Cancer Prevention Initiatives Research Articles

Cancer Prevention and Cultural Continuity for Métis Peoples in Canada: A Scoping Review.

The purpose of this scoping review was to map the literature on the relationship between cultural continuity and health among Métis people as well as how this knowledge could be translated into cancer prevention initiatives. We included any Métis-specific literature evaluating connections between culture, health, and well-being. We conducted electronic searches of Medline, PubMed, Embase, PsychInfo, I-Portal, and hand-searched journals, and reviewed the grey literature. Based on our inclusion criteria, articles were screened and assessed for eligibility, resulting in a sample of 22 publications. Qualitative, quantitative, and mixed methods designs were considered. The 22 publications included in this review were diverse, ranging from population-based studies to reports and news articles. There were no limitations to publication year, and most of the data presented in this review were published more than five years ago. Nevertheless, the results demonstrate the potential role of Métis cultural continuity in cancer prevention. The scoping review revealed the current lack of Métis-specific data regarding health and its intersectionality with culture. However, the existing literature indicates that cultural continuity for Métis appears to influence health and well-being positively. As such, there may be benefits to incorporating cultural continuity in cancer prevention efforts.

Disparities in breast cancer prevention initiatives at a comprehensive cancer center: Who are we serving?

1615 Background: Despite advances in personalized breast cancer risk assessment and screening, populations at highest risk for cancer-related mortality are often excluded. At the IU Simon Comprehensive Cancer Center, a high-risk screening program (HRSP) identifies and serves women at increased risk of breast cancer. Risk assessment using Tyrer Cuzick v.8 and Gail models is performed in mammography; women at increased risk are navigated to a clinic appointment to discuss individualized screening and prevention services including MRI, chemoprevention, and/or genetic testing. We hypothesize gaps in the demographic and socioeconomic (SES) characteristics of women seen for a HRSP appointment, compared to women receiving a cancer diagnosis at the same mammography sites. Methods: Retrospective review was performed of women who met criteria for the HRSP (age ≤65 and Gail 5 yr risk ≥3% or TC v.8 10-yr risk ≥8%, or recommended by the radiologist) and subsequently accepted, scheduled, and attended an appointment from 6/2020 to 6/2022 (n=233). This population was compared to women who were diagnosed with breast cancer at the same clinical sites over the same dates, without history of being evaluated in the HRSP. Age was restricted to ≤65 to match the HRSP population (n=685). Zip codes were used to calculate area-based SES by median household income and percent poverty. CDC social vulnerability index (SVI) was evaluated using the U.S. Census Bureau and American Community Survey (0=least vulnerable, 1=most vulnerable). Comparisons across groups by age, race, insurance status, area SES and SVI were made using the Wilcoxon or Chi-square test. Results: Cancer cases were significantly older than those attending the HRSP (median age 54 vs 49 p < 0.001). Black patients represented 19.4% of participants diagnosed with cancer, versus 10.8% of participants attending the HRSP (p=0.0032). There was also a disparity in insurance coverage, with 83.8% of women seen in the HRSP being privately insured, versus 75.6% of women diagnosed with cancer (p=0.011). There was no statistical difference in SVI (0.64 vs 0.66 p=0.11) or area poverty rate (11.2 vs 12.0 p=0.26) between the groups; cancer cases came from areas with lower household income (69,611 vs 73,165 p=0.04). Conclusions: Women seen in the HRSP were more likely to be younger, White, privately insured, and from an area with higher household income, compared to women diagnosed with cancer in the same health system at the same mammography sites. This highlights disparities in access to individualized breast cancer interception such as chemoprevention, high-risk screening, and genetic testing, which may further existing disparities in breast cancer-related mortality based on race and SES. Further studies will investigate barriers and motivators to personalized breast cancer prevention in high-risk groups, and utilize community partnerships to develop equitable interventions.

Cancer literacy differences of basic knowledge, prevention, early detection, treatment and recovery: a cross-sectional study of urban and rural residents in Northeast China.

