Cancer-related Health Outcomes Research Articles

Patterns of dietary quality, physical activity, and sleep duration among cancer survivors and caregivers.

Fruit and vegetable intake (FVI), moderate-to-vigorous physical activity (MVPA), and sleep duration are each independently associated with cancer-related and general health outcomes among cancer survivors. Past research suggests that health behaviors cluster among cancer survivors, with caregivers demonstrating similar patterns. This analysis examined co-occurrence of FVI, MVPA, and sleep duration among cancer survivors and informal cancer caregivers and identified sociodemographic and clinical correlates of health behavior engagement. Using data from the Health Information National Trends Survey (HINTS), an exploratory latent profile analysis (LPA) was conducted among those self-reporting a history of cancer or identifying as a cancer caregiver. The LPA model was fit with daily self-reported FVI (cups/d), MPVA (minutes/d) and sleep duration (hours/d). Multinomial logistic regression models were used to predict profile membership based on sociodemographic and clinical characteristics. Four health behavior profiles were identified (Least Engaged-No MVPA, Least Engaged-Low MVPA, Moderately Engaged, and Highly Engaged). The largest profile membership was Least Engaged-No MVPA, capturing 37% of the sample. Profiles were most distinguished by MVPA, with the lowest variance in sleep duration. Participants reporting higher FVI also often reported greater MVPA and longer sleep duration. Profile membership was significantly associated with age, relationship status, education, income, rurality, alcohol use, self-efficacy, psychological distress, BMI, and cancer type. This study identified four health behaviors patterns and sociodemographic correlates that distinguished those patterns among cancer survivors and caregivers drawn from a nationally representative sample. Results may help identify for whom health behavior interventions could be of greatest benefit.

Pilot Randomized Controlled Trial of Lymfit: A Theory-Guided Exercise Intervention for Young Adults with Lymphoma.

Despite the rapidly emerging evidence on the contributions of physical activity to improving cancer-related health outcomes, adherence to physical activity among young adults with lymphoma remains suboptimal. Guided by self-determination theory (SDT), the Lymfit intervention (a 12-week individualized exercise program with bi-weekly kinesiologist support and an activity tracker) aimed to foster autonomous motivation toward physical activity. This pilot randomized controlled trial aimed to evaluate the feasibility, acceptability, and preliminary effects of Lymfit. Young adults (N = 26; mean age of 32.1 years) with lymphoma who were newly diagnosed and those up to six months after completing treatment were recruited and randomly assigned one-to-one to either the intervention group (n = 13) or a wait-list control group (n = 13). All a priori feasibility benchmarks were met, confirming the feasibility of the study in terms of recruitment uptake, retention, questionnaire completion, intervention fidelity, missing data, Fitbit wear adherence, and control group design. The intervention acceptability assessment showed high ratings, with eight out of ten items receiving >80% high ratings. At post-intervention, an analysis of covariance models showed a clinically significant increase in self-reported physical activity levels, psychological need satisfaction, and exercise motivation in the intervention group compared to controls. Lymfit also led to meaningful changes in six quality-of-life domains in the intervention group, including anxiety, depression, fatigue, sleep disturbance, social roles and activities, and pain interference. The findings support Lymfit as a promising means to meet psychological needs and increase the autonomous motivation for physical activity in this group. A fully powered efficacy trial is warranted to assess the validity of these findings.

Abstract 4786: Colorectal cancer screening rates among deaf, deafblind, and hard of hearing adults aged 45 to 75 years old

