bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age disparities in the trend of colorectal cancer incidence in California.
Authors: Zell Jason A. , Singh Kathryn E. , Taylor Thomas H. , Pan Chuan-Ju G. , Stamos Michael J. 
Published: March 2020

e12528 Background: Colorectal cancer (CRC) incidence has decreased over the past three decades, due in part to screening for pre-malignant polyps. Relatively little is known about CRC incidence among adults under age 50 (when screening recommendations commence for average-risk individuals). We examined CRC incidence trends with a focus on adults under age 50, in order to identify high-risk subgroups. Methods: 231,544 incident CRC cases (including 21,220 adults <50) from the California Cancer Registry from 1988-2009 were analyzed. We assessed age-specific incidence rates by race/ethnic group, gender, and tumor location within the colorectum, and calculated annual percent change (APC) to monitor change in incidence over the 21-year study period. Results: We observed increased CRC incidence rates in the adult population under age 50 in all examined race/ethnic groups, especially in Hispanic males (APC=+7.5%/p=0.0001) and Caucasian females (APC=+6.5%/p<0.0001). Young individuals were also more likely to present with metastatic disease at diagnosis. Overall, African Americans had the highest overall incidence rates and were most likely to present with metastatic disease compared to other groups. Conclusions: Incidence of CRC in adults under 50 is increasing across all race/ethnic groups. The high frequency of metastatic disease at initial presentation in this age group is particularly concerning. However, a considerable limitation of this analysis is the lack of data on family history of CRC. Our observations highlight the importance of identifying at-risk adults under age 50, especially those in higher-risk race/ethnic groups, with the overarching goal of decreasing the burden of CRC through screening and early detection.
Barriers for compliance to breast, colorectal, and cervical screening cancer test among Hispanics patients.
Authors: Ruiz Yelitza , Betancourt Elba , Miranda Christine , Hunter Robert F. 
Published: March 2020

e12544 Background: Hispanics are less likely to undergo colorectal cancer and cervical cancer screening tests than non-Hispanic population. We address the barriers for compliance in a Hispanic community. Methods: A descriptive study was performed with 194 patients between 21 to 85 y/o, while they attended routine medical encounters at a private and a government sponsored clinics. Compliance and barriers for non compliance for mammography (MAMMO), occult blood testing (FOBT), colonoscopy (COLO) and cervical smears (Pap) were studied. Univariate and bivariate tests were used. Results: Females (62.9%) had a mean age of 53.4 ±15.0; had a high school diploma or higher degree (80.5%), unemployed (52.15), had private health insurance (68.0%), and practiced routine medical checkups (79.9%). Gender differences for patients undergoing FOBT and COLO were found only in patients older than 50 y/o. Females were more likely than males to undergo COLO (62.3% vs. 42.2%; p<0.05) whereas males are more likely than females to had a FOBT (66.7% vs. 56.5%; p>0.05). Differences between employed and unemployed patients undergoing FOBT were seen (48.4% vs. 65.1%; p=0.105) and COLO (38.7% vs. 60.2%; p=0.040). Seventy four percent of women between 40 to 65 y/o had a Pap and 85% had a MAMMO. Predominant reasons for avoiding MAMMO and Pap were fear (20%; p<0.05 and 6%; p>0.05), uncomfortable sensation (13%; p<0.05 and 19%; p<0.05), lack of time (67%; p<0.0001 and 56%; p<0.0001). Reasons for avoiding FOBT and COLO were not recommended by physician (42%; p<0.05 and 52%; p>0.05) and lack of knowledge (16%; p<0.05 and 17%; p<0.05). Conclusions: Occupational status in women (p<0.05) was found as a barrier for compliance with screening MAMMO, while it was also a barrier for COLO in both men and female over the age of 50. (p<0.05) Educational level in men and women was not associated with non compliance with FOBT or COLO in patients older than 50 y/o. Having a private health insurance is a predictor of compliance with MAMMO (71.3%), FOBT (78.3%), COLO (80.6%), and Pap (68.6%). Several physician and patient related factors were identified as barriers for compliance. Study was supported by NIH grant #'s 8U54MD007587 & 8G12MD007583.
Presence of familial colorectal cancer type X in families fulfilling Amsterdam criteria for Lynch syndrome in southern Brazil.
Authors: Ashton-Prolla Patricia , Schneider Naye Balzan , Netto Cristina , Cossio Silvia Liliana , Koehler-Santos Patricia , Meurer Luise , Prolla Joao Carlos 
Published: March 2020