Cancer literacy as a potential health intervention tool directly impacted the success of cancer prevention and treatment initiatives. This study aimed to evaluate the cancer literacy in Northeast China, and explore the factors contributing to urban-rural disparities. A cross-sectional survey was conducted in 14 cities across Liaoning Province, China, from August to October 2021, using the multistage probability proportional to size sampling (PPS) method. The survey comprised 4,325 participants aged 15-69 and encompassed 37 core knowledge-based questions spanning five dimensions. Associations between sociodemographic factors and the cancer literacy rate were evaluated using chi-square tests and multivariate logistic regression model. The overall cancer literacy rate was 66.9% (95% CI: 65.6-68.2%). In the primary indicators, cancer literacy were highest in treatment (75.8, 95% CI: 74.2-77.4%) and early detection (68.2, 95% CI: 66.8-69.6%), followed by basic knowledge (67.2, 95% CI: 65.8-68.6%), recovery (62.6, 95% CI: 60.7-64.5%) and prevention (59.7, 95% CI: 58.2-61.3%). Regarding secondary indicators, the awareness rates regarding cancer-related risk factors (54.7, 95% CI: 52.8-56.5%) and early diagnosis of cancer (54.6, 95% CI: 52.7-56.6%) were notably inadequate. Rural participates exhibited lower cancer literacy across all dimensions compared to urban. Multi-factor analysis showed that factors such as advanced age, limited education or low household income were barriers to health literacy in rural areas. Strengthening awareness concerning prevention and early detection, particularly among key populations, and bridging the urban-rural cancer literacy gap are imperative steps toward achieving the Healthy China 2030 target.

An Integrative Pancreatic Cancer Risk Prediction Model in the UK Biobank.

Pancreatic cancer (PaCa) is a lethal cancer with an increasing incidence, highlighting the need for early prevention strategies. There is a lack of a comprehensive PaCa predictive model derived from large prospective cohorts. Therefore, we have developed an integrated PaCa risk prediction model for PaCa using data from the UK Biobank, incorporating lifestyle-related, genetic-related, and medical history-related variables for application in healthcare settings. We used a machine learning-based random forest approach and a traditional multivariable logistic regression method to develop a PaCa predictive model for different purposes. Additionally, we employed dynamic nomograms to visualize the probability of PaCa risk in the prediction model. The top five influential features in the random forest model were age, PRS, pancreatitis, DM, and smoking. The significant risk variables in the logistic regression model included male gender (OR = 1.17), age (OR = 1.10), non-O blood type (OR = 1.29), higher polygenic score (PRS) (Q5 vs. Q1, OR = 2.03), smoking (OR = 1.82), alcohol consumption (OR = 1.27), pancreatitis (OR = 3.99), diabetes (DM) (OR = 2.57), and gallbladder-related disease (OR = 2.07). The area under the receiver operating curve (AUC) of the logistic regression model is 0.78. Internal validation and calibration performed well in both models. Our integrative PaCa risk prediction model with the PRS effectively stratifies individuals at future risk of PaCa, aiding targeted prevention efforts and supporting community-based cancer prevention initiatives.

Laundromats: Community-Based Partnerships to Increase Reproductive Health Literacy Outreach.

Laundromats are a regularly visited, highly localized community venue, especially in underserved communities. Few health literacy and health-promotion programs have taken place in laundromats, and there have been no efforts to apply community-based participatory research approaches in this setting. Literacy programs and cancer-prevention initiatives have been held in laundromats, but little data exist on the empirical outcomes of such initiatives or whether the programs have been fashioned as a collaboration between community and researchers. In this paper, we present a brief overview of literacy and cancer-prevention initiatives that have taken place in laundromats and introduce our Wash and Spin Toward Health/Washington Avanzando la Salud Hispana (W.A.S.H.) project. We describe how we applied community-based participatory research principles to launch this effort and identify both benefits and challenges of this approach. We hope this project will stimulate greater interest in laundromat settings for outreach and education efforts, especially those addressing disparities in health literacy and access.

