bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract PO-204: Impact of the Affordable Care Act on timeliness to treatment for patients with multiple myeloma
Authors: Jayakrishnan Thejus , Bakalov Veli , Callander Natalie , Sadashiv Santhosh , Ailawadhi Sikander 
Published: December 2020

Abstract
Background Socioeconomic disparities impact access to treatment and outcomes for patients with cancer. Affordable Care Act (ACA) sought to mitigate some of these disparities In the present study, we examined the influence of socioeconomic factors on patients facing delay in treatment initiation and the impact of Affordable Care Act (ACA). Methods We queried the National Cancer Database (NCDB) for patients with MM (ICD-0-3 code 9732) diagnosed from 2004-2016 who received any therapy.
Active MM patients were defined as those treated within 120 days of diagnosis. Time to initiation (TTI) was defined as time in days (d) from diagnosis of cancer to initial myeloma therapy and divided into quartiles. Patients belonging to 4th quartile for TTI constituted the delayed treatment group (delayed-TTI). Study period was divided into pre-ACA and post-ACA using 2010 as cut-off. Multivariate logistic regression analysis was used and p-value 0.05 was used for statistical significance. Results We identified 65,723 patients meeting the eligibility criteria (28,814 pre-ACA and 36,909 post-ACA respectively). Median age was 68 (Interquartile Range IQR 59-76) years, included 55.1% males and majority insured patients (96.4%). Racial distribution was 66%(non hispanic whites-NHW), 20%(non hispanic blacks-NHB), 6%(Hispanics-H).
Median TTI were 13 (IQR 5-27) days overall and 42 (33-58) days for delayed-TTI group. NHB and H races were associated with delayed-TTI in the multivariate model - Odds Ratio OR 1.18 (IQR 1.09-1.27)p-value &lt;0.005 pre-ACA vs. 1.17 (1.09-1.25) p-value&lt;0.005 post-ACA for NHB and OR 1.22 (1.07-1.38) p-value0.003 pre-ACA that became non-significant post-ACA for H. Treatment at comprehensive community cancer center – OR 0.79 (0.74-0.84),p-value&lt;0.005 or academic research center -0.92 (0.86-0.98) were associated with lower OR for delayed-TTI while insurance status was not significant in the overall analysis. Conclusion Contemparory results from the present study demonstrate that racial minority status may be a predisposing factor to delay in treatment initiation. While the ACA has been shown to help mitigate this in certain cancer categories, the effect is still limited among MM patients.
Citation Format: Thejus Jayakrishnan, Veli Bakalov, Natalie Callander, Santhosh Sadashiv, Sikander Ailawadhi. Impact of the Affordable Care Act on timeliness to treatment for patients with multiple myeloma [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-204.
Abstract PO-205: The impact of DSRIP and practice transformation on cancer screening outcomes for Medicaid, low income, and uninsured patients in Texas
Authors: Jones Rebecca , Ramirez Amelie , Cancino Ramon 
Published: December 2020

Abstract
Background In 2011, Texas received federal approval of the 1115 Healthcare Transformation waiver, which went to support the Texas Delivery System Reform Incentive Payment Program (DSRIP) pool, incentivizing the transformation of service delivery practices to improve quality, health status, patient experience, coordination, and cost-effectiveness. To date, no research has described the impact DSRIP has had on cancer screening outcomes on the Texas Medicaid, low income, and uninsured (MLIU) patient population. Objective To describe the impact of practice transformation at an academic medical center primary care practice towards a value- based care delivery model on breast, cervical, and colorectal cancer screening for its MLIU patient population as a result of 1115 Healthcare Transformation Texas waiver. Study Design Retrospective analysis of electronic health record data from 1/1/2017 through 12/31/2018. Participants MLIU patients who received care at an academic medical center primary care practice during the study time frame and met the criteria for colorectal, cervical, and/or breast cancer screenings. Main Measures The primary outcomes for these analyses were proportions of the patient population who received or did not receive the recommended cancer screenings. Key Results After controlling for relevant confounders, we found significantly improved rates of cervical and colorectal cancer screening among Medicaid, low income, and uninsured patients. Conclusions Practice transformation, specifically integrating primary care, quality, and health information technology, resulted in higher rates of cervical and colorectal cancer screening among a high-risk vulnerable group of patients in one year. Further research should be conducted to determine if the findings are reproducible and if the return on investment equals or surpasses the cost of upfront and sustaining costs of practice transformation.
Citation Format: Rebecca Jones, Amelie Ramirez, Ramon Cancino. The impact of DSRIP and practice transformation on cancer screening outcomes for Medicaid, low income, and uninsured patients in Texas [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-205.
Abstract PO-214: Delay time in the diagnosis and treatment of breast cancer in the California-Mexican Border
Authors: Galindo-Castañeda Antonio , Gonzalez-Corral Martín , Garcia-Armas Luis , Egurrola-Terán Oscar , Martínez-Gómez Luis , Guadarrama-Orozco Jorge Albert 
Published: December 2020

