Education Level Research Articles

Abstract 6189: Educational level as a determinant of breast cancer stage at diagnosis

Abstract Background: Presently, there is a gap in literature regarding specific demographic characteristics and the stage of breast cancer at diagnosis. Herein, we examined patients' educational levels to explore effective strategies for early breast cancer diagnosis. Methods: Convenience sampling method was used to select invasive breast cancer patients treated at a tertiary hospital in Guangzhou between January 2018 and March 2023 to determine patients' breast cancer stage at diagnosis and individual characteristics. The associations were analyzed using Student's t-test and the chi-square test, and binary logistic regression analysis was conducted to assess the odds ratios (ORs) for the occurrence of late-stage breast cancer. Results: The study encompassed a total of 3225 patients diagnosed with invasive breast cancer. Among them, 707 patients were identified with late-stage cancer (stage III-IV), comprising 21.9% of the total sample. Univariate analysis revealed a significant inverse correlation between patients' educational level and the stage of breast cancer at diagnosis, regardless of age stratification. The results of the chi-square test revealed a significant correlation between patients' educational level and their perception of illness (P < 0.001), with patients with higher levels of education being more likely to demonstrate a more comprehensive understanding of the disease. Upon controlling for other potential confounding variables, these findings were confirmed by binary logistic regression analysis, which demonstrated that individuals with lower education levels had a significantly increased likelihood of being diagnosed with late-stage breast cancer (adjusted OR = 1.409 for the middle school group and 1.518 for the illiterate and primary school group). Conclusions: Patients with lower educational levels could be more likely to present with late-stage breast cancer at diagnosis. Therefore, it is imperative to prioritize popular science and early prevention strategies for breast cancer among less educated populations. Citation Format: Xiaying Kuang. Educational level as a determinant of breast cancer stage at diagnosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6189.

Abstract 4938: Socioeconomic position and survival after lung cancer diagnosis: Comparisons in 4 continents

Background: The incidence of lung cancer is lower among higher socioeconomic position (SEP) groups in most settings. It is important to assess whether this translates to disparities in survival by SEP after lung cancer diagnosis. We sought to describe the relationship between SEP and survival after lung cancer diagnosis across different countries. Methods: We analyzed data from the Lung Cancer Cohort Consortium (LC3) and included 18 prospective cohorts from 14 countries in North America, Europe, Asia, and Australia. The total sample size included 48,482 lung cancer cases with pre-diagnostic risk factor information, amongst whom 37,559 died during the follow-up (median, IQR= 10.8, 6.5-15.0 years). Information on education was harmonized using the International Standard Classification of Education and then modeled as an ordinal variable in 4 categories. We evaluated the relationship between educational level and survival after lung cancer diagnosis using Cox proportional hazards models. Models were adjusted for age at diagnosis, sex, and (where applicable) cohort, smoking duration, cigarettes per day, and time since cessation. Results: We observed a clear trend toward better survival in participants with higher educational level in lung cancer cases diagnosed in North America, Europe and Asia, but not in Australia. After accounting for detailed smoking history, the hazard ratios were partly attenuated (North America: hazard radio per 1-unit increase in educational level [HR]=0.94, 95%CI=0.93-0.96; Europe: HR=0.94, 95%CI: 0.92-0.95; Asia: HR=0.81, 95%CI=0.77-0.85), but not in Australia. When additionally adjusting for stage at diagnosis, the inverse relationship between educational level and survival was further attenuated in Asian lung cancer cases, but not in European or North American study participants. We estimated that differences in tobacco exposure mediated approximately 20% of the relationship between education and lung cancer survival, and that disease stage mediated an additional 14% of this relationship in Asian lung cancer cases. Conclusion: Higher educational attainment is consistently associated with better lung cancer survival in North America, Europe, and Asia. Differences in tobacco exposure may partly, but not entirely mediate this relationship, and differences in stage at diagnosis may be additionally important in mediating the survival differences seen in Asian lung cancer cases. This study highlights the importance of socioeconomic position in the continuum of lung cancer disparities. Citation Format: Justina Ucheojor Onwuka, Karine Alcala, Hilary A. Robbins, Mattias Johansson, The Lung Cancer Cohort Consortium. Socioeconomic position and survival after lung cancer diagnosis: Comparisons in 4 continents [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4938.

