Secondary Cancer Prevention Research Articles

PD07 Sun exposure and associated risks in 17 countries: UK results

Abstract Primary and secondary prevention of skin cancer varies considerably from one country to another. This survey investigates knowledge and behaviours regarding sun exposure in the UK. This UK survey (n = 1000) was conducted online from 28 September to 18 October 2021 and was part of a worldwide survey (n = 17 001) conducted in 17 countries (five continents). Automated selection from the Ipsos online panel ensured samples of 1000 individuals in each country fit the quotas method based on sex, age, employment status and country regions. Data covered demographics, phototype, exposure habits and practices, and knowledge and understanding of risks. The population comprised 49% men [mean (SD) age 46.6 (15.7) years]; 61% were of skin phototypes I–II. Seventy-six per cent of Britons stated that a tanned skin looks attractive vs. 72% worldwide. Seventy per cent of Britons indicated that a tan gives a healthy look, a different perception compared with worldwide (64%). Most Britons were aware of sun-related skin health issues, a better awareness compared with worldwide (94% vs. 88%). Sixty-one per cent did know that sun protection is useful when the weather is overcast, a similar knowledge as worldwide (61%). Furthermore, 15% indicated it was safe to expose themselves without protection when already tanned, a better knowledge than worldwide (23%). In terms of photoprotection, 15% said they protected themselves from the sun all year round, a lower score compared with worldwide (23%). In detail, Britons were more likely to put sunscreen on their face (71% vs. 60%), on their hands, neck and ears (64% vs. 52%), and on the arms, legs and chest (69% vs. 55%) compared with the global population. However, Britons were less likely to try to stay in the shade (73% vs. 77% worldwide) or avoid midday sun exposure (53% vs. 66%). Of those who applied sunscreen, 69% applied it only once or twice a day – a slightly better practice compared with the worldwide average (74%). In terms of knowledge, 71% did not understand the difference between ultraviolet (UV)A and UVB vs. 70% worldwide. Although the risks of sun exposure are widely recognized, sun protection practice is inadequate. This survey provides insight into the need for additional photoprotection education in the UK.

Epidemiological features of the incidence of cervical intraepithelial neoplasia in the modern megapolis

Background. Information on the incidence of cervical intraepithelial neoplasia (CIN) is relevant for planning and evaluating the effectiveness of medical care at the stage of secondary prevention of cervical cancer. Aim. To analyze the incidence of CIN and benign diseases of the cervix: erosion and ectropion, leukoplakia, polyp, according to medical organizations in Yekaterinburg in 2013–2019. Materials and methods. A descriptive epidemiological study of the incidence of cervical pathology in the population of women in Yekaterinburg in 2013–2019 was conducted. The forms of Federal Statistical Observation No. 12 “Information on the number of diseases registered in patients living in the service area of a medical organization”, in terms of erosion and ectropion, and data from the city’s women’s consultations on the number of cases of CIN, leukoplakia and cervical polyp were examined. Information on the number of female population of the city from Sverdlovskstat was used. Results. The primary incidence of CIN increased throughout the follow-up period. The indicator increased by 1.7 times compared to 2013 (p < 0.001) in 2016, it had a maximum value in 2019 – 215.5 per 100 thousand women and was 3.2 times more than in 2013 (p < 0.001). The dynamics of the primary incidence of other types of cervical pathology: ectropion, leukoplakia and cervical polyp, was characterized by the absence of significant changes (p > 0.05) in 2013–2019. The increase in the overall incidence of CIN was registered from 2014 to 2019 in comparison with 2013 (p < 0.001). The indicator of the overall incidence of CIN in 2019 was 2.1 times higher than in 2013 (p < 0.001). Conclusions. The growth of primary and total incidence of CIN in the population of Yekaterinburg women noted since the beginning of the XXI century continued in 2013–2019. The primary incidence rate of CIN had the maximum value in 2019. The increase in the incidence of CIN is associated with the natural spread of the disease, accessibility and improvement in the quality of medical care.

Synchronous and metachronous multiple primary cancers in melanoma survivors: a gender perspective.

