Cancer Prevention Interventions Research Articles

Nowcasting and forecasting global aging and cancer burden: analysis of data from the GLOBOCAN and Global Burden of Disease Study

ObjectiveTo analyze the impact of global population aging on cancer epidemiology, with a focus on the incidence and mortality rates among individuals aged 60 and above. MethodsWe utilized open-source data, retrieving population age estimates from the UN Population Division website. The GLOBOCAN 2020 database provided estimates for cancer cases and deaths in 2020 and 2040, while the Global Burden of Disease 2019 database supplied estimates of new cancer cases worldwide from 2000 to 2019. Inclusion criteria considered individuals aged 60 and over, focusing on the top five deadliest cancers. The cohort-component method was employed for population prediction, with age-specific incidence and mortality rates estimated for 2020 used to forecast the cancer burden. ResultsIn 2021, the global population aged over 60 years accounted for 13.7%, with Europe/North America and Australia/New Zealand having the highest proportions. The older population is predicted to reach 19.2% by 2040. In 2020, of the 19.3 million new cancer cases worldwide, 64% occurred in individuals aged 60 and above, contributing to 71.3% of cancer-related deaths. The five most common cancers were lungs, colorectum, prostate, breast, and stomach. Cancer incidence and deaths are projected to rise significantly among older individuals, reaching 20.7 million new cases and 12.7 million deaths by 2040. Older age, tobacco use, dietary factors, alcohol consumption, and high BMI were identified as major risk factors for various cancers in this demographic. ConclusionsThis study reveals a significant rise in cancer incidence and mortality among the elderly due to global population aging. The urgency for targeted interventions in cancer prevention, screening, and treatment for older individuals is emphasized. Despite acknowledged limitations, these findings contribute valuable insights to inform strategies for managing cancer in the elderly amidst evolving demographic trends.

Digital Health Interventions for Cancer Prevention Among Racial and Ethnic MinorityGroups in the United States: A Scoping Review.

The COVID-19 pandemic abruptly accelerated the use of digital health for cancer care. Previously, researchers identified a variety of digital health interventions for cancer prevention. The purpose of the present scoping review was to identify digital health interventions for cancer prevention designed for racial/ethnic minoritygroups. The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and was guided by the Arksey and O'Malley methodological framework. A search of PubMed, Ovid MEDLINE, and CINAHL for peer-reviewed research articles published from database inception to August 21, 2023, was conducted. Peer-reviewed studies published in English that employed digital health interventions for cancer prevention, that were conducted among racial/ethnic minoritygroups, and thatwere conducted in the United States were included. Also included were cancer prevention interventions for people who did not have cancer, people who did have cancer, and cancer survivors. Excluded were interventions that included non-Hispanic White individuals, interventions performed outside the United States, interventions that combined face-to-face methods with digital strategies, and interventions that did not clearly include digital health. Articles that focused on technologies for collecting and transmitting health data (e.g., remote patient monitoring) without an explicit tie-in to cancer prevention intervention outcomes were also excluded. Following screening, eight articles met the eligibility criteria. Six of the articles were published prior to the COVID-19 pandemic, and two were published during it. The digital health interventions for cancer prevention in racial/ethnic minoritygroups included screening (n = 5), emotional support and education (n = 1), human papillomavirus vaccination (n = 1), and education and treatment (n = 1). A consistently measured outcome was intervention efficacy. Four authors explicitly stated that theories or theoretical constructs were employed to guide intervention development. Also, no interventions were created using novel devices such as emerging technologies. We identified several notable gaps regarding digital health for cancer prevention among racial/ethnic minoritygroups. Addressing these gaps may help guide continued innovation in the use of digital health for cancer prevention among racial/ethnic minoritygroups.

