-up. Methods Using qualitative analysis, we interviewed 20 providers and 10 patients from two urban clinics that serve low-income African American and Hispanic women. Semi-structured interviews and focus groups assessed familiarity with National Cancer Institute's Cancer Information Service (CIS) and reactions to a letter asking women with abnormal Pap test to telephone CIS. The letter suggested questions to ask prior to receiving follow-up. Results No patient or provider was familiar with CIS. Providers but not patients expressed discomfort with use of the word ‘cancer’ in the letter and in CIS's name. Providers feared that reference to cancer would provoke fatalism and impede timely follow-up, whereas patients felt information about cancer risk was needed to prompt timely follow-up. Information providers found necessary to convey in order to accurately explain abnormal Pap tests surpassed patients’ literacy levels. Conclusion Qualitative data suggest important gaps in perspective between providers and patients. There is a need to bridge the gap and overcome communication challenges to promote timely medical follow-up and have better health outcomes. Practice implications Implications and strategies for improving patient–provider education and communication about abnormal Pap test are discussed.

Abstract B1: Chatting about lung cancer: Utilization of NCI's LiveHelp cancer communication service

Abstract Background: As the voice of the National Cancer Institute, the Cancer Information Service (CIS) maintains the mission of communicating evidence-based cancer information to the public, including cancer patients, family members, friends, and health care professionals. While the CIS is predominantly a telephone-based service, the new LiveHelp format offers online information seekers the opportunity to use an instant messaging platform to ask questions and seek assistance from highly trained cancer information specialists (IS). Although LiveHelp has been in operation since 2003, no data exists regarding this novel and expanding method of conveying cancer information and communicating with cancer information consumers. The study aims were: (1) to characterize the purpose of the contact, discussion topics, and resources utilized in LiveHelp sessions focused on lung cancer and (2) to provide descriptive demographic information regarding lung cancer information seekers. Methods: Information captured in the Electronic Contact Record Form (ECRF) associated with each LiveHelp session was used to address study aims. The ECRF contains data coded by ISs during or following each contact. A pre-existing coding scheme is used by ISs to report the purpose of the session and subsequent actions taken. Additionally, approximately 25% of respondents are asked to complete a demographic survey following the LiveHelp session. Data from all lung cancer-related LiveHelp sessions conducted in 2008 were analyzed. Results: Of the 20,939 LiveHelp sessions in 2008, lung cancer was the second most common malignancy addressed (n=1,179, 5.6%). Most users were relatives or friends of cancer patients (66%) and relatively few were cancer patients (13%). The contact purpose was generally motivated by a concern about a family member or friend with cancer (47%), but contacts also sought to understand medical information (25%) or address questions about personal health concerns (10%). The primary subject of the contact was most commonly lung cancer-specific information (e.g., staging, prognosis [42%]), but also frequently addressed treatment or side effect management issues (16%). ISs primarily referred contacts to the NCI's cancer.gov portal (79%). Secondary referrals included recommending review of CIS fact sheets (40%) and consulting with a health care provider (28%). With regard to available demographic information (n=159), users were predominantly female (81%), Caucasian (87%), had a bachelor's degree or higher (55%), had private health insurance (60%), and were an average age of 43 years (±14). Surprisingly, 30% reported having no access to healthcare. The vast majority of users initially located LiveHelp via the Internet (80%) and were first-time CIS users (89%). Conclusions: Given its prevalence and impact, it is not surprising that lung cancer is the most common non-sex-specific malignancy for which individuals contact LiveHelp. Interestingly, the vast majority of these contacts are generated by family or friends of individuals diagnosed with lung cancer. Although descriptive data regarding the users and content of LiveHelp provides basic information about its educational and support functions, analyzing the information exchange embedded in the content of the session transcripts would provide an even greater understanding of how to optimize cancer communication efforts via LiveHelp. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B1.