bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse Drug Reaction Reporting in Ethiopia: Systematic Review
Authors: Hailu Abel Demerew , Mohammed Solomon Ahmed
Published: August 2020

Adverse drug reactions are major global public health problems and an important cause of mortality. Problems related to medicines safety can emerge from real‐life medication use due to increasing access to complex treatment of concomitant infectious and noncommunicable diseases, hence leading to a higher prevalence of drug‐related problems. The objective of this review was to assess the knowledge, attitude, and practice of adverse drug reaction reporting among health care professionals in Ethiopia. Relevant literatures were searched from Google Scholar, PubMed, Hinari, Web of Science, Scopus, and Science Direct using inclusion and exclusion criteria. From 133 searched studies, 13 studies were reviewed. The knowledge and attitude of health care professionals towards adverse drug reaction reporting ranged from 22.68% ‐60.33% and 47.22% ‐67.14%, with averages of 41.50% and 57.18%, respectively. While 46.93% encountered adverse drug reactions and 41.8% reported in the last 12 months. One‐third (34.15%) of health care professionals do not know how to report adverse drug reactions. Fearing to report, uncertainty about the adverse drug reaction, concern about reporting generating extra work, thinking that one report does not make any difference, nonavailability of reporting forms, and lack of feedback from regulatory authority were the stated reasons for underreporting. We conclude that the knowledge, attitude, and practice of health care professionals towards spontaneous ADR reporting were low. Conducting awareness and educational training and implementation of electronic reporting can improve the ADR reporting practice.
An Improved Indoor Positioning Technique Based on Receiving Signal’s Strength
Authors: Xue Xingsi , Lin Xiaoquan , Yang Chaofan , Wu Xiaojing
Published: August 2020

Wireless signal-transmitting process is a complex procedure, to improve the indoor positioning accuracy, and this work proposes a novel indoor positioning technique based on receiving signal’s strength. First, the indoor environment of the building is regionalized in the training phase of indoor positioning. Then, the adjacent points of the indoor space with the same wireless signal transmission characteristics are gathered into the same area, and the corresponding parameter sets and decision domains of each area are constructed. After that, during the positioning stage, the regional confidence and receiving signal’s strength are used to predict the indoor area where the mobile station is located. Finally, the ranging and solution results of the traditional three-sided positioning process are constrained to obtain the optimal solution. Comparing with the traditional positioning techniques that regard the entire complex indoor environment as an entirety, the proposed indoor space regionalization preprocessing method can effectively reduce the ranging error. Compared with the indiscriminate data fusion of the centroid method, the data filtering method based on regional confidence is more targeted. In the experiment, a practical office area is used to test our proposal’s performance, and the experimental results show that our approach can effectively improve the accuracy of indoor positioning results.
Conventional Cementless Total Hip Arthroplasty for Hip Osteoarthritis after Distal Trochanteric Transfer: A Report of Two Cases
Authors: Hirata Hirohito , Sonohata Motoki , Hashimoto Akira , Kii Sakumo , Nakashima Takema , Ueno Masaya , Eto Shuichi , Kawano Shunsuke , Mawatari Masaaki
Published: August 2020

Distal trochanteric transfer (DTT) has been widely performed to treat developmental dysplasia of the hip or Perthes disease. Total hip arthroplasty (THA) following DTT in patients with hip osteoarthritis is one of the most challenging procedures for hip surgeons, because great care must be taken regarding anatomical abnormalities of the greater trochanter and the soft tissue attached to the greater trochanter. To the best of our knowledge, there are no reports on THA after DTT. We herein report two cases of patients who underwent THA post DTT using cementless components. After THA, both patients developed abduction temporary contraction because of leg length extension and gluteus medius hypertension. However, in both cases, the contraction was reversible within two months and the final clinical result was good. Therefore, THA can be considered an effective and safe choice for treating osteoarthritis after DTT.
YTHDF1 Promotes Gastric Carcinogenesis by Controlling Translation of FZD7
Authors: Pi Jingnan , Wang Wen , Ji Ming , Wang Xiaoshuang , Wei Xueju , Jin Jing , Liu Tao , Qiang Jiaqi , Qi Zhihong , Li Feng , Liu Yue , Ma Yanni , Si Yanmin , Huo Yue , Gao Yufeng , Chen Yiying , Dong Lei , Su Rui , Chen Jianjun , Rao Shuan , Yi Ping , Yu Shuyang , Wang Fang , Yu Jia
Published: August 2020