Abstract 3599: Proteomic risk factors for prostate cancer: A case-cohort study in EPIC

Abstract Background: Prostate cancer (PCa) is the most prevalent cancer among men in Europe, yet its aetiology is poorly understood. Proteins contribute to the development of carcinogenesis and are also the target of most pharmacological interventions. The examination of associations between plasma proteins and PCa may enhance understanding of the aetiology of the PCa. Aim: Identify proteins associated with PCa risk within a large European prospective cohort, with emphasis on associations with aggressive subtypes of the disease. Methods: We conducted a case-cohort study in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, with data for a sub-cohort of 1, 573 individuals and for 982 incident PCa cases. The SomaLogic® 7K panel was used to measure 7, 363 aptamers (representing 6, 412 unique proteins) in plasma samples drawn at recruitment. PCa diagnosis was ascertained by linkage to cancer and death registry data, and was further stratified into aggressive subtypes based on histological grade, tumour stage and mortality information. The Prentice-weight Cox regression model was applied to estimate associations between individual proteins and PCa risk, with adjustment for body mass index, smoking, alcohol intake and education level. Subgroup analyses examined associations with high-grade, advanced-stage, aggressive and extended lag-time (diagnosis more than 15 years after blood draw) PCa risk. We sought external replication for our significant findings in an independent multi-ancestry cohort, the Atherosclerosis Risk in Communities (ARIC) study (SomaLogic® 5K). Results: Following a median follow-up period of 16.2 years, the sub-cohort developed 79 cases of PCa. ACP3, FLT4, and KLK3 [HRs (95% CI): 1.20 (1.10, 1.31), 1.26 (1.13, 1.40) and 2.28 (1.96, 2.65), respectively] were associated with overall PCa risk in EPIC at FDR (false discovery rate) <0.05. In the subgroup analyses, 12 proteins were associated with high-grade, 9 with advanced stage, and 7 with aggressive PCa risk. Among these, ANKRD1 was associated with approximately a 25% higher risk of all three of these clinically relevant subtypes per SD increase. Twelve proteins were associated with PCa risk diagnosed more than 15 years after blood draw, including ANXA2, OSCAR, and SAT2. Two well-established biomarkers of PCa (ACP3 and KLK3) were replicated in ARIC, together with two novel proteins (ANXA2 and APOC2). Conclusion: Multiple novel circulating proteins were associated with PCa risk, particularly with risk for aggressive subtypes. While some proteins may serve as early biomarkers of PCa, those with evidence from long-lag time highlight underlying aetiological mechanisms in the development of PCa. Citation Format: Zhe Huang, Mahboubeh Parsaeian, Vivian Viallon, Ziqiao Wang, Keren Papier, Trishna Desai, Stephanie Chan, Antonio Agudo, Carlotta Sacerdote, David C. Muller, Domenico Pali, Giovanna Masala, Nicholas Wareham, Raul Zamora-Ros, Roel C. Vermeulen, Rosario Tumino, Ian G. Mills, Nilanjan Chatterjee, Elizabeth A. Platz, Pietro Ferrari, Marc Gunter, Elio Riboli, Tim J. Key, Joshua R. Atkins, Karl Smith-Byrne, Ruth C. Travis, The EPIC SomaLogic Working Group. Proteomic risk factors for prostate cancer: A case-cohort study in EPIC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3599.

Consumer and Economic Influences on Electric Vehicle Adoption: The Mediating Role of Attitudes and the Moderating Effect of Demographics

This study explores economic and consumer factors impacting electric vehicle (EV) adoption through consumer attitude mediation and moderation by demographic factors in the Jordanian context. The study aims to fill an important knowledge gap about EV adoption mechanisms. The study analyzes the insufficient attention given to demographic indicators including age and income and educational level because they affect how economic premiums alongside psychological preferences lead to behavioral electronic vehicle adoption. The study used an online survey with 288 valid EV owner and drivers respondents in Jordan targeted to test the research model using structural equation modeling via SmartPLS. The analysis validates that economic variables relationship with EV adoption rates through consumer attitudes and demographic characteristics play a key role as influencing variables. Study presents actionable implications which policymakers and manufacturers can use to boost EV adoption rates. The results demonstrate that education programs combined with awareness campaigns about EV financial gains and environmental advantages need to become primary factors for developing positive consumer attitudes toward these vehicles. The different consumer segments require targeted marketing strategies because demographic characteristics serve as essential moderators in the adoption process. Older consumers with lower incomes need experiential information about EVs along with financial incentives since younger university-educated consumers already show interest in EV technology. Policy makers should use adjustable financial incentives to encourage adoption among groups that show low interest in electric vehicles because this approach will boost the impact of economic incentives toward wider adoption.

