Cancer Prevention Research Research Articles

Abstract C174: Examining cervical cancer screening rates among women living with HIV in Kajiado County, Kenya

Abstract Background: Kenyan women are disproportionately affected by HIV than their male counterparts, with a prevalence 5.5% compared to men whose prevalence is 2.9%. Women living with HIV (WLHIV) are more susceptible to cancer, in particular HPV-related cancers due to their immune-compromised status. In response, Kenyan Health Ministry recommends that women living with HIV (WLWH) be screened for cervical cancer annually by either visual inspection with acetic acid (VIA) or visual inspection with Lugol’s iodine (VILI), cytology and testing for HPV once every two years. Objective: Examining the rate of cervical cancer screening among women living with HIV (WLWH) in Kajiado County in 2022. Methodology: The electronic health information system was used to abstract data for WLWH in Kajiado county with 57 antiretroviral (ART) facilities. However, our analysis accessed data from 38 facilities whose data is captured in the health information system. Authorized health care workers from the County were requested to abstract redacted data from the health information system. No personal identifiers were collected from the system as away of protecting the privacy of individuals and abiding with the Kenya’s data protection law. Authorization to access the county was obtained from the county’s department of health while ethical approval was obtained from Mount Kenya University’s Institutional Scientific and Ethics Review Committee. Results: In 2022, a total of 16,827 people living with HIV were enrolled for care at the 38 ART selected sites. 11,785 (70%) were women with an age range of 15 to 49 years. A total of 3342 WLWH, representing 28.36% of the target population, were screened by using VIA. Of those screened, 3240 (97%) tested negative, 78 (2.3%) had positive results while 24 (0.7%) had suspicious lesions. Conclusion: Our analysis shows low reach of cervical cancer screening with only 28.36% of the targeted women being screened in 2022. The only available testing method (VIA) is less robust as compared to cytology and HPV testing. Thus, cervical cancer screening is underutilized, and importantly the available screening suffers fromWe also found a gap in reporting of HPV testing in the county. We thus recommend implementation science with community engagement examining the barriers to cervical cancer screening and HPV testing as well as timely reporting from multistakeholder e.g., system, provider, patient, family and advocate perspectives. This multisectoral health system-services approach will better inform research, practice and policy for effective HPV-related cancer prevention and control to reduce cancer-related morbidity and mortality among WLWH,. Citation Format: Caren Kamau, MS, Alice Njoroge,MS, Francis Makokha,PhD, Kimlin Ashing,PhD. Examining cervical cancer screening rates among women living with HIV in Kajiado County, Kenya [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 C174.

Abstract B080: UC Davis Center for Advancing Cancer Health Equity: A framework for community-led cancer health interventions

Abstract Many racial/ethnic groups in the US experience cancer health disparities, contributing to higher cancer incidence and cancer-related deaths compared to other groups. These are driven by a combination of biological and social determinants of health that affect cancer development and care response across the cancer health continuum. Underserved communities in California, many of which are communities of color, experience combinations of these factors that result in a unique landscape of barriers to cancer care. Because of this, interventions to remove these barriers cannot follow a one-fits-all approach. There is a critical need for community-directed interventions that reflect the cultural and social values of the members of a specific community to effectively identify and eliminate barriers to care. Through the UC Davis Center for Advancing Cancer Health Equity (CACHE), we have developed an infrastructure to design and implement community-directed interventions as a partnership between community members and the cancer research community at UC Davis. CACHE was launched in 2022 with the purpose of conducting community-engaged research to implement multi-level interventions for cancer health equity. CACHE is focused on placing underserved communities located in UC Davis’ catchment area at its center through community member ownership and leadership of the center’s research decision-making process. In this initial phase, the center recruited health professionals and community members throughout Northern California to participate in focus groups that inform the development of the center’s mission and vision, and name. Through these focus groups, our center identified community values and terminology that helped to guide and set expectations for its goals, actions and trust-building with underserved communities. The center establishes lasting community relationships through the development of task forces, whose goal is to identify community cancer health priorities to address through research. Given the significant cancer health disparities for American Indian and Alaska Natives in California, the first task force CACHE established is focused on Native and Indigenous cancer health. It consists of both academic researchers and community and Tribal leaders. Our task force began a cancer health needs assessment in partnership with multiple Tribal Nations and non-profit health center Northern Valley Indian Health. Native and Indigenous community conversations have uncovered cancer health and prevention education, transportation, and medical and research communities’ trustworthiness as barriers. We are now working to expand our understanding of these barriers for research interventions leading to improve Native and Indigenous cancer health. Ultimately, the goal of CACHE and its task forces is to develop community-led interventions to eliminate cancer care barriers in partnership with communities, and move towards cancer health equity for all. Citation Format: Nicole B. Halmai, Sophie Barbu, Angelica Rolon, Inigo Verduzco Gallo, Nanci Chavarria Villa, Guadalupe Carvajal, Luis G. Carvajal- Carmona. UC Davis Center for Advancing Cancer Health Equity: A framework for community-led cancer health interventions [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 B080.

