Evidence-based Cancer Research Articles

Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline).

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area. Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version. Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Exploring Patient-Related Contextual Factors and Personal Reflections About the Managing Cancer and Living Meaningfully (CALM) Intervention for Adults With Advanced Cancer in Metropolitan and Non-Metropolitan Southern Alberta: A Mixed Methods Study.

The evidence-based Managing Cancer and Living Meaningfully (CALM) psychotherapeutic intervention was designed to address the complex needs of those with advanced cancer. Ample evidence supports the efficacy of CALM therapy; less is known about the patient-specific factors that influence initiation and continuation of CALM sessions. To gain understanding of patient-specific factors and referral routes that influence initiation and continuation of CALM. An Interpretive Description framework and concurrent triangulation mixed-methods design was used to analyse baseline patient-specific variables for prediction of engagement (number of sessions) in CALM following recruitment from cancer centres, palliative care services, and community cancer care organisations across Southern Alberta, Canada. Patient input (n=10) occurred through semi-structured interviews exploring experiences with advanced cancer, CALM referral and engagement. Among consented individuals (n=69), those directly referred by healthcare providers (HCPs) and self-referred (total n=32), engaged in more CALM sessions (M=4.97, SD=3.51) than those referred indirectly (M=3.19, SD=2.26, p<0.05), particularly younger participants (< 65years) and those with longer life expectancy (> 10months). Participants chose CALM based on experiences of distress, wanting to talk openly, and expecting benefit. Greater patient engagement in the CALM intervention following HCPs' direct referrals may be based on trust in the HCP-patient relationship, and accurately prognosticating sufficient physical well-being for participation and benefit. Future health systems research may evaluate systematic programing with offering CALM referrals following an advanced cancer diagnosis.

Alcoholic beverage consumption and female breast cancer risk:A systematic review and meta-analysis of prospective cohort studies.

Alcohol consumption is an established cause of female breast cancer. This systematic review examines in detail the association between alcohol and female breast cancer overall and among the described subgroups, using all of the evidence to date. A systematic review of PubMed and Embase was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search included articles published up to November 15, 2023. Meta-analyses and regressions were performed for alcohol consumption of less than 1 standard drink (10 g of ethanol) per day and for a range of alcohol consumption categories in relation to breast cancer. Analyses by menopausal status, hormone receptor status, human epidermal growth factor receptor 2 status, and molecular subtype were performed. The search yielded 5645 publications, of which 23 publications of individual and pooled studies examined the association between overall alcohol consumption and breast cancer incidence. The meta-regression showed a positive association; relative risks (RR) of breast cancer were 1.05 (95% CI: 1.04, 1.06), 1.10 (95% CI: 1.08, 1.12), 1.18 (95% CI: 1.15, 1.21), and 1.22 (95% CI: 1.19, 1.25) for 0.5, 1, 2, and 3 standard drinks per day compared with nondrinking, respectively. A meta-analysis of nine studies indicated that for consumption of less than one standard drink per day, the RR estimate of breast cancer was 1.04 (95% CI: 1.01, 1.07) compared with nondrinking. Consumption of an additional 1 standard drink per day was associated with a higher risk of premenopausal (RR: 1.03 (95% CI: 1.01, 1.06)) and postmenopausal (RR: 1.10 (95% CI: 1.08, 1.12)) breast cancer. Alcohol consumption increases female breast cancer risk, even for women who consume one drink per day. Furthermore, alcohol consumption is associated with both pre- and postmenopausal breast cancer risk. These findings support evidence-based cancer prevention guidelines to reduce alcohol-related risks.

Developing actionable strategies to implement evidence-based breast cancer follow-up in primary care using codesign

Developing actionable strategies to implement evidence-based breast cancer follow-up in primary care using codesign