e12546 Background: The clinical diagnosis of Lynch syndrome is usually established when a family fulfills the Amsterdam Criteria, and confirmed by identification of MMR deficiency and/or germline mutations in one of the MMR genes. In a subset of families with Amsterdam criteria, no evidence of DNA mismatch repair deficiency can be identified and this clinical entity has been designated “Familial Colorectal Cancer Type X (FCCTX)”. Methods: The prevalence of MMR deficiency was assessed in a group of 25 individuals with colorectal or endometrial cancer from 20 families fulfilling Amsterdam criteria in Southern Brazil. MMR deficiency was assessed by IHC testing using a panel of antibodies against MSH2, MLH1, MSH6, and PMS2. In cases showing loss of nuclear expression of MLH1, presence of the BRAF p.V600E mutation and microsatellite instability were assessed in the tumor. Results: Fourteen of the 20 families studied fulfilled Amsterdam II criteria. MMR deficiency was identified in the tumor of 11 index cases and in the remaining 9, nuclear expression of all four MMR proteins was normal, suggesting the diagnosis of FCCTX. This FCCTX phenotype was observed in both Amsterdam I and Amsterdam II families. CRC with MMR-deficiency was diagnosed at an earlier age (41.2 years) than CRC showing MMR proficiency (47.2 years), although the difference did not reach significance. Conclusions: FCCTX is a frequent differential diagnosis in hereditary colorectal cancer in patients presenting to high risk cancer genetics clinics in Southern Brazil and further molecular characterization of hereditary colorectal cancer families with these features is warranted.
Meta-analysis of sweetened carbonated beverage consumption and cancer risk.
Authors: Koechlin Alice , Autier Philippe , Boyle Peter 
Published: March 2020

e12548 Background: There is speculation of possible links between sweetened carbonated beverage consumption and the risk of developing cancer. The aim of this study was to examine the association between sweetened, carbonated beverage consumption and cancer risk. Methods: PRISMA guidelines of meta-analyses were followed as closely as possible. Over 50 independent estimates of risk were available, 11 for colas specifically. A random effects meta-analysis was performed with tests for publication bias (Begg, Egger, Macaskill) performed as well as Higgins and Thompson’s I2 measure of the percentage of heterogeneity between studies which could not be explained by chance. Results: Overall the different sites of cancer, the summary relative risk (SRR) when all 56 independent estimates were considered together was SRR=1.04 (95% CI (0.96, 1.13)). On this overall scale, there appears to be no association between consumption of soft-drinks and the risk of cancer. When individual cancer sites were considered, there was no significant increase, or decrease in the meta-analysis estimate of risk of cancer of the pancreas, bladder, kidney, oesophageal squamous cell or adenocarcinoma, colon, gastric cardia, gastric non-cardia, prostate, breast, larynx and ovary nor from the oral cavity, pharynx, glioma, leukaemia or non-Hodgkin’s lymphoma where only one study was available. There was no evidence in a sensitivity analysis from those studies which reported results separately for coke, pepsi or other colas of an associated risk of pancreas cancer (SRR=1.00, 95% CI (0.61; 1.65)) based on three studies. The results for all other forms of cancers were greatly hampered by poor methodology and small numbers of studies (mainly one report on each cancer site studied). Conclusions: Overall, the findings are reassuring regarding the association between soft drinks, including colas and cancer risk, although the quality of many of the studies is quite poor by acceptable, modern standards and no study has been conducted with use of carbonated beverages as a primary hypothesis.
Variations in breast cancer awareness among urban Tanzanian women.
Authors: Morse Emma Perry , Maegga Bertha , Joseph Getrud , Miesfeldt Susan 
Published: March 2020