Exploring Vitamin D Deficiency and IGF Axis Dynamics in Colorectal Adenomas.

(1) Colorectal cancer is a major cause of cancer-related death, with colorectal adenomas (CRAs) serving as precursors. Identifying risk factors such as vitamin D deficiency and the insulin-like growth factor (IGF) axis is crucial for prevention. (2) This case-control study included 85 participants (53 CRA patients and 32 controls) who underwent colonoscopy. We measured serum vitamin D3 (cholecalciferol), calcidiol (vitamin D metabolite), calcitriol (active vitamin D metabolite), insulin-like growth factor-1 (IGF-1), and insulin-like growth factor binding protein-3 (IGFBP-3) to explore their associations with CRA risk. (3) Results: We found that lower cholecalciferol levels were a significant risk factor for CRA (OR = 4.63, p = 0.004). Although no significant differences in calcidiol and calcitriol levels were observed between CRA patients and controls, calcidiol deficiency was common in the study population. IGF-1 levels inversely correlated with age, calcitriol, and IGFBP-3 in CRA patients. (4) This study highlights the potential of lower cholecalciferol levels to detect patients at risk of CRA when calcidiol values cannot, suggesting the importance of evaluating different vitamin D metabolites in cancer prevention research. Our findings underscore the need to further investigate the interactions between calcitriol, the active form of vitamin D, and the IGF axis in colorectal cancer development.

Phytoactive Molecules and Nanodelivery Approaches for Breast Cancer Treatment: Current and Future Perspectives

Abstract: One of the most common malignancies in women, breast cancer accounts for nearly 25% of all cancer cases. Breast cancer is a diverse cancer form that exhibits variability in both morphology and molecular characteristics and is linked to numerous risk factors. Although various approaches and research are ongoing in the treatment and prevention of breast cancer, medication resistance in the current breast cancer treatment contributes to the disease's relapse and recurrence. Phytoactive molecules are the subject of growing research in both breast cancer prevention and treatment, but currently used conventional medicines and techniques limit their application. In recent years, significant advancements have been made in the field of nanotechnology, which has proven to be essential in the fight against drug resistance. The transport of synthetic and natural anticancer molecules via nanocarriers has recently been added to breast cancer therapy, greatly alleviating the constraints of the current approach. In light of these developments, interest in nano-delivery studies of phytoactive molecules has also increased. In this review, research of phytoactive molecules for breast cancers along with their clinical studies and nanoformulations, was presented from current and future perspectives.

Abstract PO5-08-03: Breastfeeding and Breast Cancer Screening Among Carriers of Pathogenic Variants in BRCA 1 and BRCA 2 and Other High Penetrance Genes: Knowledge and Perspectives