Abstract Background: Deaf, deafblind, and hard of hearing (DDBHH) individuals who use American Sign Language (ASL), a subpopulation of the disability, experience disparities concerning cancer screening and cancer-related health outcomes. For this study, we explored colorectal cancer screening rates among DDBHH survey respondents in comparison to rates found in the hearing population. Materials and Methods: Using the National Cancer Institute Health Information National Trends Survey in ASL (Kushalnagar et al., 2015), we surveyed participants 18+ years old using the Center for Deaf Health Equity at Gallaudet University’s database of over 2,500 DDBHH participants from all over the USA, including Hawaii and Puerto Rico. We used the U.S. Preventive Services Task Force (USPSTF) guidelines’ age cutoffs to assess adherence to colorectal cancer screenings. Results: Survey response rate within three weeks of mail out in July 2023 was 12%. A total of 405 DDBHH adult participants answered screening questions for colorectal cancer in ASL and English. Overall, 43.7% self-reported screening adherence for age-eligible (45-75 years) colorectal cancer screening; 54.7% reported never having a colorectal cancer screening. Similarly-aged hearing adults reported 58.7% adherence in the English version of the National Health Interview Survey (NHIS). Discussion: With the 43.7% adherence rate, the DDBHH community is lagging behind colorectal cancer screenings compared to the general population of hearing adults. Estimating the colorectal cancer screening rates among the DBHH community and understanding the reasons for these existing disparities is important to achieve screening adherence of 68.3%, the target set by the Healthy People 2030. Such research will aid the Center for Deaf Health Equity to actively work with the community to improve strategies to increase colorectal cancer screening. Citation Format: Regina M. Wang, Sowmya R. Rao, Erika J. Bergeron, Emmanuel C. Perrodin-Njoku, Poorna Kushalnagar. Colorectal cancer screening rates among deaf, deafblind, and hard of hearing adults aged 45 to 75 years old [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4786.

The relationship between social determinants of health and neurocognitive and mood-related symptoms in the primary brain tumor population: A systematic review.

Social determinants of health (SDOH) impact cancer-related health outcomes, including survival, but their impact on symptoms is less understood among the primary brain tumor (PBT) population. We conducted a systematic review to examine the relationships between SDOH and neurocognitive and mood-related symptoms among the PBT population. PubMed, EMBASE, and CINAHL were searched using PROGRESS criteria (place of residence, race/ethnicity, occupation, gender/sex, religion, education, socioeconomic status, and social capital) on March 8th, 2022. Two individuals screened and assessed study quality using the NHLBI Assessment Tool for Observational Cohort and Cross-sectional Studies. Of 3006 abstracts identified, 150 full-text articles were assessed, and 48 were included for a total sample of 28 454 study participants. Twenty-two studies examined 1 SDOH; none examined all 8. Four studies measured place of residence, 2 race/ethnicity, 13 occupation, 42 gender, 1 religion, 18 education, 4 socioeconomic status, and 15 social capital. Fifteen studies assessed neurocognitive and 37 mood-related symptoms. While higher education was associated with less neurocognitive symptoms, and among individuals with meningioma sustained unemployment after surgery was associated with depressive symptoms, results were otherwise disparate among SDOH and symptoms. Most studies were descriptive or exploratory, lacking comprehensive inclusion of SDOH. Standardizing SDOH collection, reducing bias, and recruiting diverse samples are recommended in future interventions.

Cancer-Related Fatigue and Its Influencing Factors Among Colorectal Cancer Patients: A Generalized Linear Modeling Approach.

This study aimed to improve cancer-related fatigue (CRF) and health outcomes of colorectal cancer patients by understanding the status quo of CRF, exploring the relations of coping, anxiety symptoms, depressive symptoms, body image perception and CRF, and also identifying the factors affecting CRF based on a generalized linear modeling approach. An exploratory cross-sectional study was conducted on 370 colorectal cancer patients at two hospitals in Anhui Province, China, from July 2020 to February 2021. The data were collected by using general information questionnaire, cancer fatigue scale, simplified coping style questionnaire, generalized anxiety disorder-7 scale, patient health questionnaire-9, and body image scale. Descriptive statistics, t-tests, one-way analysis of variance, Pearson correlation analyses, and generalized linear model analyses were applied to analyze the data. The average CRF score of the patients was 21.612 (SD=6.160), with a prevalence rate of 69.4% for clinically relevant fatigue. The generalized linear model revealed that: In step 1, gender (female) (B=1.799, Waldχ2=7.506, p=0.006), per capita monthly income (1001-3000 RMB) (B=-1.673, Waldχ2=5.536, p=0.019) and treatment modalities (chemotherapy+others) (B=2.425, Waldχ2=8.211, p=0.004) were related to CRF. In step 2, depressive symptoms (B=1.223, Waldχ2=129.019, p<0.001) and negative coping strategies (B=0.215, Waldχ2=11.347, p=0.001) exhibited significant positive correlations with CRF, positive coping strategies (B=-0.319, Waldχ2=59.175, p<0.001) showed significant negative correlations with CRF; While anxiety symptoms (B=0.162, Waldχ2=1.840, p=0.175) and body image perception (B=0.013, Waldχ2=0.048, p=0.826) had no correlations with CRF. The prevalence of CRF was relatively high among colorectal cancer patients. Coping and depressive symptoms were the modifiable influencing factors of CRF. Tailored interventions dedicated to promoting positive coping behavior, diminishing negative coping behavior and reducing depressive symptoms may improve the CRF of patients with colorectal cancer. Healthcare providers working with these patients should receive corresponding education and training in these complementary treatments. Additionally, when developing non-pharmacological interventions, appropriate consideration of the patients' gender, income condition and the type of anticancer treatment is also necessary.