N6-methyladenosine (m6A) is the most prevalent internal RNA modification in mammals that regulates homeostasis and function of modified RNA transcripts. Here, we aimed to investigate the role of YTH m6A RNA-binding protein 1 (YTHDF1), a key regulator of m6A methylation in gastric cancer tumorigenesis. Multiple bioinformatic analyses of different human cancer databases identified key m6A-associated genetic mutations that regulated gastric tumorigenesis. YTHDF1 was mutated in about 7% of patients with gastric cancer, and high expression of YTHDF1 was associated with more aggressive tumor progression and poor overall survival. Inhibition of YTHDF1 attenuated gastric cancer cell proliferation and tumorigenesis in vitro and in vivo. Mechanistically, YTHDF1 promoted the translation of a key Wnt receptor frizzled7 (FZD7) in an m6A-dependent manner, and mutated YTHDF1 enhanced expression of FZD7, leading to hyperactivation of the Wnt/β-catenin pathway and promotion of gastric carcinogenesis. Our results demonstrate the oncogenic role of YTHDF1 and its m6A-mediated regulation of Wnt/β-catenin signaling in gastric cancer, providing a novel approach of targeting such epigenetic regulators in this disease.

Significance:

This study provides a rationale for controlling translation of key oncogenic drivers in cancer by manipulating epigenetic regulators, representing a novel and efficient strategy for anticancer treatment.
Stochastic Epigenetic Mutations Are Associated with Risk of Breast Cancer, Lung Cancer, and Mature B-cell Neoplasms
Authors: Gagliardi Amedeo , Dugué Pierre-Antoine , Nøst Therese H. , Southey Melissa C. , Buchanan Daniel D. , Schmidt Daniel F. , Makalic Enes , Hodge Allison M. , English Dallas R. , Doo Nicole W. , Hopper John L. , Severi Gianluca , Baglietto Laura , Naccarati Alessio , Tarallo Sonia , Pace Luigia , Krogh Vittorio , Palli Domenico , Panico Salvatore , Sacerdote Carlotta , Tumino Rosario , Lund Eiliv , Giles Graham G. , Pardini Barbara , Sandanger Torkjel M. , Milne Roger L. , Vineis Paolo , Polidoro Silvia , Fiorito Giovanni
Published: August 2020

Background:

Age-related epigenetic dysregulations are associated with several diseases, including cancer. The number of stochastic epigenetic mutations (SEM) has been suggested as a biomarker of life-course accumulation of exposure-related DNA damage; however, the predictive role of SEMs in cancer has seldom been investigated.

Methods:

A SEM, at a given CpG site, was defined as an extreme outlier of DNA methylation value distribution across individuals. We investigated the association of the total number of SEMs with the risk of eight cancers in 4,497 case–control pairs nested in three prospective cohorts. Furthermore, we investigated whether SEMs were randomly distributed across the genome or enriched in functional genomic regions.

Results:

In the three-study meta-analysis, the estimated ORs per one-unit increase in log(SEM) from logistic regression models adjusted for age and cancer risk factors were 1.25; 95% confidence interval (CI), 1.11–1.41 for breast cancer, and 1.23; 95% CI, 1.07–1.42 for lung cancer. In the Melbourne Collaborative Cohort Study, the OR for mature B-cell neoplasm was 1.46; 95% CI, 1.25–1.71. Enrichment analyses indicated that SEMs frequently occur in silenced genomic regions and in transcription factor binding sites regulated by EZH2 and SUZ12 (P < 0.0001 and P = 0.0005, respectively): two components of the polycomb repressive complex 2 (PCR2). Finally, we showed that PCR2-specific SEMs are generally more stable over time compared with SEMs occurring in the whole genome.

Conclusions:

The number of SEMs is associated with a higher risk of different cancers in prediagnostic blood samples.

Impact:

We identified a candidate biomarker for cancer early detection, and we described a carcinogenesis mechanism involving PCR2 complex proteins worthy of further investigations.
Immune Escape After Adoptive T-cell Therapy for Malignant Gliomas
Authors: Wildes Tyler J. , Dyson Kyle A. , Francis Connor , Wummer Brandon , Yang Changlin , Yegorov Oleg , Shin David , Grippin Adam , Dean Bayli DiVita , Abraham Rebecca , Pham Christina , Moore Ginger , Kuizon Carmelle , Mitchell Duane A. , Flores Catherine T.
Published: August 2020

Purpose:

Immunotherapy has been demonstrably effective against multiple cancers, yet tumor escape is common. It remains unclear how brain tumors escape immunotherapy and how to overcome this immune escape.

Experimental Design:

We studied KR158B-luc glioma-bearing mice during treatment with adoptive cellular therapy (ACT) with polyclonal tumor-specific T cells. We tested the immunogenicity of primary and escaped tumors using T-cell restimulation assays. We used flow cytometry and RNA profiling of whole tumors to further define escape mechanisms. To treat immune-escaped tumors, we generated escape variant-specific T cells through the use of escape variant total tumor RNA and administered these cells as ACT. In addition, programmed cell death protein-1 (PD-1) checkpoint blockade was studied in combination with ACT.