Abstract Objectives: Carriers of pathogenic variants in high penetrance mutations, including BRCA 1 or BRCA 2 face higher lifetime risks of developing breast and tubo-ovarian cancers, and possibly endometrial cancers, than non-carriers. In particular, relative risks are higher among carriers than non-carriers at younger ages, suggesting the value of early initiation of breast cancer screening and the use of sensitive imaging methods, such as magnetic resonance imaging (MRI). Further, breastfeeding appears protective for these three cancers in the general population, and potentially among mutation carriers, albeit based on limited evidence. Given that data related to knowledge and perspectives of carriers about these issues are limited, we surveyed mutation carriers regarding breastfeeding, cancer risk, and the deferral of breast cancer screening coinciding with reproductive events. These data may guide future cancer prevention research and developing of targeted communication campaigns. Methods: Researchers at Mayo Clinic, in collaboration with Facing Our Risk of Cancer Empowered (FORCE) – a large, national non-profit organization that addresses the needs of people and families affected by inherited mutations linked to cancer – designed and conducted a survey using the Mayo Clinic’s external RedCap system. The survey covered genetic testing and results, history of live births and breastfeeding history for mothers, history of risk-reducing surgery, personal cancer history, sources of information about cancer screening, breastfeeding knowledge, and breast cancer screening at various times, including during pregnancy, while breastfeeding, and after weaning. The survey was disseminated through FORCE’s electronic newsletter, website, social media pages, and advocacy partners. Survey responses were collected anonymously and analyzed descriptively using standard descriptive statistics, including frequency and percentages for categorical responses and means (SD) or medians (IQR) for continuously scaled responses. The open-ended responses were analyzed qualitatively using standard qualitative methodology. Results: Respondents included 253 women, of whom 88.7% were U.S. residents and 92.9% were white. The mean age + SD was 47(13) years, 61.7% were parous, with a mean age at first birth of 22.58 (13.16) years. Approximately 60% of women were carriers of mutations in BRCA1 or BRCA2 or both genes and all but two of the remaining women reported mutations in other genes linked to increased cancer risk. At the time of the survey, 92% of women had undergone a mammogram, with first screen at a mean age of 35 (6.49) years, and 85.3% had undergone breast MRI, with first screen at a mean age of 43 (12.39) years. Among 34.3% of participants, their 1st postpartum mammogram occurred >3 years after the birth of their last child and 57% had 1st MRI 3 years postpartum. Preliminarily, our analysis shows that nearly 90% of women were unaware of their mutation status prior to pregnancy and approximately 1/3 did not undergo radiologic screening until 3 years postpartum. While 62.6% of respondents believed that breastfeeding lowers breast cancer risk, 74.2% of participants responded that nursing had no effect on tubo-ovarian cancer risk, and 78.2% considered that nursing did not impact endometrial cancer risk. Discussion and Conclusions: Preliminarily, we conclude that most women in the surveyed population were unaware of their mutation status when pregnant years earlier and many had not undergone screening until years after delivery. Many participants did not consider breastfeeding a potentially protective factor for women’s cancers. These data raise issues about the potential value of discussing genetic testing with women when considering family planning and mutation carriers, addressing complex issues about breast cancer screening while pregnant and breastfeeding. Citation Format: Laura Pacheco-Spann, Mark Sherman, Susan Friedman, Diane Rose, Miriam Levi, Alex Hochwald, Jennifer Ridgeway, Sophia Blumenfeld. Breastfeeding and Breast Cancer Screening Among Carriers of Pathogenic Variants in BRCA 1 and BRCA 2 and Other High Penetrance Genes: Knowledge and Perspectives [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-08-03.

Leveraging Maker Learning in STEM to Promote Children's Interest in Cancer Research: A Pilot Program.

Children's early awareness about cancer, through exposure to cancer biology and prevention strategies and research principles, is a promising focus of education and learning. It may also benefit the pipeline of people entering into science, technology, engineering, and math (STEM) careers. We describe an educational pilot program for elementary school students, using developmentally appropriate activities focused on cancer at a museum dedicated to children's maker-centered learning and STEM. The program was implemented through a public school in Washington, DC serving students underrepresented in STEM. Program conceptualization, museum and school engagement, and maker learning pedagogy are described, as well as curricular outcomes. A total of N = 111 students (44% female, 75% Black/African American, 5% Latine) participated in a day-long field trip. Museum educators, assisted by cancer center researchers, led a multipart workshop on cancer and the environment and hands-on rotation of activities in microbiology, immunology, and ultraviolet radiation safety; students then completed self-report evaluations. Results indicate that nearly all (> 95%) students practiced activities typical of a STEM professional at the program, and > 70% correctly answered factual questions about topics studied. Importantly, 87-94% demonstrated clear STEM interest, a sense of belonging in the field, and practice implementing skills for success in STEM (e.g., perseverance, imagination, teamwork). This pilot demonstrated acceptability and feasibility in delivering a cancer-focused curriculum to underserved elementary students using maker learning while favorably impacting key objectives. Future scale-up of this program is warranted, with the potential to increase students' motivation to engage in STEM and cancer research.

