Skin Cancer Research Articles

Application of ensemble learning models in computer-aided diagnosis of skin diseases

Abstract Computer-aided diagnosis (CADx) systems often involve error-prone and/or manual processes. Recent studies show that various machine learning models have the potential to improve the accuracy of CADx systems. However, existing models suffer from low prediction accuracy. In this work, we present research findings to improve the effectiveness of CADx systems for detecting skin diseases by adopting optimized ensemble machine learning models. The investigation encompasses the exploration of three popular classification methods: linear discriminant analysis (LDA), support vector machine (SVM), and convolutional neural network (CNN); two customized CNN models: LeNet-5 and ResNet; and an ensemble model of CNN with SVM. The ensemble CNN-SVM model is optimized using techniques such as feature aggregation and weight adjustments. Skin lesion images from Kaggle’s Human Against Machine 10000 (HAM10000) are used to train and test all classification models. Through rigorous experiments, the results highlight the compelling efficacy of the ensemble CNN-SVM model, unveiling heightened accuracy of up to 92% (from ResNet accuracy of 88%, CNN accuracy of 85%, SVM accuracy of 83%, LeNet-5 accuracy of 77%, and LDA accuracy of 75%). The models are tested on another dataset from Kaggle’s Melanoma Skin Cancer Dataset of 10000 Images; new results follow a similar trend to those using the HAM10000 dataset. The outcome of this work has profound implications for artificial intelligence (AI) accelerated engineering applications in advancing the effectiveness of skin disease treatment through diagnosis systems.

Suppression of NRAS-mutant melanoma growth with NRAS-targeting Antisense Oligonucleotide treatment reveals therapeutically relevant kinase co-dependencies

BackgroundMelanoma is an aggressive form of skin cancer, and patients with NRAS-mutant melanoma face limited treatment options due to the lack of direct NRAS inhibitors. This study explores the utilization of antisense oligonucleotides (ASOs) to directly target NRAS-mRNA for therapeutic approaches.MethodsWe designed and tested NRAS-mRNA-targeting ASOs. Experiments in melanoma cell lines and mouse models assessed effects on cell survival, apoptosis, and tumor growth. A kinase activity profiling platform identified therapeutically exploitable pathways influenced by NRAS suppression.ResultsOur research suggests that ASOs do not need to target the mutated NRAS segment to be effective. ASOs designed for the non-mutated NRAS sequence eliminate NRAS-dependent melanoma cells while sparing NRAS wild-type cells. They act independently of subcellular target localization, reduce NRAS-mRNA levels, inhibit MAPK signaling, induce apoptosis, and suppress melanoma growth in vitro and in vivo. Outcomes of high-throughput kinase activity mapping (HT-KAM) indicate a significant dependency between NRAS-mRNA expression and the activity of MEK1, FGFR2, and CDK4 kinases. Co-targeting these kinases enhances the antiproliferative effect of NRAS ASOs, showing synergy.ConclusionsThese findings highlight antisense oligonucleotides as a promising therapeutic approach for NRAS-mutant melanoma. By effectively blocking NRAS-mRNA, this strategy overcomes challenges posed by the absence of a direct small molecule inhibitor for NRAS, and may offer new treatment options for patients.

Frequency and timing of multiple skin cancer development in five cohorts.

Frequency and timing of multiple skin cancer development in five cohorts.

Promoting sun safety and melanoma prevention in the community through a multi-component community-wide intervention.