Abstract LB375: Multimodality dietary intervention for colorectal cancer prevention: The MyBestGI randomized trial

Abstract Colorectal cancer (CRC) is one of the cancers most highly affected by diet. Recommendations for reducing risk of CRC include weight management, eating plentiful plant-based high fiber foods, and limiting intakes of red meats and ultra-processed foods. In addition, an increased proportion of monounsaturated and omega-3 fats in the diet is beneficial for promoting weight management and reducing inflammation. Despite the evidence supporting the importance of diet and the demonstrated success for eliciting dietary changes in research settings, simple methods that can be easily implemented in medical settings are lacking. We developed a bespoke mHealth app (MyBestGI), incorporating an autonomy-supporting, self-regulatory approach to behavior change. The program promotes identification of the benefits of healthy eating on well-being. Two versions of the program are being tested in a 12-month, 3-arm randomized trial that seeks to recruit 240 people at increased risk for CRC. Participants are randomized to either 1) a control group that receives written information on cancer preventive diets, 2) a treatment group that receives a MyBestGI app version for logging 4 food groups associated with increased risks of CRC (red meats, processed meats, added sugars and refined grains), or 3) a treatment group that receives a MyBestGI app version for logging the same 4 food groups to limit plus 7 food groups to encourage in personalized quantities. The two treatment groups also receive a user manual, behavior-oriented, biweekly text messages, and supportive coaching calls. Logging food groups is requested at least 3 per week for 3 months, and 3 per week every other week for the next 9 months. The app displays logging results relative to individualized targets and has features that prompt reflecting on the user’s own results and planning for future eating. The primary endpoints are weight loss and improvement in a dietary cancer prevention score. Recruitment began in June 2023, and the study is enrolling 8-10 participants per month. The drop-out rate is lower than expected. Compliance with study procedures and app use is high. Responses to the end-of-day reflection questions within the app show that 92% of users are neutral, happy, or very happy with their dietary behavior for the day. For the 15 participants who had 12 weeks of logging data available, foods were logged for an average of 38 days (range 20-75) which is slightly higher than the requested logging of 36 days over 12 weeks. Review of the support calls for protocol fidelity indicates participants are enthusiastic about the MyBestGI program, making changes in their eating, and are internalizing the autonomy-supporting beliefs promoted in the program. These early results suggest users are engaging with the MyBestGI app at a very high level, making use of the provided app features, and enjoying the program. The MyBestGI approach therefore has excellent potential to support dietary change towards a cancer preventive diet in a format that is facile to implement in high-risk populations. Citation Format: Zora Djuric, Michelle Segar, Ananda Sen, Reema Kadri, Rob Adwere-Boamah, Juno Orr, Katherine Poore, Samara Rifkin, Lorraine Buis. Multimodality dietary intervention for colorectal cancer prevention: The MyBestGI randomized trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB375.

Knockdown of growth differentiation factor-15 restrains prostate cancer through regulating MAPK/ERK signaling pathway.

Prostate cancer, prevalent among males, is influenced by various molecular factors, including Growth Differentiation Factor 15 (GDF15). Despite its recognized role in multiple tumor types, GDF15's specific involvement in prostate cancer remains insufficiently explored. This study investigates the regulatory function of GDF15 in prostate cancer. To explore GDF15's impact, we established GDF15 knockdown and overexpression models in prostate cancer cells. We quantified mRNA and protein levels using RT-PCR and Western blotting. Functional assays, including CCK8, Transwell, wound healing, and flow cytometry, were employed to evaluate cell proliferation, invasion, migration, and apoptosis. Additionally, the effect of GDF15 on tumor growth was assessed using a metastatic tumor model in nude mice. Elevated GDF15 expression was identified in prostate cancer tissues and cells. The knockdown of GDF15 led to the activation of the MAPK/ERK signaling pathway. C16PAF was found to counteract the inhibitory effects of sh-GDF15 on cell proliferation, invasion, migration, and apoptosis in LNCaP cells. It also reversed the sh-GDF15-induced alterations in the epithelial-mesenchymal transition (EMT) process. In vivo, C16PAF notably mitigated the sh-GDF15-induced suppression of tumor growth. The study demonstrated that sh-GDF15 inhibits cell proliferation, invasion, migration, EMT process, and tumor growth, while it promotes apoptosis. However, these effects were significantly reversed by C16PAF. The study underscores the potential of GDF15 as a target for novel therapeutic interventions in prostate cancer treatment and prevention. These findings illuminate GDF15's multifaceted role in prostate cancer pathogenesis and suggest its viability as a therapeutic target.