Results:

Escape mechanisms included a shift in immunogenic tumor antigens, downregulation of MHC class I, and upregulation of checkpoint molecules. Polyclonal T cells specific for escape variants displayed greater recognition of escaped tumors than primary tumors. When administered as ACT, these T cells prolonged median survival of escape variant-bearing mice by 60%. The rational combination of ACT with PD-1 blockade prolonged median survival of escape variant glioma-bearing mice by 110% and was dependent upon natural killer cells and T cells.

Conclusions:

These findings suggest that the immune landscape of brain tumors are markedly different postimmunotherapy yet can still be targeted with immunotherapy.
Preclinical Antitumor Activity and Biodistribution of a Novel Anti-GCC Antibody–Drug Conjugate in Patient-derived Xenografts
Authors: Abu-Yousif Adnan O. , Cvet Donna , Gallery Melissa , Bannerman Bret M. , Ganno Michelle L. , Smith Michael D. , Lai Katharine C. , Keating Thomas A. , Stringer Bradley , Kamali Afrand , Eng Kurt , Koseoglu Secil , Zhu Andy , Xia Cindy Q. , Landen Melissa Saylor , Borland Maria , Robertson Robbie , Bolleddula Jayaprakasam , Qian Mark G. , Fretland Jennifer , Veiby O. Petter
Published: August 2020

Guanylyl cyclase C (GCC) is a unique therapeutic target with expression restricted to the apical side of epithelial cell tight junctions thought to be only accessible by intravenously administered agents on malignant tissues where GCC expression is aberrant. In this study, we sought to evaluate the therapeutic potential of a second-generation investigational antibody–dug conjugate (ADC), TAK-164, comprised of a human anti-GCC mAb conjugated via a peptide linker to the highly cytotoxic DNA alkylator, DGN549. The in vitro binding, payload release, and in vitro activity of TAK-164 was characterized motivating in vivo evaluation. The efficacy of TAK-164 and the relationship to exposure, pharmacodynamic marker activation, and biodistribution was evaluated in xenograft models and primary human tumor xenograft (PHTX) models. We demonstrate TAK-164 selectively binds to, is internalized by, and has potent cytotoxic effects against GCC-expressing cells in vitro. A single intravenous administration of TAK-164 (0.76 mg/kg) resulted in significant growth rate inhibition in PHTX models of metastatic colorectal cancer. Furthermore, imaging studies characterized TAK-164 uptake and activity and showed positive relationships between GCC expression and tumor uptake which correlated with antitumor activity. Collectively, our data suggest that TAK-164 is highly active in multiple GCC-positive tumors including those refractory to TAK-264, a GCC-targeted auristatin ADC. A strong relationship between uptake of 89Zr-labeled TAK-164, levels of GCC expression and, most notably, response to TAK-164 therapy in GCC-expressing xenografts and PHTX models. These data supported the clinical development of TAK-164 as part of a first-in-human clinical trial (NCT03449030).
Aurora A Inhibitor TAS-119 Enhances Antitumor Efficacy of TaxanesIn VitroandIn Vivo: Preclinical Studies as Guidance for Clinical Development and Trial Design
Authors: Sootome Hiroshi , Miura Akihiro , Masuko Norio , Suzuki Takamasa , Uto Yoshihiro , Hirai Hiroshi
Published: August 2020

TAS-119 is a novel orally active, selective inhibitor of Aurora kinase A identified as a clinical candidate for efficacy testing in combination with taxanes. In vitro, TAS-119 enhanced cell growth inhibition of paclitaxel in multiple human cancer cell lines derived from various tissues, including paclitaxel-resistant cell lines. Interestingly, TAS-119 did not enhance paclitaxel antitumor activity in normal lung diploid fibroblast cell lines WI-38 and MRC5. In vivo, TAS-119 enhanced the antitumor efficacy of paclitaxel and docetaxel in multiple models at doses inhibitory to Aurora A in tumors. Moreover, the drug combination was well tolerated, and TAS-119 did not exaggerate clinically documented side effects of taxanes, neutropenia and neurotoxicity, in rats. The same TAS-119 concentration enhanced the cell growth inhibitory activity of three clinically approved taxanes, paclitaxel, docetaxel, and cabazitaxel. The degree of enhancement calculated as fold of change of the IC50 value for each taxane was almost the same among the three taxanes. We conducted in vitro and in vivo experiments to develop an optimized combination therapy regimen for TAS-119 with paclitaxel/docetaxel. Using in vitro and in vivo models, we tested the drug administration order for TAS-119 combined with paclitaxel and the TAS-119 treatment duration. The best regimen in preclinical models was combining paclitaxel or docetaxel treatment with 4 days of TAS-119 dosing, which was initiated on the same day as the paclitaxel or docetaxel administration or one day later. This information provided guidance for the design of a clinical trial of TAS-119 and paclitaxel or docetaxel combination.
Abstract A008: Barriers and facilitator to minorities' participation in cancer clinical trials: Perspectives from a safety-net hospital
Authors: Rivers Brian M. , Harris Monica , Cooper Dexter L. , Lisovicz Nedra , Durant Raegan , Hernandez Natalie D. , Rivers Desiree , McKinney Lawrence , Carmichael Bria , Rutland Sarah B. , Shamim Ainny
Published: August 2020