Global Disparities of Cancer and Its Projected Burden in 2050

Cancer prevention and care efforts have been challenged by the COVID-19 pandemic and armed conflicts, resulting in a decline in the global Human Development Index (HDI), particularly in low- and middle-income countries. These challenges and subsequent shifts in health care priorities underscore the need to continuously monitor cancer outcome disparities and statistics globally to ensure delivery of equitable and optimal cancer prevention and care in uncertain times. To measure the global burden of 36 cancers in 2022 by sex, age, and geographic location and to project future trends by 2050. This cross-sectional study used population-based data from 2022 in 185 countries and territories were obtained from the Global Cancer Observatory database. Data extraction and analysis were carried out in April 2024. Counts, rates, prevalence, mortality to incidence ratios (MIRs), and demography-based projections were used to characterize current and future cancer burden. This population-based study included 36 cancer types from 185 countries and territories. By 2050, 35.3 million cancer cases worldwide are expected, a 76.6% increase from the 2022 estimate of 20 million. Similarly, 18.5 million cancer deaths are projected by 2050, an 89.7% increase from the 2022 estimate of 9.7 million. Cancer cases and deaths are projected to nearly triple in low-HDI countries by 2050, compared to a moderate increase in very high-HDI countries (142.1% vs 41.7% for cancer cases and 146.1% vs 56.8% for cancer deaths). Males had a higher incidence and greater number of deaths in 2022 than females, with this disparity projected to widen by up to 16.0% in 2050. In 2022, the MIR for all cancers was 46.6%, with higher MIRs observed for pancreatic cancer (89.4%), among males (51.7%), among those aged 75 years or older (64.3%), in low-HDI countries (69.9%), and in the African region (67.2%). In this cross-sectional study based on data from 2022, cancer disparities were evident across HDI, geographic regions, age, and sex, with further widening projected by 2050. These findings suggest that strengthening access to and quality of health care, including universal health insurance coverage, is key to providing evidence-based cancer prevention, diagnostics, and care.

Developing an Evidence-Based Primary Cancer Prevention Repository: insights from the PIECES project

Abstract Introduction Up to 40% of cancer cases could be avoided through effective primary prevention. However, cancer prevention tends to be fragmented across Europe, leading to geographical health differences. The dissemination and scale-up of effective primary cancer prevention interventions may address this. Although effective cancer prevention programs exist, finding them and their materials (especially regarding implementation) can be challenging. Repositories of evidence-based interventions provide insight into “what is out there” and can support dissemination within and across national borders. The PIECES project aims to develop and disseminate a repository of evidence-based primary cancer prevention programs adaptable to European contexts, with information to aid adaptation and implementation across countries. Methods The development of the PIECES repository has been informed by established repositories such as NCI’s Evidence-Based Cancer Control Programs. The project team developed a scoring sheet with a selection of items that could be included in the repository. All participants rated each item on relevance and applicability and provided comments and suggestions. A final framework, including a set of minimal requirement items, was agreed upon during three online consensus building meetings. Results We created a repository of evidence-based primary cancer prevention interventions targeting modifiable risk factors suitable for implementation in European healthcare settings. This 22-item repository provides information about an intervention’s logic model, implementation practices, and appraisal of published evidence of effectiveness. Conclusions This repository is innovative as it includes practical information and tools to facilitate implementation. While initially built to serve the PIECES project, the repository is designed to be a valuable tool for European policymakers, researchers, and implementers. Lessons learned from this process will inform future developers. Key messages • A comprehensive cancer prevention intervention repository avoids “reinventing the wheel” and allows for more efficient use of existing interventions by building upon the best available evidence. • The ongoing efforts of the PIECES project represent a significant contribution to reduce cancer prevention disparities and to facilitate the adoption of evidence-based interventions in Europe.

Abstract B021: Quitxt research study: A mobile messaging intervention to promote smoking cessation among young adult smokers in South Texas