Abstract 6186: HPV vaccine hesitancy and uptake: A conceptual analysis using Rodgers' evolutionary approach

Abstract Aim: This study examines the factors contributing to HPV vaccine hesitancy through Rodgers's evolutionary concept analysis, with a focus on the role of uncertainties surrounding the vaccine's impact on preventing HPV-related diseases despite its availability.Design: Rodgers's evolutionary concept analysis was employed to investigate factors influencing HPV vaccine hesitancy. The analysis considered studies published in English within the past five years (2019 - 2024), excluding those older than five years, non-English publications, and studies focused on other vaccines. Data Sources: To ensure a thorough review, a comprehensive literature search was conducted across key databases, including PsycINFO, CINAHL, MEDLINE, and PubMed. Relevant keywords such as “HPV” and “vaccine hesitancy” were used. Review Methods: Following PRISMA guidelines, 29 articles were selected for analysis: 19 quantitative studies, 8 qualitative studies, and 2 mixed-methods studies. The analysis explored factors related to HPV vaccine hesitancy, examining antecedents, attributes, and consequences. Results: Key antecedents identified included cultural beliefs, educational level, knowledge, and vaccine availability, along with factors like insurance status, perceived risk, and decision-making processes. Significant attributes influencing hesitancy involved media coverage, environmental and community influences, social factors, trust in healthcare, efficacy rates, and safety concerns. Consequences of hesitancy were noted as lower vaccine uptake, increased HPV-related diseases, and the persistence of misinformation. Conclusion: This study underscores the complex interaction of factors contributing to HPV vaccine hesitancy. Addressing these factors is essential to overcoming vaccine hesitancy challenges and creating effective intervention strategies. Impact: This analysis's findings provide valuable insights into public health strategies for enhancing vaccine uptake and reducing HPV-related diseases. Targeted efforts to address misinformation and build vaccine trust can improve public health outcomes. Patient or Public Contribution: This concept analysis was conducted without the direct involvement of patients, service users, caregivers, or members of the public. Citation Format: Grace Kwakyewaa Kyei, Evans F. Kyei, Rockson Ansong. HPV vaccine hesitancy and uptake: A conceptual analysis using Rodgers' evolutionary approach [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6186.

Abstract 2264: Disparities in perceptions and uptake of genetic testing among the United States population: trends from 2011-2022

Background: Over the last decade, genetic testing has become more readily available, but it is not known whether this has translated to greater public awareness and usage over time. We aimed to evaluate patterns and temporal trends in genetic testing awareness and usage, along with their sociodemographic and cancer history correlates, in the United States (US) population. Methods: We performed a serial, cross-sectional analysis of nationally representative data from the National Cancer Institute’s Health Information National Trends Survey (HINTS). We analyzed survey responses from adults aged 18 or older from HINTS 4 Cycle 1 (2011), 4 Cycle 2 (2012), 4 Cycle 3 (2013), 4 Cycle 4 (2014), 5 Cycle 1 (2017), 5 Cycle 4 (2020), 6 (2022). Crude linear trend was evaluated using a linear regression model and multivariable logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Results: Data on 22,256 individuals (mean [SD] age, 46.7 [17.0] years; 13,208 (50.7%) female; non-Hispanic White 13,559 (65.2%)) were analyzed from 2011-2022 HINTS data. Awareness of genetic testing increased from 36.6% in 2011 to 81.7% in 2022 (p<0.001). Older adults, men, non-Hispanic Black individuals, non-Hispanic Asian individuals, Hispanic individuals, those with an education level less than some college, and individuals with annual household incomes less than $75,000 were significantly less likely to be aware of genetic testing. Uptake of genetic testing, however, lagged behind awareness with rates of 21.4% in 2020 and 35.6% in 2022. Uptake of genetic testing was significantly lower among non-Hispanic Asian individuals, those with household incomes under $35,000, and those without a personal history of cancer. Conclusion: Despite high levels of awareness, genetic testing uptake remains disproportionately low, with notable disparities across sociodemographic groups. Targeted educational interventions focused on genetic testing are necessary for marginalized populations and the providers caring for them. Further study is needed to understand genetic testing uptake patterns in the US. Citation Format: Ariana Naaseh, Mengyao Shi, Steven Tohmasi, Erin L. Linnenbringer, Julie A. Margenthaler, Graham A. Colditz, Yin Cao. Disparities in perceptions and uptake of genetic testing among the United States population: trends from 2011-2022 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2264.

Assessing Economic and Infrastructure Constraints on Electric Vehicle Purchase Decisions: A Demographic-Moderated Analysis in Emerging Markets

Electric vehicle (EV) adoption is gaining global attention; however, economic and infrastructure barriers remain critical challenges in emerging markets. This study examines the impact of economic constraints (high purchase costs, maintenance expenses, and spare parts availability) and infrastructure limitations (Charging Infrastructure Availability, charging time, and spare parts supply chain inefficiencies) on EV purchase decisions in Jordan. The study further investigates the moderating role of demographics (age, gender, and education level) in shaping consumer responses to these constraints. The research employed Structural Equation Modeling (SEM) as a quantitative method to examine data obtained from Jordanian EV consumer prospects. The adoption of EVs depends heavily on economic and infrastructure factors where infrastructure play a dominant role. The demographic characteristics determine how consumers handle obstacles that prevent them from adopting electric vehicles. The research enhances theoretical EV adoption frameworks through economic and infrastructure analysis combined with demographic variables which improves our understanding of purchase choices in developing markets. The implementation of policy needs to concentrate on building charging infrastructure along with supply chain optimization and targeted incentives for different groups of people. The research provides strategic guidance for policy makers as well as businesses and industry stakeholders to accelerate sustainable transportation adoption in emerging market settings.