Long-term survivors of cutaneous malignant melanoma (CMM) risk subsequent malignancies due to both host-related and environmental risk factors. This retrospective population-based study differentially assesses the risk of synchronous and metachronous cancers in a cohort of CMM survivors stratified by sex. The cohort study (1999-2018) included 9,726 CMM survivors (M = 4,873, F = 4,853) recorded by the cancer registry of all 5,000,000 residents in the Italian Veneto Region. By excluding subsequent CMM and non-CMM skin cancers, the incidence of synchronous and metachronous malignancies was calculated according to sex and tumor site, standardizing for age and calendar year. The Standardized Incidence Ratio (SIR) was calculated as the ratio between the number of subsequent cancers among CMM survivors and the expected number of malignancies among the regional population. Irrespective of the site, the SIR for synchronous cancers increased in both sexes (SIR = 1.90 in males and 1.73 in females). Both sexes also demonstrated an excess risk for synchronous kidney/urinary tract malignancies (SIR = 6.99 in males and 12.11 in females), and women had an increased risk of synchronous breast cancer (SIR = 1.69). CMM male survivors featured a higher risk of metachronous thyroid (SIR = 3.51, 95% CI [1.87, 6.01]), and prostate (SIR = 1.35, 95% CI [1.12, 1.61]) malignancies. Among females, metachronous cancers featured higher SIR values than expected: kidney/urinary tract (SIR = 2.27, 95% CI [1.29, 3.68]), non-Hodgkin's lymphoma (SIR = 2.06, 95% CI [1.24, 3.21]), and breast (SIR = 1.46, 95% CI [1.22, 1.74]). Females had an overall increased risk of metachronous cancers in the first 5 years after CMM diagnosis (SIR = 1.54 at 6-11 months and 1.37 at 1-5 years). Among CMM survivors, the risk of metachronous non-skin cancers is higher than in the general population and differs significantly by sex. These results encourage sex-tailored interventions for metachronous secondary cancer prevention.

Awareness and Compliance with the Recommendations of Primary and Secondary Prevention of Cancer in Patients with Inflammatory Bowel Disease.

Patients with Inflammatory Bowel Disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are at high risk of developing malignancies, so prevention and adherence to cancer screening may improve detection. The aim of this study was to assess compliance with medical recommendations, especially primary and secondary prevention of cancer. This one-center cross-sectional study was carried out between June and December 2021 amongst patients at the Department of Internal Medicine and Gastroenterology, IBD Division, National Medical Institute of Ministry of Interior Affairs and Administrations, or the outpatient clinic. Patients with IBD were asked to complete an anonymous questionnaire, which included 42 questions concerning lifestyle, cancer risk factors, cancer history, and checkups. The results of the qualitative variables were expressed as frequencies and percentages. We used Fisher's exact test and the Chi-squared test. A value of p < 0.05 was considered significant. Statistical analyses were performed with the SPSS statistical package. A total of 313 patients were enrolled in the study: 145 women and 168 men. In the group, 182 had Crohn's disease (CD), 120 had ulcerative colitis (UC), and 11 with IBDU (unclassified IBD). Most participants had a disease duration of over 8 years and received biological treatment, corticoids, and/or immunosuppressive therapy. Amongst respondents, 17% (31) of patients with CD and 25.8% (31) with UC were overweight, and 10.5% (19) with CD and 15.8% (19) with UC were obese (p = 0.017). We found that 16.3% of all respondents were smokers (79.6% (144) with CD, 90.8% (109) with UC, and 72.7% (8) with IBDU; p = 0.053), and 33.9% declared that they consumed alcohol (39.4% (71) with CD, 26.9% (32) with UC, and 18.2% (2) with IBDU; p = 0.045). A total of 25.4% of patients were exposed to UV radiation, but only 18.8% used sunblock. In addition, 58.8% (67) of patients with CD and 35.8% (19) with UC receiving immunosuppressants had regular laboratory tests (p = 0.02). Furthermore, 41.4% (46) of patients with UC, 27.1% (49) of patients with CD, and 70.0% (7) of patients with IBDU declared not to perform any dermatological control (p = 0.013). A total of 77% of patients had abdominal ultrasound. Out of 52.9% of patients for whom colonoscopy was recommended, only 27.3% had it performed (16.9% (30) with CD vs. 43.1% (50) with UC p < 0.001). Most examinations were ordered by gastroenterologists. Female patients had regular breast control (CD, 78.6% (66); UC, 91.2% (52); IBDU, 50% (2); p = 0.034), and 93.8% (76) had gynecological examinations. Additionally, 80.2% of patients knew about HPV, but most declared not to be vaccinated. A total of 17.9% of patients had urological control, but most had no important pathology detected. According to our study, many patients are still exposed to risk factors, such as obesity, smoking, and low physical activity, that are modifiable. Laboratory tests in patients with immunosuppressive treatment should be performed regularly. Systematic control, especially dermatological checkups, should be recommended. Additionally, not only gastrologists but also other specialists and GPs should remind patients about regular checkups. Primary prevention, such as HPV vaccinations, should be recommended to all patients.