e12561 Background: Nearly 70% of the 7.6 million cancer deaths occur annually in developing countries like Tanzania, with breast cancer being among the most common causes of cancer mortality. Although data are incomplete, late-stage disease is believed to limit breast cancer control in Tanzania, with delayed diagnosis linked to low levels of breast cancer awareness among women. The goal of this study was to explore awareness of this disease among low-income women accessing routine medical care from three district hospitals in Dar es Salaam, Tanzania. Methods: This survey-based study examined participants' knowledge, attitudes, and beliefs regarding breast cancer causes, risk factors, symptoms, early detection measures, treatment, and preferred education sources. Sociodemographic variations in knowledge of breast cancer risk factors, symptoms, and treatments were assessed. Results: Two hundred and twenty-five women, ages 18-55 years, participated. Over half (52%) reported a primary school education or less; 69.9% were married; 26.2% were unemployed. The average monthly household income was just below the Dar es Salaam mean. Ninety-eight percent were aware of breast cancer; 22% knew someone with a history of breast cancer. Among the 126 women who heard of breast self exam, 25% and 34% practiced it regularly and occasionally, respectively; 41% never practiced it. Only 6.2% had regular clinical breast exams. A minority knew of mammography (32%); <2% had undergone a mammogram. Of the items listed, respondents correctly identified symptoms (51%), risk factors (31%), and treatments (51%). Data reflecting sociodemographic variations in knowledge will be shown. Preferred sources of breast cancer educational materials included group sessions, television or radio programs, and meetings with breast cancer survivors. Conclusions: This work provides valuable insight into preferred sources of breast cancer education among Tanzanian women.
Gastrointestinal cancer risk in Irish hereditary breast ovarian cancer families.
Authors: Lyons Tomas G , Gogarty Darragh S , Farrell Michael P. , Dorman Naoise Maria , Green Andrew J , Gallagher David J. 
Published: March 2020

e12565 Background: Colorectal and breast cancer are linked in certain predisposition syndromes such as Cowden and Peutz-Jegers syndrome. Breast cancer risk also appears increased in certain Lynch Syndrome kindreds. Original reports suggested an increased risk of gastrointestinal malignancies in BRCA1 or 2 mutation carriers. Two large studies in Ashkenazi Jewish populations subsequently contradicted this evidence, although only the three founder mutations were included in these studies. We report the Irish experience of colorectal and gastro-oesophageal (GE) cancer in Irish hereditary breast ovarian cancer (HBOC) families. Methods: 104 HBOC families at two tertiary referral centres were reviewed for the presence of early onset gastrointestinal (GI) malignancies. The medical records of individuals with GI cancer were reviewed to determine carrier status. Clinical data including age at diagnosis, stage, treatment and outcome were extracted. Median age of diagnosis and outcome were compared among BRCA1/2 mutation carriers and non-carriers. Results: We identified 33 individuals with GI malignancies in 102 HBOC families (22 with colorectal, 11 with gastric). Definitive carrier status was available on 8 individuals. An additional 7 individuals were obligate carriers. Age at diagnosis ranged from 27-84 years (median=60). Median age of colorectal cancer diagnosis among carriers was 54 compared with 61 among non-carriers. Median age of gastric cancer diagnosis among carriers was 66 compared with 53 among non-carriers. Conclusions: Early onset colorectal cancer occurs in certain HBOC families and may be related to mutation status. No genotype-phenotype association was identified in this study. An additional 60 Irish HBOC families are being screened for GI malignancies and updated data will be presented at the meeting.
The prevalence of abnormal cervical cytology among postnatal clinic attendees at the University of Calabar Teaching Hospital, Calabar, Nigeria.
Authors: Ago Boniface Uji 
Published: March 2020

e12568 Background: Carcinoma of the uterine cervix is a deadly but preventable disease. It is still a major gynecologic problem in our subregion. Cervical cytology remains the key to its early detection and prompt treatment. Methods: This was a prospective cross sectional study of postnatal women to determine the prevalence of abnormal cervical cytology and their socio-demographic characteristics. Institutional ethical clearance and informed consent of participants were obtained. Aye's spatula and endocervical brush were used to collect specimen from the ectocervix and endocervix respectively and smeared on individually labelled glass slides. The samples were treated using the conventional Papanicolaou staining method and reported using the Bethesda system. Researcher-administered questionnaire generated data as well as results of cytology were analyzed using Epi-Info version 3.5.1.0 (CDC Atlanta USA 2008). Results: There were 100 women screened. Three percent had low grade squamous intraepithelial lesion. Colposcopy done, however, did not reveal abnormal findings. Ninety-five percent of the women had no prior knowledge of cervical cancer and Pap smear. Two percent of the women had a family history of cervical cancer and both patients died of the disease due to lack of facilities for treatment. Conclusions: Cervical cancer is a preventable disease. Women in our subregion are under-screened. Effective screening methods are the mainstay in its prevention. Availability of well equipped gynecologic oncology centers with personnel training are a necessary end to this carnage.
Management of breast cancer associated with pregnancy.
Authors: Lewis Catherine Renee , Robertson Alysia , Yan Fengxia , Danner Omar , Beech Derrick 
Published: March 2020