Oncology Patient Education and Student Education Program

Background For many medical students interested in oncology during medical school, they will face a range of often disconnected activities. This may include participating in mentorship with faculty (shadowing/rotating), oncology lectures separated across multiple modules on step1/step2 topics, interest group meetings, volunteering, as well as participating in fundraisers or events through their local cancer center. We wanted to find a way to combine these efforts at the Georgia Cancer Center, as a model for other medical schools who also want to strength the oncology education and career exploration opportunities at their programs. Methods We paired teams of medical students with a physician-oncologist mentors covering every major oncology field from radiology/pathology to heme-onc to surgery and radiation oncology. Each team was given a topic (ie Breast Cancer, Pediatric Cancer etc) to produce a Patient Education video to inform patients about the most up-to-date cancer prevention and screening initiatives. In addition, these teams also raised money for our local 'Unite in the Fight' fundraiser supporting the Georgia Cancer Center (GCC). The videos they produced were shown to the participants of main event of the fundraiser. Next, the teams were tasked with producing Student education videos that focused on high yield step review for their same topics. These videos were judged by a panel of medical educators, oncologists, and cancer-survivors with awards for top patient education, top student education, and top fundraising team. Results We had 10 teams of students (48 students overall) participate, each producing Patient and Student videos that were highly rated by the judges. The Dean of Curriculum has now included the Student Education videos as part of the Capstone module that prepares M2′s for Step 1 and clerkships. We are working with the GCC to include the Patient Education videos on tablets provides to patients in the oncology clinic. Lastly, student teams raised over $10,000 from 167 donors for Unite in the Fight (total fundraiser that year was $50,000). Discussion We feel that we were able to provide a synergistic longitudinal experience that allowed 48 students to 1) explore oncology as a career, 2) contribute to patient education, 3) contribute to student education, and make an impact on the local cancer survivor community. By contrast, in years past oncology interest group events were attending by 5-10 students. Many students reported building strong mentorship relationships after working with their physician mentors over the year of this event. For many medical students interested in oncology during medical school, they will face a range of often disconnected activities. This may include participating in mentorship with faculty (shadowing/rotating), oncology lectures separated across multiple modules on step1/step2 topics, interest group meetings, volunteering, as well as participating in fundraisers or events through their local cancer center. We wanted to find a way to combine these efforts at the Georgia Cancer Center, as a model for other medical schools who also want to strength the oncology education and career exploration opportunities at their programs. We paired teams of medical students with a physician-oncologist mentors covering every major oncology field from radiology/pathology to heme-onc to surgery and radiation oncology. Each team was given a topic (ie Breast Cancer, Pediatric Cancer etc) to produce a Patient Education video to inform patients about the most up-to-date cancer prevention and screening initiatives. In addition, these teams also raised money for our local 'Unite in the Fight' fundraiser supporting the Georgia Cancer Center (GCC). The videos they produced were shown to the participants of main event of the fundraiser. Next, the teams were tasked with producing Student education videos that focused on high yield step review for their same topics. These videos were judged by a panel of medical educators, oncologists, and cancer-survivors with awards for top patient education, top student education, and top fundraising team. We had 10 teams of students (48 students overall) participate, each producing Patient and Student videos that were highly rated by the judges. The Dean of Curriculum has now included the Student Education videos as part of the Capstone module that prepares M2′s for Step 1 and clerkships. We are working with the GCC to include the Patient Education videos on tablets provides to patients in the oncology clinic. Lastly, student teams raised over $10,000 from 167 donors for Unite in the Fight (total fundraiser that year was $50,000). We feel that we were able to provide a synergistic longitudinal experience that allowed 48 students to 1) explore oncology as a career, 2) contribute to patient education, 3) contribute to student education, and make an impact on the local cancer survivor community. By contrast, in years past oncology interest group events were attending by 5-10 students. Many students reported building strong mentorship relationships after working with their physician mentors over the year of this event.

Abstract 1979: Examining stereotype perceptions of colorectal cancer in the Latino community

