Prevalence Of Cancer Screening Research Articles

Far behind 90-70-90’s screening target: the prevalence and determinants of cervical cancer screening among Sub-Saharan African women: evidence from Demographic and Health Survey

BackgroundCervical cancer screening is the primary goal in 90-70-90 targets to reduce cervical cancer incidence and mortality by identifying and treating women with precancerous lesions. Although several studies have been conducted in Sub-Saharan African (SSA) countries on cervical cancer screening, their coverage was limited to the regional or national level, and/or did not address individual- and community-level determinants, with existing evidence gaps to the wider SSA region using the most recent data. Hence, this study aimed to assess the pooled prevalence and multilevel correlates of cervical cancer screening among women with SSA.MethodsThis study was conducted using the Demographic Health Survey data (2015–2022) from 11 countries, and a total weighted sample of 124,787 women was considered in the analysis. Using multilevel mixed-effects logistic regression, the influence of each factor on cervical cancer screening uptake was investigated, and significant predictors were reported using the adjusted odds ratio (aOR) with their respective 95% confidence intervals (95% CI).ResultsThe overall weighted prevalence of cervical cancer screening was 10.29 (95% CI: 7.77, 11.26), with the highest and lowest screening rates detected in Namibia and Benin at 39.3% (95% CI: 38.05, 40.54) and 0.5% (95% CI: 0.36, 0.69), respectively. Higher cervical screening uptake was observed among women aged 35–49 [aOR = 4.11; 95% CI: 3.69, 4.58] compared to 15–24 years, attending higher education [aOR = 2.71; 95% CI: 2.35, 3.23] than no formal education, being in the richest wealth quintile [aOR = 1.45; 95% CI: 1.26, 1.67], having a recent visit to a health facility [aOR = 1.83; 95% CI: 1.71, 1.95], using contraception [aOR = 1.54; 95% CI: 1.45, 1.64], recent sexual activity [aOR = 3.59; 95% CI: 2.97, 4.34], and listening to the radio [aOR = 1.78; 95%CI: 1.60, 2.15].ConclusionThe overall prevalence of cervical cancer screening in SSA countries was found to be low; only one in every ten women has been screened. Strengthening universal health coverage, and promoting screening programs with an emphasis on rural areas and low socioeconomic status are key to improving screening rates and equity. Additionally, integrating cervical cancer screening with existing reproductive health programs, e.g. contraceptive service would be important.

Proportion trends, cancer stage, and survival of patients with cancer diagnosed through emergency and nonemergency departments: a nationwide cohort study.

To reduce mortality, the Taiwan government has vigorously promoted free cancer screening and preventive health screening services. Cancers are usually advanced by the time they are discovered in the emergency department. Through this study, we aimed to understand the characteristics of cancer patients diagnosed through the emergency department and thus identify high-risk populations by comparing cancer staging and survival rates in patients diagnosed in the emergency department and those diagnosed in the non-emergency department. The retrospective study enrolled a total of 389,043 patients over the age of 20 who were newly diagnosed with one of the five major cancers (including lung cancer, colorectal cancer, breast cancer, prostate cancer, and oral cancer) between 2008 and 2017 and analyzed their diagnostic pathway, cancer stage at diagnosis, and survival time. Of the study participants, 59,423 patients (about 15.3%) were diagnosed with cancer through the emergency department. We found that a sizable proportion of older people and patients with low education and low incomes were diagnosed through emergency department visits, and those with a health condition comorbidity severity of 3 had the highest proportion diagnosed by the emergency department, advanced stages at diagnosis, and risk of death. These can be classified as high-risk groups. In addition, 76.4% of patients diagnosed in the emergency department had advanced cancer, and the risk of death was 1.46 times higher than that of patients diagnosed in the non-emergency department. Although cancer screening is available, it does not reduce the proportion of patients with advanced cancer who are diagnosed through or at the time of diagnosis in the emergency department. The present study found that the government's cancer screening did not affect the proportion or number of cancers diagnosed through emergency department visits. Therefore, the government should focus on more cancer screening, health education in high-risk groups, and strengthening the link between emergency and oncology departments to reduce the risk of death for patients diagnosed through emergency department visits.