Abstract Background: Despite major advances in tobacco control and treatment, tobacco use remains the single largest preventable cause of morbidity and mortality in the US. Smoking prevalence is highest among Texas young adults (ages 18-29), especially those with lower education and income and those living in rural areas, like Latinos. About 19.2% of Latinos ages 18-29 in the study areas are current smokers, putting them at higher risk of cancer and other tobacco-related morbidity and mortality. Young adults are heavy users of smartphones, text messaging, social media chats, and other mobile social media, providing a remarkable opportunity for innovation in the delivery of health promotion interventions to reduce health disparities in this large and rapidly growing racial/ethnic population. This research study aims to assess the effectiveness of Quitxt, our culturally appropriate mobile smoking cessation program. Quitxt – launched by our interdisciplinary research team using proven social cognitive, motivational interviewing, and brief intervention methods for promoting behavior change – blends bilingual text and social media messaging for smoking cessation tailored to the language and culture of young adult smokers in our vulnerable region of South Texas. The team also adapted the program to the Primary Care and Mays Cancer Center patient population, and it is currently being implemented. Quitxt has not been tested in a research study, as its creation as an evidence-based cancer prevention service for young adult smokers was supported by the Cancer Prevention and Research Institute of Texas. Methods: The proposed 5-year study involves a 2-group parallel randomized controlled trial with 4 assessments (baseline, 1, 3, and 6 months) and will recruit 1,200 young adult Latino smokers: 1)The intervention group will receive Quitxt (text messaging or chat); and 2) the usual care group will receive abbreviated text messaging with health promotion-related content, including smoking cessation and referral to the Texas DSHS cessation program YesQuit. Smoking cessation will be validated via biological tests for those who report smoking cessation at the study follow-ups. We hypothesize that the group receiving the Quitxt intervention will achieve significantly higher smoking cessation rates than the group receiving usual care. Results: The proposed intervention will mark the first significant study to assess the effectiveness of an innovative, bilingual, culturally, and linguistically appropriate mobile cessation intervention tailored to young adult Latinos living in South Texas by enhancing their skills development, competence, and self-efficacy to initiate and maintain cessation. Conclusion: This study will advance public health by testing the effectiveness of a scalable, evidence-based, easily disseminated, and adaptable intervention with potentially broad national reach to help young adults stop smoking and reduce smoking-related cancer and chronic disease morbidity and mortality and their associated healthcare costs. Citation Format: Patricia Chalela, Vivian Cortez, Sandra Sivak, Armida Flores, Martha De La Mora, Zully Garcia, Byeongyeob Choi, Edgar Muñoz, Cliff Despres, Alfred L. McAlister, Qurathul Ahmed, Audrey Cordova, Maria I. Sung-Cuadrado, Luis F. Velez, Sahak Kaghyan, Rahul Mundlamuri, David Akopian, Amelie G. Ramirez. Quitxt research study: A mobile messaging intervention to promote smoking cessation among young adult smokers in South Texas [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B021.

Japan's cancer survivorship guidelines for exercise and physical activity.

This research aimed to establish the inaugural evidence-based cancer survivorship guidelines for Japan, with a particular focus on exercise and physical activity, in order to enhance health outcomes for cancer survivors. A panel of experts, including oncologists, physicians, exercise scientists, epidemiologists and patient advocates, utilized a modified Delphi process and systematic reviews to establish consensus on exercise recommendations for cancer survivors. The panel focused on setting the objectives of the Clinical Practice Guidelines and addressing crucial clinical issues in Japan. Recommendations were formulated based on the strength and certainty of evidence, the benefit-harm balance and patient values and preferences. The panel formulated exercise recommendations for cancer survivors of two age groups: 18-64years and ≥65years. The recommendations for both age groups are consistent, emphasizing the importance of regular exercise and physical activity tailored to individual capabilities and health conditions. The guidelines underline the benefits of exercise in improving the overall health and quality of life of cancer survivors. This consensus on exercise recommendations marks a significant step in the development of comprehensive cancer survivorship guidelines in Japan, with potential implications for improving clinical outcomes and advancing research in cancer survivorship. These guidelines will serve as a critical resource for cancer survivors, highlighting exercise as a key component of survivorship care, and for clinicians, in recommending appropriate physical activities to improve survivor health and well-being.

Subsequent risk of cancer among adults with peripheral artery disease in the community: The atherosclerosis risk in communities (ARIC) study

Background and aimsSeveral studies reported an increased cancer risk related to lower-extremity peripheral artery disease (PAD) but had important caveats: not accounting for key confounders like smoking, follow-up <10 years, or no race-specific results. To assess the long-term independent association of PAD with cancer incidence in a bi-racial community-based cohort. MethodsWe categorized 13,106 ARIC participants without cancer at baseline (mean age 54.0 [SD 5.7] years, 45.7 % male, and 26.1 % Black) into symptomatic PAD (clinical history or intermittent claudication), asymptomatic PAD (ankle-brachial index [ABI] ≤0.9), and five ABI categories (0.1-interval between 0.9 and 1.3 and > 1.3). We used cancer registries and medical records to ascertain cancer cases and ran multivariable Cox models. ResultsDuring the median follow-up of 25.3 years, there were 4143 incident cancer cases. 25-year cumulative incidence was 37.2 % in symptomatic PAD, 32.3 % in asymptomatic PAD, and 28.0–31.0 % in the other categories. Symptomatic and asymptomatic PAD remained significantly associated with cancer incidence after adjusting for potential confounders, including smoking and diabetes (hazard ratio [HR] 1.42 [1.05–1.92] and 1.24 [1.05–1.46], respectively). When stratified by smoking status, we observed a robust association of PAD (symptomatic and asymptomatic combined) vs. no PAD with cancer risk in ever smokers (HR 1.42 [1.21–1.67]) but not in never smokers. The results were most evident for lung cancer (HR 2.16 (95 %CI 1.65–2.83) for PAD vs. no PAD within ever smokers). ConclusionsSymptomatic and asymptomatic PAD conferred cancer risk, particularly among ever smokers and for lung cancer. Patients with PAD should receive evidence-based cancer prevention and screening.