Identification of Breast-Cancer-Associated Properties of Drinking Water under a Composite-Toxicity Perspective of Mixed Contaminants: A Case Study in a High-Prevalence Area of China

Breast cancer is the most frequently diagnosed female cancer worldwide. Environmental contaminant exposure is suspected to be crucial, but the broad-spectrum communal properties that these suspected contaminants all share remain to be explored, especially in source and drinking water. In this work, we focused on the Pearl River Basin, which has the highest breast cancer incidence and mortality in China, and hypothesized that the breast cancer risk in this area is associated with its water source. Our objective was to resolve the possible communal properties that are associated with breast cancer from water mixture extracts of source and drinking water and to identify the key drivers by utilizing the latest epidemiology data, performing an exhaustive water toxicological and chemical characterization, and combining partial least-squares path statistics modeling (PLS-PM). We proposed a path for a drinking water-toxicity-induced breast cancer risk and confirmed its association with estrogen-receptor- and thiol-depletion-relevant mechanisms. The breast cancer incidence risk was associated with water-mixture-promoted mammalian cell proliferation (i.e., estrogenic effect), while the mortality risk was associated with a greater thiol depletion (i.e., oxidative stress). Endocrine-disrupting chemicals (EDCs) and dissolved organic matter (DOM) from anthropogenic sources in drinking water are key drivers for estrogenic effects and oxidative stress, respectively. The PLS-PM standardized effects of the DOM and EDCs in treated water on the breast cancer incidence and mortality were −0.07 and 0.31, and 0.35 and 0.31, respectively, further revealing that EDCs strongly influence the incidence risk, whereas the mortality risk resulted from the joint effects of EDCs and DOM. This study clearly shows an association between the breast cancer risk and drinking water toxicity in a high-prevalence area of China, broadening the future perspectives for water-contaminant-specific breast cancer prevention research.

HPV and Cervical Cancer: Molecular and Immunological Aspects, Epidemiology and Effect of Vaccination in Latin American Women.

Cervical cancer is primarily caused by Human Papillomavirus (HPV) infection and remains a significant public health concern, particularly in Latin American regions. This comprehensive narrative review addresses the relationship between Human Papillomavirus (HPV) and cervical cancer, focusing on Latin American women. It explores molecular and immunological aspects of HPV infection, its role in cervical cancer development, and the epidemiology in this region, highlighting the prevalence and diversity of HPV genotypes. The impact of vaccination initiatives on cervical cancer rates in Latin America is critically evaluated. The advent of HPV vaccines has presented a significant tool in combating the burden of this malignancy, with notable successes observed in various countries, the latter due to their impact on immune responses. The review synthesizes current knowledge, emphasizes the importance of continued research and strategies for cervical cancer prevention, and underscores the need for ongoing efforts in this field.

Concept mapping sociocultural aspects of cervical cancer prevention among African American women.

For African American women in Houston, cervical cancer mortality is disproportionate to their racial and ethnic counterparts. Most notably, lack of human papillomavirus (HPV) screening and vaccination as well as late diagnosis increase cervical cancer mortality. However, cervical cancer is largely preventable. While previous research has identified a few social determinants that are specifically related to cervical cancer (e.g., education, income, neighborhood), there may be a host of additional social and cultural factors that contribute to a lack of preventative behavior. The present study used concept mapping to explore sociocultural determinants of cervical cancer prevention beliefs among young African American women. N = 15 African American women, ages 18-25, participated in a group concept mapping session focused on cervical cancer knowledge, beliefs about women's health, and how their social environment and culture play a role in their conceptualization of cervical cancer prevention. Five overarching concepts emerged: (1) Screening, (2) Support System, (3) Cervical Cancer 101 (knowledge), (4) Fatalism, and (5) Ease of Prevention. The present study highlights the use of concept mapping for prevention science, particularly in exploratory studies for understanding cervical cancer screening barriers, avenues for intervention, and public health messaging. We discuss the findings and implications for public health research in cervical cancer prevention tailored for African American women.

NCI Resources for Cancer Immunoprevention Research.