Utility Scores for Risk-Reducing Mastectomy and Risk-Reducing Salpingo-Oophorectomy: Mapping to EQ-5D.

Risk-reducing mastectomy (RRM) and risk-reducing salpingo-oophorectomy (RRSO) are the most effective breast and ovarian cancer preventive interventions. EQ-5D is the recommended tool to assess the quality of life and determine health-related utility scores (HRUSs), yet there are no published EQ-5D HRUSs after these procedures. These are essential for clinicians counselling patients and for health-economic evaluations. We used aggregate data from our published systematic review and converted SF-36/SF-12 summary scores to EQ-5D HRUSs using a published mapping algorithm. Study control arm or age-matched country-specific reference values provided comparison. Random-effects meta-analysis provided adjusted disutilities and utility scores. Subgroup analyses included long-term vs. short-term follow-up. Four studies (209 patients) reported RRM outcomes using SF-36, and five studies (742 patients) reported RRSO outcomes using SF-12/SF-36. RRM is associated with a long-term (>2 years) disutility of -0.08 (95% CI -0.11, -0.04) (I2 31.4%) and a utility of 0.92 (95% CI 0.88, 0.95) (I2 31.4%). RRSO is associated with a long-term (>1 year) disutility of -0.03 (95% CI -0.05, 0.00) (I2 17.2%) and a utility of 0.97 (95% CI 0.94, 0.99) (I2 34.0%). We present the first HRUSs sourced from patients following RRM and RRSO. There is a need for high-quality prospective studies to characterise quality of life at different timepoints.

Abstract 816: Implementation of a community-based multi-component cancer screening intervention supported by a cross-sector community coalition

Abstract It is widely agreed that screening and early detection of cancer saves lives. However, disparities exist in those who received routine screenings and variability in clinic screening protocol. Working with community-based clinics on quality improvement as well as systematically screening all eligible patients can result in increased equity in screening and thus early detection. Be Well Communities™ is MD Anderson’s place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. The first several years of the initiative in Baytown focused on healthy eating and active living interventions for cancer prevention, over time the community’s trust and appetite increased which allowed for additional and more traditional cancer prevention interventions (e.g., human papilloma virus vaccination, screening). In this project, three evidence-based interventions for cancer screening were implemented in collaboration with Chambers Health, a local FQHC in Baytown, Texas, to work toward addressing the disparities in screening outcomes experienced by community residents. Chambers Health compliance rates have increased since the beginning of the Cancer Screening Navigation program, supported by Be Well Communities. Two full-time patient navigators are supported to facilitate increased screening through patient education, increased clinic compliance and development of standard operating procedures for navigation related operations. In addition, one full-time Outreach Coordinator is supported to engage with patients and provide education on cancer screenings. Compared to 2022, there was a 39% increase in colon cancer screening compliance rates, a 25% increase in cervical cancer screening compliance rates, and a 47% increase in breast cancer screening compliance rates. Compliance refers to any patient who is up-to-date in their cancer screenings. The Be Well Communities team supported Chambers Health through funding, technical assistance, and capacity building. They were then able to provide culturally relevant and high-quality care to enhance community capacity to address low rates of cancer screening in Baytown. Furthermore, Chambers Health has since integrated the patient navigators and Outreach Coordinator into their operational budget, a notable systems change for the organization and demonstration of commitment to the project and continued clinic quality improvement and more so dedication to the patients served. Citation Format: Ruth Rechis, Mayra Aquino, Haley Gardiner, Blanca Puga, Michael T. Walsh. Implementation of a community-based multi-component cancer screening intervention supported by a cross-sector community coalition [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 816.