Give Me More, and More Variety: Sexual Satisfaction Among BDSM and Kink Practitioners in Chile.

Previous research has shown a positive association between BDSM/kink behaviors and sexual satisfaction. The present study further explored this relationship within a Chilean population of BDSM practitioners. A total of 543 participants responded to an online questionnaire about BDSM/kink roles, practices, and overall sexual satisfaction. The main regression analyses evaluated the associations between BDSM roles, the frequency and variety of BDSM/kink interests and behaviors and the degree of discordance between the BDSM/kink behaviors participants find arousing and those that they have engaged in, as well as the contributions of the socio-demographic factors such as gender, age, sexual orientation, educational level, and relationship status on sexual satisfaction levels. The results indicated that the frequency and diversity of BDSM and kink activities were linked with higher sexual satisfaction. While no significant differences were found in sexual satisfaction across dominant, submissive, and switch roles, individuals in both monogamous and non-monogamous relationships reported higher satisfaction levels in comparison to those not in a relationship. These results emphasize the importance of respecting and de-pathologizing "non-conventional" forms of sexuality, such as BDSM. Future research should focus on the long-term psychological and relational effects of BDSM participation and aim to include more diverse and representative samples.

Abstract 4969: Ethnic disparities in breast and cervical cancer screening in Guam: a cross-sectional analysis (2012-2022)

Background: In Guam, breast and cervical cancer late-stage diagnoses and mortality rates exceed U.S. averages. From 2013-2017, 30.7% of breast and 28.6% of cervical cancers were diagnosed late. Micronesians had the highest late-stage breast cancer rate (59.1%); Filipinos had the highest for cervical cancer (33.3%). Breast cancer mortality was 27.3 per 100,000 in Guam vs. 20.3 in the U.S., with Micronesians at 104.6. Cervical cancer mortality was 6.7 in Guam vs. 2.3 in the U.S., with Micronesians at 22.3. Methods: A cross-sectional study analyzed 6,625 female adults from Guam using Behavioral Risk Factors Surveillance System data from 2012 to 2022. We examined current mammogram screenings for women aged 40 and older and Pap tests for women aged 21 to 65. Binary logistic regression models assessed trends and associations, adjusting for age, education, income, and survey year. Results: Overall, 64.4% of women ≥40 were current with mammograms, and 67.7% of women aged 21 to 65 had recent Pap tests. White women had the highest screening rates (70.7% for mammograms; 79.7% for Pap tests), while Micronesian had the lowest (44.2% for mammograms; 49.1% for Pap tests). Mammogram rates increased by 1.4% bi-annually, with the highest increases among Filipino (2.9%) and White (1.3%) women, but declined among Micronesians (-0.8%). Pap test rates declined slightly (-0.3%), with CHamoru women having the biggest decrease (-2.1%). Despite Micronesian women having the largest increase in Pap test rates (3.7%), their screening rates (54.1%) remained significantly below the overall rate (68%). Adjusted odds ratios showed higher mammogram screening among Asians (OR = 1.3; 95% CI: 1.1-1.6) and lower among Micronesians (OR = 0.6; 95% CI: 0.6-0.8) compared to White women. Age groups 50-59 (OR = 2.2; 95% CI: 2.0-2.6), 60-69 (OR = 2.8; 95% CI: 2.6-3.0), and 70+ (OR = 2.0; 95% CI: 1.8-2.2) had higher odds than ages 40-49. Higher education and income levels were associated with increased screening. For Pap tests, Filipinos (OR = 0.6, 95% CI: 0.6-0.7), Asians (OR = 0.7, 95% CI: 0.6-0.8), and Micronesians (OR = 0.5, 95% CI: 0.5-0.6) had lower odds compared to White women. Age group 60-69 had lower odds (OR = 0.6; 95% CI: 0.5-0.7) compared to ages 18-29. Higher education and income were also associated with increased Pap test screening. Conclusion: Despite some improvements, Guam’s cancer screening rates remain below U.S. medians. Significant ethnic disparities exist, especially among Micronesian and CHamoru populations. Targeted interventions are needed to improve screening rates and reduce late-stage cancer diagnoses among these groups. Acknowledgement: This research was funded by the National Cancer Institute: The University of Guam/University of Hawaii Cancer Center Partnership to Advance Cancer Health Equity (PIPCHE), Grant U54CA143728 (University of Guam, YCP)/Grant U54CA143727 (University of Hawaii Cancer Center). Citation Format: Aurienne Cruz, Grazyna Badowski, Grace Garces Bordallo. Ethnic disparities in breast and cervical cancer screening in Guam: a cross-sectional analysis (2012-2022) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4969.