Abstract Purpose: Colorectal cancer (CRC) screening is significantly lower in the Hispanic community compared to non-Hispanic whites. Qualitative research has suggested that cultural attitudes towards cancer may be a potential barrier to screening. The purpose of the study was to quantitatively examine explicit stereotypes about CRC and CRC screening within the Hispanic community using the stereotype content model. Methods: A one-time online cross-sectional survey was administered to individuals self-identifying as Hispanic living across the United States. Based on participant preference, the survey was completed in English or Spanish. In counterbalanced order, participants were asked to read brief paragraphs about a control target, a target with CRC, and a target undergoing colonoscopy CRC screening. The target was a Hispanic individual assigned a gender-neutral name. Other than the one sentence with CRC-related information in the CRC and CRC screening paragraphs, all the paragraphs were identical describing the individual, their family, and their hobbies. After each paragraph, participants were asked to rate the target on validated surveys assessing warmth and competence, two indicators of explicit stereotypes. Data was analyzed using linear mixed-effects models, which were fitted to evaluate the effect of each target on warmth and competence, controlling for age, gender, race, Hispanic heritage, cancer exposure, and randomization. Results: The target condition was not statistically significantly associated with the Warmth and Competence outcomes when the models were fitted considering only the main effects. However, in the presence of interactions the condition was associated with the outcomes. Specifically, the analysis yielded a significant fixed effect for the interaction between target condition and participant age, such that younger participants had greater perceptions of warmth [F(2, 511.93)=7.045, p=0.001] and competence [F(2, 522.73)=11.129, p<0.001] towards the target undergoing cancer screening. The analysis also yielded a further significant effect for the interaction between target condition and Hispanic heritage with differences in perceptions of warmth between those born in the USA and participants born in Central and South America or in Europe [(F(2, 520.16)=2.299, p=0.02)]. Conclusion: Findings highlight the importance of understanding the heterogeneity within the Hispanic community when seeking to address stigma towards CRC. First, there are differences in explicit perceptions based on generation, suggesting the need for age-appropriate cancer prevention initiatives. Second, the findings demonstrate the need to account for diverse cultural perspectives of cancer screening based on country of origin. Thus, this research supports the importance of respecting the diversity within the Hispanic community and tailoring cancer prevention interventions accordingly. Citation Format: Bianca Luna-Lupercio, Aidan Foley, Nenette A. Caceres, Ergueen Herrera, Galen Wiens-Cook, Vinicius Calsavara, Zul Surani, Sarah-Jeanne Salvy, Robert Haile, Celina H. Shirazipour. Examining stereotype perceptions of colorectal cancer in the Latino community [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1979.

Knowledge and awareness of colorectal cancer among a predominantly Indigenous Caribbean community

ObjectiveTo assess awareness levels and knowledge of colorectal cancer (CRC) and CRC screening among an Indigenous Caribbean community.MethodsA community-based participatory research project was developed to perform a needs assessment of cancer prevention and education in an Indigenous non-metropolitan community in Dominica. Purposive sampling occurred at a local health clinic. Data was collected from 58 eligible patients via a 57-item structured interview. Descriptive statistics were calculated, and demographic correlates of CRC knowledge and awareness were assessed using chi-square and Fisher Exact tests.ResultsOf 58 participants, 72.4% identified as Indigenous, and 36.5% had heard of CRC. Most respondents (96.1%) believed CRC screening to be “important,” yet only 3.0% of those who were age eligible had received screening in the prior 10 years, and 12.5% knew how to get screened. More respondents with incomes over $5,000 ECD had heard of CRC (72.2%) compared to those who had not (21.7%), and those who were unsure (16.7%, p < 0.01). Among those with a family cancer history, 14.3% knew how to get tested for CRC, 60.0% did not, and 25.0% were unsure (p < 0.03).ConclusionDespite limited familiarity with CRC screening, participants broadly believed CRC screening to be important. Health education research is needed to develop patient-centered, culturally appropriate materials about CRC screening and prevention. Future work facilitating productive community partnerships and incorporating prevailing community traditions may align cancer prevention and education initiatives with community priorities.

COST Action to address challenges facing people with intellectual disabilities accessing cancer prevention and response services across Europe – Introducing CUPID - Cancer- Understanding Prevention in Intellectual Disabilities.

COST Actions are grants provided by the European Union to support the establishment of networks of expertise to explore and address a scientific or social issue that impacts across Europe. This article introduces and describes one such action that started in October 2022 - CUPID - will address issues of policy and equity of access to cancer prevention initiatives by people with intellectual disabilities compared to the general population in Europe. With 82 individual members drawn from 30 countries CUPID will establish an interdisciplinary network of stakeholders representing carers, service providers, advocacy groups, educators, healthcare professionals, researchers and people with intellectual disabilities. The CUPID COST Action will be implemented over four years and will identify what needs to be addressed by the European Union and health and social services to improve cancer prevention among people with intellectual disabilities.

One Million Kids Lost Mom to Cancer in 2020.

Researchers say that in 2020, deaths from cancer, dominated by breast and cervical cancers, left 1,047,000 children without a mother. The findings highlight the need to accelerate cancer prevention initiatives and improve treatment, especially in developing countries.