Protocol for a cluster-randomized trial of a school-based skin cancer preventive intervention for adolescents

BackgroundAdolescents infrequently use sun protection and engage in intentional tanning more frequently compared to other age groups, leading to increased ultraviolet radiation (UVR) exposure that heightens skin cancer risk across the lifespan. High schools are therefore an ideal setting for offering skin cancer preventive interventions. Yet, there are limited UVR protection interventions for high school students, especially those that are personalized, tested using randomized designs, and include long-term outcome assessment to determine the durability of intervention effects. MethodThe Sun-safe Habits Intervention and Education (SHINE) cluster-randomized trial will test a novel, personalized intervention that targets high school adolescents' sun protection and tanning behaviors, and tracks their outcomes for up to one year following intervention. Enrolled high schools will be randomized to receive either the personalized SHINE intervention, which includes facial UVR photographs and sun protection action planning, or standard education using publicly available materials. Students in both conditions will receive information about skin cancer, sun protection, and skin self-examination. Outcome variables will include students' sun protection and tanning behaviors and sunburn occurrence. Potential moderators (e.g., race/ethnicity) and mediators (e.g., self-efficacy) will also be assessed and tested. ConclusionsThis trial examines the efficacy of a personalized intervention targeting sun protection and tanning of high school students. The project will lead to new scientific understanding of the theoretical mechanisms underlying outcomes and moderators of the intervention effects, which will inform future intervention tailoring to meet the needs of vulnerable subgroups.

Unraveling the Multifaceted Role of the miR-17-92 Cluster in Colorectal Cancer: From Mechanisms to Biomarker Potential.

Colorectal cancer (CRC) is a complex disease driven by intricate mechanisms, making it challenging to understand and manage. The miR-17-92 cluster has gained significant attention in CRC research due to its diverse functions and crucial role in various aspects of the disease. This cluster, consisting of multiple individual miRNAs, influences critical processes like tumor initiation, angiogenesis, metastasis, and the epithelial-mesenchymal transition (EMT). Beyond its roles in tumorigenesis and progression, miR-17-92's dysregulation in CRC has substantial implications for diagnosis, prognosis, and treatment, including chemotherapy responsiveness. It also shows promise as a diagnostic and prognostic biomarker, offering insights into treatment responses and disease progression. This review provides a comprehensive overview of recent advancements and the context-dependent role of the miR-17-92 cluster in colorectal cancer, drawing from the latest high-quality published data. It summarizes the established mechanisms governing miR-17-92 expression and the molecular pathways under its influence. Furthermore, it examines instances where it functions as an oncogene or a tumor suppressor, elucidating how cellular contexts dictate its biological effects. Ultimately, miR-17-92 holds promise as a biomarker for prognosis and therapy response, as well as a potential target for cancer prevention and therapeutic interventions. In essence, this review underscores the multifaceted nature of miR-17-92 in CRC research, offering promising avenues for enhancing the management of CRC patients.

Rural-urban differences in meeting of physical activity recommendations by sun exposure and protection behaviors in the United States

ObjectiveTo examine associations between sun protection behaviors and physical activity (PA) by rural and urban residence in the United States. MethodsWe analyzed data from the National Health and Nutrition Examination Survey (2013–2018), restricting to participants ages 20–59 with sun behavior data. Sunburns, sun exposure, and sun protection measures were dichotomized (yes/no): ≥1 sunburn in the past year, 2+ hour outside during workdays or non-workdays, and never/rarely/sometimes using sunscreen, wearing long sleeves, and staying in the shade. Meeting PA recommendations (yes/no) was defined as ≥150 min of vigorous/moderate or ≥ 75 min vigorous PA per week. Associations between sun behaviors and PA were analyzed using logistic regression models, which accounted for survey-weights and potential confounders, and stratified by rural-urban status. ResultsRural and urban individuals meeting PA recommendations had greater odds of spending 2+ hour outside during workdays (OR: 2.26 [1.88, 2.74] and 3.95 [2.72, 5.73]) and non-workdays (OR: 2.06 [1.78, 2.38] and 3.33 [2.47, 4.46]). Among urban residents, odds of staying in the shade were lower among those who met PA recommendations (OR: 0.78 [0.66, 0.92]). We did not observe differences in sunburns or other sun behaviors by PA status, regardless of rurality. ConclusionsMeeting PA recommendations was associated with greater sun exposure in both rural and urban populations. Additional exercise location (indoors/outside) data is needed to inform PA and skin cancer prevention interventions to reduce unintended increases in sun exposure and reductions in PA, respectively, especially among rural populations.