Cervical Cancer Screening Barriers and Facilitators for Sexual and Gender Minority People: A Community-Engaged Feasibility Approach

The purposes of this study were to identify barriers and facilitators to cervical cancer screening (CCS) among sexual and gender minority (SGM) people and to determine strategies to facilitate increased CCS among these populations. Between August 2021 and December 2022, 33 semistructured, in-depth qualitative interviews were conducted with SGM adults in Kentucky. Interview transcripts were analyzed using inductive content analysis to identify patterns and themes. Barriers to CCS included negative experiences with CCS, negative associations with CCS, and healthcare providers’ lack of SGM population awareness. Facilitators of CCS included positive CCS experiences related to healthcare providers and positive CCS experiences related to healthcare settings. Recommended strategies to increase CCS were SGM population-targeted CCS encouragement and cervical cancer self-screening. Healthcare provider and healthcare system barriers and facilitators have a disproportionate influence on SGM individuals’ CCS behaviors. CCS must be normalized in the SGM community and presented and promoted specifically to SGM populations. Human papillomavirus self-sampling acceptability for SGM populations should be explored. There is a critical need for piloting culturally tailored, innovative interventions supported by healthcare providers, healthcare systems, and SGM community partners, underpinned with acceptable, accessible, and evidence-based cervical cancer prevention strategies for SGM populations.

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

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

Clinical management of oligometastatic cancer: Applying multidisciplinary tumor board recommendations in practice

AimsMultidisciplinary tumor boards (MDTs) are an integral part of ensuring high-quality, evidence-based and personalized cancer care. In this study, we aimed to evaluate the adherence to and implementation of MDT recommendations in patients with oligometastatic disease (OMD). MethodsWe screened all oncologic positron emission tomography (PET) scans conducted at a single comprehensive cancer center in 2020. Patients were included if they had evidence of imaging-based OMD from a solid organ malignancy on the index scans, had their OMD case discussed at an MDT, and were treated and followed up at the same center. A switch away from the MDT-recommended treatment modalities was classified as a major deviation; non-MDT-mandated adjustments to a recommended treatment modality were coded as minor deviation. Clinical data was obtained via chart review; statistical calculations were computed using the R software. ResultsAfter review of PET and/or concurrent brain scans, 787 cases of OMD were identified. Thereof, 347 (44.1 %) cases were discussed at MDT, of which 331 (42.1 %) were therapeutically managed and subsequently followed. The three most commonly recommended therapies were systemic therapy (35.6 %), multimodality treatment including definitive local therapy (17.8 %), and radiotherapy (13.9 %). A major deviation was recorded in 16.3 % of cases (most commonly: none of the MDT-recommended treatment modalities were performed: 19 (35.2 %); not all MDT-planned treatment modalities were performed: 12 (22.2 %); and additional treatment modality was performed: 11 (20.3 %). A minor deviation was found in 1.5 % of cases. On multivariable regression, number of distant metastases (n > 1) was associated with a major deviation (OR: 1.85; 95 % CI, 1.0–3.52). Major deviations were associated with a significantly worse OS (p = 0.0034). ConclusionsAdherence to and implementation of MDT recommendations in OMD patients was generally high (83.7%). Major deviations might be further reduced by more careful and elaborate discussions of OMD patient characteristics s and patient preferences.

Evidence-based Prostate Cancer Screening Interventions for Black Men: A Systematic Review.