Abstract A045: Adhering to a culturally responsive framework: Integrating kinship into a multilevel community-based intervention for American Indian adults with comorbid type 2 diabetes and cancer

Abstract The prolific disparities of type 2 diabetes (T2D) and cancer in tribal communities is well documented. American Indian (AI) adults living with T2D are at greater risk of not only developing cancer, but also dying from it, with cooccurrence becoming increasingly prevalent. On rural tribal reservations, common environmental diabetogenic factors (e.g., obesity, lack of physical activity, poor diet, and stress) are considered as sources of elevated risk for both T2D and cancer. Critically important in improving both diabetes and cancer-related health behaviors and outcomes, particularly for AI people, is psychosocial support from family and community ties (e.g., kinship). Despite supporting evidence, few interventions include kinship as a key factor to promote best outcomes for T2D management among AI adults with a dual diagnosis of cancer. To address this growing issue, there is an urgent need for culturally and contextually adapted interventions aiming to address the cooccurrence of T2D and cancer that are, ideally, led by tribal communities. In this session, healthcare professional Early-Stage Investigators (ESIs), some of whom also identify as AI, will present community-based participatory research (CBPR) principles used to develop a multilevel Tribally tailored intervention, with kinship as a moderating factor, for AI adults living with both T2D and cancer. The ESIs represent a unique pool of providers invested in the community within which they work by co-creating an intervention which utilizes pre-existing strong community and familial norms. The ESIs further look to break away from the common trend in research to overgeneralize interventions and findings to all AI Tribal communities by tailoring the intervention to each specific Tribal Community engaged in the research intervention. To foster innovative research methods by emphasizing important historic and socio-cultural influences relevant to understanding the holistic context of health disparities in tribal communities, the guiding framework is the NIMHD Minority Health and Health Disparities Research Framework adapted for AI and Alaska Native Nations. In this research, individuals are viewed within the context of the broader social system where they function daily, while families and community are key stakeholders and leaders in the successful management of T2D and cancer. The approach focuses on diabetes-related barriers by providing family and social units with skills for successful T2D and cancer management, healthy communication, and shared commitment. In addition to these domains of influence, involving community systems is critical for a sustainable intervention that effectively addresses health disparities for T2D and cancer. Citation Format: Sheila L. Hammer, Timian M. Godfrey. Adhering to a culturally responsive framework: Integrating kinship into a multilevel community-based intervention for American Indian adults with comorbid type 2 diabetes and cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A045.

Abstract B059: Food insecurity among Asian Americans: A scoping review and recommendations for policy and practice