e22613 Background: Although among the most preventable cancers, skin cancer is the most common cancer in the United States. The Community Preventive Service Task Force (CPSTF) recommends multi-component community-wide interventions as an effective strategy to prevent skin cancer. These interventions are particularly effective in addressing the cumulative impact of cancer by including youth – > = 5 blistering sunburns while young is estimated to increase the risk for skin cancer risk by 80%. Between 2018 and 2024, The University of Texas MD Anderson Cancer Center delivered a multi-component community-wide intervention for sun safety as a part of its Be Well Communities initiative in Baytown, Texas. Components of this intervention included a community-wide communications campaign, SPF is your BFF, education among early childhood, K-12, and community college students and outdoor workers, school-based policy changes, and infrastructure changes to increase shade. Methods: Our Center with support from a community-based Steering Committee coordinated four organizations implementing evidence-based interventions from The Community Guide to Preventive Services. Implementing organizations reported on process outcomes in quarterly and annual reports and conducted surveys to assess impact outcomes. Results: The county health department implemented interventions with four childcare centers to provide children (n = 250) physical activity in sun safe environments. The local school district, Goose Creek CISD (GCCISD), reached more than 23,000 K-12 students with sun safety education increasing from 1 school in 2018 to all 29 schools in 2024. Eleven schools installed sunshade structures. Furthermore, 92% of campuses reported a positive change in sun safety behaviors after implementing the district-wide sun safety plan. The City of Baytown (n = 70) and GCCISD (n = 107) implemented annual skin cancer prevention trainings and provided sun-protective hats and clothing to outdoor workers. The City of Baytown planted 1,054 shade trees and installed 10 sunshade structures (and 20 non-permanent shades) at parks and pools across the city. All community college, students and staff (n = 7,500) received sun safety education, a campus-wide sun safety campaign; 10 sunshades were also installed. Overall, the percentage of community locations with a sunshade increased from 1% in 2018 to 29% in 2024 and 83% of the community was reached with education and resources for sun safety. Conclusions: Using the Be Well Communities model and following CPSTF recommendations, we have developed a replicable, sustainable, and community-led multicomponent approach to skin cancer prevention. Actions taken and investments through the initiative are likely to help prevent skin cancer in the future within this community; lessons learned can be shared with other communities interested in reducing the risk for skin cancer.

Cellulose based nanofiber-assisted stabilization of cationic ethosomes for skin penetration of bleomycin sulphate in the treatment of skin cancer.

Cellulose based nanofiber-assisted stabilization of cationic ethosomes for skin penetration of bleomycin sulphate in the treatment of skin cancer.

Preventive effect of acemannan on DMBA-induced mouse skin tumorigenesis by modulating inflammatory cytokines and apoptosis pathways: molecular docking and molecular dynamic simulation approaches.

Preventive effect of acemannan on DMBA-induced mouse skin tumorigenesis by modulating inflammatory cytokines and apoptosis pathways: molecular docking and molecular dynamic simulation approaches.

Innovations in Skin Cancer Nanotechnology: A Comprehensive Review.

Skin cancer is the most common type of cancer among white people, according to the World Health Organisation. The incidence of melanoma and non-melanoma skin cancers has increased to epidemic levels, making them the most widespread type of skin cancer. Melanoma is a very aggressive form of cancer, characterized by limited treatment choices due to multidrug resistance and an extremely low probability of patient survival. This article explores the various impediments and limitations associated with conventionally available treatments. Chemotherapy, radiation, immunotherapy, and targeted therapy are among the conventional treatments for melanoma; however, each of these approaches has several adverse reactions. Recently, there has been a focus on biological and pharmacological research on developing alternative, site-specific therapy approaches. Nanotechnology offers several benefits in this regard, with the potential to enhance the longevity of melanoma patients while minimizing adverse effects. Nanoparticles serve as effective drug carrier systems due to their capacity to improve the solubility of medications with low water solubility, modify pharmacokinetics, prolong drug half-life by reducing immunogenicity, boost bioavailability, and decrease drug metabolism. This article highlights recent advancements in utilizing several nanotechnological techniques, including solid lipid nanoparticles, nanostructured lipid carriers, liposomes, transferosomes, ethosomes, and nanoemulsion polymeric mixed micelles.

Oncolytic viral therapy for nonmelanoma skin cancer and cutaneous lymphoma - A systematic review.

The rising incidence and consequent health care burden of nonmelanoma skin cancers, including cutaneous lymphomas, are a growing cause for concern. Oncolytic viruses (OVs) are emerging immunotherapies with limited literature on their use. We conducted a systematic review to evaluate their role in nonmelanoma skin cancer and cutaneous lymphoma treatment (CRD42024526854). We identified 11 published studies involving a total of 20 patients (squamous cell carcinoma n=3, Merkel cell carcinoma n=7, cutaneous T cell lymphoma n=9, basal cell carcinoma n=1). OVs used include Talimogene laherparepvec (73%, n=8), measles virus (9%, n=1), vesicular stomatitis virus (9%, n=1), and adenovirus (9%, n=1). Complete response occurred in 67% (n=2) of squamous cell carcinoma cases, 85% (n=6) of Merkel cell carcinoma cases, and 11% (n=1) of cutaneous T cell lymphoma cases. The most common adverse event was fever or flu-like symptoms (n=5, 25%). Fourteen unpublished clinical trials investigating regimes such as OV monotherapy (43%, n=6), combination therapy with existing immunotherapy (21%, n=3), and comparing OV combination versus monotherapy (29%, n=4) or versus immune checkpoint inhibitor alone (7%, n=1). Overall, heterogeneity of existing studies significantly limits generalizability of results. Further research is needed to reveal the potential role of OVs in the future of nonmelanoma skin cancer and cutaneous lymphoma treatment.