Introduction: Cancer clinical trials (CCTs) are vital to clinical oncology research, in that they provide a foundation for the development and implementation of effective cancer therapies. However, there is a disparity in CCT participation given that only 2.7% of all CCT participants in the U.S. are African-American (AA). Grady Memorial Hospital in Atlanta, Georgia, the setting for this study, is a safety-net hospital with over 80% of its patients on Medicare, Medicaid, or uninsured. The objective of this two-phase pilot study is to utilize a multilevel, qualitative approach to assess the clinical and nonclinical facilitators and barriers to AA participation in CCTs (Phase I) and develop and pilot a multilevel intervention (Phase II).

Methods: Study participants were recruited from a cancer center at a safety-net hospital in Atlanta, GA. Twenty key informant interviews were conducted with key stakeholders at the safety-net hospital and 2 focus groups with AA cancer survivors. Interview guides were adapted from the NIH-funded EMPACT study. The interviews and focus groups were recorded on digital devices upon which the data was transcribed and subsequently analyzed using NVIVO 11 software.

Results: The interview transcripts were analyzed using a combination of hand coding and NVIVO 11 software. Content analysis was conducted using an immersion/crystallizing analysis plan. Common themes regarding Barriers and Facilitators within the context of Institution-level, Participant-level, System-level, and Trial-level will be presented.

Conclusion: These findings will assist in the development and testing of culturally appropriate resources and interventions to increase AA participation in CCTs.

Citation Format: Brian M. Rivers, Monica Harris, Dexter L. Cooper, Nedra Lisovicz, Raegan Durant, Natalie D. Hernandez, Desiree Rivers, Lawrence McKinney, Bria Carmichael, Sarah B. Rutland, Ainny Shamim. Barriers and facilitator to minorities' participation in cancer clinical trials: Perspectives from a safety-net hospital [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A008.
Abstract A009: Validation of an instrument to measure health professionals' health literacy competence
Authors: Dawkins-Moultin Lenna , McKyer Lisako
Published: August 2020

Introduction: Health literacy (HL) has been identified as a significant predictor of outcomes across the health continuum, including cancer care. As a result it is recommended that all health professionals receive health literacy training. Some institutions have begun integrating health literacy into training programs, but there is a dearth of reliable assessment tools to measure learners' knowledge. Only one validated instrument (Health Literacy Knowledge and Experience Scale (HL-KES)) exists that specifically assess health professionals' health literacy competence, but it was validated for use among nurses. The purpose of this study was to evaluate the reliability and validity of the HL-KES as a suitable measure for assessing the HL knowledge and experience of health promotion professionals.

Methods: Advanced (junior and senior) students (n=250) enrolled in bachelor-level health promotion programs in three large public universities in Texas completed the 29-item HL-KES. Exploratory and confirmatory factor analyses were conducted to test the factor structure. Reliability estimates of the overall scale and subscales were assessed using the item covariance method with coefficient alpha (α).

Results: The analyses identified three factors that accounted for 62% of the total variance. Twelve items loaded on factor 1 (Knowledge of HL challenges), four items loaded on factor 2 (knowledge of HL assessment strategies), and three items loaded on factor 3 (knowledge of HL principles for written healthcare materials). Results from the test of internal consistency indicated the HL-KES had acceptable reliability for the overall knowledge scale (Cronbach's alpha = 0.77). The sub-scales had Cronbach's alphas ranging from .31 to .52.

Conclusion: The results suggest the HLKES is a reliable instrument for assessing health promotion professionals' health literacy knowledge. As a whole, the Cronbach's alpha for the instrument falls within the acceptable range (.65 - .90). The subscales, however, have low reliability coefficients. Cronbach's alpha is a function of test length and inter-item correlation and a couple of subscales had just a few items. Reduction in the number of items no doubt attenuated the internal consistency.

Citation Format: Lenna Dawkins-Moultin, Lisako McKyer. Validation of an instrument to measure health professionals' health literacy competence [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A009.
Abstract A016: [Advocate Abstract] Journey of life
Authors: Barefield Brian L.
Published: August 2020

I never knew much about colorectal cancer until it found its way into my home. The one thing I was always told was that it is an “Old Person's” disease and you shouldn't even check for it until after 50. Well, I found out that was not true as my wife was diagnosed at age 36 and passed at age 39. My sole purpose in life is to make young adults aware that they should get checked at an earlier age or when they see even the smallest symptoms. I never want anyone else to suffer from lack of knowledge.