Abstract Background: Food insecurity is a critical social determinant of health and is associated with deleterious cancer-related health outcomes. Adults in households with food insecurity are more likely to forgo cancer screenings; they have also been found to have higher risks of cancer. In addition, patients with cancer have high rates of food insecurity. However, little is known about experiences of food insecurity among Asian Americans, including their experiences of food insecurity that are related to cancer prevention or care. We conducted a scoping review on food insecurity and strategies to cope with food insecurity among individuals of Asian origins living in the U.S. Methods: In 2022, we searched peer-reviewed articles in MEDLINE, the Cochrane Library, Scopus, CINAHL, PsycINFO, and Google Scholar. Two authors screened each title and abstract of 900 records and the full text of 48 records. Thirty-five studies were selected and analyzed. Results: Among the 35 studies included in the review, 9 studies reported disaggregated data by Asian origin group for food insecurity prevalence. We observed great heterogeneity in reported prevalence. For example, food insecurity ranges 8.3%-41.1% for Filipinos, 13.1%-28.2% for Vietnamese, 6.6%-22.2% for Koreans, and 2.3%-11.2% for Japanese. Only eight studies included standardized data collection instruments in Asian languages. Seven studies noted collaboration with community partners. Lower acculturation, limited English proficiency, and higher social isolation were significantly associated with food insecurity. Supplemental Nutrition Assistance Program benefits were seen as inadequate to remediate food insecurity. Barriers to nutrition assistance program participation involved negative experiences with social workers, burdensome application process, and confusion surrounding the program. Notably, no study focuses on how food insecurity influences cancer prevention or cancer treatment among Asian Americans. Discussion: Our review found heterogenous food insecurity prevalence among Asian origin groups. We underscored a need for further research using disaggregated data by Asian origin group, employing multilingual data collection strategies, and involving community partners. Researchers should consider how social contexts and acculturation influences food insecurity. More research is needed on food insecurity as it relates to cancer prevention, screening, or management among Asian Americans. Future studies should investigate policy and interventions to ameliorate food insecurity and encourage nutrition program participation among Asian Americans living with food insecurity. Citation Format: Victoria Huynh, Nhat-Ha Pham, Suji Ro, Q. Eileen Wafford, Milkie Vu. Food insecurity among Asian Americans: A scoping review and recommendations for policy and practice [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B059.

The Impact of Medicaid Expansion on Patients with Cancer in the United States: A Review.

Since 2014, American states have had the option to expand their Medicaid programs as part of the Affordable Care Act (ACA), which was signed into law by former President Barack H. Obama in 2010. Emerging research has found that Medicaid expansion has had a significant impact on patients with cancer, who often face significant financial barriers to receiving the care they need. In this review, we aim to provide a comprehensive examination of the research conducted thus far on the impact of Medicaid expansion on patients with cancer. We begin with a discussion of the history of Medicaid expansion and the key features of the ACA that facilitated it. We then review the literature, analyzing studies that have investigated the impact of Medicaid expansion on cancer patients in terms of access to care, quality of care, and health outcomes. Our findings suggest that Medicaid expansion has had a positive impact on patients with cancer in a number of ways. Patients in expansion states are more likely to receive timely cancer screening and diagnoses, and are more likely to receive appropriate cancer-directed treatment. Additionally, Medicaid expansion has been associated with improvements in cancer-related health outcomes, including improved survival rates. However, limitations and gaps in the current research on the impact of Medicaid expansion on patients with cancer exist, including a lack of long-term data on health outcomes. Additionally, further research is needed to better understand the mechanisms through which Medicaid expansion impacts cancer care.

Abstract 3: Adapting a Tobacco Cessation Treatment Intervention and Implementation Strategies to Enhance Implementation Effectiveness and Clinical Outcomes in the Context of HIV Care in Viet Nam: A Case Study

Abstract Purpose: In Vietnam, tobacco use among men living with HIV/AIDS (PLWH) is substantially higher than among the general population. Tobacco use is responsible for significant disparities in cancer-related health outcomes among PLWH who smoke compared with nonsmokers. Despite the burden of disease, there is a lack of evidence for effective treatment for PLWH. We conducted a randomized-controlled trial comparing the effectiveness of three tobacco cessation interventions among PLWH receiving care in HIV outpatient clinics (OPCs). Methods: Patients identified as current cigarette and dual use smokers at the time of their visit (waterpipe and cigarettes) (n=288) were recruited and randomized into one of three interventions: 1) 3As (Ask about tobacco use, Advise to quit, Assist with brief counseling delivered by physicians)+R (proactively Refer to Vietnam’s National Smoker’s Quitline); 2) 3As+Counsel (6-session counseling intervention tailored to PLWH and delivered by trained nurses); and 3) 3As+Counsel+N (nicotine replacement therapy). The primary outcome is six-month carbon monoxide-confirmed smoking abstinence. We are also assessing hypothesized mediators (e.g., self-efficacy, social support). A formative assessment guided adaptation of the intervention to the local context and population. Results: Mean age was 42.4, 96% of patient were male, 8% live alone, 91% are employed, 53.8% were dual users, mean # cigarettes smoked per day was 15.9, and 21.9% reported drug use in the past 3 months. There were no differences across arms in baseline rates of clinical depression or substance use. At 3 months (n=211, those eligible to date), 45% in Arm 1 and 2, and 43.5% in Arm 3, reported smoking abstinence. Among those eligible and reached (98%) for the 6-month survey, 35.9%, 28.9% and 38.3% reported abstinence respectively. Six-month CO- confirmed quit rates were 15.1, 13.3 and 21.3% respectively. 91% of patient received at least one Quitline call and 94% completed 6 sessions of counseling. Discussion: Results are promising and indicate that smoking cessation interventions adapted for PLWH and delivered by health care providers as part of routine care can be effective. The study is the first to demonstrate the feasibility of integrating a Quitline referral system in the context of HIV care. Therefore, the similar outcome across arms has important policy implications; the Quitline is a sustainable resource requiring fewer OPC resources than more intensive counseling. Citation Format: Donna Shelley, Mari Armstrong-Hough, Lloyd Goldsamt, Gloria Guevera Alvarez, Trang Nguyen, Nam Nguyen. Adapting a Tobacco Cessation Treatment Intervention and Implementation Strategies to Enhance Implementation Effectiveness and Clinical Outcomes in the Context of HIV Care in Viet Nam: A Case Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 3.