Exploring Cancer Incidence Trends by Age and Sex Among 14.14 Million Individuals in China From 2007 to 2021: Population-Based Study.

Sex is a crucial factor in the development, progression, and treatment of cancer, making it vital to examine cancer incidence trends by sex for effective prevention strategies. This study aimed to assess the incidence of cancer in China between 2007 and 2021, with a focus on sex-based trends. A population-based cancer registry comprising 14.14 million individuals was maintained between 2007 and 2021 by the Beijing Municipal Health Big Data and Policy Research Center. The age-standardized rates (ASRs) of cancers were calculated using the Segi population. The average annual percentage of change (AAPC) was evaluated using the joinpoint regression model, while the Bayesian age-period-cohort model was used to predict cancer incidence in the next 10 years. From 2007 to 2021, the study included 651,342 incident patients with cancer, of whom 51.2% (n=333,577) were women. The incidence indicated by the ASR for all cancers combined was 200.8 per 100,000 for women and 184.4 per 100,000 for men. The increase in incidence indicated by AAPC for all malignancies combined significantly increased in women between 2007 and 2021 (AAPC=3.1%; P<.001), whereas it remained constant in men (AAPC=0.3%; P=.30). Although the overall incidence of all cancers indicated by AAPC increased in young men (AAPC=3.2%; P=.01), the greatest increase was observed among young women (AAPC=6.1%; P<.001). The incidence rate ratio for cancer in women increased among subsequent younger generations compared with patients born in the 1962-1966 cohort. The ASR in women will increase 1.6-fold over the next 10 years, with women having twice the incidence rate of men by 2031. The rising incidence of cancer among women in China has become a growing concern, emphasizing the need for increased efforts in cancer prevention and early screening, especially among young women.

Experiences of a group of indigenous women from the Colombian Amazon with cervical cancer prevention screening. Qualitative study in the context of participatory research to reduce inequalities

ABSTRACT Objectives Despite cervical cancer (CC) being a preventable disease, its incidence remains high in marginalized communities due to inequalities that restrict access to health services. This article investigates the experiences, perceptions, and attitudes regarding the screening of indigenous women in a region of the Colombian Amazon during a cervical cancer prevention initiative facilitated by community participation. Design Qualitative study based on interviews conducted with women and indigenous leaders from Paujil reserve. They participated in research focused on cervical cancer prevention, which employed a methodology of collaboration between academia and communities aimed at enhancing women’s health and reducing inequalities in access to healthcare services. The analysis utilized a deductive and inductive approach. Results Five main themes were addressed: ‘Barriers within health services’; ‘Individual and cultural constraints’; ‘Motivations and facilitators’; ‘Positive experiences within the research framework’; and ‘Suggestions for encouraging women's participation.’ Challenges related to appointment scheduling and result delivery were frequently cited as obstacles to access. Misinformation, feelings of shame, fear, and distrust towards health services played significant roles in the reluctance to undergo screening. Factors such as support from family and community networks, respectful treatment, ease of scheduling appointments, the presence of female healthcare professionals, and involvement of leaders fluent in indigenous languages were identified as positive facilitators of screening acceptance. Conclusion Understanding the factors that influence access to screening is crucial for reducing inequalities in service delivery for indigenous women. The involvement of trained leaders who can identify these factors and motivate women can have a positive impact on the acceptance and guidance of cervical cancer prevention programs.

National Trends in PSA Cancer Screening With Parallel Investigation of Colorectal Cancer Screening: An Analysis of the CDC Behavioral Risk Factor Surveillance System From 2012 to 2022