Cancer prevention and early detection, the first two of the eight primary goals of the National Cancer Plan released in April 2023, are at the forefront of the nation's strategic efforts to reduce cancer incidence and mortality. The Division of Cancer Prevention (DCP) of the NCI is the federal government's principal component devoted to promoting and supporting innovative cancer prevention research. Recent advances in tumor immunology, cancer immunotherapy, and vaccinology strongly suggest that the host immune system can be effectively harnessed to elicit protective immunity against the development of cancer, that is, cancer immunoprevention. Cancer immunoprevention may be most effective if the intervention is given before or early in the carcinogenic process while the immune system remains relatively uncompromised. DCP has increased the emphasis on immunoprevention research in recent years and continues to expand program resources and interagency collaborations designed to facilitate research in the immunoprevention field. These resources support a wide array of basic, translational, and clinical research activities, including discovery, development, and validation of biomarkers for cancer risk assessment and early detection (Early Detection Research Network), elucidation of biological and pathophysiological mechanistic determinants of precancer growth and its control (Translational and Basic Science Research in Early Lesions), spatiotemporal multiomics characterization of precancerous lesions (Human Tumor Atlas Network/Pre-Cancer Atlas), discovery of immunoprevention pathways and immune targets (Cancer Immunoprevention Network), and preclinical and clinical development of novel agents for immunoprevention and interception (Cancer Prevention-Interception Targeted Agent Discovery Program, PREVENT Cancer Preclinical Drug Development Program, and Cancer Prevention Clinical Trials Network).

Evaluation and lessons learned from the dissemination and implementation science scholars program in the national cancer prevention and control research network

Abstract Background: The Centers for Disease Control and Prevention (CDC)-funded Cancer Prevention and Control Research Network (CPCRN) has been a leader in cancer-related dissemination & implementation (D&I) science. Given increased demand for D&I research, the CPCRN Scholars Program launched in 2021 to expand the number of practitioners, researchers, and trainees proficient in cancer D&I science methods. Methods: The evaluation was informed by a logic model and data collected through electronic surveys. Through an application process (baseline survey), we assessed scholars’ competencies in D&I science domains/subdomains, collected demographic data, and asked scholars to share proposed project ideas. We distributed an exit survey one month after program completion to assess scholars’ experience and engagement with the program and changes in D&I competencies. A follow-up survey was administered to alumni nine months post-program to measure their continued network engagement, accomplishments, and skills. Results: Three cohorts completed the program, consisting of 20, 17, and 25 scholars in Years 1-3, respectively. There was a significant increase in the total D&I competency scores for all three cohorts for 4 overarching domains and 43 subdomains (MPre = 1.38 MPost = 1.89). Differences were greatest for the domain of Practice-Based Considerations (0.50 mean difference) and Theory & Analysis (0.47 mean difference). Alumni surveys revealed that scholars appreciated access to D&I-focused webinars, toolkits, and training resources. 80% remain engaged with CPCRN workgroups and investigators. Conclusions: Program evaluation with scholars and alumni helped with ongoing quality assurance, introspection, and iterative program adaptation to meet scholars’ needs. This approach is recommended for large-scale capacity-building training programs.

Big data in breast cancer: Towards precision treatment.

Breast cancer is the most prevalent and deadliest cancer among women globally, representing a major threat to public health. In response, the World Health Organization has established the Global Breast Cancer Initiative framework to reduce breast cancer mortality through global collaboration. The integration of big data analytics (BDA) and precision medicine has transformed our understanding of breast cancer's biological traits and treatment responses. By harnessing large-scale datasets - encompassing genetic, clinical, and environmental data - BDA has enhanced strategies for breast cancer prevention, diagnosis, and treatment, driving the advancement of precision oncology and personalised care. Despite the increasing importance of big data in breast cancer research, comprehensive studies remain sparse, underscoring the need for more systematic investigation. This review evaluates the contributions of big data to breast cancer precision medicine while addressing the associated opportunities and challenges. Through the application of big data, we aim to deepen insights into breast cancer pathogenesis, optimise therapeutic approaches, improve patient outcomes, and ultimately contribute to better survival rates and quality of life. This review seeks to provide a foundation for future research in breast cancer prevention, treatment, and management.

Enhancing cancer detection and prevention mechanisms using advanced machine learning approaches

Cancer is a major global health challenge, emphasizing the critical need for early detection to enhance patient outcomes. This study thoroughly investigates the applications of advanced machine learning methods for cancer detection and prevention, aiming to develop robust algorithms that can accurately identify cancerous cells and assess cancer severity based on key parameters. The authors synthesize insights from previous cancer detection and prevention research through an in-depth literature review. The study sets specific objectives, including creating and evaluating innovative algorithms for classifying cancer cells.The authors employed machine learning techniques to analyze parameters, such as cell size, shape, nucleus characteristics, and additional factors like cell texture, mitosis count, tumour progression, metastasis, gene expression patterns, and biological markers. This methodology is distinguished by its effective use of diverse data types and automated feature extraction to improve cancer detection and prediction accuracy. Advanced machine learning methods enhance the precision and reliability of current cancer cell classification algorithms. The research underscores the importance of timely and accurate cancer detection, which enables early intervention and significantly improves patient survival rates. The results and discussion section meticulously analyzes the findings, demonstrating the approach's effectiveness in accurately identifying cancerous cells and assessing cancer severity. This study is a valuable resource for medical professionals, supporting early-stage cancer detection and classification of cancer cells at different stages. The proposed algorithms show promising results in improving the accuracy and efficiency of cancer detection systems, paving the way for future advancements in cancer research and offering essential insights for healthcare practitioners and researchers.