Huntington’s disease as a protective factor for non-melanoma skin cancer: A retrospective case-control study using the TriNetX dataset.

e21585 Background: Huntington’s disease (HD) is an inherited neurodegenerative disorder caused by a mutation in the encoded protein huntingtin (HTT). Patients exhibit cognitive decline, psychiatric symptoms, and distinctive movement patterns. Previous studies, such as Sørensen et al. and Hamshere et al. have found a reduced incidence of certain cancers in this patient population; data from Murmann et al. show that the mutated HTT molecules are toxic to cancer cells but not healthy cells. However, the association with non-melanoma skin cancer (NMSC) has not been specifically studied. We aimed to investigate HD’s association with such skin cancers. Methods: The TriNetX (Cambridge, MA) US network was utilized to conduct a retrospective case-control study. The case group was defined using the ICD-10 code for individuals diagnosed with HD. All diagnoses of NMSC were identified in the time interval after HD diagnosis. The controls included patients who had undergone at least one general outpatient annual physical examination and had no documented history of HD, as identified using ICD-10 codes. We performed adjusted analyses with 1:1 propensity score matching between cohorts for age at index, sex, black and white race, and ethnicity. Results: Of 114,457,565 individuals in the US network, 11,203 met HD diagnosis criteria. 10,326 were included after matching to controls. Individuals with HD were less likely to have a diagnosis of SCC compared to those without (OR: 0.178, 95% CI: 0.111,0.287, p<0.0001). There was also a statistically significant decrease in having a diagnosis of BCC (OR: 0.219, 95% CI: 0.156,0.308, p<0.0001). Conclusions: Our study results suggest that patients with HD may have a significantly reduced risk of subsequent NMSC diagnosis. These conclusions support the previous findings of reduced cancer incidence in this subpopulation and the potential protective effects of the mutated huntingtin protein. Given our conclusions, further studies into the associations of HD with various subtypes of cancers and subgroups of patients should be explored and better characterized. In addition, our study supports the emerging idea of leveraging HD insight for neoplastic therapeutic discovery.

Estimation of the proportion of skin cancers attributable to occupational sun exposure in Reunion Island.

Estimation of the proportion of skin cancers attributable to occupational sun exposure in Reunion Island.

Cinnamomum verum: Biogenic Synthesis of Silver Nanoparticles and In Vitro Anticancer Activity on A-431 Cell Lines

Human skin cancers are the most common type of cancer, especially among white individuals. Due to the rising incidence of cutaneous malignancies, various therapies have been developed. While surgical treatments remain the gold standard, innovative approaches are needed to reduce morbidity and mortality. This study explores the potential of green synthesized silver nanoparticles using Cinnamomum verum aqueous extract as an eco-friendly and cost effective alternative for skin cancer treatment. The plant extract served as a capping and reducing agent to biosynthesize silver ions into silver nanoparticles. Among the formulations, NP3 had the smallest particle size 220.5 nm and a zeta potential of -4.4 mV, as revealed by dynamic light scattering. Energy-dispersive X-ray analysis confirmed 26.18% silver content. The antiproliferative efficacy of NP3 was evaluated on A431 cell lines by cytotoxicity evaluation. The IC50 value for Cinnamomum verum extract was 57.92±0.25µg/ml, while biosynthesized NP3 had an improved IC50 of 45.30±0.72µg/ml, demonstrating significant antiproliferative activity. These findings suggest that biosynthesized silver nanoparticles could serve as an alternative therapy for managing skin cancer.

Teledermatology-dermoscopy: Expanding access to skin cancer screening to reduce healthcare disparities.