Abstract PR010: Evaluating a bidirectional academic–community partnership with multiple racial/ethnic communities for cancer prevention initiatives and cancer health disparities research

Abstract Background: The Temple University Fox Chase Cancer Center and Hunter College Cancer Health Disparity Partnership (TUFCCC/HC Cancer Partnership) is a comprehensive collaborative cancer health research infrastructure in Pennsylvania, New Jersey, and New York City (PNN) Region. Its goals are to enhance equity in cancer health through rigorous and sustainable cancer research, train the next generation of researchers, and establish community outreach programs. Establishing and strengthening a bidirectional academic-community partnership is a key component of this partnership. While such collaborative relationships have been strongly endorsed by the National Institutes of Health (NIH), little has been documented demonstrating how such partnership can be created and maintained. Objectives: Building on previous established collaborative relationships with the community-based organizations (CBOs), we created and expanded a bidirectional, academic–community partnership in African American, Asian American, and Latinx communities in the PNN region to (1) assess the level of awareness of cancer prevention knowledge; (2) identify community needs and barriers to cancer prevention healthcare services; (3) jointly develop and implement community-based educational initiatives to promote cancer prevention in medically underserved communities. Methods: In this presentation, we established a comprehensive evaluation metric to assess the bidirectional partnership. The metric, its outputs, and outcomes were adapted from the Evaluation Metrics Manual published by the National Institute of Environmental Health Services of NIH. We also formed a Community Advisory Board (CAB) to guide our bidirectional communication and jointly develop a community-driven cancer education agenda. Results: The CAB played a critical role in the development of the bidirectional partnership. They provided key inputs in identifying the goals and benchmarks of the educational initiative, and in facilitating the recruitment and implementation of the initiative. Our evaluation indicated that a bidirectional partnership is an interactive and non-linear process that requires constant feedback and communication. We identified several successes and challenges during our co-learning and co-implementing process. We also identified areas for improvement, specifically, establishing a more efficient channel for information and resource sharing, and greater efforts on dissemination of scientific findings to the community. Conclusions: Actively engaging CAB and CBOs in the cancer prevention educational initiatives from the onset enhanced the efficacy of the initiatives and strengthened the research training capacity of the academic institutions. We will share best practices in our bidirectional, academic–community partnership building and discuss next steps in adaptation and further development of the partnership. Citation Format: Lin Zhu, Ellen J. Kim, Steven Zhu, Nathaly Rubio-Torio, Evelyn González, Marilyn A. Fraser, Ming-chin Yeh, Marsha Zibalese-Crawford, Grace X. Ma, Olorunseun O. Ogunwobi, Yin Tan. Evaluating a bidirectional academic–community partnership with multiple racial/ethnic communities for cancer prevention initiatives and cancer health disparities research [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PR010.

Abstract B054: FIT distribution in underserved communities in Arkansas

Abstract Colorectal cancer is one of the leading causes of cancer attributed deaths in the U.S. Among the states, Arkansas has one of the highest colorectal cancer mortality rates at 15.5 deaths per 100,000 compared to the national average of 13.4 deaths per 100,000 (American Cancer Society, n.d.). In addition to all Arkansans facing higher incidence and mortality from the disease, more disparities are highlighted when these statistics are examined along racial lines. African Americans face higher incidence and mortality from the disease with African American men facing the highest burden of disease (Arkansas Cancer Facts and Figures 2017, n.d.). The most effective method of colorectal cancer prevention is screening, though many may not have access in many areas in Arkansas. To remedy this issue, the University of Arkansas for Medical Sciences created the Colorectal Cancer Screening and Prevention Program (CCSPP) to increase preventive colorectal cancer care accessibility in underserved communities. This program partners with community services such as food drives to distribute Fecal Immunochemical Test (FIT) kits to community members that can be mailed back to UAMS free of charge. To ensure effective distribution, a script was prepared for community health workers (CHWs) attending these events. CHWs follow the script to determine community member eligibility in the CCSPP followed by FIT kit distribution. Eligible participants have fourteen days to return their completed FIT before they begin receiving weekly reminders via mail or mobile phone. The involvement of CHWs in this program is vital, highlighting the need for effective training. To assure that CHWs have the knowledge necessary for community FIT distribution, a presentation was prepared to provide colorectal cancer screening education and detail the script and consent forms. The objective of the training presentation is to ensure the preparedness of CHWs for community events. The presentation has shown positive results with a two-point increase in the average posttest score of 7.88 after the presentation when compared to the average pretest score of 5.88 before the presentation. This program and methodology allow the most vulnerable Arkansans to receive previously inaccessible preventive care. Though data analysis is still needed to determine the efficacy of this method, this program may serve as an adaptable model for other colorectal cancer prevention initiatives that seek to reach underserved communities. References American Cancer Society. (n.d.). American Cancer Society: Cancer Facts &amp; Statistics. American Cancer Society | Cancer Facts &amp; Statistics. Retrieved from https://cancerstatisticscenter.cancer.org/?_ga=2.234590110.106142599.1654007572-1141503805.1630428031#!/cancer-site/Colorectum Arkansas Cancer Facts and Figures 2017 (Arkansas Cancer Facts and Figures, p. 170). (n.d.-c). Arkansas Department of Health. Retrieved from https://www.healthy.arkansas.gov/images/uploads/publications/ARCancerFacts2017.pdf Citation Format: Sydney T. Baker. FIT distribution in underserved communities in Arkansas [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B054.