Recent Research Progress in Chinese Alternative Medicine in the Prevention and Treatment of Liver Cancer

The modernization of traditional/alternative Chinese medicine research provides diverse and comprehensive methods for disease treatment and health management by integrating the advantages of traditional medicine and modern science. Recent evidence has accumulated rich experience and outstanding achievements in the research of integrated traditional Chinese and Western medicine for the prevention and treatment of liver cancer. Their recent research is dedicated to the research and development of traditional Chinese medicine formulas, the discovery of treatment targets and predictive markers, providing new effective evidence for liver cancer prevention and treatment research, and expanding research directions. This article provides a review of the clinical and experimental research progress of this team in recent 5 years, in order to provide more ideas and insights for research in this field.

EXAMINING AWARENESS AND USE OF COMPREHENSIVE GERIATRIC ASSESSMENTS IN CANCER CARE: A QUALITATIVE STUDY

Abstract Comprehensive geriatric assessments (CGAs) are critical tools for identifying the needs of older cancer survivors and planning effective treatment and follow-up care. Research on CGA implementation in clinical settings remains limited. We interviewed primary and cancer care providers to better understand current CGA practices, their potential, and the challenges of clinical use. Eight semi-structured interviews, lasting ~60 minutes, were conducted with participants identified through Cancer Prevention and Control Research Network partner listservs. Analysis was conducted iteratively. Providers reported that CGAs were useful and administering them with all incoming patients would be ideal but was not always possible. Instead, they used brief screening tools, which meant CGA domains were inconsistently assessed. Implementation was facilitated by clinic champions, multidisciplinary care teams, and institutional resources and buy-in. Findings from this research will provide potential solutions to addressing barriers to using CGAs related to staff capacity and competing demands, provider experience, and institutional priorities.

Examining provider perceptions and practices for comprehensive geriatric assessment among cancer survivors: a qualitative study with an implementation science focus.

Introduction: Cancer rates increase with age, and older cancer survivors have unique medical care needs, making assessment of health status and identification of appropriate supportive resources key to delivery of optimal cancer care. Comprehensive geriatric assessments (CGAs) help determine an older person's functional capabilities as cancer care providers plan treatment and follow-up care. Despite its proven utility, research on implementation of CGA is lacking. Methods: Guided by a qualitative description approach and through interviews with primary care providers and oncologists, our goal was to better understand barriers and facilitators of CGA use and identify training and support needs for implementation. Participants were identified through Cancer Prevention and Control Research Network partner listservs and a national cancer and aging organization. Potential interviewees, contacted via email, were provided with a description of the study purpose. Eight semi-structured interviews were conducted via Zoom, recorded, and transcribed verbatim by a professional transcription service. The interview guide explored providers' knowledge and use of CGAs. For codebook development, three representative transcripts were independently reviewed and coded by four team members. The interpretive process involved reflecting, transcribing, coding, and searching for and identifying themes. Results: Providers shared that, while it would be ideal to administer CGAs with all new patients, they were not always able to do this. Instead, they used brief screening tools or portions of CGAs, or both. There was variability in how CGA domains were assessed; however, all considered CGAs useful and they communicated with patients about their benefits. Identified facilitators of implementation included having clinic champions, an interdisciplinary care team to assist with implementation and referrals for intervention, and institutional resources and buy-in. Barriers noted included limited staff capacity and competing demands on time, provider inexperience, and misaligned institutional priorities. Discussion: Findings can guide solutions for improving the broader and more systematic use of CGAs in the care of older cancer patients. Uptake of processes like CGA to better identify those at risk of poor outcomes and intervening early to modify treatments are critical to maximize the health of the growing population of older cancer survivors living through and beyond their disease.