Introduction/BackgroundFrom 2012 to 2022 there have been numerous revisions in the United States Preventative Task Force guidelines for prostate cancer screening, including advising against PSA testing to allowing shared-decision making for men aged 55 to 69. We sought to observe trends in PSA testing rates in relation to the changing guidelines. Conversely, colorectal cancer screening recommendations remained consistent for patients aged 50-75 and we sought to use this as a comparison to observe the effect of differing guidelines. MethodsThe Centers for Disease Control Behavioral Risk Factor Surveillance System is a national database of surveys on health-related behaviors and preventive medical services. We extracted responses from 2012 to 2022 regarding both prostate and colorectal cancer screening. Our primary variable of interest was prostate cancer screening while colorectal cancer screening served as a positive control. ResultsProstate cancer screening decreased among respondents from 70.1% in 2012 to 59.7% in 2022. However, there was a significant rebound in prostate cancer screening prevalence in 2022. In contrast, colorectal cancer screening rates steadily increased from 70.7% in 2012 to 78% in 2022. The annual percentage of men who had received prostate cancer screening was statistically different year to year. ConclusionsTrends in the rate of screening for prostate and colorectal cancer appeared to adapt to the updated recommendations. However, further investigation regarding lower income levels, minority groups, and uninsured men are essential to address the social and racial disparities seen in prostate cancer screening. Efforts to promote shared-decision making may improve effective cancer screening.

From Insights to Impact: Understanding Cancer Screening Choices through Mixed-Methods.

The main objective of this comprehensive mixed-methods investigation conducted in Jordan were to explore and understand men's engagement in cancer screening. The research employed a mixed-methods approach, combining a survey with 209 participants and focus group interviews with 30 individuals. The survey involved quantitative data collection methods to gather information on cancer screening participation rates among men in Amman. Focus group interviews were conducted to collect qualitative data on the factors influencing cancer screening utilization among men in Amman. The study revealed a notably low participation rate, with less than 37% of men engaging in cancer screening. The diminished involvement was attributed to several factors, including health illiteracy, language barriers, restricted access to health-related information and screening services, and cultural considerations. Based on the findings, the research strongly advocates for tailored interventions that are culturally specific. The emphasis is on the importance of training community health workers to address the identified challenges and enhance both cancer prevention awareness and screening accessibility in Jordan.

Online cancer information seeking and colorectal cancer screening in China: Considering threat and coping appraisals, and cancer fatalism

BackgroundColorectal cancer is major public health concern in China. This study seeks to explore the role of online cancer information seeking in influencing colorectal cancer screening, by taking into account one’s coping appraisals (i.e., self-efficacy, response efficacy), threat appraisals (i.e., perceived severity, cancer worry) and cancer fatalism. MethodsA cross-sectional survey was conducted with 730 participants in China recruited from a Chinese survey company’s online panels. Path analysis was performed to investigate the relationships between the key constructs. ResultsFirst, online cancer information seeking increased both coping appraisals and threat appraisals. Second, threat appraisal did not significantly influence cancer fatalism, but coping appraisal reduced cancer fatalism. Third, cancer fatalism had no effects on colorectal cancer screening. Lastly, online cancer information also had a direct and positive relationship with cancer screening. ConclusionsThis research emphasises the need for health organisations to offer timely cancer information to people, and educate them about the importance of cancer screening. Health authorities may also regulate online cancer information to ensure that the information is accurate and appropriate in improving people’s cancer prevention and cancer screening knowledge.

Assessing the rates of false-positive ovarian cancer screenings and surgical interventions associated with screening tools: a systematic review

ObjectiveEarly detection of ovarian cancer can improve patient outcomes; however, screening tests can yield false-positive results, leading to unnecessary surgical interventions. This systematic review explores the prevalence of false-positive ovarian...

Demand-side barriers and economic burden in accessing Human Papillomavirus screening for cervical cancer prevention in rural India: Evidence from a cross-sectional study

Introduction Cervical cancer is a significant global health concern, especially in low- and middle-income countries with limited access to preventive healthcare. India’s vast rural population amplifies the challenge, demanding immediate action. Despite advancements, cervical cancer remains prevalent among underserved rural communities, hindered by barriers to Human Papillomavirus (HPV) screening uptake, including socioeconomic and financial constraints. This study aims to evaluate the economic challenges encountered by rural women when accessing HPV screening. Methods A cross-sectional survey was conducted among 1502 women aged 30 to 45 in Pondicherry, India, utilizing the Andersen Model as a conceptual framework. Household questionnaires gathered data on HPV screening expenses, including patient travel costs, productivity loss, and companion costs. The analysis utilized regression models, to identify the factors impacting the economic challenges associated with accessing HPV screening. Results Employment status and higher education significantly increase total costs by 73.483 (p &lt; 0.001) and 90.169 units (p &lt; 0.001) respectively. Income level, though with a minimal coefficient (B = 0.000), shows a significant effect (p = 0.019) on total costs. Longer travel hours raise costs by 5.129 units (p &lt; 0.001), while having a companion increases costs by 106.095 units (p = 0.004). Prolonged patient time at Primary Health Center (PHC) contributes to a 2.357-unit increase in costs (p &lt; 0.001). Conclusions The study highlights the multifaceted economic challenges faced by rural populations accessing HPV screening for cervical cancer prevention in India. Notwithstanding diverse demographics and varying proximity to healthcare facilities, individuals encounter significant barriers such as travel time and associated costs. Addressing these challenges necessitates targeted interventions to reduce socioeconomic disparities and improve healthcare accessibility for vulnerable populations, thereby advancing cervical cancer prevention efforts and promoting health equity in rural communities.