Red/processed meat consumption and non-cancer-related outcomes in humans: umbrella review.

The associations of red/processed meat consumption and cancer-related health outcomes have been well discussed. The umbrella review aimed to summarise the associations of red/processed meat consumption and various non-cancer-related outcomes in humans. We systematically searched the systematic reviews and meta-analyses of associations between red/processed meat intake and health outcomes from PubMed, Embase, Web of Science and the Cochrane Library databases. The umbrella review has been registered in PROSPERO (CRD 42021218568). A total of 40 meta-analyses were included. High consumption of red meat, particularly processed meat, was associated with a higher risk of all-cause mortality, CVD and metabolic outcomes. Dose-response analysis revealed that an additional 100 g/d red meat intake was positively associated with a 17 % increased risk of type 2 diabetes mellitus (T2DM), 15 % increased risk of CHD, 14 % of hypertension and 12 % of stroke. The highest dose-response/50 g increase in processed meat consumption at 95 % confident levels was 1·37, 95 % CI (1·22, 1·55) for T2DM, 1·27, 95 % CI (1·09, 1·49) for CHD, 1·17, 95 % CI (1·02, 1·34) for stroke, 1·15, 95 % CI (1·11, 1·19) for all-cause mortality and 1·08, 95 % CI (1·02, 1·14) for heart failure. In addition, red/processed meat intake was associated with several other health-related outcomes. Red and processed meat consumption seems to be more harmful than beneficial to human health in this umbrella review. It is necessary to take the impacts of red/processed meat consumption on non-cancer-related outcomes into consideration when developing new dietary guidelines, which will be of great public health importance. However, more additional randomised controlled trials are warranted to clarify the causality.

Effectiveness of psychosocial interventions on health outcomes of children with cancer: A systematic review of randomised controlled trials

Nowadays, there is promising evidence that psychosocial interventions could be helpful in paediatric oncology. Thus, this review aimed to describe the impact of psychosocial interventions on cancer-related health outcomes in children. Fifteen English electronic databases were searched from October to December 2020. Only randomised controlled trials that (1) included children ≤18 years old diagnosed with cancer, (2) evaluated the effects of psychosocial interventions, and (3) reported health outcomes including quality of life, anxiety, depression, stress, distress, self-esteem, psychological adjustment, treatment adherence, pain, fatigue, and academic performance were included. Ten RCTs were included in this review. Six types of psychosocial interventions (social skill training, music-based intervention, therapeutic play, cognitive therapy, wish intervention, and art therapy) were identified. The studies were assessed as having low to high risk of bias. Nine of the studies reported significant improvement in at least one outcome measure. But quantifying the pooled effect was not applicable due to the heterogeneity of interventions. Psychosocial interventions could be beneficial in paediatric oncology. Yet, the outcomes were reported in heterogeneous types of interventions and participants. The results underscore the need to conduct further studies that include participants with specific cancer diagnoses and types of interventions.