A Systematic Review of the Effectiveness of Cervical Cancer Screening and Prevention Interventions for African American Women: Implications for Promoting Health Equity.

African American women suffer under the burden of cervical cancer as they are first in mortality, diagnosed at later stages, and have a survivorship rate that is lower than the national average. The aim of our review is to evaluate the effectiveness of cervical cancer screening and prevention interventions for African American women living in the United States and to assess their commitment to health equity. A literature search was conducted using PubMed, Embase, CINAHL, and Scopus using MeSH terms related to cervical cancer, human papillomavirus (HPV), screening and prevention, and African Americans. This resulted in 1970 articles. Studies were included if they promoted cervical screening or prevention, sampled African American women aged 18 and over, and evaluated interventions. Among the 23 articles that met inclusion criteria, there were a wide variety of intervention strategies, that is, community health workers, patient navigation, patient reminders, self-sampling collection, and HPV vaccination. Health education interventions, when coupled with patient navigation or community health workers, were effective in promoting screening participation (odds ratio: 2.43, 95% confidence interval: 1.47-4.02). There were mixed results regarding the incorporation of health equity principles. This review supports the importance of incorporating health equity principles and community based methods in screening and prevention interventions. Future research and practice should incorporate African American women's perspectives in intervention development and implementation.

Managing Colorectal Cancer from Ethology to Interdisciplinary Treatment: The Gains and Challenges of Modern Medicine.

Colorectal cancer (CRC) is a common malignant tumor of the gastrointestinal tract, which has become a serious threat to human health worldwide. This article exhaustively reviews colorectal cancer's incidence and relevance, carcinogenesis molecular pathways, up-to-date treatment opportunities, prophylaxis, and screening program achievements, with attention paid to its regional variations and changes over time. This paper provides a concise overview of known CRC risk factors, including familial, hereditary, and environmental lifestyle-related risk factors. The authors take a closer look into CRC's molecular genetic pathways and the role of specific enzymes involved in carcinogenesis. Moreover, the role of the general practitioner and multidisciplinary approach in CRC treatment is summarized and highlighted based on recent recommendations and experience. This article gives a clear understanding and review of the gains and challenges of modern medicine towards CRC. The authors believe that understanding the current patterns of CRC and its revolution is imperative to the prospects of reducing its burden through cancer prevention and cancer-adjusted treatment.

Invesigate How Cultural and Socioeconomic Factors Influence Oral Cancer Prevention Behaviors, Screening Uptake, and Treatment Outcomes

ABSTRACT Background: Oral cancer is a significant global health issue, with prevention and early detection being pivotal for improved outcomes. This study investigates the impact of cultural and socioeconomic factors on oral cancer prevention behaviors, screening participation, and treatment outcomes Materials and Methods: A cross-sectional study design was employed, involving a sample size of 1,000 participants. Participants were recruited through stratified sampling to ensure cultural and socioeconomic diversity. Statistical analyses, including logistic regression, were used to explore associations between factors and outcomes. Results: The study revealed multifaceted influences of cultural and socioeconomic factors on oral cancer-related aspects. Cultural factors significantly influenced prevention behaviors, with participants from certain cultural backgrounds exhibiting higher rates of tobacco use and lower rates of dietary adherence). Socioeconomic status played a role in screening uptake, with individuals from lower income brackets less likely to undergo regular screenings Conclusion: Cultural and socioeconomic factors have a substantial influence on oral cancer prevention behaviors, screening participation, and treatment outcomes.