Prevalence and risk factors associated with precancerous and cancerous cervical lesions among HIV-infected women in University of Gondar specialized comprehensive referral hospital, Northwest Ethiopia: cross-sectional study design

BackgroundCervical cancer is one of the leading causes of death in women worldwide. The majority of the cases are found in developing countries. The increasing risk of cervical cancer prevalence and growing danger of death from cervical cancer and the high occurrence of human papillomavirus (HPV) infection in women who are HIV positive give us the ground to study the prevalence and associated risk factors.ObjectiveThe study aims to assess the prevalence of cervical cancer screening and associated risk factors among HIV-positive women attending the Adult ART clinic at the University of Gondar Hospital.MethodsAn institution-based cross-sectional study was conducted from March to August 2021, on adult HIV-positive women attending the Adult ART clinic at Gondar University Referral Hospital by phone calling patients per week for six months to complete a total of 2744 HIV-positive patients who were not screened for cervical cancer before. The data were collected using an interviewer-administered questionnaire. Bivariate and multivariable logistic regression analyses were used to determine the presence and the degree of association between dependent and independent variables. In the multivariable logistic analysis, a P-value of < 0.05 and odds ratio with a 95% confidence interval were considered to determine independent predictors for the prevalence of premalignant or malignant cervical lesions among HIV-positive patients.ResultThis study assessed 915 HIV Positive women who were screened for cervical cancer via visual inspection with acetic acid (VIA) as the primary screening tool and found that 24.48% had positive VIA results. Those with VIA-positive cases pathology examination showed 72.4% had abnormal pathology reports (CIN 1/2/3–51.25%, 17.23% cancer & 3.9% CIS), strengthening the finding in many studies that suggest HIV-positive women have a high rate of premalignant lesions.

Disparities uncovered: LGBTQ+ patients report on their cancer care journey.

1516 Background : In the U.S, LGBTQ+ people face higher cancer rates and worse outcomes than the general population. Few studies have described the experiences of LGBTQ+ people and their caregivers during treatment. As part of an implementation science initiative aimed at improving care for LGBTQ+ patients, we conducted a large survey (n=817) to understand treatment experiences of this population. Here we report our findings which provide insight into how stigma and incorrect assumptions may contribute to medical mistrust and worse experiences. Methods: In 2023, 817 diverse LGBTQ+ cancer patients from academic and community-based settings, as well as patient advocacy groups, completed web-based surveys evaluating their care experiences during cancer treatment. Participants included patients with gastric (n=165), breast (n=238), ovarian (n=218), prostate (n=56), and colorectal cancers (n=140), including 83 gender non-conforming patients. Results: Most LGBTQ+ patients (80%) reported not receiving appropriate preventative cancer screening, with top barriers including provider did not mention cancer screening tests (40%) and did not have a healthcare provider (28%). Additionally, only 24% felt at least moderately comfortable disclosing their LGBTQ+ status. Inclusive measures that helped patients feel most comfortable included care teams sharing/displaying their own pronouns (39%), making public statements of support (43%), or wearing personal items indicating acceptance (39%). Of those who did disclose their identity, only 50% of gender-expansive patients reported consistently being referred to by the correct names and pronouns. Importantly, patients reported that only 34% of their partners/caregivers felt welcome at appointments, and only 4% felt respected by the care team. Few patients reported receiving key supportive care services, including counseling/support groups (23%), quality-of-life related care, such as sexual function counseling (23%), and LGBTQ-specific resources/education (19%). Furthermore, less than half of LGBTQ+ patients discussed with HCPs how cancer treatment affects fertility (41%), fertility preferences (26%), or fertility preservation (14%), even though only 22% of patients reported not being eligible for fertility services. Interestingly, many of these gaps in care differed based on cancer type. For example, prostate, colorectal, and gastric patients were more likely to report not feeling safe disclosing their LGBTQ+ status (80%, 69%, and 54% respectively), while breast cancer patients were more likely to report having discussed fertility prior to starting treatment (64%). Conclusions: This study offers insights into experiences of LGBTQ+ patients and confirms disparities in care are real and pervasive. Ongoing education and inclusion efforts can help create a safe and welcoming environment, enabling equitable care and improved outcomes.