PDCD4 and CDX-2 as immunohistochemical markers of gastric mucosa atrophy in chronic gastritis

Introduction Diagnosis of the gastric mucosa atrophy represents an important problem, the solution of which depends on the possibility of secondary prevention of gastric cancer. A possible way of solution is the use of immunohistochemical markers - proteins associated with cellular remodeling of gastric mucosa, PDCD4 and CDX2.The aim of the work is to evaluate the possibility of using immunohistochemical markers PDCD4 and CDX-2 to diagnose atrophy of the gastric mucosa in chronic gastritis and increase the informative value of biopsy examination.Materials and method The object of the study was 155 cases of biopsy examination of the gastric mucosa of patients with chronic gastritis (5 fragments per case − 775 biopsy specimens). A comparative semi-quantitative assessment of immunohistochemical expression of CDX2, PDCD4 at different stages of chronic gastritis was performed. Spearman correlation coefficient was used to assess correlation relationship.Results There were no statistically significant differences in the level of PDCD4 in studied samples depending on the stage of chronic gastritis, p=0.06. Statistically significant increase of CDX2sum index in progressing stage of chronic atrophic gastritis (p=0.005), demonstrated a pronounced positive correlation r=0.70 (p&lt;0.01).Discussion According to the results obtained, it is shown that the decline in PDCD4 protein does not occur with the progression of atrophy severity. Complementary use of immunohistochemical marker CDX2 is able to give an idea of the presence and severity of both metaplastic and absolute atrophic changes in the gastric mucosa.Conclusion Equally high level of PDCD4 protein index in the gastric mucosa at different stages of chronic gastritis excludes the possibility of its use as an immunohistochemical marker of atrophy. Semi-quantitative immunohistochemical index of CDX2 protein can be used as an additional marker in decision support system for assessment of atrophic changes in gastric mucosa.

Women’s Willingness to Pay for Mammography Screening under Two Medical Information Scenarios

Objective. Secondary prevention of breast cancer (BC) helps diagnose the disease in the early stages and prevent disease progression. World Health Organization and the American Cancer Society consider early diagnosis as the best way to control BC. Mammography screening is the most sensitive and specific test that can be conducted along with the clinical examination for the early diagnosis of BC. However, like other tests, mammography is not a perfect test. The purpose of the present study is to measure willingness to pay (WTP) for mammography among a sample of women by providing each of them one of two scenarios describing medical information on the test. Methods. 450 women aged 35–55 years were assigned randomly into two groups of equal numbers in a quasi-experimental study conducted in Tabriz city, Iran. Each group was presented with one of the two designed scenarios. First scenario described the basic medical information on mammography as a good test of BC screening. The alternative scenario described some information on potential diagnostic errors of the mammography result alongside basic medical information about this test. The double bounded dichotomous choice method was used to extract women’s WTP for mammography under each scenario. Results. Based on the official currency exchange rate of 37000 IRR/USD, the mean WTP for BC screening with mammography was estimated as 30.5$ in the group receiving basic medical information and 26.8$ in the other group. However, the result of regression analysis revealed receiving information on potential diagnostic errors of mammography result did not lead to significant higher WTP for the test. The WTP for mammography raised significantly among older women, employed women, and those with higher level of education. Conclusion. The result of our study suggests that providing women with information about the potential diagnostic errors of mammography may not be correlated to economic value they give to this test. However, women with different individual status may reveal different economic value on mammography.