The databases PubMed, Ovid MEDLINE, CINAHL Plus, and PsychInfo were utilized to examine peer-reviewed publications between 2017 and 2023. Data extracted included implementation plans, outcome measures, intervention details, and results of the study. The Critical Appraisal Skills Programme was used to assess the quality of the evidence presented. Of the 206 full-text articles assessed, three were included in this review. Educational interventions about prostate cancer knowledge with shared and informed decision-making (IDM) features, as well as counseling, treatment options, and healthcare navigation information, may increase prostate cancer screening participation among Black men. Additionally, health partner educational interventions may not improve IDM related to screening participation. The quality of the evidence presented in each article was valid and potentially impactful to the community. Black men face various social determinants of health barriers related to racism, discrimination, cost of health services, time away from work, and lack of trust in the healthcare system when making health-related decisions, including prostate cancer screening participation. A multifactorial intervention approach is required to address these inequities faced by Black men especially as prostate cancer is curable when diagnosed at an earlier stage.

Estimating regional and national cancer incidence in Uganda: a retrospective population-based study, 2013–2017

BackgroundCancer is becoming a major health problem in Uganda. Cancer control requires accurate estimates of the cancer burden for planning and monitoring of the cancer control strategies. However, cancer estimates and trends for Uganda are mainly based on one population-based cancer registry (PBCR), located in Kampala, the capital city, due to a lack of PBCRs in other regions. This study aimed at estimating cancer incidence among the geographical regions and providing national estimates of cancer incidence in Uganda.MethodsA retrospective study, using a catchment population approach, was conducted from June 2019 to February 2020. The study registered all newly diagnosed cancer cases, in the period of 2013 to 2017, among three geographical regions: Central, Western and Eastern regions. Utilizing regions as strata, stratified random sampling was used to select the study populations. Cases were coded according to the International Classification of Diseases for Oncology (ICD-0-03). Data was analysed using CanReg5 and Microsoft Excel.Results11598 cases (5157 males and 6441 females) were recorded. The overall national age-standardized incidence rates (ASIR) were 82.9 and 87.4 per 100,000 people in males and females respectively. The regional ASIRs were: 125.4 per 100,000 in males and 134.6 per 100,000 in females in central region; 58.2 per 100,000 in males and 56.5 per 100,000 in females in Western region; and 46.5 per 100,000 in males and 53.7 per 100,000 in females in Eastern region. Overall, the most common cancers in males over the study period were cancers of the prostate, oesophagus, Kaposi’s sarcoma, stomach and liver. In females, the most frequent cancers were: cervix, breast, oesophagus, Kaposi’s sarcoma and stomach.ConclusionThe overall cancer incidence rates from this study are different from the documented national estimates for Uganda. This emphasises the need to enhance the current methodologies for describing the country’s cancer burden. Studies like this one are critical in enhancing the cancer surveillance system by estimating regional and national cancer incidence and allowing for the planning and monitoring of evidence-based cancer control strategies at all levels.

A Review on Educational Intervention Approaches on Cancer Knowledge and Awareness in Quasi-Experimental Studies.

Cancer is a highly prevalent noncommunicable disease with low levels of awareness among the general public, as reported in numerous studies worldwide. Given the daunting nature of cancer, poor knowledge and awareness levels of this disease with regard to its warning signs, risk factors, and the importance of cancer screening among the public may lead to unfavorable health-related outcomes, such as delayed diagnosis and treatment initiation. However, there is potential to tackle this issue with properly designed health educational interventions. Quasi-experimental studies can be implemented to raise awareness in this subject matter via a myriad of traditional and digitalized educational intervention methods. Relevant studies identified across electronic databases were categorized based on the various educational interventions employed in promoting cancer knowledge and awareness. The effectiveness of these interventional approaches was assessed based on the pre-test and post-test scores, which captured the changes in knowledge and awareness levels before and after the educational intervention. Varying outcomes were observed across the diverse methods in individuals of different age groups. Nevertheless, evidence-based cancer educational interventions often yield multifaceted positive outcomes. The aim of this article is to review the various approaches of educational interventions utilized to positively alter the knowledge and awareness on cancer among the general public.