Cancer screening in sexual and gender minority populations: A systematic review and meta-analysis.

10540 Background: The sexual and gender minority (SGM) populations experience a greater cancer burden than their heterosexual or cisgender counterparts. Screening rates for cancer within this cohort are frequently suboptimal, highlighting notable deficiencies in screening recommendations. Inadequate culturally competent care and screening guidelines may contribute to delays in cancer diagnosis and treatment, ultimately impacting survival and quality of life. We sought to investigate the existing disparities in cancer screening among SGM populations. Methods: We conducted a systematic review and meta-analysis to assess the cancer screening rates in SGM. The SGM population included in this study were gays, lesbians, bisexuals, transgender men, and transgender women. Two reviewers conducted a systematic search of numerous databases, including PubMed, PsycINFO, and CINAHL, and then extracted relevant information from eligible studies. For this study, we conducted a meta-analysis using a random-effects model. Pooled estimates of the odds ratio were calculated for any combination of outcomes and population when at least two studies had relevant data. Study heterogeneity was assessed using I² statistics. Meta-regression, accounting for the study weight, year, and latitude, was performed on variables potentially associated with heterogeneity. Newcastle-Ottawa Scale was used to assess the quality of selected studies. Results: We analyzed data from a total of 60 eligible studies with 65,315 patients. Pooled analysis showed that sexual minority groups were at lower risk for cancer screening such as breast cancer screening (OR: 0.79, 95% CI, 0.75-0.82; Chi2=835.23; p&lt;0.001; I2=97%), cervical cancer screening (OR: 0.62, 95% CI, 0.56-0.72; Chi2=926.23; p&lt;0.001; I2=96%), colorectal cancer screening (OR: 0.51, 95% CI, 0.45-0.61; Chi2=3272.21; p&lt;0.001; I2=98%), and prostate cancer screening (OR: 0.71, 95% CI, 0.63-0.82; Chi2=1282.92; p&lt;0.001; I2=99%). The prevalence of lung cancer (p&lt;0.001) and anal cancer screening (p&lt;0.001) were also lower in sexual minority groups. The analysis also showed no small study effects (Egger test: 1.33; 95% CI: −5.42, −0.63; p=0.182). All the subgroups (geographical location, screening procedure, screening period) had high between-study heterogeneity. Conclusions: Our findings indicate that cancer screening rates for breast, cervical, colorectal, prostate, lung, and anal cell cancer are significantly lower in SGM populations and emphasize the urgent need for targeted interventions, culturally competent care, and inclusive screening guidelines to address these disparities. Understanding and addressing these issues are crucial for reducing delays in cancer diagnosis and improving survival and quality of life for SGM population. Further research and comprehensive strategies are warranted to bridge these gaps in cancer screening accessibility and uptake.

Oral Cancer Risk and Screening Prevalence Among Hospitalized Women.