Citation Format: Brian L. Barefield. [Advocate Abstract] Journey of life [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A016.
Abstract A024: Planning for scale-up of an evidence-based intervention in community settings: Project HEAL insights from the SPRINT Initiative
Authors: Jones Laundette P. , Slade Jimmie L. , Davenport Felicia , Santos Sherie Lou Z. , Holt Cheryl L.
Published: August 2020

Project HEAL (Health through Early Awareness and Learning) is an evidence-based intervention rooted in health behavior change theory and aiming to increase cancer awareness and early detection through African American faith-based organizations. This study explored the potential for broader scale-up and dissemination of Project HEAL through the team's participation in a training program called Speeding Research-tested INTerventions (SPRINT). The SPRINT training was framed using tools from the Business Model Canvas and the Value Proposition Canvas to guide trainees in designing (1) compelling value propositions, (2) a minimal viable product, and (3) questions to gain critical insight from various stakeholders during a process called Customer Discovery. We report on our experiences in the SPRINT training and insights on intervention scale-up that we gained from the training, including key findings from 41 discovery interviews conducted with various stakeholders of the church ecosystem. We learned several valuable lessons from the discovery interviews, including the realization that scale-up will likely be more incremental than immediate. Additional refinement will be needed to scale up the intervention for “real world” application, including making our technology more user-friendly and including additional health topics beyond cancer. The SPRINT training helped our team consider broader scale-up and dissemination in a constituent-informed way. We discuss how insights from the training helped to refine our plans for future intervention scale-up.

Citation Format: Laundette P. Jones, Jimmie L. Slade, Felicia Davenport, Sherie Lou Z. Santos, Cheryl L. Holt. Planning for scale-up of an evidence-based intervention in community settings: Project HEAL insights from the SPRINT Initiative [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A024.
Abstract A027: [Advocate Abstract] How to promote diversity and inclusion in the community
Authors: Hauge Winona Hollins
Published: August 2020

Reaching underserved communities is not always easy but it remains a critical area of need. To become an effective champion there are three critical areas that you must clearly define before you start your research. One important factor is understanding the population that you are attempting to reach into. Will your research harm or create any unclear expectations? Did you consult with the community to discern what they think they need or would like to see implemented in their area? At the end of the study or the program, will the community see how their cooperation and engagement has made a impact or a difference?

Citation Format: Winona Hollins Hauge. [Advocate Abstract] How to promote diversity and inclusion in the community [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A027.
Abstract A037: [Advocate Abstract] The benefits of partnering to combat disparities
Authors: Townsend Virgie
Published: August 2020

My poster will focus on partnering and working together to fight or eliminate disparities. It will focus on the need for health systems, comunity groups and public organizations to come together in working to educate and bring together prevention and treatment.

Citation Format: Virgie Townsend. [Advocate Abstract] The benefits of partnering to combat disparities [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A037.
Abstract A046: Colorectal cancer screening among Chamorro on Guam: Barriers and access to care
Authors: Diaz Tressa P.
Published: August 2020

Colorectal cancer (CRC) is the second most common cause of cancer death on Guahan (Guam). Chamoru, the Indigenous peoples of Guahan, have the highest mortality rates in CRC on the island, which implicates the need for earlier detection. Limited research has been conducted on CRC screening behavior among Chamoru. To address the gap, this study seeks to understand, explore, and predict factors associated with CRC screening among Chamoru, and to address the research questions: (1) How does access to care impact colorectal cancer screening among Chamoru on Guam, and (2) What are barriers to colorectal cancer screening among Chamoru on Guam? Guided by Andersen's Behavioral Model of Health Service Utilization, individual predictors were categorized as predisposing, enabling, and need factors that facilitate or hinder CRC screening. A mixed quantitative and qualitative methods approach was utilized. First, screening data from the 2010 Guam Behavioral Risk Factor Surveillance System were used to model the association between CRC screening and predisposing, enabling, and need factors. Second, semistructured in-depth interviews with Chamoru men and women were conducted on why they opted for or against CRC screening. Purposive and snowball sampling was implemented to recruit participants due to the potentially sensitive and stigmatizing subject of colon/rectum screening processes. Binary logistic regression was used in quantitative analysis to determine significant predictors of CRC screening utilization. Qualitative analysis implemented grounded theory to determine relevant themes and key findings. Quantitative results show that having an annual check-up and educational attainment of high school or greater significantly predicted CRC screening. Qualitative analysis points to five themes in CRC screening decision-making: (1) being proactive in one's health care; (2) intergenerational consciousness of cancer diagnosis and related screening behaviors; (3) social stigma associated with colonoscopies; (4) “If I'm gonna die, I'm gonna die”; and (5) negative perceptions of the medical system. Findings provide insight toward cultural and health beliefs as facilitators and barriers to CRC screening with broader implications for political status as a determinant of health. Further research toward culturally tailored screening interventions is recommended to address cancer disparities in the context of health care access and health equity for Chamoru.