SY02-3 Expectations of home-based exercise research for enhancing cancer survivorship care

Exercise guidelines for cancer survivors issued by multiple international organizations (Campbell KL et al, 2019) updated the recommendations that aerobic, combined aerobic plus resistance training, and/or resistance training could improve common cancer-related health outcomes (eg, anxiety, depression, fatigue, physical function, and health-related quality of life). Despite these guidelines, the majority of cancer survivors are not regularly physically active. A lack of awareness regarding available effective program to help facilitate exercise in cancer survivors was suggested to be a one of barriers to clinicians referring them to exercise.

Incorporating Participatory Approaches and Implementation Science Toward an Integrated Research Paradigm to Promote Equity in Cancer Prevention and Control Research for Sexual and Gender Diverse Populations

Multiple, complex factors contribute to cancer disparities for sexual and gender diverse (SGD) individuals, including a high prevalence of behavioral risk factors (e.g., smoking, alcohol consumption, and obesity), higher exposure to sexually transmitted infectious agents (e.g., human immunodeficiency and human papilloma viruses), and low utilization of preventive services including vaccination and cancer screening. While ongoing research focuses on documenting these disparities, few studies have produced interventions to address these disparities and promote equity. Moreover, existing research does not always translate to real-world clinical and/or community practice to achieve meaningful and sustainable improvements in cancer-related health outcomes for SGD populations. In this paper, we propose an integrated research paradigm that incorporates Community Based Participatory Research (CBPR) approaches and Implementation Science (IS) to ensure that we develop interventions that truly benefit SGD communities along the cancer care continuum. Using two ongoing research programs as examples, we demonstrate how participatory approaches and existing implementation frameworks are particularly appropriate for working with medically underserved SGD populations. We discuss ways in which such a research paradigm could lead to informed, actionable, and achievable outcomes for researchers, practitioners, and SGD communities. Combined with resources and training opportunities highlighted in this paper, we call on investigators to employ CBPR approaches and IS to make a shift from research that operates in silos and simply focuses on identifying disparities to one that synergistically promotes and sustains health equity by engaging stakeholders across the research to practice and cancer care continuums.

Breast Cancer Information Behaviours and Needs among Singapore Women: A Qualitative Study.

Background:There is growing evidence on cancer communication and its impact on cancer-related health outcomes; however, little is known about how women gain access to and use breast cancer information in the multi-ethnic Asian context. This paper aimed to explore the breast cancer information acquisition behaviours and needs among Singapore women who attended a community-based health organisation for mammography screening. Methods, design and setting:Qualitative data were collected through semi-structured interviews with 37 racially diverse, aged 50 and above women, who have received mammography screening within the past two years. The interviews were conducted at either the Singapore Cancer Society Clinic or participant’s home. Results:Although cancer information scanning was more prevalent than information seeking (91.9% vs. 62.2%), those who purposively seek information exhibited a higher knowledge level of breast cancer. The most commonly cited sources for information scanning were friends, television and family, and for information seeking were the Internet, pamphlets from a healthcare organisation/ public authority, and healthcare providers. Singapore women were well-informed about the benefits of mammogram; however, specific knowledge, such as modifiable risk factors, reasons for different screening options and the trade-off between harm and benefit, was still lacking which led to confusion about screening.Conclusion:Breast cancer health educational materials should provide clear and balanced information to give women a more accurate or realistic expectation about mammography screening. Study findings provide important implications for breast cancer education and programs to move beyond simply raising awareness and craft specific informative messages addressing the needs of the target group.

Exercise efficacy and prescription during treatment for pancreatic ductal adenocarcinoma: a systematic review

BackgroundSurgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population.MethodsA systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study.ResultsTwelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating.ConclusionsHigh quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.

Tackling the cancer burden: the economic impact of primary prevention policies.

Cancer is a noncommunicable disease (NCD) with increasing incidence and therefore constitutes a major public health issue. To reduce the health and economic burden of cancer, policy-makers across the world have implemented a range of preventative interventions targeting risk factors with a known link to the disease. In this article, we examine the impact of six primary prevention interventions - related to physical inactivity, unhealthy diet or harmful alcohol use - on cancer-related health outcomes and healthcare expenditure. Here, we used the OECD Strategic Public Health Planning for NCDs (SPHeP-NCDs) model to quantify outcomes and costs for each intervention for years 2020-2050 across 37 countries. Results from the model indicate that all interventions could lead to a reduction in the number of new cancer cases, in particular those targeting harmful alcohol consumption. Introducing an alcohol tax, for instance, is estimated to reduce related cancer cases by 5619 a year or 174193 by 2050. A breakdown of results by type of cancer revealed interventions had the largest impact on colorectal cancer with, on average, 41140 cases avoided per intervention by 2050. In proportional terms, interventions had the greatest impact on new oesophageal and liver cancers. Findings from this article are designed to assist decision-makers efficiently allocate limited resources to meet public health objectives.