State of the Science of Scale-Up of Cancer Prevention and Early Detection Interventions in Low- and Middle-Income Countries: A Scoping Review.

Cancer deaths in low- and middle-income countries (LMICs) will nearly double by 2040. Available evidence-based interventions (EBIs) for cancer prevention and early detection can reduce cancer-related mortality, yet there is a lack of evidence on effectively scaling these EBIs in LMIC settings. We conducted a scoping review to identify published literature from six databases between 2012 and 2022 that described efforts for scaling cancer prevention and early detection EBIs in LMICs. Included studies met one of two definitions of scale-up: (1) deliberate efforts to increase the impact of effective intervention to benefit more people or (2) an intervention shown to be efficacious on a small scale expanded under real-world conditions to reach a greater proportion of eligible population. Study characteristics, including EBIs, implementation strategies, and outcomes used, were summarized using frameworks from the field of implementation science. This search yielded 3,076 abstracts, with 24 studies eligible for inclusion. Included studies focused on a number of cancer sites including cervical (67%), breast (13%), breast and cervical (13%), liver (4%), and colon (4%). Commonly reported scale-up strategies included developing stakeholder inter-relationships, training and education, and changing infrastructure. Barriers to scale-up were reported at individual, health facility, and community levels. Few studies reported applying conceptual frameworks to guide strategy selection and evaluation. Although there were relatively few published reports, this scoping review offers insight into the approaches used by LMICs to scale up cancer EBIs, including common strategies and barriers. More importantly, it illustrates the urgent need to fill gaps in research to guide best practices for bringing the implementation of cancer EBIs to scale in LMICs.

Body composition changes during breast cancer preventive treatment with anastrozole: Findings from the IBIS-II trial

BackgroundUptake to anastrozole for breast cancer prevention is low, partly due to women’s concerns about side effects including gains in weight and specifically gains in body fat. Previous evidence does not link anastrozole with gains in weight, but there is a lack of data on any effects on body composition i.e. changes in fat and fat free mass. Here we assess association of anastrozole with body composition changes in a prospective sub-study from the second international breast intervention trial (IBIS-II). MethodsParticipants had DXA scans at baseline and for five years of anastrozole/placebo and beyond (between March 2004 and September 2017. Primary outcomes were changes in body weight, body fat and fat free mass at 9–18 months. A linear model was used to estimate the size of a differential effect in these outcomes by randomised treatment allocation adjusted for baseline value and time since last scan, age, 10-year breast cancer risk, smoking and HRT status. Results203 postmenopausal women were recruited (n = 95 anastrozole, n = 108 placebo), mean age 58 years (SD = 5.4), BMI 28.0 kg/m2 (SD = 5.5). There was no evidence of a strong association between anastrozole or placebo and endpoints at 9–18 months; effect size (95 %CI) for anastrozole minus placebo for body weight (per/kg) −0.11 (−1.29–1.08); body fat 0.11 (−0.75–0.96) and fat free mass −0.30 (−0.79–0.19). ConclusionsThere is unlikely to be a clinically significant change to body composition with anastrozole for breast cancer prevention.

Preliminary effects of a rural skin cancer prevention intervention for youths.

To pilot and assess the feasibility, acceptability, and preliminary effects of the Rural Adult and Youth Sun (RAYS) protection program, a multilevel skin cancer preventive intervention for young children living in rural U.S. communities, delivered through community-organized team sports. Three rural counties in Utah participated with two receiving the intervention and the third serving as a control. Youth sports leagues were recruited through recreation departments and the study took place from May through October 2021. Intervention leagues received sun protection supplies for players and coaches, educational materials for parents, and coaches were offered training on skin cancer and sun protection behaviors. The RAYS program is both feasible to deliver and acceptable to coaches, parents, and players. The intervention also demonstrates beneficial preliminary effects on components of observed child sun-protective behaviors, coach sun protection behaviors, knowledge of skin cancer prevention recommendations, and self-efficacy in skin cancer prevention. Multilevel interventions for skin cancer prevention among young children can be successfully delivered through community organizations and their settings. A priority moving forward is the identification of ways to optimize delivery of such programs to positively influence skin cancer preventive behaviors among children living in diverse rural areas. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dietary intervention for tertiary prevention in head and neck squamous cell carcinoma survivors: clinical and translational results of a randomized phase II trial.