Improving Distress Screening for People with Prostate Cancer: Evaluation of an E-Learning Course to Increase Healthcare Professionals’ Knowledge

ObjectivesPsychological distress can occur following diagnosis and treatment for prostate cancer, compromising psychosocial wellbeing. Improved recognition and management of distress by healthcare professionals can enhance clinical practice and promote evidence-based prostate cancer care. This paper explores the effectiveness and feasibility of the online Distress Screening for Prostate Cancer course, designed to improve healthcare professionals’ understanding of screening for prostate cancer-related distress. It aims to evaluate whether this e-learning course increases learners’ knowledge of distress screening for prostate cancer. MethodsHealthcare professionals were invited to enroll in the online course and complete optional evaluation questions. The pretest posttest design identified changes in learners’ knowledge about distress screening for people with prostate cancer, including prevalence, risk factors, assessment and management strategies for distress (n = 149). Learners also rated satisfaction in a cross-sectional survey (n = 116). Most respondents were nurses, including Prostate Cancer Specialist Nurses. ResultsLearners’ knowledge of distress screening was higher after course completion. Improvement between pre- and posttest results was statistically significant for four of ten items, including risk of prostate cancer-related distress, and suicidality, and the purpose of distress screening. Learners reported high satisfaction with course content, structure, engagement, relevance, and approach. They particularly valued the narrative-based approach and interactivity. Small numbers encountered technological problems and some offered suggestions to improve learner feedback. ConclusionsThe course improved healthcare professionals’ knowledge of distress among people affected by prostate cancer. Learners found the e-learning format feasible and acceptable. Implications for Nursing PracticeDeeper understanding of the psychological implications of diagnosis and treatment of prostate cancer can help healthcare professionals respond to and manage distress among men and their families, and provide supportive care to improve health-related quality of life. Access to an online course can offer effective, feasible education on distress screening.

Association Between COVID-19 and Planned and Postponed Cancer Screenings Among American Indian Adults Residing in California and Oklahoma, March-December 2020.

Little is known about how the COVID-19 pandemic affected cancer screenings among American Indian people residing in California and Oklahoma, 2 states with the largest American Indian populations. We assessed rates and factors associated with cancer screenings among American Indian adults during the pandemic. From October 2020 through January 2021, we surveyed 767 American Indian adults residing in California and Oklahoma. We asked participants whether they had planned to obtain screenings for breast cancer, cervical cancer, and colorectal cancer (CRC) from March through December 2020 and whether screening was postponed because of COVID-19. We calculated adjusted odds ratios (AORs) for factors associated with reasons for planned and postponed cancer screening. Among 395 participants eligible for breast cancer screening, 234 (59.2%) planned to obtain the screening, 127 (54.3%) of whom postponed it. Among 517 participants eligible for cervical cancer screening, 357 (69.1%) planned to obtain the screening, 115 (32.2%) of whom postponed it. Among 454 participants eligible for CRC screening, 282 (62.1%) planned to obtain CRC screening, 80 of whom (28.4%) postponed it. In multivariate analyses, women who lived with a child (vs did not) had lower odds of planning to obtain a breast cancer screening (AOR = 0.6; 95% CI, 0.3-1.0). Adherence to social distancing recommendations was associated with planning to have and postponement of cervical cancer screening (AOR = 7.3; 95% CI, 0.9-58.9). Participants who received (vs did not receive) social or financial support had higher odds of planning to have CRC screening (AOR = 2.0; 95% CI, 1.1-3.9). The COVID-19 pandemic impeded completion of cancer screenings among American Indian adults. Interventions are needed to increase the intent to receive evidence-based cancer screenings among eligible American Indian adults.

System-level variation in evidence-based multidisciplinary cancer care delivery.