Background Oral cancer screenings are often on the back burner in the face of other cancer screenings. In high-risk individuals, early detection of oral cancer has a better prognosis and survival. Hospitalization may offer an opportunity to target high-risk populations. This study evaluates the prevalence of women at high risk for oral cancer among hospitalized women and their preference for oral cancer screening. Design and participants Five hundred and ten cancer-free women admitted to the hospital under the internal medicine service at an academic center were enrolled to participate in the study. Three hundred and seventy women were at high risk for developing oral cancer, defined by smoking status, alcohol use, or both. High-risk women received bedside smoking cessation counseling and oral cancer informational handouts and were offered oral screening examinations during hospitalization. Six months after discharge, study participants received a follow-up phone call to determine if these women discussed oral cancer screening with their primary care physicians at the follow-up visit. Results Seventy-three percent of the hospitalized women were at high risk for developing oral cancer. Fifty-seven percent of high-risk women reported having no primary dentist. High-risk women were more likely to be younger, reported a disability, and had a lower comorbidity burden than the average-risk group. Only 41% of high-risk hospitalized women received oral cancer screening examinations during the hospital stay. Post-hospitalization, 66% of high-risk patients discussed oral cancer screening with their primary care. Conclusion Almost three-fourths of hospitalized women are at high risk for developing oral cancer. Hospitalization provides an opportunity to educate and screen high-risk populations.

Prevalence and trends of cervical cancer screening among women in Fiji from 2014 to 2018

IntroductionCervical cancer is the third most common cancer in women both in developed and developing countries. This study aimed to determine the prevalence of cervical cancer and the trends of cervical cancer screening among women who had cervical cancer screening in Suva, Fiji between 2014 and 2018. Materials and methodThis study applied a 5-year retrospective electronic chart review of data from all women attending the Women's Wellness Clinic (WWC) in Suva, Fiji. The women who were selected for this study and screened for cervical cancer were Fijian citizens above 18 years of age and were registered in 2014–2018. A data collection form was used to collect data. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 24; p <0.05 % was considered as the level of significance. ResultsAmong the 39,579 women who attended WWC for other family planning services, 12,074 women screened for cervical cancer with a prevalence of 30.5 %. The overall mean age for women screened for cervical cancer was 37.6 (SD ± 11.2). Two-thirds (76.4 %) of the women screened for cervical cancer were less than 46 years of age and 53.9 % were I-taukei. The number of women who came for Pap smear increased in 2015, however, a slight decline was observed in 2016 which was later improved to 35.1 % in 2018. Malignancy was more common in the age range of 42–49 respectively. In this study, women of 46 years and above had an OR of 0.51 (95 % CI: 0.36, 0.72), other ethnicity OR was 1.73 (95 % CI: 1.27, 2.35), and the Muslim religion OR recorded was 1.44 (95 % CI: 1.03, 2.01) which was comparatively considered a high-risk group. Women who are widowed 1.57 (95 % CI: 0.798, 3.11), single 1.29 (95 % CI: 0.87, 1.92) or divorced 1.08 (95 % CI: 0.59, 1.99), employed 1.01 (95 % CI: 0.83, 1.24) and are living in rural areas 1.19 (95 % CI: 0.82, 1.73) are also associated with higher odds of having abnormal results. ConclusionCervical cancer is listed as the first and most common type of cancer in women which is noticeably increasing in Fiji. Even though cervical cancer screening has improved over the years, adequate surveillance systems and ongoing programs should be designed and implemented to increase awareness and monitor the trend of cervical cancer screening in order to reduce cervical cancer prevalence and mortality rates.

Social Media Campaigns: A Game Changer for the Prevention of Breast Cancer in Romania.

Social media can be used to raise awareness about health issues, especially concerning the importance of periodical screening. The present study aims to identify the role of social media awareness campaigns in the early detection of breast cancer, with a focus on Romania, a country with a high female mortality due to this disease. The research is performed using a survey, based on an online questionnaire, which was self-administered by the respondents included in two samples selected from a Facebook community of Romanian women. Sample A was composed of 1945 women who were not exposed to periodic campaigns regarding the importance of screening for the prevention and early detection of this type of disease, and Sample B was composed of 289 women who were exposed to such annual campaigns within the last 5 years. The results outline several differences among respondents from the two samples regarding their awareness of prevention necessity, as well as the frequency and chosen methods for breast cancer screening. The findings hold important implications for public authorities, which must intensify their efforts in raising women's awareness regarding the importance of screening for the early detection and prevention of breast cancer.