e12573 Background: Pregnancy-associated breast cancer (PABC) continues to be a challenging problem and may be increasing in frequency as women delay childbearing. As of yet, there is no absolute consensus on the management of PABC. Methods: In order to determine the ideal management for breast cancer during pregnancy, a comprehensive chart review of all women diagnosed with breast cancer during pregnancy from 1995-2010, at a large, urban hospital was performed. We reviewed the medical records of over 2000 patients and identified 15 individuals with PABC. A literature review and retrospective analysis of treatment modalities used for patients diagnosed with breast cancer during pregnancy or during the immediate postpartum period were performed. Trimester of pregnancy, stage at diagnosis, nodal status and age were compared amongst pregnant and non-pregnant patients. The study was approved by our institutional review board. Results: Preliminary results indicated that there was an even distribution between stages of breast cancer at diagnosis among our patient population. Over 80% of the patients had infiltrating ductal carcinoma. Of the patients diagnosed during the first or second trimester, the majority underwent breast conservation therapy (BCT) with subsequent chemotherapy and/or radiation after delivery. Several patients underwent elected to terminate their pregnancy and received chemotherapy either during pregnancy or after termination. Conclusions: Our analysis shows that BCT is the most common treatment strategy for PABC at our institution, which is consistent with current literature. BCT appears to be safe and well tolerated in patients with PABC. Infiltrating ductal breast cancer is the most common type of malignancy in this subpopulation. A multi-disciplinary approach involving obstetricians, medical oncologists, radiation oncologists and surgical oncologists is needed to provide optimal care to these patients.
Bevacizumab (BV) plus irinotecan (I) in recurrent glioblastoma multiforme (GBM): A single center experience.
Authors: Iruarrizaga Eluska , Azkona Eider , Aresti Unai , Rubio Itziar , Arruti Mikel , Carrera Sergio , Fuente Natalia , Marrodan Ines , Lopez Escola Cristina , Condori Elizabeth , Mane Joan Manel , Lopez-Vivanco Guillermo 
Published: March 2020

e13000 Background: Glioblastoma multiforme constitutes the most common and malignant form of primary brain tumor. Median survival for recurrent disease is 3-9 months. Combining bevacizumab with irinotecan represents an option of treatment in recurrent GBM. Methods: We performed a retrospective review of patients with recurrent GBM treated with bevacizumab (10 mg/kg) and irinotecan (340 mg/m2 for patients receiving enzyme-inducing antiepileptic drugs –EIAEDs- and 125 mg/m2 for patients not receiving EIAEDs) every 14 days on a 4-week cycle. Inclusion criteria: age ≥ 18, histology of GBM, progression after radiotherapy and temozolomide and signed informed consent for bevacizumab compassionate use. MRI-FLAIR sequence was used every 8 weeks to assess response. Results: From October 2009 to December 2012, a total of 26 patients were included; 15 (57.7%) male/11 (42.3%) female. Median age of the patients was 52 years (32-69); ECOG 0/1/2/3: 7.7/46.2/38.5/7.7% respectively; 19.23 % of patients received EIAEDs. Median number of cycles was 2.5 (1-14). Response rate was 30.8% (23.1% PR; 7.7 % CR); SD 23.1 %. Median PFS was 23 weeks; median OS was 30 weeks. Most common grade 3 toxicities were: asthenia 26.9%, arthromyalgia 3.8%, diarrhea 3.8% and hepatotoxicity 15.4%; grade 2 thromboembolic complications: 3.8 %. Conclusions: Combination of bevacizumab and irinotecan is effective against recurrent GBM and prolongs PFS and OS compared with historical controls, with mild toxicity.
Continuation of adjuvant temozolomide until tumor progression after upfront chemoradiation therapy produces promising survival in patients with GBM, especially with pseudoprogression.
Authors: Gahramanov Seymur , Tyson Rose Marie , Lacy Cynthia , Prola Netto Joao , Nasseri Morad , Fu Rochelle , Giles Stephen , White Tricia , Neuwelt Edward A. 
Published: March 2020