Estimated prevalence of human papillomavirus among Nigerian women: A systematic review and meta-analysis.

HPV prevalence in Nigeria has been challenging to quantify given regional population heterogeneity and differences in diagnostic methodology. We conducted a systematic review and meta-analysis of 17 studies, each of which summarized HPV prevalence in women residing in six geopolitical zones of Nigeria. The estimated pooled prevalence (effect size) of HPV in Nigeria was 32% (CI: 23-41%). HPV prevalence was 29% (CI: 20-39%) among studies that detected HPV by genotype. HPV prevalence among studies that used serologic detection was 38% (CI: 12-65%). When stratified by region, a study in the South East (SE) geopolitical zone reported the highest prevalence of 71% (CI: 61-80%) while a study in the South South (SS) geopolitical zone reported the lowest prevalence of 4.9% (CI: 3-9%). HPV prevalence in Nigeria was high. Heterogeneity between study regions and differing HPV detection methods both contribute to variation in estimates. Using pooled estimates serves to inform future strategies for epidemiologic surveillance and future design of HPV and cervical cancer prevention initiatives.

Abstract PO-069: Engaging the American Indian community in North Carolina to assess cancer research and training opportunities

Abstract Background: American Indians have significant barriers to cancer prevention and control due to a number of social structural factors. North Carolina has the largest American Indian population east of the Mississippi River with eight tribes and four urban Indian centers, yet there have been few coordinated strategies to address cancer disparities in this population. Engagement with tribal communities is vital in successful implementation of research and outreach activities. Methods: The Wake Forest Baptist Comprehensive Cancer Center (WFBCCC) received a supplement to their P30 Cancer Center Support Grant to inform Community Outreach and Engagement initiatives through The Healing Walk project which was designed to determine the most pressing cancer concerns for American Indian communities in North Carolina and identify needs for research training for American Indian students. Feedback was obtained from tribal leaders, educators, and college students through one large and three mini-round table discussions and solicited by email throughout late 2018 and 2019. The final round table occurred two days before the 2020 COVID 19 mitigation mandates. Results: Community interviews produced a wealth of information on the self-reported issues within American Indian populations in North Carolina. Tribal community leaders identified systemic and demographic issues that contribute to health disparities among their people. These issues include: lack of trust in the medical community, structural barriers to care leading to late-stage diagnosis, perceptions related to cancer, high rates of cancer risk factors, including obesity and tobacco use, and historical trauma. Students identified factors which contribute to barriers in pursuing careers in cancer research, including a lack of American Indian mentors, financial barriers, mental health challenges that arise in attending majority institutions, and a lack of culturally competent research training. Conclusions: By relying on the viewpoints of tribal leaders, the WFBCCC can accurately address the needs of the communities and develop cancer prevention and control initiatives that are culturally responsible, such as Tribal Health Ambassadors. In accordance with the majority of the requests both students and educators made, the WFBCCC is creating an undergraduate research program for engaging AI students. Focusing on community identified areas of need, students will develop a research question relative to the health concerns of their tribe. The goal of this research program is two fold. First, to enable tribal communities to accurately assess cancer risk, incidence, and mortality, and with that knowledge reduce the current health disparities in AI populations. Second, to provide American Indian students with the opportunity to not only serve their community, but to give them the tools and experience to help understand and eliminate cancer disparities in their tribal communities. Citation Format: Ronny Bell, Carla Strom, Kelsey Shore, Charlene Hunt, Karen Winkfield. Engaging the American Indian community in North Carolina to assess cancer research and training opportunities [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-069.

Health-Related and Behavioral Factors Associated With Lung Cancer Stage at Diagnosis: Observations From Alberta's Tomorrow Project.