Cancer Screening and Prevention in the Transgender and Gender Diverse Population: Considerations and Strategies for Advanced Practice Nurses

ObjectivesThis discussion paper presents recent evidence regarding cancer screening and prevention among the transgender and gender diverse (TGD) community and highlights where and how advanced practice nurses (APNs), particularly those in primary care, can better contribute to closing the gap between healthcare disparities between TGD and cisgendered populations. MethodsRelevant publications on the topic and professional guidelines and evidence have formed the basis for this discussion paper. ResultsTGD individuals are a vulnerable population with unique needs. They remain at risk of cancer and might be at greater risk of developing some cancers compared to cisgendered people but are underscreened. Barriers to gender-affirming care need to be addressed to improve access to prevention and screening services and improve the cancer care experiences and outcomes of TGD people. ConclusionAPNs can work in collaboration with TGD individuals and the healthcare system to improve access to culturally safe cancer screening and more effective prevention of cancer and poor cancer outcomes. Implications for Nursing PracticeAPNs have the potential to improve access to cancer screening for TGD people by increasing their understanding of the needs of the population, providing culturally safe care, and advocating for more preventative care and cancer screening. With greater knowledge and understanding of the needs and preferences of TGD people both broadly and in relation to cancer screening and prevention, targeted interventions and care approaches can be implemented. APNs should also aim to conduct evaluations and research into cancer prevention and screening to build the currently limited evidence base and nursing knowledge in this important field.

Cost-effectiveness of BRCA1 testing at time of obstetrical prenatal carrier screening for cancer prevention

BackgroundImproved technologies paired with an increase in access to genetic testing has led to the availability of expanded carrier screening evaluating hundreds of disorders. Currently, most autosomal dominant mutations, such as BRCA1, are not included in expanded carrier assays. Screening pregnant or preconception reproductive-aged women for BRCA1 may present a unique opportunity to perform population-based screening for patients at a time where precancer screening, chemoprevention and/or risk reducing surgery may be beneficial. ObjectiveThe objective of our study was to inform clinical decision making as to whether the universal incorporation of BRCA1 testing at the time of obstetrical prenatal carrier screening is cost-effective. Study DesignA decision analysis and Markov model was created. The initial decision point in the model was BRCA1 testing at the time of expanded carrier screening. Model probabilities, cost, and utility values were derived from published literature. For BRCA1-positive patients, the model simulated breast cancer screening and risk-reducing surgical interventions. A cycle length of 1 year and a time horizon of 47 years was used to simulate the lifespan of patients. Setting was Obstetrical clinics in U.S., and Participants were a theoretical cohort of 1,429,074 pregnant patients who annually undergo expanded carrier screening. ResultsAmong our cohort, BRCA1 testing resulted in identification of an additional 3,716 BRCA1 patients, prevention of 1,394 breast and ovarian cancer cases, and 1,084 fewer deaths. BRCA1 testing was a cost-effective strategy compared to no BRCA1 testing with an ICER of $86,001/QALYs. In a one-way sensitivity analysis, we varied the prevalence of BRCA1 in the population from 0% up to 20% and found that BRCA1 testing continued to be the cost-effective strategy until prevalence rate was reduced to 0.16% (Table S1). Multiple additional sensitivity analyses did not substantially impact the cost-effectiveness. ConclusionThe addition of BRCA1 testing to obstetrical prenatal carrier screening is a cost-effective management strategy to identify at-risk women at a time when cancer screening and preventive strategies can be effective. Despite the burden of additional genetic counseling, prenatal care represents a unique opportunity to implement population-based genetic testing.

Prevalence and predictors of colon and prostate cancer screening among volunteer firefighters: The United States Firefighter Cancer Assessment and Prevention Study.