e13001 Background: Radiation therapy with concomitant temozolomide (TMZ) followed by 6 months of adjuvant TMZ is standard of care in newly diagnosed glioblastoma multiforme (GBM). The 6-month time frame for adjuvant TMZ was chosen arbitrarily and the optimal duration of TMZ chemotherapy remains undefined. In addition, the duration of TMZ chemotherapy and survival can be affected by uncertainty in differentiating pseudoprogression (Ps), indicating necrosis/inflammation, from true tumor progression. This IRB-approved retrospective study determined the survival of GBM patients treated with chemoradiotherapy (CRT) and adjuvant TMZ continued until tumor progression. Methods: Patients with biopsy-proven newly diagnosed GBM at Oregon Health and Science University from January 2006 to June 2012 were treated with upfront CRT followed by adjuvant TMZ without Pneumocystis jirovecii pneumonia prophylaxis until tumor progression. Diagnosis of Ps was made by relative cerebral blood volume (rCBV) estimation based on perfusion MRI with ferumoxytol or RANO criteria. Survival was determined using Kaplan-Meier product limit analysis. Results: A total of 67 patients were included. Overall median survival in the whole group was 21.3 months (95% CI 17.3, 26.3), significantly higher than the median survival in Stupp et al (2008) (14.6 months; 95% CI 13.2, 16.8). However 46 (69%) patients of our series received bevacizumab. Ps was diagnosed in 17 of 47 patients underwent ferumoxytol perfusion MRI based on rCBV measurement; 4 additional Ps cases were diagnosed based on RANO criteria. Median survival in the 21 patients with Ps was 49.1 months, though the estimate may be unstable due to the small sample size and 12 patients remain alive. Median TMZ cumulative dose for all patients was 5250 mg/m2 (range 2250 to 64000). Conclusions: The increase in median survival compared to historical data supports the continuation of adjuvant TMZ treatment, especially in patients with Ps. Differentiation between true tumor progression and Ps is important for treatment (TMZ) decisions and may affect survival. Ferumoxytol perfusion MRI may help as diagnostic tool.
Imatinib plus hydroxyurea in pretreated nonprogressive glioblastoma (GBM): Long-term follow up of a single-center phase II study.
Authors: Dresemann Gregor Paul 
Published: March 2020

e13004 Background: GBM is malignant brain tumour with a median survival of 15.6 months. Dysregulated signalling of platelet derived growth factor receptors is suggested to play a role in pathogenesis. The combination of imatinib (I) plus hydroxyurea (HU) is known to be well tolerated and to show moderate efficacy in patients (pts) with recurrent GBM. Despite the aggressive course of GBM once starting progression, short periods of disease stabilisation after primary treatment or effective treatment of relapse can be observed. This Phase II study was initiated to analyse the efficacy of I plus HU as maintenance treatment (MT) in GBM pts. Methods: From December 2003 up to June 2005 30 pts were included. No enzyme-inducing anticonvulsive drugs were allowed. I (600 mg/day) and HU (1000 mg/day) were given as a continuous treatment. Blood cell counts were taken weekly and magnetic resonance imaging every 6 weeks. Primary endpoint (PE) was 6 and 12 months progression free survival (PFS), secondary endpoints (SE) were 5 years PFS and overall survival (OS). Results: All pts were eligible for PE and SE. 25 pts were male, 5 pts female, median age was 44 years (32 to 71). All pts had prior irradiation, 21 pts had prior temozolomide (T) containing therapy and 9 pts non-temozolomide containing therapy. 8 pts had none, 17 pts one and 5 pts two prior relapses. 25 pts had measurable disease, 4 of these pts achieved a partial response (PR), there was no complete remission, 5 pts had no evidence of disease. Median follow up is 90 months. Hematotoxicity grade 2 and 3 occurred in 11 out of 30 pts and required dose reduction of HU in 8 pts, dose reduction of I in 1 patient and G-CSF in 8 pts. PFS rate at 6, 12, 24 and 60 months were 60% (18/30), 40% (12/30), 17% (5/30) and 17% (5/30 ) respectively, OS rate at 6, 12, 24 and 60 months were 90% (27/30), 67% (20/30), 37% (11/30) and 17% (5/30). 4 pts are still alive without progression. Conclusions: Although I and HU did not demonstrate relevant efficacy in GBM and never reached admission status the reported study indicates impressive long-term survival data for I and HU as a continuous oral MT. Further studies should analyse more effective drugs like temozolomide as MT (proof of principle). Clinical trial information: STI571DE21.