Abstract 1890: Proteomic analysis of colorectal cancer risk across two prospective cohorts

Abstract High-throughput proteomic profiling in prospective cohorts has the potential to uncover biomarkers of cancer risk and biology of cancer development. We investigated prospective associations of up-to 7, 335 aptamers with overall and site-specific colorectal cancer in a case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC) and then evaluated associations in the Atherosclerosis Risk in Communities (ARIC) study. Hazard ratios and 95% confidence intervals were estimated using Prentice weighted Cox-proportional hazard models (stratified by recruitment center, sex, and 5 year age group and adjusted for fasting status, day of blood draw, body mass index, smoking status, daily alcohol consumption, physical activity level, and highest level of education) in 977 incident colorectal (colon, 658; rectum, 319) cancer cases and 5, 057 non-cases under a case-cohort design. The identified associations were then evaluated in ARIC in a cohort design including 271 colorectal (colon, 235; rectum, 36) cancers in 9, 495 individuals using multivariate Cox-proportional hazard models. Overall, 37 aptamers were associated (false discovery rate[FDR] p-value < 0.05) with colorectal cancer in EPIC; data on 27 of these were available in ARIC, 7 of which had consistent directions of association in both studies and met a nominal p-value (0.05) threshold in ARIC (positive associations: ACAA1, ASL, GDF15, IQCF1, TFF3; inverse associations: CLEC3B, COMP). Associations did not change after 5-year follow-up exclusion. In site-specific analyses in EPIC, 66 and 6 aptamers were specifically associated with colon and rectal cancer, respectively at FDR<0.05. Four of these aptamers were nominally (P<0.05) associated with colon cancer in ARIC (inverse association: CLEC3B; positive association: ACAA1, GDF15, TFF3) while a further 29 showed associations directionally consistent with those in EPIC. These large-scale proteomic analyses identified a set of proteins associated with colorectal cancer risk across two independent cohorts. These proteins reflect pathways involved in cell migration and adhesion, colorectal mucosal integrity and growth and differentiation, among others, and may represent novel biomarkers of colorectal cancer risk. Citation Format: Matthew A. Lee, Vivian Viallon, David C. Muller, Ziqiao Wang, Paula Jakszyn, Pietro Ferrari, Giovanna Masala, Domenico Pali, Salvatore Panico, Carlotta Sacerdote, Karl Smith-Byrne, Ruth C. Travis, 8 Rosario Tumino, P. Martijn Kolijn, Roel Vermeulen, Monique Verschuren, Nicholas Wareham, Elizabeth A. Platz, Nilanjan Chatterjee, Elio Riboli, Marc J. Gunter. Proteomic analysis of colorectal cancer risk across two prospective cohorts [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1890.

The Impact of Behavioral and Psychological Symptoms on Financial Decision-Making Capacity in Mild to Moderate Dementia

ABSTRACT Objectives The study aims to assess the impact of behavioral and psychological symptoms on financial decision-making in individuals with mild to moderate dementia. Methods A cross-sectional quantitative study assessed cognitive status, behavioral and psychological symptoms as well as financial capacities. A multiple regression hierarchical model determined the relative contributions of demographic, cognitive, and behavioral and psychological symptoms to financial capacity. Results A total of 87 participants, with a median age of 84 years, were included in the study. Nearly all participants (94.5%) exhibited one or more behavioral and psychological symptoms. Greater dementia severity, increased behavioral and psychological symptoms, and lower educational levels were associated with poorer financial capacity. Conclusions This study underlines the impact of behavioral and psychological symptoms on financial decision-making in individuals with mild to moderate dementia, even when accounting education and dementia severity. Further research is necessary to elucidate the connection between these symptoms and financial capacity. Clinical Implications The critical need for early diagnosis of dementia and its associated behavioral and psychological symptoms is highlighted. Additionally, implementing timely behavioral and psychological management strategies and encouraging patients to engage in lifetime intellectual enrichment may be helpful for preserving financial capacity and promoting independence in individuals with dementia.