Abstract
Introduction The delay in the diagnosis and treatment of breast cancer has a direct correlation with more advanced stages of the disease and a lower survival rate.
These delays represent an urgent situation in developing countries due to their high prevalence. Objective This study aims to determine the time intervals in the diagnosis and treatment of patients with breast cancer in the main public hospital in the city of Tijuana, to identify the mechanisms through which the different population aspects and Hospitals affect the treatment of patients. Methods A descriptive, observational, and retrospective study was conducted, including patients with breast cancer diagnoses treated at the General Hospital Tijuana in the period from January 2019 to December 2019. We used data from the medical record, including dates, demographics, histopathological, and clinical data from each visit.
Descriptive statistics were calculated in SPSS V27. Results A total of 154 patients with breast cancer were treated at the TGH during 2019. Of these, 97 patients included in the study, with an average age of 52.34 ± 9.14 years. The patient delay time was higher than three months in 61% of cases. The diagnosis delay time was between 5 and 13 weeks. Conclusion Mexican breast cancer patients, as Latinas in California, are more likely to exhibit late-stage breast cancers at the time of diagnosis and have lower survival rates. Mexico counts an opportunistic or non-organized mammography screening program, leading to considerable delays in the diagnosis of breast cancer, even in border cities near to the US (where some people use multiple healthcare systems). With this context, it is necessary to recommend the creation of an organized screening program based on a more exceptional ability to cover the target population and, therefore, greater effectiveness at the community, as well as more equitable access.
Citation Format: Antonio Galindo-Castañeda, Martín Gonzalez-Corral, Luis Garcia-Armas, Oscar Egurrola-Terán, Luis Martínez-Gómez, Jorge Albert Guadarrama-Orozco. Delay time in the diagnosis and treatment of breast cancer in the California-Mexican Border [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-214.
Abstract PO-261: Barriers to Pap smear screening among medical students in Yemen: A qualitative study
Authors: Al-Naggar Redhwan 
Published: December 2020

Abstract
Objective: The objective of this study is to explore the barriers to Pap smear screening among medical students in Yemen. Methodology: This study was conducted among forty one medical students. Ten female and 31 male. Four focus groups discussions participated in this study, one female group discussion and 3 male group’s discussions. The obtained data were sorted into categories based on content analysis and data were analyzed manually. Results: Total number of 41 medical students participated in this qualitative study. The majority of the participants were male and in their 22 years of age. All groups reported that the lack of awareness is the main barrier to Pap smear screening. The conservative culture and traditions of the people, shameful of the doing pap testing despite the gender of healthcare workers, not trusting the health care workers, man has the final decision for his wife to do the Pap smear screening, fear of the disease, fear of the complications of the test were considered the main barriers of Pap smear testing. All groups were willing to suggest this test to their families and friends to prevent and treat the disease as early as possible. All groups agreed that the gender of the healthcare workers is matter and definitely will affect the women decision to do the Pap smear screening. All girls preferred to be examined by female. All the groups mentioned that the advantages of Pap smear screening is to diagnose and treat the disease early. All groups mentioned that personal hygiene of the private parts is the most important prevention measures for cervical cancer. Conclusion: Lack of awareness is the main barrier to Pap smear screening. Gender of the healthcare workers greatly affect the women decision to do the Pap smear screening and all female medical students preferred to be examined by female. Therefore raising awareness among the general population is urgently needed considering the culture of the Yemeni people.
Citation Format: Redhwan Al-Naggar. Barriers to Pap smear screening among medical students in Yemen: A qualitative study [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-261.
Abstract PO-266: Factors affecting Appalachian Kentuckians' beliefs related to colorectal cancer and colorectal cancer screening
Authors: Aleshire Mollie E. , Adegboyega Adebola , Sha Shuying , Hatcher Jennifer 
Published: December 2020