Cervical Cancer Prevention: The Role of the Nurse and Medical Care in Primary and Secondary Cancer Prevention

Cervical Cancer Prevention: The Role of the Nurse and Medical Care in Primary and Secondary Cancer Prevention

ASSESSMENT OF AWARENESS AND RISK FACTORS FOR CERVICAL CANCER AMONG YOUNG WOMEN IN ALMATY

Relevance: Currently, in the world, including Kazakhstan, the increasing number of new cervical cancer cases among women of reproductive age is a socio-demographic problem. The increase in cervical cancer incidence among young women, the high prevalence of human papillomavirus (HPV) infection among young sexually active women, the lack of screening programs for the early detection of cervical cancer in young women, the need to take urgent measures to increase awareness of young women about risk factors for cervical cancer and methods of prevention and determined the relevance of this study.&#x0D; The study aimed to estimate the awareness, identify risk factors for cervical cancer, and assess the state of reproductive health of young women of Almaty by questioning.&#x0D; Methods: The article presents an analytical study of the intermediate results of a survey of young women aged 18 to 32 years and living in Almaty. Participants received full information on the upcoming survey. The questionnaire collected information on socio-demographic data, awareness of cervical cancer prevention, and women’s gynecological history. The questionnaire contained 30 questions in total and took 10 minutes to complete.&#x0D; Results: Among young women in Almaty, low awareness of primary and secondary prevention of cervical cancer was revealed in all age groups. The most common risk factors for cervical cancer among young women in Almaty were an early onset of sexual activity, smoking, and hormonal contraceptive uptake.&#x0D; Conclusion: The survey showed the problem of low awareness of girls about cervical cancer and the risk factors for developing cervical cancer. Based on these data, we can state the need for educational work on these issues among young people.

ASSESSMENT OF AWARENESS AND RISK FACTORS FOR CERVICAL CANCER AMONG YOUNG WOMEN IN ALMATY

Relevance: Currently, in the world, including Kazakhstan, the increasing number of new cervical cancer cases among women of reproductive age is a socio-demographic problem. The increase in cervical cancer incidence among young women, the high prevalence of human papillomavirus (HPV) infection among young sexually active women, the lack of screening programs for the early detection of cervical cancer in young women, the need to take urgent measures to increase awareness of young women about risk factors for cervical cancer and methods of prevention and determined the relevance of this study.&#x0D; The study aimed to estimate the awareness, identify risk factors for cervical cancer, and assess the state of reproductive health of young women of Almaty by questioning.&#x0D; Methods: The article presents an analytical study of the intermediate results of a survey of young women aged 18 to 32 years and living in Almaty. Participants received full information on the upcoming survey. The questionnaire collected information on socio-demographic data, awareness of cervical cancer prevention, and women’s gynecological history. The questionnaire contained 30 questions in total and took 10 minutes to complete.&#x0D; Results: Among young women in Almaty, low awareness of primary and secondary prevention of cervical cancer was revealed in all age groups. The most common risk factors for cervical cancer among young women in Almaty were an early onset of sexual activity, smoking, and hormonal contraceptive uptake.&#x0D; Conclusion: The survey showed the problem of low awareness of girls about cervical cancer and the risk factors for developing cervical cancer. Based on these data, we can state the need for educational work on these issues among young people.

Racial/Ethnic Disparity in the Relationship of Mental and Physical Health With Colorectal Cancer Screening Utilization Among Breast and Prostate Cancer Survivors.