Current Evidence on Traditional Chinese Exercise for Cancers: A Systematic Review of Randomized Controlled Trials.

Traditional Chinese exercise (TCE) has gradually become one of the widespread complementary therapies for treatment and recovery of cancers. However, evidence based on the systematic evaluation of its efficacy is lacking, and there appears to be no conclusion regarding the setting of TCE interventions. The purpose of this systematic review is to summarize the current randomized controlled trials (RCTs) that outline the effects of TCE on cancer patients. Relevant studies were searched by GOOGLE SCHOLAR, SCIENCEDIRECT, and WEB OF SCIENCE using “traditional Chinese exercise” and “cancer.” Only RCTs published in peer-reviewed English journals were included. A total of 27 studies covering 1616 cancer patients satisfied the eligibility criteria for this review. Despite the methodological limitation and relatively high risk of bias possessed by some included studies, positive evidence was still detected on the effects of TCE on these cancer-related health outcomes in physical, psychological, and physiological parameters. The 60-min or 90-min course of TCE intervention for two to three times per week for 10 to 12 weeks was found to be the most common setting in these studies and has effectively benefited cancer patients. These findings add scientific support to encourage cancer patients to practice TCE during or after conventional medical treatment. Nevertheless, future well-designed RCTs with improved methodology and larger sample size on this field are much warranted for further verification.

Abstract B042: Identifying effective interventions using community-based participatory practices to improve cancer-related health outcomes in a high-risk population

Abstract Persons Living with HIV/AIDS (PLWHA) have an increased life expectancy when they adhere to highly active antiretroviral treatment (HAART). At the same time, ~25% of AIDS related deaths are due to non-HIV related comorbidities including cardiovascular disease, atherosclerosis, and hypertension. In the aging PLWHA population on HAART, an increasing risk for multiple cancers is clear and the cancers are more aggressive and advanced compared with an age-matched population. In addition to the liver cancer related to Hepatitis B and C, genital cancers related to human papillomavirus (HPV), increases in non-immune cancers including lung and melanoma cancers are the leading causes of death in PLWHA. Evidence has shown that community-based participatory approaches can be used to improve health outcomes in many populations. In this study, we focus on interventions for at-risk African-American, HIV positive, Men having Sex with Men (MSM) population. Typical community-based participatory activities include cancer-related awareness, prevention, diagnosis, and treatment. We plan to utilize partnerships with community-based AIDS service organizations (ASO), community leaders, and local community state-representatives. Preliminary data shows that partnering with city-wide programming initiatives such as Black Gay Pride, Philly Pride Present and National Coming-Out Week will ensure community participation, leadership and engagement among the community. Currently, there is little research on how best to reach the Black or Hispanic PLWHA community. This project will investigate the socio-political-economic factors impacting these populations and the interventions that will increase engagement with healthcare educators and providers. Furthermore, knowledge from the PLWHA will help devise preventative approaches for reducing and addressing cancer risks. Citation Format: Tyrell T Mann-Barnes, Grace X Ma. Identifying effective interventions using community-based participatory practices to improve cancer-related health outcomes in a high-risk population [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B042.

Exploring the causes of chronic cancer pain and possible remedies.

Exploring the causes of chronic cancer pain and possible remedies.

A primer for cancer research programs on defining and evaluating the catchment area and evaluating minority clinical trials recruitment.

National Cancer Institute (NCI) designated cancer centers are charged with reducing disparities, improving cancer-related health outcomes, and increasing clinical trial participation for the catchment area population. Succeeding in this endeavor requires a clear definition of each cancer center's geographic catchment area as well as the demographic characteristics of the populations residing in the catchment area. For this reason, the definition of the catchment area is now a required element of NCI grant applications. This primer provides detailed information related to the definition of cancer centers' catchment areas and provides a case example from the University of Texas MD Anderson Cancer Center to highlight best practice strategies for compiling and interpreting cancer health statistics for the catchment area.