11064 Background: Widespread health system integration of hospitals continues to reshape the landscape of U.S. healthcare delivery. While complex cancer care has become centralized to high-volume centers, care for common cancers happens across the spectrum of hospital sizes, with known variation in receipt of evidence-based practice (EBP) based on system affiliation. Strategies are needed to evaluate system performance in order to identify system characteristics and processes that contribute to high-quality cancer care. Methods: Using a novel data linkage between the National Cancer Database and AHRQ Compendium of U.S. Health Systems, adult patients treated for breast, colon, melanoma, and thyroid cancers between 2010 and 2020 at Commission on Cancer (CoC) hospitals were identified. Systems were categorized based on number of CoC hospitals (small, 2-3; medium, 4-9; large, 10+). Eight EBP measures were developed using national multidisciplinary guidelines, and measure-specific cohorts were extracted to calculate system-level EBP performance and within-system variation using mixed effects multivariable logistic regression models. Systems were then ranked across all measures for performance and variation, and average rankings were compared by system size. Results: 3,052,453 patients with breast (60.0%), colon (17.0%), melanoma (14.0%), and thyroid (9.0%) cancers were treated at 866 CoC hospitals in 368 health systems. The 8-measure analytic cohort had 104 systems, most of which were small systems (n=74, 71.2%). Large systems (n=9, 8.7%) had worse average performance rankings compared to medium or small systems, though this was not statistically significant (p=0.1) (Table). A significant increase in within-system variation (as measured by average ranking of variability across EBP measures) was seen with increasing system size (p&lt;0.001). Conclusions: Significant variation in EBP performance for common cancers was noted based on health system size in this large, contemporary cohort, with greater within-system variation as system size increased. Future work will identify modifiable system characteristics associated with performance that could aid system leaders and policy makers to design, measure, and incentivize systems that employ effective cancer care delivery strategies. System rankings from 1 to 104 (best to worst), averaged over all measures; data presented as median (IQR). [Table: see text]

Expanding the Global Capacity for Childhood Cancer Registration: The ChildGICR Masterclass.

One determinant of the paucity of data on childhood cancer in low- and middle-income countries is the lack of capacity to register these cases. Combining expertise of the Global Initiative for Cancer Registry Development (GICR) and St Jude Global, we developed a ChildGICR educational program to promote data production. We first conducted a needs assessment to identify priority educational topics. Then, we designed the ChildGICR Masterclass, in which individuals with the potential to lead pediatric cancer registration were supported to prepare standard educational material. The outcomes were evaluated using qualitative and quantitative measures. On the basis of indications by 38 GICR collaborators, we identified seven topics relevant to childhood cancer: burden description, registration principles, tumor classification, tumor staging, data quality control, data analysis, and data use. The ChildGICR Masterclass was held online in 2021 over 12 weeks. The 22 nominated participants created presentations in working groups and during live sessions. They also designed future training courses tailored to the needs of their region. Nineteen participants viewed the course experience as excellent, and 20 would continue engagement in the ChildGICR training activities. The developed material was 89% useful according to the faculty of the three online end courses, taught to 88 participants in 16 countries in 2022 and 2023. Among the 75 responding participants, 72 agreed that the learning objectives were attained and 60 were keen to engage in childhood cancer registration activities. The ChildGICR Masterclass participants laid the foundation for a network of trainers. Knowledge dissemination in childhood cancer registration is the first necessary step toward evidence-based cancer control. The ChildGICR Masterclass can serve as a model to design, plan, and implement educational programs for health care professionals.

Integrating MDT Tumor Board Shadowing into the Undergraduate Medical Curriculum: Perspective of Medical Students.

Site-specific multidisciplinary team (MDT) tumor boards are valuable resources for medical students, enabling them to familiarize themselves with the latest evidence-based cancer management strategies and observe effective teamwork in action. In this study, we looked at the awareness and perceptions of medical students about incorporating MDT tumor boards in the medical curriculum. A cross-sectional study was conducted among medical students from year 1 to year 5 at the Aga Khan University after exemption from ethical review committee. A 20-item self-administered questionnaire was used to evaluate the awareness and perceptions of medical students regarding MDT tumor boards. A total of 285 medical students participated in this study, with their mean age (± standard deviation) being 21.91 ± 1.67years. A majority of 183 (64.2%) had no prior knowledge of the existence of a site-specific MDT tumor board for cancer management. Of the 285 students, 252 (88.4%) demonstrated sufficient awareness of the effectiveness of MDT tumor boards; similarly, 232 (81.4%) responded positively to the idea of mandatory tumor board rotations being incorporated into the undergraduate curriculum. No significant association was found between the student's year of study (χ2 = 6.03, p = 0.20) or gender (χ2 = 35, p = 0.84) and their perceptions of the effectiveness of MDT tumor boards. However, it was found that students who had prior knowledge of their existence had a stronger association with sufficient awareness (χ2 = 4.2, p = 0.04). The results indicate that while the majority of the medical students have no prior attendance or knowledge regarding MDT tumor boards, there is an overwhelming willingness among students to incorporate them into the medical curriculum.