We examined colorectal cancer (CRC) screening utilization among non-Hispanic White, non-Hispanic Black (NHB), non-Hispanic other (NHO)/Hispanic cancer survivors. We also determined whether experiencing poor physical and/or mental health affects CRC screening utilization in breast and prostate cancers across different racial/ethnic groups. Data from years 2016, 2018, and 2020 of the Behavioral Risk Factor Surveillance System on 3,023 eligible treatment-utilizing cancer survivors with complete treatment were used. We performed descriptive statistics and multivariable logistic regression to examine the mentioned association. Among 3,023 eligible survivors, 67.7% of NHO/Hispanic survivors demonstrated lower CRC screening use compared with non-Hispanic White (82%) and NHB (89%) survivors (P < .001). In multivariable analysis, having frequent (14-30 days) poor mental health was associated with lower odds of receiving CRC screening among NHB (odds ratio [OR], 0.32; 95% CI, 0.11 to 0.95) and NHO/Hispanic (OR, 0.39; 95% CI, 0.18 to 0.81) survivors. Similar results in physical health were also found in NHB (OR, 0.34; 95% CI, 0.13 to 0.91) and NHO/Hispanic (OR, 0.22; 95% CI, 0.05 to 0.91) groups. Among those experienced both frequent poor mental and physical health, NHB/NHO/Hispanic were less likely to be screened for CRC (OR, 0.05; 95% CI, 0.02 to 0.10). NHO/Hispanic survivors demonstrated lower CRC screening use. Frequent poor mental and/or physical health was strongly associated with lower CRC screening use among NHB and NHO/Hispanic survivors. Our study suggests that cancer survivorship care considering mental and physical health status may improve adherence to CRC screening recommendation (for secondary cancer prevention) for NHB, NHO, and Hispanic survivors.

Maximizing the cost-effectiveness of cervical screening in the context of routine HPV vaccination by optimizing screening strategies with respect to vaccine uptake: a modeling analysis

BackgroundRegarding primary and secondary cervical cancer prevention, the World Health Organization proposed the cervical cancer elimination strategy that requires countries to achieve 90% uptake of human papillomavirus (HPV) vaccines and 70% screening uptake. The optimal cervical screening strategy is likely different for unvaccinated and vaccinated cohorts upon national HPV immunization. However, health authorities typically only provide a one-size-fits-all recommendation for the general population. We aimed to evaluate the cost-effectiveness for determining the optimal screening strategies for vaccinated and unvaccinated cohorts.MethodsWe considered the women population in Hong Kong which has a unique HPV infection and cervical cancer epidemiology compared to other regions in China and Asia. We used mathematical models which comprise a deterministic age-structured compartmental dynamic component and a stochastic individual-based cohort component to evaluate the cost-effectiveness of screening strategies for cervical screening. Following the recommendations in local guidelines in Hong Kong, we considered strategies that involved cytology, HPV testing, or co-testing as primary cervical screening. We also explored the impacts of adopting alternative de-intensified strategies for vaccinated cohorts. The 3-year cytology screening was used as the base comparator while no screening was also considered for vaccinated cohorts. Women’s lifetime life years, quality-adjusted life years, and costs of screening and treatment were estimated from the societal perspective based on the year 2022 and were discounted by 3% annually. Incremental cost-effectiveness ratios (ICERs) were compared to a willingness to pay (WTP) threshold of one gross domestic product per capita (US $47,792). Probabilistic and one-way sensitivity analyses were conducted.ResultsAmong unvaccinated cohorts, the strategy that adds reflex HPV to triage mild cytology abnormality generated more life years saved than cytology-only screening and could be a cost-effective alternative. Among vaccinated cohorts, when vaccine uptake was 85% (based on the uptake in 2022), all guideline-based strategies (including the cytology-only screening) had ICERs above the WTP threshold when compared with no screening if the vaccine-induced protection duration was 20 years or longer. Under the same conditions, HPV testing with genotyping triage had ICERs (compared with no screening) below the WTP threshold if the routine screening interval was lengthened to 10 and 15 years or screening was initiated at ages 30 and 35 years.ConclusionsHPV testing is a cost-effective alternative to cytology for vaccinated cohorts, and the associated optimal screening frequency depends on vaccine uptake. Health authorities should optimize screening recommendations by accounting for population vaccine uptake.