1653 Background: Skin cancer, the most common malignancy in the United States, continues to rise in incidence. Underserved populations face significant barriers to care, including lack of insurance, language differences, and limited access to specialists. The Augusta Free Dermatology Clinic, a student-run clinic, collaborates with the Teledermatology in Rural Georgia program to address these challenges through store-and-forward (SAF) teledermatology-dermoscopy. This approach involves transmitting dermoscopic images to a dermatologist for remote analysis. Implemented during Community Health Fairs (CHFs), this initiative aims to enhance access to skin cancer screening in underserved communities. Methods: Volunteer medical students (MS) from the Medical College of Georgia (MCG) and general physicians underwent training to use a dermatoscope effectively. Trained MS collected brief medical histories and dermoscopic images for SAF referrals during CHFs serving individuals with incomes below 200% of the federal poverty line. Polarized dermoscopic images were captured using iPhones equipped with magnetic dermatoscope attachments and were securely transmitted to a board-certified dermatologist via a teledermatology platform. Dermatological recommendations were provided within one hour and communicated to patients, with Spanish translators facilitating communication. Results: Across two CHFs (~8 hours each), 10 MS volunteered in shifts under the supervision of a general physician (n = 1) or dermatology resident (n = 1). A total of 141 patients presented with dermatological concerns, of whom 24 (17.02%) were referred for SAF consultations due to suspicious skin lesions. Among these, 17 (70.83%) had benign lesions, while 7 (29.17%) were identified as potentially malignant and referred for in-person follow-up at the Augusta Free Dermatology Clinic for further evaluation or biopsy. Comprehensive data were available for 112 patients (79.43%), most of whom were female (58.04%, n = 65) and Latino/Hispanic (98.21%, n = 110). The majority were uninsured (73.21%, n = 82), Spanish-speaking (98.21%, n = 110), and required translation services (98.21%, n = 110). Nearly all participants worked in skilled agricultural roles (98.21%, n = 110) and reported a median of two household dependents (range: 0–9). Common diagnoses among follow-up patients included healthy skin (45.54%, n = 51), acne (5.36%, n = 6), melasma (5.36%, n = 6), benign nevi (5.36%, n = 6), dermatitis (4.46%, n = 5), and folliculitis (3.57%, n = 4). Other less common conditions were diagnosed in 30.36% (n = 34) of patients. Conclusions: The implementation of teledermatology-dermoscopy at CHFs effectively addressed barriers to dermatological care in underserved populations. This approach demonstrated the potential to improve early detection of skin cancer, facilitate timely care, and reduce healthcare disparities.

Skin cancer disease analysis using classification mechanism based on 3D feature extraction

<p>Dermoscopic image analysis is essential for effective skin cancer diagnosis and classification. Extensive research work has been carried out on dermoscopic image classification for the early detection of skin cancer. However, most of the research works are concentrated on 2D features. Therefore, a 3D lesion establishment mechanism is presented in this work to generate 3D features from the obtained 3D lesions. The objective of this work is to reconstruct 3D lesion image from 2D lesion images and a multispectral reference IR light image. The 3D lesion establishment is achieved by designing an efficient convolutional neural network (CNN) architecture. Details of CNN design architecture are discussed. After reconstruction of 3D lesions, 2D and 3D features are extracted and classification is performed on the obtained 2D and 3D features. Classification performance is evaluated using the images from PH2 database. The mean classification accuracy using K-nearest neighbors (KNN) classifier based on the 3D lesion establishment using the CNN architecture is 98.70%. The performance results are compared against varied classification methods in terms of accuracy, sensitivity, specificity and are proved to be better.</p>

Clinicopathological spectrum of cutaneous carcinoma: A single-center retrospective analysis.