The Impact of Non-Acoustic Factors on Chinese Community Response to Noise: A Systematic Review

Noise pollution has become one of the most prominent environmental issues in China. Although many studies have summarized the impact of non-acoustic factors on noise annoyance, the unique mechanisms of these factors within the context of Chinese society and culture still require systematic investigation. In this study, a systematic review of articles obtained from the CNKI, WanFang, WoS Core Collection, and Scopus databases (up to December 2024) was conducted, and 42 articles were included in a qualitative analysis to summarize the patterns of non-acoustic factors’ influence on the community response of Chinese residents to noise. The results revealed the following: (1) The effects of non-acoustic factors on Chinese residents are significant, with the trends for factors such as noise sensitivity, attitude to noise source, health status, perceived quality of the living environment, and education level influencing the Chinese community response to noise having been basically clarified. However, the influence of the remaining factors and the unique influences of various non-acoustic factors await further quantitative analyses. (2) Interactions among various factors deserve close attention. The interactions between non-acoustic factors, as well as those between non-acoustic factors and sound source types, have been reflected in some studies. These may be significant for explaining the effects of non-acoustic factors and merit further research. (3) Compared to international studies, research on non-acoustic factors in China is relatively limited in quantity and unevenly distributed, which is insufficient to support further quantitative analysis or a detailed exploration of the underlying mechanisms. Therefore, more studies are necessary to support the future rationalization of noise policies and national standards in China.

Abstract 4963: The role of education level in cervical cancer screening adherence among deaf, deafblind, and hard of hearing women

Abstract Background: Deaf, deafblind, and hard of hearing (DDBHH) women using American Sign Language (ASL) experience disparities in cancer screening and cancer-related health outcomes. Barriers to cancer screenings and cancer care have been well documented, owing to social determinants of health ranging from communication barriers to systemic inequalities within the healthcare system. There is a need to further clarify the roles of education status and English proficiency in DDBHH women’s adherence to the U.S. Preventive Services Task Force (USPSTF) screening guidelines for cervical cancer. Methods: Using the NCI Health Information National Trends Survey in ASL, we surveyed adult participants to assess the USPSTF guidelines’ age-appropriate adherence to cervical cancer screening. Associations between pap smear adherence (screened vs not screened), self-reported English proficiency (well vs not well), and education status (HS degree or less, some college, college) were assessed using Pearson Chi-squared tests. A two-sided p<=.05 was considered significant. Results: Over 475 DDBHH adult participants (21-65 years), recruited in-person and virtually between July 2023 and October 2024, answered screening questions for cancer screening in ASL and English. Within this group, 67% self-reported screening adherence for pap smear. In a published study, similarly aged hearing women reported 73.9% adherence in the English version of the National Health Interview Survey (NHIS). Chi-square results indicated that more years of education was significantly associated with screening adherence [X2 (2, 484) = 7.613, p= 0.02]. Self-reported English proficiency was not associated with cervical screening adherence [X2 (1, 477) = 1.104, p= 0.30]. Discussion: With a 67% adherence rate, the DDBHH community has lower adherence to the recommended screening guidelines compared to the general hearing population. Within this group, those who self-report as HS graduates and/or have left college demonstrate lower adherence to cervical cancer screening guidelines. These findings show that education is key in preventive health behaviors, highlighting the need for targeted interventions to address educational gaps and achieve the Healthy People 2030 target of 79.2% screening adherence. Such research will also aid the Center for Deaf Health Equity in actively working with this DDBHH group to improve strategies for increasing cervical cancer screening adherence. Citation Format: Ciara Luttrell, Hiruni Hewapathiranage-Mayadunne, Erika Bergeron, Poorna Kushalnagar. The role of education level in cervical cancer screening adherence among deaf, deafblind, and hard of hearing women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4963.

Knowledge, attitude and practice towards healthy diet and their determinants among readymade garment workers in Bangladesh: a cross-sectional study

ObjectivesThis study aimed to examine the knowledge, attitude and practice (KAP) related to a healthy diet and explore the associations between the KAP and sociodemographic variables among readymade garment (RMG)...

Abstract 4959: Hearing Status and Colorectal Cancer Screening: Identifying Access Barriers