Citation Format: Tressa P. Diaz. Colorectal cancer screening among Chamorro on Guam: Barriers and access to care [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A046.
Abstract A057: Biospecimen donation among breast cancer survivors: Opportunities for research among nondonors
Authors: Sutton Arnethea , Sheppard Vanessa , Edmonds Megan C. , Cummings Yvonne , Thomas Justin , Chavis Jessica
Published: August 2020

Purpose: Participation in genomic research may further advance effective therapies, yet samples are often not sociodemographically diverse. Information is lacking about strategies to improve biospecimen donation. This pilot study focused on identifying strategies to enhance biospecimen donation among nondonors.

Methods: Women diagnosed with hormone receptor-positive (HR+) breast cancer who initiated hormonal therapy were recruited from three integrated health systems. Our sample was limited to women >21 years of age and diagnosed within the past 12 months. The analytical sample (N=144) consisted of women who consented but did not return a saliva sample within one year of baseline; 67% were White, 27% were Black, and 2% represented other races. A brief informational intervention was developed via published literature and preliminary data. Respondents received intervention materials, which included a personalized information letter, a colorful low-literacy instruction sheet, a postage-paid envelope, and collection kits. Descriptive and bivariate statistics were employed to describe and compare factors associated with biospecimen donation.

Results: Overall, 29 surveys (20%) were returned, and 17% returned saliva kits. No significant differences were noted by demographic or clinical factors between those who provided biospecimen (vs. not). Women with higher levels of functional well-being and lower ratings of religiosity/spirituality were more likely to return specimens (p <0.005) after receiving the enhanced materials. The most frequently cited factors related to returned specimens were found among participants with higher levels of knowledge and concern about provision of saliva and the usability of biospecimen samples in biomedical research.

Conclusion: A brief print intervention inclusive of personalized messages may enhance receipt of biospecimens among diverse survivors. The inclusion of messages with a focus on spirituality and functional wellness may increase biospecimen provision among nondonors; however, further work is needed to support this claim.

Citation Format: Arnethea Sutton, Vanessa Sheppard, Megan C. Edmonds, Yvonne Cummings, Justin Thomas, Jessica Chavis. Biospecimen donation among breast cancer survivors: Opportunities for research among nondonors [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A057.
Abstract A067: [Advocate Abstract] Making strides against a rare disease: Renal medullary carcinoma
Authors: Lawing Michael B.
Published: August 2020

Making Strides Against a Rare Disease: Renal Medullary Carcinoma (RMC) seeks to provide an overview of an extremely rare cancer that was first described as a novel form of renal malignancy in a series published by Colonel Davis of the Armed Forces Institute of Pathology in 1995. This study was based upon retrospective analysis of tumors coded as renal pelvic carcinoma from patients aged less than 40 years. Where race had been recorded, all patients were black and all had sickled erythrocytes on histologic examination. On this basis the tumor, which was termed medullary carcinoma on morphologic grounds, was designated the seventh sickle cell nephropathy.

Citation Format: Michael B. Lawing. [Advocate Abstract] Making strides against a rare disease: Renal medullary carcinoma [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A067.
Abstract A070: Engaging under-represented researchers (UR) in cancer research: Engagement strategies utilized for recruitment and retention in the Geographic Management of Cancer Health Disparities Program (GMaP) Region 4
Authors: Fleisher Linda , Norbeck Carrie
Published: August 2020

Purpose: The Geographic Management of Cancer Health Disparities Program (GMaP), initiated in 2009, is a national program funded by the National Cancer Institute's Center to Reduce Cancer Health Disparities (CRCHD). CRCHD is committed to funding training for those from backgrounds under-represented in cancer research via comprehensive research training programs, Continuing Umbrella of Research Experiences (CURE). GMaP Region 4, housed at Fox Chase Cancer Center, works to engage diverse investigators in our geographically expansive thirteen-state region utilizing a multipronged engagement approach to increase recruitment and retention of diverse investigators, expand the CURE Pipeline, and cultivate professional development. Based on nine years of experience as well as recent results from surveys provided to recipients of travel scholarships and/or CURE funding (i.e., NCI Diversity F, K or R series grant), we will share recommended strategies to incorporate best practices to recruit investigators into a sustainable network.

Methods: Two surveys were conducted. A survey with the goal to learn more about CURE program awareness at institutions was sent via our listserv with the request that any eligible (current or former CURE awardee) respond via an open link. A second survey with the goal of learning how our travel award scholarship program has benefited investigators was sent directly to our 37 previously funded travel award recipients. Questions were a mix of open ended and Likert scale.