Facebook Intervention for Young-Onset Melanoma Survivors and Families: Protocol for a Randomized Controlled Trial

Individuals diagnosed with melanoma before the age of 40 years (young-onset melanoma survivors) and their first-degree relatives (FDRs) are a growing population at risk for developing recurrent melanoma or new melanomas. Regular surveillance using clinical skin examination (CSE) and skin self-examination (SSE) and engagement in preventive behaviors including sun protection are recommended. Given the growing population of survivors and their families who are at increased risk, it is surprising that no behavioral interventions have been developed and evaluated to improve risk-reduction behaviors. We describe the rationale and methodology for a randomized controlled trial evaluating the efficacy of a Facebook intervention providing information, goal setting, and peer support to increase CSE, SSE, and sun protection for young-onset melanoma survivors and their FDRs. Overall, 577 survivors and 577 FDRs will be randomly assigned to either the Young Melanoma Family Facebook Group or the Melanoma Family Healthy Lifestyle Facebook Group condition. Participants will complete measures of CSE, SSE, and sun protection, and mediator measures of attitudes and beliefs before and after the intervention. The primary aim is to evaluate the impact of the Young Melanoma Family Facebook intervention versus the Melanoma Family Healthy Lifestyle Facebook intervention on CSE, SSE frequency and comprehensiveness, and sun protection among FDRs. The secondary aims examine the efficacy of the Young Melanoma Family Facebook intervention on survivors' SSE frequency and comprehensiveness and sun protection behaviors and mechanisms of intervention efficacy for intervention impact on FDR and survivor outcomes. The exploratory aim is to evaluate the efficacy of the 2 interventions on perceived stress, physical activity, and healthy eating. This project was funded by the National Institutes of Health (R01CA221854). The project began in May 2018, and recruitment started in January 2019. We anticipate completing enrollment by November 2023. Power calculations recommended a sample size of 577 survivors and 577 FDRs. Multilevel modeling treating family as the upper-level sampling unit and individual as the lower-level sampling unit will be the primary data analytic approach. Fixed effect predictors in these models will include condition, role, sex, all 2- and 3-way interactions, and covariates. The Young Melanoma Family Facebook intervention aims to improve primary and secondary skin cancer prevention for young-onset melanoma survivors and their family members. The intervention's delivery via a popular, freely available social media platform increases its impact because of the potential for dissemination in many contexts. If efficacious, this program could be disseminated by dermatologist practices, public health or nonprofit organizations focused on melanoma, and existing melanoma and skin cancer Facebook groups, thereby expanding its reach. This project will produce a content library of posts and a moderation guide for others. ClinicalTrials.gov NCT03677739; https://clinicaltrials.gov/ct2/show/NCT03677739. DERR1-10.2196/39640.

Determinants of Lung Cancer Screening in a Minnesota Urban Indigenous Community: A Community-Based, Participatory, Action-Oriented Study.

Secondary prevention of lung cancer through screening is potentially lifesaving considering that overall survival of lung cancer is 20% at 5 years but curable if detected at an early stage. This work provides insight into culturally tailored approaches to implementing the service in individuals at high risk of the disease.