Background: Early detection through colorectal cancer screening is critical for effective treatment, improved survival rates, and reduced mortality. However, adherence to screening is influenced by various factors, including education and communication barriers. These barriers can be particularly pronounced for the deaf, deafblind, and hard of hearing (DDBHH) population using American Sign Language (ASL), potentially hindering preventive care. Education is widely known to be associated with cancer screening; however, the contributory role of a person’s functional ability to understand spoken language (e.g., lipreading, speechreading, combination with gestures) in a quiet room has not been explored. Methods: Using the NCI Health Information National Trends Survey in ASL as well as USPSTF guideline for colorectal cancer screening, we surveyed 566 DDBHH adult participants between July 2023 and October 2024. Binary logistic regression was used to assess the association between functional hearing ability (understand well vs cannot understand well in a quiet room) and colorectal cancer screening adherence, after adjusting for age and education. A two-sided p<=.05 was considered significant. Results: After adjusting for age and education, results did not indicate a significant association between functional hearing status and cancer screening adherence [β=1.14 (95% CI=0.75,1.73)], suggesting that a person's functional hearing ability does not independently influence screening rates. In this model, education level remained as a significant predictor, with lower educational attainment associated with a decreased likelihood of adhering to colorectal cancer screening guidelines [β =.51(95% CI=0.31,.84)]. Discussion: These findings highlight that functional hearing status alone is not a significant predictor of cancer screening adherence within the DDBHH community, underscoring the need for providers to look beyond a single moment of effective communication. While sign language interpreters ensure effective healthcare communication, they alone cannot address the educational disparities affecting DDBHH populations. Our study shows that DDBHH individuals with fewer years of education are less likely to undergo cancer screening. To achieve equitable health outcomes, providers should consider adding trained community health workers or patient navigators who have lived experience to the interpreter team. These navigators have potential to help overcome educational barriers and improve cancer screening rates among DDBHH patients. Citation Format: DT Bruno, Erika Bergeron, Regina Wang, Poorna Kushalnagar. Hearing Status and Colorectal Cancer Screening: Identifying Access Barriers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4959.

Association between periodontitis and prostate cancer: A case-control study.

Recent evidence suggests that chronic inflammation may play a role in the development and clinical course of cancer. In this context, periodontitis (PE) has been associated with prostate cancer (PC), but the results are still inconsistent. Therefore, the aim of this study was to evaluate the potential association between PE and PC, and their shared risk factors. This case-control study comprised 152 cases with PC and 220 controls. All participants underwent a complete periodontal examination, and sociodemographic and medical variables of interest were collected. The association between occurrence and severity of PC and covariates was assessed by binary and multinomial multivariate logistic regression, respectively. The cases had a higher prevalence (p=0.012) and severity (p=0.007) of PE. The occurrence of PC was associated with an educational level <9 years (adjusted odds ratio [OR]=1.93), smoking (adjusted OR=2.62), alcohol consumption (adjusted OR=3.45), diabetes (adjusted OR=0.32), chronic hypertension (adjusted OR=2.03), and PE (adjusted OR=1.80). Regarding the severity of PC, Gleason grades 1 and 2 were associated with PE (adjusted OR=1.96), but Gleason grades 3-5 were not. PE was associated with the occurrence of PC. Males diagnosed with PE would potentially benefit from being screened for prostate alterations. Periodontitis is an infectious disease that affects the supporting structures of the teeth. It has been characterized as a chronic inflammatory stimulus with potential risk for the occurrence or worsening of the clinical course of cancer. We evaluated the potential relationship between periodontitis and prostate cancer, as well as their shared risk factors, in a case-control study comprising 372 male individuals. The participants were recruited in a urology outpatient clinic and underwent a complete periodontal examination. The results showed that individuals with prostate cancer presented a worse periodontal status and a higher prevalence and severity of periodontitis. Prostate cancer was mainly associated with educational level, smoking, alcohol consumption, and periodontitis. Individuals with periodontitis were 1.8 times more likely to have prostate cancer. Prostate-specific antigen levels in individuals with periodontitis were also significantly higher. We concluded that periodontitis was associated with the occurrence of prostate cancer. Therefore, males diagnosed with periodontitis would potentially benefit from being screened for prostate alterations.

Association Between the Oral Health Status and Sociodemographic Factors Among 5–15-Year-Old Schoolchildren from Mallorca, Spain—A Cross-Sectional Study

Background: Oral health is a key indicator of general health, well-being, and quality of life. Sociodemographic factors can affect children’s oral health status. The aim of this study was to analyze the sociodemographic factors that influence the oral health of schoolchildren in Mallorca. Materials and methods: We conducted a cross-sectional observational epidemiological study in Mallorca, analyzing different indicators of oral health, such as the DMFT/dmft index and the Community Periodontal Index (CPI), and sociodemographic variables among 718 schoolchildren aged 5–6, 12 and 15 years. Results: The DMFT (Decayed, Missing, and Filled Permanent Teeth) caries index was higher in public (Pub) schools than in private/charter (P/C) schools for children in the sixth grade of elementary school (Pub, 0.6918 ± 1.272; P/C, 0.323 ± 0.824; p &lt; 0.05) and in the fourth year of secondary school (Pub, 1.178 ± 1.724; P/C, 0.627 ± 1.195; p &lt; 0.05), as determined using a t-test. First-grade elementary students with more highly educated mothers/guardians had a lower rate of DMFT (Decayed, Missing, and Filled Primary Teeth) caries than those whose mothers obtained only elementary-level education (higher, 0.800 ± 1.616; elementary, 3.333 ± 3.393; p &lt; 0.05). Regarding periodontal health, we observed that sixth-grade elementary schoolchildren with more highly educated mothers/guardians had more healthy sextants (higher, 3.987 ± 1.977; elementary, 1.333 ± 2.461; p &lt; 0.001). Conclusions: The sociodemographic and parental factors analyzed, such as the type of school and parents’ education levels, significantly affected the oral health of the schoolchildren in this study.