Citation Format: Linda Fleisher, Carrie Norbeck. Engaging under-represented researchers (UR) in cancer research: Engagement strategies utilized for recruitment and retention in the Geographic Management of Cancer Health Disparities Program (GMaP) Region 4 [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A070.
Abstract A071: Use of finasteride in the Prostate, Lung, Colorectal and Ovarian Cancer Prevention (PLCO) Trial cohort: Effects of sociodemographic factors and a black box warning
Authors: Johnson Jarrett A. , Pinsky Paul F.
Published: August 2020

Background: In 1992, finasteride, a 5α-reductase inhibitor, was approved by the Food and Drug Administration (FDA) for the treatment of benign prostatic hyperplasia (BPH). Finasteride also showed early signs of lowering prostate-specific antigen (PSA) levels, indicating that it may be useful for the prevention of prostate cancer. The Prostate Cancer Prevention Trial (PCPT) was conducted from 1994 to 2003 and showed that finasteride reduced overall prostate cancer incidence; however, it also appeared to increase the incidence of high-grade disease. Consequently, in 2011 the FDA issued a black box warning based in part on the PCPT results. Little is known, however, about the effect this warning had on finasteride use among men after 2011. The purpose of this study was to assess the use of finasteride, for BPH or other reasons, among a sample of Prostate, Lung, Colorectal, Ovarian Cancer Prevention Trial (PLCO) participants. Specifically, we wanted to assess the effects of sociodemographic characteristics (e.g., age, race/ethnicity) and BPH on finasteride use and the effect of the FDA's black box warning on finasteride use after 2011.

Method: This was a retrospective longitudinal study. Men's age, race/ethnicity, and BPH status were ascertained from questionnaires. Medication use was ascertained from linkage to Medicare Part D claims data from 2010 to 2014.

Results: The sample contained 14,044 PLCO men with at least one year of part D claims data. The majority self-identified as non-Hispanic white (12,429; 88.5%); 236 (1.7%) were black, 753 (5.4%) were Asian, and 239 (1.7%) were Hispanic. Median (25th/75th) age in 2010 was 73 years (69/28). From 2010 to 2014, 11% (n=1,590) of these men used finasteride at any time. Overall, 63% (n=1,005) of the men who used finasteride reported a diagnosis of BPH. Finasteride use increased steadily over time from 5.5% in 2010 to 8.5% in 2014.

Conclusion: Overall use of finasteride from 2010 to 2014 was low, and mainly in men with BPH. Finasteride use increased after the FDA's 2011 black box warning; the effect of the warning is unclear.

Citation Format: Jarrett A. Johnson, Paul F. Pinsky. Use of finasteride in the Prostate, Lung, Colorectal and Ovarian Cancer Prevention (PLCO) Trial cohort: Effects of sociodemographic factors and a black box warning [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A071.
Abstract A076: Adherence to adjuvant endocrine therapy: Do racial disparities persist among the insured?
Authors: Tolsma Dennis , Tadesse Mahlet G. , Sutton Arnethea , Cromwell Lee , Adunlin Georges , Salgado Teresa M. , He Jun , Trout Martha , Robinson Brandi E. , Edmonds Megan C. , Bosworth Hayden B. , Sheppard Vanessa B.
Published: August 2020

Purpose: Adjuvant endocrine therapy (AET) improves survival in women with hormone receptor-positive (HR+) breast cancer (BC). Yet medication adherence is suboptimal. The aim of this study was to assess adherence to AET among insured women using innovative statistical approaches.

Methods: Black and White women diagnosed with HR+ BC were identified from two health maintenance organizations. Automated pharmacy records captured oral AET prescriptions and refill dates. Logistic regression identified predictors of adherence defined in terms of proportion of days covered (PDC) (>=80%) and medication gap of ≤10 days. A zero-inflated negative binominal (ZINB) regression model identified variables associated with the total number of days of medication gaps.

Results: A total of 1,925 women met inclusion criteria. Eighty percent of women were adherent per the PDC measure; 44% had a medication gap of ≤10 days; and 24% of women had zero days without any medication gaps. Race and age were significant predictors of adherence in all multivariable models. Black women were less likely to have PDC >=80% than Whites (OR=0.72; 95%CI: 0.57-0.90; p<0.01), and they were less likely to have a medication gap of ≤10 days (OR=0.65; 95%CI: 0.54-0.79; p<0.001). Women 25-49 years old were less likely to have PDC >=80% than women 65-93 years old (OR=0.65; 95%CI: 0.48-0.87; p<0.001), and they also were less likely to have a medication gap of ≤10 days (OR=0.73; 95%CI: 0.57-0.93; p<0.01). In the zero-inflated negative binominal model, Black women were less likely to having no medication gaps compared to Whites (OR=0.46; 95%CI: 0.54-0.79; p<0.001), and women 25-49 years old were less likely to have no medication gaps compared to women 65-93 years old (OR=0.61; 95%CI: 0.42-0.88; p<0.01).

Conclusions: Disparities in adherence to AET persist among insured women, particularly in Black and young women, highlighting a need for interventions among this population. Novel statistical approaches to study adherence, such as the ZINB approach, appear to constitute a useful alternative to the dichotomous PDC variable to tailor analysis to adherence patterns.