e23260 Background: Skin carcinomas, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), rank among the most prevalent malignancies globally, imposing significant health and economic burdens. Despite over 5 million annual cases of non-melanoma skin cancer, disparities in early diagnosis and treatment persist, particularly in diverse populations. This retrospective study aimed to delineate the clinicopathological spectrum, incidence, and risk factors of cutaneous carcinomas among patients at Services Hospital, Lahore, Pakistan, between 2022 and 2024. Methods: We conducted a retrospective analysis of 100 histologically confirmed cases of skin carcinomas, comprising BCC and SCC. Data were obtained from the Dermatology Department, and histopathological slides were meticulously reviewed at the Pathology Department of the Services Institute of Medical Sciences. Tumors were classified using World Health Organization (WHO) guidelines. Patient demographics, clinical features, and histopathological characteristics were analyzed alongside hematoxylin and eosin-stained samples. Cases failing to meet inclusion criteria were excluded. Results: The study cohort included an equal distribution of genders (male-to-female ratio: 1:1.3), with a mean age at diagnosis of 56.42 years. BCC emerged as the predominant malignancy (76%), with SCC accounting for 24%. The nose (13%) and cheek (11%) were the most frequently affected sites. Nodular BCC was the leading histological subtype (37%), followed by basosquamous carcinoma (15%). Ultraviolet (UV) exposure was the most significant risk factor, while arsenic exposure was documented in 3% of cases. Tumor grading revealed that 58% of carcinomas were Grade 1, indicating a predominance of low-grade malignancies. Conclusions: This study provides a comprehensive assessment of the clinicopathological landscape of skin carcinomas in a diverse South Asian population, challenging the stereotype that skin cancer predominantly affects individuals with fair skin. The findings highlight the nodular subtype's predominance in BCC and acantholytic characteristics in SCC, with UV exposure as the primary risk factor. Additionally, the identification of arsenic exposure and HPV as notable regional risk factors underscores the importance of tailored prevention strategies. These insights pave the way for improved diagnostic accuracy, early intervention, and future research in skin carcinoma management. Keywords: Basal cell carcinoma; Squamous cell carcinoma; Skin cancer; Clinicopathological spectrum; Risk factors; Epidemiology.

Utilizing the EORTC Item Library to develop a tailored patient-reported outcome measure (PROM; CSCC-NAAP-32) to evaluate quality of life in resectable advanced (RA) cutaneous squamous cell carcinoma (CSCC).

e18014 Background: RA CSCC most frequently involves the head and neck region, with close proximity to important functional structures. Standard-of-care treatment, typically surgery and radiation, can lead to significant functional impairment and disfiguration. Patients with RA CSCC often experience symptoms that negatively impact their physical, social, and psychological functioning, and overall health-related quality of life (HRQoL). New treatment strategies using neoadjuvant and/or adjuvant immunotherapies are being actively explored, with the potential to improve both oncologic and functional outcomes, that may be reflected in improved HRQoL. Currently, no CSCC-specific PROMs exist to capture the core symptoms and impacts that most affect HRQoL in RA CSCC. This study used the European Organization for Research Treatment of Cancer (EORTC) Item Library to develop a CSCC-specific PROM for the evaluation of neoadjuvant and/or adjuvant treatments. Methods: A targeted literature review of qualitative patient studies (n=12) in non-melanoma skin cancer (NMSC) and interviews with expert clinicians (n=4) were conducted to identify the core concepts (signs, symptoms, and impacts) that most affect HRQoL among patients with RA CSCC. A PROM was developed by selecting items from the EORTC Item Library which mapped to these core concepts. When no items were available to measure the concepts, de novo items were drafted using the same structure (eg, recall period, response options) as the items in EORTC Item Library. Results: From the literature review, 126 concepts were identified as potentially relevant to NMSC. This list was refined to 8 core concepts most relevant to RA CSCC following expert clinician interviews (Table). To measure these, 26 existing items were selected from the EORTC Item Library and 6 de novo items were drafted. These items were combined to form the CSCC Neoadjuvant, Adjuvant & Perioperative 32-item questionnaire (CSCC-NAAP-32). Conclusions: The CSCC-NAAP-32 is a tailored PROM to capture 8 core concepts that most affect HRQoL among RA CSCC. The CSCC-NAAP-32 will be tested and validated in a National Cancer Institute–sponsored randomized phase 3 trial (NRG-HN014, NCT06568172) of neoadjuvant immunotherapy in patients with stage III/IV RA CSCC. After further validation is completed, the CSCC-NAP-32 could be used for future studies exploring HRQoL in patients with RA CSCC. Eight core concepts most relevant to RA CSCC. Category Core concept Disease-related signs/symptoms Pain at tumor location Open wound at tumor location Disease- and treatment-related signs/symptoms Fatigue Treatment-related signs/symptoms Disfigurement Functional impairment Disease- and treatment-related impacts Psychological distress Role functioning Physical functioning

Design, synthesis, and evaluation of 1,4-benzodioxane-hydrazone derivatives as potential therapeutics for skin cancer: In silico, in vitro, and in vivo studies.

Design, synthesis, and evaluation of 1,4-benzodioxane-hydrazone derivatives as potential therapeutics for skin cancer: In silico, in vitro, and in vivo studies.