Abstract A121: Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors

Abstract Background: Advancement in cancer detection and treatment has improved survival rates leading to a growing population of cancer survivors, yet cancer survivors are at a 20% increased risk of developing a secondary cancer. Breast, cervical, prostate, and lung cancer survivors as well as malignant melanoma survivors have been reported an increased risk for developing colorectal cancer (CRC). Although receiving appropriate cancer screening for secondary cancers is recommended, evidence on CRC screening among different cancer survivors are lacking. Methods: We examined the relationship between sociodemographic characteristics, access to care, risk behavior factors, and chronic health conditions in cancer survivors, with up-to-date CRC screening utilization (colonoscopy, flexible sigmoidoscopy, fecal occult blood test) among breast, cervical, prostate, skin (including melanoma), and lung cancer survivors, using data from the 2020 Behavioral Risk Factor Surveillance System. Descriptive statistics were used to summarize the data and multivariable logistic regressions were applied to assess the association of these characteristics with up-to-date CRC screening use. Results: Among 9,780 cancer survivors included in the analysis, most were age 60-69 years, had first cancer at 41-59 years, were Non-Hispanic White, and had some college or college graduate education. Compared to CRC screening rates in breast, prostate, skin, and lung cancer survivors, cervical cancer survivors had a lower rate of screening at 65% (breast cancer: 82%, prostate cancer: 88%, skin cancer: 78%, and lung cancer: 80%). In multivariable analysis, breast, cervical, and skin cancer survivors aged ≥ 60 years were associated with higher odds of receiving CRC screening compared to adults aged 45-59 years (p-value &amp;lt;0.05). Respondents that had their last routine checkup two or more years prior, had lower odds of having CRC screening among cervical (OR=0.06; 95% CI, 0.02-0.22), prostate (OR=0.26; 95% CI, 0.14-0.49), and skin cancer (OR=0.50; 95% CI, 0.36-0.70) survivors. The presence of one or more chronic diseases were associated with higher odds of having up-to-date CRC screening among breast, prostate, and skin cancer survivors; however, lung cancer survivors with one or two chronic diseases exhibited lower odds of receiving CRC screening (OR=0.16; 95% CI, 0.04-0.61) compared to respondents without chronic disease. Conclusion: Findings from this study provide important evidence on factors that may be associated with up-to-date CRC screening use across different cancer survivors which include older age, routine checkup, and multiple chronic diseases. Moreover, variations of CRC screening utilization among cancer survivors may highlight missed opportunities for secondary cancer prevention. These findings will inform the importance of secondary cancer prevention in survivorship care plans for breast, cervical, prostate, skin, and lung cancer survivors and effective implementation of these plans through primary health care initiatives. Citation Format: Meng-Han Tsai, Justin X. Moore, Lorriane Odhiambo, Sydney E. Andrzejak, Martha S. Tingen. Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A121.

乳腺癌的二级预防研究进展

乳腺癌的二级预防研究进展

Screen-and-Treat Approach in Secondary Prevention of Cervical Cancer among HIV-Infected Women in Faith Alive Hospital, Jos Nigeria

Screen-and-Treat Approach in Secondary Prevention of Cervical Cancer among HIV-Infected Women in Faith Alive Hospital, Jos Nigeria

Development, implementation, and evaluation of a program to expand the nurse's roles in colorectal cancer prevention: A mixed-methods protocol study.

Nurses play an important role in cancer prevention. However, studies conducted on nurses' roles, in the field of cancer prevention in Iran, are very limited. This study will identify the role of nurses and designs, implements, and evaluates a program to expand their role in the prevention of colorectal cancer (CRC). This exploratory mixed-methods study will be performed using quantitative-qualitative methods in three consecutive stages. In the first phase, a qualitative study will be conducted to identify the potential and actual roles of nurses in Iran using in-depth semi-structured interviews. Participants will be selected by purposive and snowball sampling, followed by a literature review; the actual and potential roles of nurses at the primary, secondary, and tertiary levels of CRC prevention in Iran and around the world will be extracted. And the actual role is determined. In the second phase, the roles of nurses will be prioritized using the modified Delphi method, and the program will be designed. In the third phase, the part of the program will be implemented as a quasi-experimental intervention, and the effect of the intervention will be evaluated. Developing a program can provide some evidence for promoting nurses' position in cancer prevention. Moreover, it is expected that this program promotes knowledge and empowerment and the position of nurses to provide primary, secondary, and tertiary cancer prevention. The entry of nurses into the field of cancer prevention leads to better quality care and more cost-effectiveness.

Engaging At-Risk Rural Residents in Secondary Lung Cancer Prevention.