Citation Format: Dennis Tolsma, Mahlet G. Tadesse, Arnethea Sutton, Lee Cromwell, Georges Adunlin, Teresa M. Salgado, Jun He, Martha Trout, Brandi E. Robinson, Megan C. Edmonds, Hayden B. Bosworth, Vanessa B. Sheppard. Adherence to adjuvant endocrine therapy: Do racial disparities persist among the insured? [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A076.
Abstract A078: Cause for concern: Understanding Black women's concerns with endocrine therapy
Authors: Sutton Arnethea L. , Sheppard Vanessa B.
Published: August 2020

Background: Although endocrine therapy (ET) has been shown to improve breast cancer-related outcomes, Black women tend to initiate and adhere to ET at lower rates than White women. Black women also express more concerns about ET when compared to their White counterparts. Beliefs about medication, specifically in regard to concerns about ET, are related to women's decisions to adhere or not adhere to their medication. This study seeks to 1) understand Black women's concerns about ET and 2) identify factors related to black women's concerns about ET.

Methods: This study is part of the Women's Hormonal Initiation and Persistence Study (WHIP), which sought to observe women's patterns of endocrine therapy adherence over time and elucidate factors (e.g., clinical, sociocultural) that relate to medication adherence and discontinuation. Eligible women were at least 21 years of age, diagnosed with hormone receptor-positive (HR+) breast cancer, and initiated endocrine therapy at least 12 months post-diagnosis. Participants completed one telephone or online survey; data also included medical records and pharmacy refill records. This secondary analysis will identify specific concerns about medication as measured by the concern subscale of the beliefs about medicines questionnaire (BMQ) and regression analyses will identify factors (e.g., age, religiosity) related to those concerns. The BMQ concerns scale scores range from 5-20.

Results: A total of 150 Black women were eligible and completed all study activities. A majority (71%) were over the age of 50 and were college educated (81%). All women were insured. Concerns about ET were moderate (m=11.8 SD 3.1). Most women worried about the long-term effects of ET (65.2%). Most women were not concerned that they would become too dependent on ET (83.9%). Bivariate analysis indicates significant relationships between concerns about medication and satisfaction with care (p=0.018), religiosity (p=0.003), provider communication (p=0.013), and education (p=0.035). In the multivariable regression model, Black women who were least satisfied with their care expressed more concerns about ET (p<0.0002). No other factors were selected to the model.

Conclusion: Women's satisfaction with their care impact beliefs about their ET, which may contribute to nonadherence to this life-saving treatment. Further work is needed to fully understand women's ratings of satisfaction with care and how to intervene with women and providers to improve satisfaction and beliefs about ET.

Citation Format: Arnethea L. Sutton, Vanessa B. Sheppard. Cause for concern: Understanding Black women's concerns with endocrine therapy [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A078.
Abstract A087: Community Research Navigators (CRN): The bridge to increasing Latino participation in clinical research
Authors: Serrano Mayra , Garcia Marisela , Kittles Rick , Ashing Kimlin Tam
Published: August 2020

The participation of underserved ethnic minorities in biomedical research is critical to achieving progress in health equity. Increasing ethnic minority including Latino accrual in biomedical research, including clinical trials, is a formidable challenge that requires improving participant trust and commitment and overcoming of barriers to participation. Latinos make up about 18% of the US population. Yet Latinos are not adequately targeted in research studies, currently constituting only 7.6% of NIH clinical trial participants and only about 2%-5% of participants in cancer clinical trials. The National Cancer Institute (NCI) has recommended patient navigation as a research strategy that may be adapted to overcome ethnic minority biomedical research and clinical trial participation barriers. City of Hope has participated in training community research navigators (CRN) to increase diversity participation. These CRNs are trained to address gaps in knowledge, medical mistrust, access to participation, and engagement of under-represented groups in biomedical research. The research navigator draws from the patient navigation and promotora model and the community-engaged research approach. CRNs' curriculum include the importance of biomedical to disease prevention, diagnosis, and treatment; the value to group and family participation, Clinical Trials, HIPPA, human subject protection, ethics; patient-provider communication, cost and coverage, and family communication and decision making. In total, we trained and mentored a team of 30 CRNs from our community partner Pomona's Health Promoters for increased public education and Latino participation in research. CRNs were 25-74 years old, 97% female, 96% foreign-born, and 54% < high school education. Their pre- and post-test results showed an increase in willingness to participate in research (p < .005); increase in knowledge of the importance of biomedical including clinical research (p < .000); and an increase in confidence in improving community's attitude and knowledge about clinical research (p < .000). Our findings suggest that the CRN training is effective in improving appropriate knowledge and confidence to conduct community research navigation. This approach holds the promise of utility and applicability to address barriers to research enrollment and increase Latino biomedical research participation.

Citation Format: Mayra Serrano, Marisela Garcia, Rick Kittles, Kimlin Tam Ashing. Community Research Navigators (CRN): The bridge to increasing Latino participation in clinical research [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A087.