There is a strong need for preventive approaches to reduce the incidence of recurrence, second cancers, and late toxicities in head and neck squamous cell carcinoma (HNSCC) survivors. We conducted a randomized controlled trial (RCT) to assess a dietary intervention as a non-expensive and non-toxic method of tertiary prevention in HNSCC survivors. Eligible participants were disease-free patients with HNSCC in follow-up after curative treatments. Subjects were randomized 1:1 to receive a highly monitored dietary intervention plus the Word Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention (intervention arm) or standard-of-care recommendations (control arm). The planned sample size for the event-free survival evaluation (primary endpoint) was not reached, and the protocol was amended in order to investigate the clinical (nutritional and quality-of-life questionnaires) and translational study [plasma-circulating food-related microRNAs (miRNAs)] as main endpoints, the results of which are reported herein. One hundred patients were screened, 94 were randomized, and 89 were eligible for intention-to-treat analysis. Median event-free survival was not reached in both arms. After 18 months, nutritional questionnaires showed a significant increase in Recommended Food Score (p = 0.04) in the intervention arm vs. control arm. The frequency of patients with and without a clinically meaningful deterioration or improvement of the C30 global health status in the two study arms was similar. Food-derived circulating miRNAs were identified in plasma samples at baseline, with a significant difference among countries. This RCT represented the first proof-of-principle study, indicating the feasibility of a clinical study based on nutritional and lifestyle interventions in HNSCC survivors. Subjects receiving specific counseling increased the consumption of the recommended foods, but no relevant changes in quality of life were recorded between the two study arms. Food-derived plasma miRNA might be considered promising circulating dietary biomarkers.

Factors Associated with Cancer Prevention/Risk Reduction Behaviors among Latinos.

Improving understanding of behaviors that increase or reduce cancer risk for different Hispanic groups is a public health priority; such knowledge is sparse in new gateway immigration locations such as Indiana. The aims of this study were to: 1) describe cancer beliefs and cancer preventive/risk reduction behaviors (physical activity, tobacco, and alcohol use) among Hispanic adults; 2) examine differences in cancer beliefs and preventive behaviors by country/territory of birth, socioeconomic status, and area of residence (urban vs. rural); and 3) determine predictors of engagement in cancer prevention and risk reduction behaviors in this population. A cross-sectional online survey targeted adult Indiana residents who identified as Latino, Hispanic, or Spanish recruited using Facebook-targeted advertising. Complete survey data from 1520 respondents were analyzed using descriptive, unadjusted, and adjusted models. The majority of respondents believed they were unlikely to get cancer but held many other fatalistic beliefs about cancer. Only 35.6% of respondents had received the HPV vaccine, 37.6% reported they were currently smoking cigarettes, and 64% reported occasional or frequent drinking of alcohol. Respondents spent an average of 3.55days per week engaged in moderate exercise. Differences were observed by country/territory of birth, income, and education but not by rural residence status. Predictors of cancer risk/risk reduction behaviors were identified. The Hispanic population in Indiana is diverse and effective interventions for cancer prevention should be culturally targeted based on country/territory of birth and individually tailored based on cancer-related beliefs.