Rural residents are at elevated risk for lung cancer and related mortality, yet limited research has explored their perspectives on cancer risk or prevention options, including tobacco treatment and lung cancer screening with low-dose computed tomography (LDCT). This qualitative study examined attitudes and beliefs among rural adults who reported either current or former tobacco use, as well as disengagement from the health care system. We conducted 6 focus groups with rural Maine residents at risk for lung cancer based on age and smoking history (n = 50). Semistructured interviews explored participants' knowledge, perceptions, and attitudes regarding lung cancer risk, LDCT screening, and patient provider relationships. Inductive qualitative analysis of interview transcripts was conducted to identify key themes. Participants were cognizant of their elevated lung cancer risk, yet few were aware of LDCT screening. When informed about LDCT, most participants indicated a willingness to undergo screening, although a substantial minority indicated reluctance related to fear and fatalism. Participants generally expressed the belief that relationships with a primary care provider could support their health and identified several provider factors that influence these relationships, including attention and time for patient concerns; respect and non-judgmental, nonstigmatizing attitudes; treating patients as individuals; and provider empathy and emotional support. Rural residents at risk for lung cancer report limited knowledge and substantial ambivalence regarding LDCT screening, but identify provider behaviors that may promote patient-provider relationships and greater engagement with their health. More research is needed to confirm these findings and understand how to help rural residents and healthcare providers work together to reduce lung cancer risk.

Gingival Overgrowths Revealing PTEN Hamartoma Tumor Syndrome: Report of Novel PTEN Pathogenic Variants.

PTEN hamartoma tumor syndrome (PHTS), is a spectrum of disorders caused by mutations of PTEN, in which non-cancerous growths, called hamartomas, develop in different areas of the body, often including the oral mucosa. PHTS also implies a recognized increased risk of malignancies, as PTEN is a tumor suppressor gene capable of inhibiting progression of several cancers. One of the main and most common clinical manifestation of PHTS are gingival overgrowths presenting as warty lumps. The current study describes patients with gingival or mucosal enlargements leading to the diagnosis of PHTS associated to novel PTEN pathogenic variants. Patients referred to us for gingival lumps suggestive of PHTS associated overgrowths were submitted to genetic analysis in the PTEN gene. Two related and two unrelated patients were investigated. PTEN novel pathogenic variant was found in all of them. Two patients also fulfilled diagnostic criteria of Cowden syndrome (CS). Mucocutaneous lesions, and particularly diffuse gingival overgrowths, are both early and major clinical signs revealing a potential diagnosis of PHTS. Further genetic and clinical assessments are needed in order to confirm and clarify the diagnosis within the PHTS spectrum, including, among others, the CS. A correct interpretation of oral clinical features potentially associated to PHTS is mandatory for diagnosis and a surgical approach can be useful just in case of impairment of periodontal health or for aesthetic needs. The increased risk of malignancies associated to PHTS makes a correct diagnosis pivotal to set up an appropriate lifelong surveillance, aiming at secondary cancer prevention.

The incidence of cervical intraepithelial neoplasia and its correlation with the results of histopathological examination in the female population of the Podlaskie Voivodeship

&lt;br&gt;Introduction: Cervical cancer was the seventh most common malignant tumor among women in the Podlaskie Voivodeship in 2016. The development of this cancer is preceded by the occurrence of cervical intraepithelial neoplasia (CIN). Pap smear is still the basic method of secondary prevention of cervical cancer. If the result of the Pap test is positive, further diagnosis is necessary (colposcopy, histopathological examination).&lt;/br&gt; &lt;br&gt;Aim: The aim of the study was to assess the incidence of intraepithelial cervical lesions and its correlation with the results of histopathological examination in the female population of the Podlaskie Voivodeship.&lt;/br&gt; &lt;br&gt;Material and methods: 51,136 Pap smear tests were analyzed (retrospectively). The tests were performed in the Podlaskie Voivodeship from January 2012 to December 2019. Of this group, 134 patients had a histopathological examination. The results of both studies were compared.&lt;/br&gt; &lt;br&gt;Results: Among the cytological tests performed in private offices, incorrect results accounted for 1.35%. The value is two times lower than in the case of tests carried out in the prevention program in Podlaskie Voivodeship. The results were consistent in 77% of patients diagnosed with HSIL and in 35% of patients diagnosed with LSIL.&lt;/br&gt; &lt;br&gt;Conclusions: The obtained congruence of cytological and histopathological results is comparable to the data in the literature. The creation of a central registry of pap smears would be helpful in the quality monitoring and the number of abnormal results.&lt;/br&gt;