Expanding Prospects for Dermal Health with Bioactive Phytochemicals

The largest and most defensive organ in the human body is the skin. Skin health significantly affects the quality of life due to its crucial function in aesthetic appearance. The onset of numerous skin illnesses is frequently accompanied by chronic skin inflammation. Immune-mediated reactions defend the body against external harm and need to be quickly controlled. If unregulated, they can result in long-term cellular damage and a variety of skin diseases. Dermatological illnesses encompass a wide range of skin conditions, including but not limited to acne, eczema, psoriasis, vitiligo, dermatitis, skin cancer, and fungal infections. Phytochemicals are produced by plants as a defense mechanism against pathogens that have various biological activities and can be harnessed for therapeutic purposes. Through the quenching of free radicals and the suppression of nuclear factor-κB, phytochemicals shield the skin from damage. Phytochemicals also offer a safe topical delivery system for improving the skin and regenerative treatment. Some phytochemicals' direct molecular targets have been identified, and their underlying mechanisms of action are being researched. In this review, we summarise current studies on phytochemicals' impacts on dermal illnesses and their underlying mechanisms of action.

Targetable mutations in cutaneous skin cancers: A comparative study across melanoma, squamous cell carcinoma, basal cell carcinoma, and Merkel cell carcinoma.

e21555 Background: Skin cancers, including melanoma, squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and Merkel cell carcinoma (MCC), exhibit unique clinical and molecular characteristics. The prevalence of targetable genomic alterations (TGAs) may influence treatment strategies. This retrospective study compared the frequency and types of targetable mutations among these subtypes. Methods: A retrospective analysis was conducted on 50 patients diagnosed with cutaneous skin cancer, including 28 with melanoma, 13 with SCC, 5 with BCC, and 4 with MCC. The study began with 80 patients, excluding 29 for missing data and 1 for being categorized under multiple cancer types. We conducted a descriptive analysis using GraphPad Prism Software, where mutations were evaluated as continuous variables. The statistical significance of differences between groups was assessed using the Kruskal-Wallis test, given the non-normal distribution of data. Pairwise comparisons between groups were also performed. The median number of targetable mutations, race, age, sex, survival status, and the most common mutations in each subtype were analyzed. Data was sourced from Signatera™ assay database to obtain the primary endpoints. Marker values were treated as continuous variables in these analyses. All analyses were executed in GraphPad Prism software. Results: No significant differences were observed in age (p = 0.31), sex (p = 0.09), or survival status (p = 1) among subgroups. The median number of targetable mutations was 2.25 (IQR = 3) in melanoma, 3.7 (IQR = 4) in SCC, 2.3 (IQR = 2) in BCC, and 6.85 (IQR = 6.75) in MCC; however, these values did not differ significantly (p = 0.31). Melanoma presented the highest number of unique mutations (n = 34), followed by SCC (30), BCC (14), and MCC (11). In melanoma, the most frequent mutations involved BRAF (n = 17), TP53 (n = 7), and CDKN2A (n = 8). SCC was dominated by TP53 (n = 13), while BCC featured TP53 (n = 6), PTCH1 (n = 2), and ASXL1 (n = 2). MCC was characterized by RB1 (n = 2) and EGFR (n = 2). Despite these subtype-specific patterns, the overall prevalence of targetable mutations did not differ significantly among the four groups. Conclusions: No significant differences were observed in the number of targetable mutations among melanoma, SCC, BCC, and MCC. Although melanoma showed the highest number of unique mutations (dominated by BRAF and TP53) and SCC had a high frequency of TP53, these patterns were not statistically significant. These findings suggest that targetable mutations may be similarly prevalent across subtypes, underscoring the need for larger studies to clarify their clinical significance and inform targeted therapy.

Brazilian Society of Surgical Oncology: Realities and challenges of surgical oncologists in palliative care practice.