Although firefighters have increased risk for colon and prostate cancer, limited information exists on screening practices for these cancers in volunteer firefighters who compose two-thirds of the US fire service. We estimated the prevalence of colon and prostate cancer screening among volunteer firefighters using eligibility criteria from 4 evidence-based screening recommendations and evaluated factors influencing screening. We evaluated colon (n = 569) and prostate (n = 498) cancer screening prevalence in a sample of US volunteer firefighters using eligibility criteria from the US Preventive Services Taskforce (USPSTF), National Fire Protection Association, American Cancer Society, and National Comprehensive Cancer Network. We assessed associations with fire service experience, demographics, and cancer risk perception based on USPSTF guidelines. For those eligible based on USPSTF guidelines, colon and prostate cancer screening prevalence was 51.7% (95% CI: 45.7, 57.8) and 48.8% (95% CI: 40.0, 57.6), respectively. Higher odds of colon and prostate cancer screening were observed with older age and with some college education compared to those with less education. Fire service experience and cancer risk perception were not associated with screening practices. This is the first large study to assess colon and prostate cancer screening among US volunteer firefighters based on different screening guidelines. Our findings suggest gaps in cancer prevention efforts in the US volunteer fire service. Promoting cancer screening education and opportunities for volunteer firefighters by their fire departments, healthcare professionals, and public health practitioners, may help to address the gaps.

Abstract 7475: The contribution of the oral bacteriome and mycobiome in cancer risk in people with HIV in Puerto Rico

Abstract Although under highly effective antiretroviral therapy, people with HIV (PWH) still experience an increased risk of developing cancer compared to people without HIV (PWOH). Dysbiosis of the oral microbiota in PWH can contribute to persistent inflammation and cancer risk. We previously showed higher levels of inflammation in saliva of PWH measured by TGF-β1 and IL-2. In addition, microbial products such as short-chain fatty acids (SCFA) can regulate the transcription of immune-related genes, particularly those necessary for the innate immune response to pathogens. In this study, we characterized the composition of the oral bacteriome and mycobiome in saliva of Puerto Rican PWH and PWOH, and analyzed these data in relation to markers of inflammation and cancer risk in saliva. Saliva, sociodemographic, and clinical data from 100 adults were collected (50 PWH and 50 PWOH). PWH were virally suppressed (&amp;lt;50 copies/mL) and had a median CD4 count of 699.8 cells/µL. We sequenced the 16S rDNA and the ITS in extracted DNA from saliva to characterize and quantify the bacterial and fungal communities, respectively. Furthermore, measurement of inflammatory markers (TGF-β1, IL-2, and IL-8) in saliva was performed using quantitative immunoassays. Microbiome data was processed using Qiime2, and statistical analysis was carried out using R-statistical software. Biological pathways associated to changes in the microbiome were inferred using PiCRUST2. PWH showed lower alpha diversity in the oral bacteriome (Observed OTUs: p=0.02, Faith: p=0.03) and oral mycobiome (Shannon: p=0.02) when compared to PWOH. In a multivariate analysis, lower alpha diversity in the bacteriome was associated with biological sex and HIV status. Lower alpha diversity in the oral bacteriome was associated with higher levels of acetate (r=-0.38, p&amp;lt;0.001) and lower levels of IL-8 (r= 0.21, p= 0.056) in saliva independent of HIV status. Taxonomic analyses showed PWH had a significantly lower abundance of Porphyromonas, Peptostreptococcus, Oribacterium, Parvimonas, Leptotrichia, Fusobacterium, Eubacterium, Dialister, and Alkalibacter genera of bacteria but there not significant changes in taxonomy in the oral mycobiome. Biological processes significantly affected by dysbiosis of the oral mycobiome include cytosolic and mitochondrial NADPH production, amino acid and sugar degradation, and phospholipid remodeling. Dysbiosis of both the oral bacteriome and mycobiome occur in HIV infection, which can contribute to chronic inflammation. However, the bacteriome and mycobiome may have different biological mechanisms, which suggest different roles in increasing cancer risk in Puerto Rican PWH. These findings provide more information regarding the oral health in people with HIV and may contribute to innovative cancer prevention strategies and screening guidelines for this high-risk population. Citation Format: Veronica Sofia Sanchez Gonzalez, Yakshi N. Ortiz-Maldonado, Gabriel Borges-Vélez, Tanner L. Shull, Jeannette L. Salgado-Montilla, Josué Pérez-Santiago1. The contribution of the oral bacteriome and mycobiome in cancer risk in people with HIV in Puerto Rico [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 7475.

Prevalence of Lung Cancer Screening in the US, 2022

This cross-sectional study compares lung cancer screening prevalence in 2022 among individuals eligible by 2021 vs 2013 criteria by sociodemographics and state.