Abstract IA019: Implementation science as an opportunity to address cancer equity

Abstract The past decade of research has continued to identify and understand health disparities for cancer prevention and control. Although emerging, progress in addressing these disparities continues to fall short achieving equity. Specifically, for cancer prevention and control, Khan and colleagues in 2021 showed a 15-year lag in implementation of evidence-based interventions (i.e., HPV vaccinations, cancer screenings, etc.). This gap highlights the lack of attention towards the implementation of scientific evidence, the complexity and fragmentation of health systems, and lays bare the structural causes of inequities that continue to persist from a population perspective. Integrating implementation science in cancer prevention and control research can provide a pathway to reduce the time to translation while addressing and advancing cancer equity. Implementation science is defined as the study of methods to promote the adoption and integration of evidence-based practices, interventions, and policies into routine health care and public health settings to improve the impact on population health. Implementation science has pushed the cancer prevention and control field to pay close attention to how we dissemination scientific information towards the adoption of interventions (i.e., dissemination research) and how we systematically study strategies (i.e., the building blocks) that aid in the implementation, scale-up, and sustainability of interventions (i.e., implementation science). With implementation research, there has been a push towards hybrid designs that considers intervention effectiveness and its implementation within the same study. Given the dearth of literature around the implementation of interventions, the science of implementation continues to build on a foundational theoretical base that further provide important opportunities for the promoting equitable outcomes for cancer prevention and control research. In this educational session, we will discuss why and how applying a health equity lens to implementation science is crucial to achieve equity in cancer prevention and control. Using ongoing and completed research studies as examples, this session will help attendees learn about core elements of implementation science including theories, models, and frameworks; implementation strategies; and focal areas of adaptations and de-implementation. Citation Format: Prajakta Adsul. Implementation science as an opportunity to address cancer equity [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 IA019.

Applications of implementation science frameworks, models and theories in disparities-focused cancer screening interventions: a scoping review protocol

BackgroundImplementation science (IS) frameworks, models and theories (FMTs) have gained popularity in guiding the implementation and evaluation of evidence-based interventions (EBIs) for cancer screening. However, there are significant research gaps...

Assessing the Comparative Spatial Variances in the Effects of Urban Built Environments, City Risking Behaviors, and Air Pollutants on Breast and Prostate Cancer

Cancer is a serious public health dilemma. According to the World Health Organization (WHO), cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths. Therefore, research on effectively preventing and managing cancer is continuously needed in various fields in order to improve people's quality of life and safety. This study aims to explore the spatial distribution of incidences of breast cancer and prostate cancer that occurred in Korea from 2009 to 2013 with the use of the Geographic Information System (GIS). This research also examined the association between prostate cancer, breast cancer, air pollutants (CO, NO2, PM10, SO2), urban health-risk behaviors (smoking, drinking, and obesity), and the built environment of industrial, commercial, residential, and green areas. The main results showed that cancer incidence rates were highly clustered in specific regions and the regional differences in cancer incidence rates significantly depended on the cancer type. Concentrations of air pollutants also vary by region and tend to be high in certain regions. Air pollution is likely to play a mediating role in the relationship between the built environment and cancer incidences rather than the built environment directly affecting cancer incidences. These findings suggest that it is necessary to examine spatial and regional characteristics in building cancer prevention strategies and policies. This also emphasizes the need for interdisciplinary research for cancer prevention, not only in the medical field, but also in public health, urban planning, and environmental fields.

From study plans to capacity building: a journey towards health equity in cancer survivorship

This article highlights the importance of pausing and reflecting on one's motivation, capacity, and positionality when engaging in health equity research and encourages researchers to engage in critical self-reflection and contribute to the ongoing dialogue on the ethical conduct of health equity-focused cancer research. In response to the urgent need to address health disparities and improve health equity in cancer survivorship care, the Cancer Prevention and Control Research Network (CPCRN) Survivorship workgroup discussed developing a study focused on understanding how racism impacts patient engagement in cancer survivorship care. However, during the study's development, the workgroup recognized limitations in research team composition and infrastructure. The workgroup engaged in critical self-reflections, individually and collectively, leading to the halting of the research study. Consequently, they redirected their efforts towards strengthening the necessary infrastructure for conducting such research, including diverse investigator representation and equitable partnerships with cancer survivors. The description of this process, along with suggestions for reflection, may be helpful and informative to other researchers and research networks seeking to center marginalized voices and work in partnership to address healthcare and health equity.