e13553 Background: Palliative care (PC) enhances symptom control, quality of life (QoL), and decision-making in oncology. Despite its relevance to surgical oncology (SO), research on surgeon´s perceptions and practices is limited. This study surveyed members of the Brazilian Society of Surgical Oncology (SBCO) to assess their perceptions, practices, and barriers related to PC in surgical oncology. Methods: A 25-question SurveyMonkey survey was distributed to SBCO members (September–December 2024). It evaluated formal training, PC practices, and integration into SO. Responses were confidential, and group differences were analyzed using Fisher's exact and chi-square tests. Results: Among 184 respondents (response rate: 18.4%), most were aged 30–50 years (76.7%) and were male (69.6%). A majority (70.7%) worked in the South or Southeast regions of Brazil, and 87.4% primarily treated gastrointestinal, gynecological, or skin tumors. All respondents acknowledged the importance of PC, but 91.9% reported limited formal training, and 69.6% had infrequent participation in PC courses. Notably, 95.7% supported integrating PC education into surgical training programs. Although 93% expressed moderate to high confidence in managing PC, and 97.2% emphasized patient preferences and 55% reported access to PC in specialized services. Early integration of PC into surgical planning was supported by 76.6%, and 89.6believed team collaboration improves outcomes. For palliative surgeries, 61.4% cited concerns about efficacy and postoperative QoL, 25% mentioned patient or family expectations, and 13.6% cited risks of complications. Most (78.8%) felt confident discussing surgical options, and 69.6% were comfortable addressing prognostic information. However, discomfort with palliative surgeries was higher among those aged 50 or older respondents (14.6% vs. 5.6%). Barriers included resource limitations (37.5%), insufficient training (27.7%), communication challenges (21.7%), and ethical issues (11.4%). Pain management (71.2%), psychological support (15.8%), nutritional support (9.2%), and complementary therapies (3.8%) were prioritized QoL interventions. No significant differences were observed between public and private healthcare systems regarding perceptions or practices. Conclusions: Surgical oncologists recognize the importance of palliative care, including its early integration into surgical planning, and emphasize the need for training to address barriers and optimize care goals in both public and private services.

Cancer incidence among indigenous adults in Brazil: A 19-year analysis of hospital cancer registry data (2000–2018).

e13830 Background: Cancer disparities persist among Indigenous populations due to socio-demographic, cultural, and environmental factors. In Brazil, limited healthcare access contributes to late diagnoses and worse outcomes. While cancer trends have been extensively studied in the general population, evidence on Indigenous adults remains scarce. This study evaluates temporal trends in cancer incidence among Indigenous adults in Brazil from 2000 to 2018, using data from the Brazilian Hospital-based Cancer Registry (HbCR), and compares findings with estimates from the Brazilian Demographic Census. Methods: A retrospective cohort study was conducted using HbCR (SIS-RHC) data. The cohort included Indigenous individuals aged ≥18 years, diagnosed with malignant neoplasms (ICD-10), and treated within the Brazilian Unified Health System (SUS). Temporal trends in cancer incidence were assessed using the Mann-Kendall test, with bivariate analyses evaluating associations between variables. Cumulative incidence rates (CIR) were calculated based on the Brazilian Demographic Census of 2000 and 2010. Results: Among 3,701 Indigenous individuals (mean age: 56.91 years, SD: 16.22), 58.61% were female, 51.44% had elementary education, and 32.14% resided in the Northeast. Family history of cancer was reported by 35.22%; 62.19% did not consume alcohol, and 53% were non-smokers. Multiple primary tumors were absent in 96.93% of cases. The most common cancers were cervical (19.02%) and breast (11.51%), followed by non-melanoma skin (10.81%) and prostate (8.46%) cancer. Most cases were localized (stages I–II, 35.38%), while 33.71% were regional (stage III) and 30.92% metastatic (stage IV). Diagnoses at localized and regional stages (I–III) increased significantly (p < 0.001). Significant differences were observed across sexes and age groups (p < 0.001). Annual cancer case counts rose significantly from 2000 to 2018 (S = 113; p < 0.001), with 337 cases (8.84%) reported from 2000–2004, 982 (26.53%) from 2005–2009, 849 (22.94%) from 2010–2014, and 1,238 (33.45%) from 2015–2018. Overall, cases increased by 378.59% during the study period. The CIR calculated for the period, were as follows: 2000 to 2009: 169.59 cases/100,000 Indigenous individuals; and 2010 to 2018: 188.05 cases/100,000 Indigenous individuals. Conclusions: Cancer incidence among Indigenous adults in Brazil increased substantially from 2000 to 2018, with cervical and breast cancers being the most prevalent. Despite improvements in early detection, a significant proportion of cases remain diagnosed at advanced stages. These findings highlight the need for targeted public health efforts to improve screening, early diagnosis, and access to culturally tailored cancer care. This study provides critical insights to inform future cancer prevention and control efforts tailored to Indigenous populations in Brazil.