Abstract C141: From insights to action: Engaging women living with HIV in the data-driven development of an mHealth intervention for cervical cancer prevention and HPV self-sampling

Abstract Background: Women living with HIV (WLH) face a higher risk of invasive cervical cancer (CC) due to a greater incidence and longer persistence of high-risk human papillomavirus (HPV) infection. Health education programs, including text-messaging interventions, have demonstrated effectiveness in improving CC and HPV knowledge and promoting recommended screening. Emerging strategies involving self-collected cervicovaginal samples as an alternative to office-based HPV screening offer additional promise in reaching women who face several obstacles to timely care, such as WLH. Purpose: This mixed-methods study aims to describe the data-driven development of a four-week text-messaging intervention, named “My Self-Sampling, HPV Awareness, Results, and Empowerment (MySHARE)”, to improve CC prevention knowledge and promote HPV self-sampling among WLH. Methods: Surveys (n=81) and focus group discussions (FGDs; n=39) were conducted among WLH in the Washington-Baltimore metropolitan region, with the findings guiding the development of MySHARE. Results: While most WLH indicated that in-person group sessions were their typical source of health information, they highlighted the impracticality of these sessions since the pandemic and expressed openness to a text-messaging intervention. Survey results informed the logistical aspects and functionality of the intervention, while FGD participants' responses, guided by constructs from the Protection Motivation Theory, shaped the content of the text-messaging library. The library covered topics such as CC and HPV knowledge, prevention behaviors, and HPV self-sampling. Conclusions: This study emphasizes the significance of engaging the target population in intervention development. WLH participants provided clear and actionable recommendations, which, together with best practices in digital health technology, directed decisions on the intervention delivery platform, messaging timing and frequency, and text-messaging content. Low-cost and accessible interventions like MySHARE have the potential to substantially enhance CC and HPV knowledge, as well as screening rates, among historically underserved populations, particularly during public health crises. Citation Format: Daisy Le, Annie Coriolan Ciceron, Min (Jaime) Jeong Jeon, Lorien C. Abroms, Carla J. Berg. From insights to action: Engaging women living with HIV in the data-driven development of an mHealth intervention for cervical cancer prevention and HPV self-sampling [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 C141.

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.

Abstract A027: Creating partnerships to deliver community-based interventions for cancer prevention in a historically African American community

Abstract Be Well Communities™ is MD Anderson’s signature place-based approach for cancer prevention and control, working with communities to promote wellness and address modifiable risk factors for cancer. In this project, the planning phase of the Be Well Communities’ model was implemented in Acres Homes, a neighborhood in northwest Houston with more than 57,000 residents. While the changing demographics show increasing numbers of residents of Hispanic descent (43% of the population), Acres Homes still experiences effects of a legacy of Blacks experiencing poverty; more than half of the population of Acres Homes resides in census tracts that are considered areas of persistent poverty. Further, it is a medically underserved area with relatively high rates of unhealthy behaviors, as compared to Healthy People 2030 goals. To work toward addressing the disparities in health outcomes experienced by community residents, a community advisory group (Steering Committee) including residents, non-profit organizations, health care partners, city and county agencies, plus other stakeholders, was convened and aligned through a structured process to develop shared goals, foster multisector collaboration (as measured by a stakeholder survey administered twice), and enhance community capacity to improve health outcomes through development of a Community Action Plan. Clear, achievable goals were developed, multisector collaboration was enhanced, and more than 400 hours of capacity building support led to a Community Action Plan focused on healthy eating and active living, including 15 evidence-based interventions led by 18 organizations. The majority (93%) of the Steering Committee reports that this plan reflects community priorities and will reach the residents most in need. In the first 2 years of implementation nearly 40% of the residents of the community have been reached by programs including more than 5,000 residents participating in physical activity opportunities, classes and over 1000 individuals receiving outreach from a Community Health Worker within the safety-net hospital system to receive access to healthy food access and nutrition education programming. By listening and developing trust, the Be Well Communities team successfully worked with Acres Homes residents and organizations to enhance community capacity to address health inequities in one of Houston’s most historic communities. Citation Format: Ruth Rechis, Haley Gardiner, Katy Oestman, Stephanie Nutt, Michael T. Walsh Jr.. Creating partnerships to deliver community-based interventions for cancer prevention in a historically African American community [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 A027.