BackgroundLung cancer is the leading cause of cancer death in Canada, with stage at diagnosis among the top predictors of lung cancer survival. Identifying factors associated with stage at diagnosis can help reduce lung cancer morbidity and mortality. This study used data from a prospective cohort study of adults living in Alberta, Canada to examine factors associated with lung cancer stage at diagnosis.MethodsThis cohort study used data from adults aged 35–69 years enrolled in Alberta’s Tomorrow Project. Partial Proportional Odds models were used to examine associations between sociodemographic characteristics and health-related factors and subsequent lung cancer stage at diagnosis.ResultsA total of 221 participants (88 males and 133 females) developed lung cancer over the study period. Nearly half (48.0%) of lung cancers were diagnosed at a late stage (stage IV), whereas 30.8 % and 21.3% were diagnosed at stage I/II and III, respectively. History of sunburn in the past year was protective against late-stage lung cancer diagnosis (odds ratio (OR) .40, P=.005). In males, a higher number of lifetime prostate specific antigen tests was associated with reduced odds of late-stage lung cancer diagnosis (odds ratio .66, P=.02). Total recreational physical activity was associated with increased odds of late-stage lung cancer diagnosis (OR 1.08, P=.01).DiscussionLung cancer stage at diagnosis remains a crucial determinant of prognosis. This study identified important factors associated with lung cancer stage at diagnosis. Study findings can inform targeted cancer prevention initiatives towards improving early detection of lung cancer and lung cancer survival.

Using the Community Readiness Model to Assess American Indian Communities Readiness to Address Cancer Prevention and Control Programs.

Cancer disparities continue among American Indian and Alaska Native (AI/AN) populations while they have decreased among other racial and ethnic groups. No studies were found that utilized the Community Readiness Model (CRM) to ascertain the readiness of Tribal and American Indian organizations to participate in cancer research and cancer prevention and control initiatives. The Partnership for Native American Cancer Prevention conducted an assessment of the status of American Indian communities' readiness to implement activities for prevention, early detection, and treatment to improve AI/AN cancer rates. The assessment was a component of the Community Outreach Core of the grant. Thirty-four key Informants participated in the interview process. The Community Readiness Assessment (CRA) provided a baseline assessment of community partners' readiness to participate in cancer research and programming. Despite years of cancer intervention programs, the communities were classified as being in the early stages of readiness [1-5] of the nine-stage model. Additionally, findings showed low levels of awareness of previous or ongoing cancer research. The findings in prevention and control efforts indicated a need for technical assistance and funding to support community projects in prevention and control. This supported the implementation of a community grants initiative. They also indicated that communities were not ready to conduct research, despite ongoing cancer related research in at least two communities. Communication tools and social media methods and messages were developed to increase awareness of cancer as a health concern and cancer research in the community. The CRM informed these and other engagement activities to meet the appropriate stage of readiness for each Tribe/community, and to build their capacity to participate in cancer research and programming activities.

Engaging rural communities in cancer prevention and control research: Development and preliminary insights from a community-based research registry.

ObjectiveTo report on the development and preliminary findings of a community‐based cancer registry, including the community‐engaged approach to recruitment, participant profile, and distribution of cancer risk factors by race/ethnicity and geography.MethodsCommunity outreach and engagement best practices were used to recruit a diverse convenience sample of Virginia residents (≥18 years) that oversampled residents living in rural areas, defined as Rural‐Urban Continuum Codes (RUCC) 4–9 and African American (AA)/Black residents. Multiple survey administration methods included electronic (e‐survey) and in‐person survey by community‐based staff.ResultsAt the time of this analysis, 595 participants are enrolled; 73% are rural, 46% are AA/Black. AA/Black participants reported similar education but lower income (p < 0.01) and health literacy (p < 0.01), lower alcohol use (p < 0.001), fewer sedentary behaviors (p = 0.01), but greater BMI (p < 0.05) compared to White participants. Rural residents reported significantly lower household income (p < 0.001) and greater use of Medicaid (p = 0.01) compared to urban participants. Biennial mammography was reported by 82% of women aged 45–74 years old and colonoscopy by 77% of participants ≥50 years old. Tobacco use was reported by 17%; no differences in cancer screening or tobacco use were identified by geography or by race.Conclusion and relevanceCommunity engagement strategies successfully enrolled diverse residents within the cancer service area. AA/Black participants reported fewer cancer risk behaviors, similar educational attainment but lower income and health literacy compared to White respondents. Nuanced examinations of interactions among multilevel factors are needed to understand how individual, community, and institutional factors converge to maintain cancer disparities among AA/Black Virginians. Additional findings indicate a need for tobacco cessation, lung cancer screening, obesity treatment, and prevention initiatives.