A study of job polarization in Sweden from an urban-rural perspective

This study is an explorative examination of changes in employment, revenue, and firm structure for low, mid, and high-skill firms in urban and rural areas in Sweden from 2007 to 2019, using skill groups based on education levels. For employment in Sweden in general, we find evidence of job upgrading. In the city of Stockholm we also document job polarization in the sense that employment in both low-skill and high-skill industries increased. We discuss various reasons why job polarization might be an urban phenomenon. We also document some consolidation towards larger firms in the low-skill sector and note that the revenue share of high-skill industries was constant during the period. Even though Swedish labour market institutions differ substantially from those of other OECD countries, the patterns of job polarization are strikingly similar.

Digital Health Interventions to Improve Vaccination Rates and Awareness Among Immigrant Populations: Barriers, Facilitators, and Outcomes - A Scoping Review

Background: Digital health interventions are suggested to improve vaccine coverage and awareness in the general population. However, given the scarcity of information within migrant populations, this scoping review aims to identify existing evidence on digital health interventions designed to improve vaccination and health outcomes among this social group. Methods: In this scoping review, we searched CENTRAL, PubMed, and Scopus for observational studies and randomized controlled trials (RCT). Two independent reviewers screened articles, performed data extraction and synthesis, and assessed bias risk using CovidenceⓇ. Bias was evaluated with the Cochrane RoB 2, Newcastle-Ottawa Scale (NOS), or JBI tool. We analyzed digital health interventions aiming to boost vaccination rates and awareness among immigrant populations, evaluating barriers and facilitators. The focus was on vaccines such as COVID 19, HPV, Hepatitis B, Influenza, childhood vaccines. Targeting immigrants, primarily from South and East Asia, the Middle East, and Hispanic/Latinx populations. The interventions of interest included digital appointment reminders, mobile applications, messaging platforms, and digital storytelling. Findings: Out of the 673 studies initially identified, 19 met the criteria for data extraction and synthesis. Published between 2012 and 2024, these included six quasi experimental studies, five cross-sectional studies, four randomized control trials, three qualitative studies and one survey. Research spanned several continents and countries such as North America, Germany, China, Jordan,Turkey and Uganda. The role of digital tools in increasing the vaccination rate must be reinforced, with particular emphasis on the personalized content of the message for recipients. The measurement tools influencing vaccination rates are not only diverse but also complex. They encompass a wide range of factors, from knowledge about immunization to emotions and vaccine intention, highlighting the multifaceted nature of the issue. Several factors interfere with vaccination rates (e.g., language barriers, costs, long wait times, scheduling difficulties, lack of transportation, and child support). Some confounders may impact the effectiveness and uptake of vaccination programs in undocumented immigrants from seeking vaccination services, such as socioeconomic status, education level, language barriers, cultural beliefs and practices, distrust in the healthcare system, legal status and fear of deportation. Interpretation: Digital health interventions show promise in enhancing vaccination awareness among migrant populations. Findings from this scoping review suggest that these interventions should be customized for specific populations, taking into account barriers, facilitators, and cultural beliefs.

Noticeable Behavioral Differences Observed in Turkish Students Following Online Education

The COVID-19 pandemic, which posed a global threat, led many countries, including Turkey, to implement changes in their educational practices. In response to the “stay at home” directive aimed at preventing the spread of the virus, face-to-face education was suspended, and online education was adopted. As a result, children were unable to attend school for nearly two years. This sudden shift posed significant challenges for children, who were in the process of socialization and learning, as adapting to this new educational norm was not in alignment with their natural developmental needs. This study examines how staying at home affected the behaviors of children who were supposed to attend school, interact with their teachers and peers, socialize, and engage in learning. The research follows a qualitative phenomenological design, with the study group selected through criterion sampling. The collected data were analyzed using content analysis, leading to the identification of themes, categories, and codes. Particular attention was paid to participant and data saturation during the analysis process. The findings indicate that noticeable behavioral patterns were categorized under discipline, cognitive skills, social skills, motor skills, emotional skills, digital addiction, and personality traits across different educational levels. It is suggested that the type and frequency of these prominent behaviors observed in students may be associated with the shift to online education following the suspension of face-to-face learning due to COVID-19. Factors such as reduced peer interaction, diminished social engagement, and a lack of communication and interaction are considered to have played a role in these behavioral changes.