Changes in sun protection behaviours, sun exposure and shade availability among adults, children and adolescents in New South Wales, 2003–2016

ObjectiveTo inform skin cancer prevention policies and campaigns, we investigated changes over time in sun protection behaviours, sunburn, sun exposure and shade availability in public spaces among people living in New South Wales (NSW), Australia, between 2003 and 2016. MethodsWe analysed cross‐sectional data from the NSW Population Health Survey collected in 2003, 2007, 2014 and 2016, which included approximately 15,000 respondents of all ages in each year. Logistic regression models were used to analyse overall changes over time and for different age, sex and sociodemographic groups. ResultsThe use of sunscreen and protective clothing and the availability of shade increased between 2003 and 2016, but sunburn and sun exposure during peak times of ultraviolet radiation also increased. In subgroup analyses, there was no improvement in sun protection behaviours among adolescents and increases in sunburn and sun exposure were observed only among adults, particularly women and in areas with less social disadvantage. ConclusionsSun protection behaviours have improved over time among some population subgroups, but over‐exposure to ultraviolet radiation remains prevalent. Implications for public healthSkin cancer prevention initiatives that specifically target adolescents and sun exposure during peak times are needed to help reduce population skin cancer risk.

Public awareness of environmental risk factors of cancer and attitude towards its prevention among the Lebanese general population.

SummaryIntroductionSince the majority of cancers occur as a result of modifiable risk factors, cancer is being seen more as a preventable disease. The primary objective of our study was to assess the level of awareness of environmental risk factors of cancer among the Lebanese general population. The secondary objective focused on identifying the predictors of the preventability of the disease.MethodsWe conducted a cross-sectional study between June and July 2020. An online questionnaire was used to collect data pertaining to the knowledge of environmental risk factors of cancer, source of information and personal practice of the participants. Bivariate and multivariate analyzes were performed.ResultsAbout 387 respondents agreed to participate in the study. The study showed low awareness regarding infectious agents, lifestyle, diet and many work exposures. The predictors of the attitude of respondents regarding the preventability of cancer were: believing that cancer has an environmental cause (p=.014), not having a healthy lifestyle (p = 0.004), not smoking waterpipe (p = 0.023), being single (p = 0.013), and having a university degree (p = 0.049).ConclusionsEfforts should be made to improve awareness of the cancer risk factors regarding infectious agents, lifestyle, diet and many work exposures. This can also be followed by further studies assessing the impact of these community and governmental cancer prevention initiatives on cancer risk factors level of awareness.

Abstract 72: Slow Progress in Low-Resource Environments: Is Lack of Education and Training in Cancer Prevention Key?

Abstract Purpose: Explore attitudes about education and training in cancer prevention research and practice on dissemination and implementation of cancer prevention practices in India. Methods: Conduct focus groups to understand how cancer prevention education and training – or their absence – influence dissemination and implementation of cancer prevention and control strategies from stakeholder groups: o Professionals with leadership responsibilities in cancer and public health, managing people and resources, and with experience working with patients and communities, clinicians and public health professionals, health administrators, government agencies, and non-profits; and o Patients with cancers for which prevention and early detection strategies exist. Results: In focus group discussion guides, we consider how to appropriately probe aspects of individual and professional responsibility, leadership style, public and system capacity, cultural and educational influence, and surface other aspects important to the influence of education and training of professionals, leaders, and the public in cancer prevention and control. We expect to gain rich insight from leaders and professionals with knowledge of cancer prevention and control success achieved in developed countries and lived experience managing cancer resources for patients and systems in India. We also anticipate rich insight from survivors about their expectations of and experiences with oncology care for contrast and alignment of themes from leaders and professionals. Conclusio:n Slow progress in dissemination and adoption of proven cancer prevention and control initiatives in LMICs creates critical opportunities missed. Through focus groups, we hope to unearth foundational barriers to cancer prevention in low-resource settings related to cancer prevention education and training for fuller NCI R01 dissemination science investigations in India and other low-resource settings that share the experience of preventable cancers diagnosed at advanced stage but are culturally different for comparison. Insight from such studies may reveal new directions for achieving high impact, long-term implementation of cancer prevention strategies. Citation Format: Melissa Varon, Chang Shine, Sharmila Pimple, Surendranath Shastri. Slow Progress in Low-Resource Environments: Is Lack of Education and Training in Cancer Prevention Key? [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 72.