Abstract
Background: Rural Appalachian Kentucky has much higher colorectal cancer (CRC) morbidity (50.6 per 100,00) and mortality (19.8 per 100,000) than the U.S. Appalachian Kentucky CRC screening rates are 36% compared with 27% statewide and 53% nationally. This study assessed factors affecting Appalachian Kentuckians’ beliefs related to CRC and CRC screening. Methods: Appalachian Kentuckians 50 years of age and older who were not up-to-date on CRC screening (N = 190) completed a survey including subscales measuring perceived CRC susceptibility and perceived benefits of CRC screening. Mann-Whitney U and Kruskal-Wallis tests compared differences in beliefs and Spearman’s Rho examined the correlation between variables. Results: Sixty-two percent were concerned about developing CRC, and 94.7% had completed CRC screening previously. Participants felt more susceptible to CRC if they had a family history of CRC (p &lt; .01) and if their healthcare provider recommended CRC screening (13.03 versus 12.19, p &lt; .01). Perceived benefits of CRC screening were not significantly associated with demographic or healthcare access variables. Conclusions: Although many participants were concerned about developing CRC, very few had completed CRC screening. These findings and those of previous research provide information to guide tailored interventions to promote CRC screening in Appalachian Kentuckians. Individuals with a family history of cancer may perceive a higher CRC susceptibility and be more likely to complete CRC screening. Healthcare providers’ recommendations for CRC screening can influence perceived CRC susceptibility and potentially influence completion of CRC screening in this population.
Citation Format: Mollie E. Aleshire, Adebola Adegboyega, Shuying Sha, Jennifer Hatcher. Factors affecting Appalachian Kentuckians' beliefs related to colorectal cancer and colorectal cancer screening [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-266.
Abstract PR08: African-centric p53 hypomorphs play significant roles in cancer risk and efficacy of therapy
Authors: Barnoud Tim , Leung Jessica , Gnanapradeepan Keerthana , Ke Lei , Karanicolas John , Murphy Maureen E. 
Published: December 2020

Abstract
The p53 tumor suppressor gene plays a central role in human cancer. In addition to mutation, there are genetic coding region variants of p53 that exist in different ethnic groups. In some cases, these variants have incomplete or impaired function and confer increased cancer risk. We call such variants ‘hypomorphs’. Two p53 hypomorphs exist in populations of African descent: P47S and Y107H. Our research on the P47S hypomorph of p53 revealed that this variant confers increased risk for cancer in humans and in mouse models (Jennis, Genes Dev 2016; Murphy, NPJ Breast Cancer 2017). We find that P47S protein is selectively impaired for the ability to confer sensitivity to ferroptosis (Leu, PNAS 2019); consequently, we find that human and mouse cells with this variant accumulate iron in certain tissues, and that the P47S variant is associated with iron overload in African Americans (Singh, Nat Comm 2020). We find that tumor cells containing the P47S variant are resistant to most genotoxic chemotherapies, but we have discovered that P47S tumor cells are markedly more sensitive to other therapies, including cisplatin and BRD2/4 inhibitors (Barnoud, Can Res 2018). Our current focus is on another African-centric p53 hypomorph, Y107H. We show that this variant is impaired for p53-mediated apoptosis, and is associated with cancer risk in a mouse model. We also show that Y107H is impaired for the transactivation of only a dozen p53 target genes. Notably, half of these genes are known tumor suppressor genes. Our biophysical and NMR structure of the Y107H protein explains the mechanistic basis for the impaired function of this hypomorph. Our analysis of the P47S and Y107H hypomorphs of p53 has significant potential to understand cancer risk and improve cancer therapy in populations of African descent.
Citation Format: Tim Barnoud, Jessica Leung, Keerthana Gnanapradeepan, Lei Ke, John Karanicolas, Maureen E. Murphy. African-centric p53 hypomorphs play significant roles in cancer risk and efficacy of therapy [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PR08.
Abstract IA24: Navigating the new normal: Trends shaping post-COVID-19 cancer care delivery
Authors: Richardson Lisa 
Published: December 2020

Abstract
In just a few short weeks, COVID-19 transformed cancer care around the world. The crisis has dismantled how care is delivered and forced providers to make difficult decisions about what types of care are essential and can be sustained with the resources and staff available. This presentation will provide an overview of the emerging trends that are shaping cancer care and how providers are adapting to these new challenges to continue to safely provide necessary care to those who need it most.
Citation Format: Lisa Richardson. Navigating the new normal: Trends shaping post-COVID-19 cancer care delivery [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr IA24.
Abstract PO-009: Cancer-related distress among multiple myeloma patients during the COVID-19 pandemic
Authors: Sweeney Nathan W. , Ahlstrom Jenny 
Published: December 2020

Abstract
Background: The rapid outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the delay of non-urgent or routine medical appointments, placing tremendous burden on cancer patients. Meanwhile, the emotional effect of the novel coronavirus (COVID-19) on high-risk groups, such as multiple myeloma (MM) patients, remains unclear. The purpose of this project was to understand psychosocial distress and unmet needs among patients with active MM during the acute phase of social distancing and COVID-19 impact in the United States.
Methods: We utilized HealthTree (healthtree.org) and invited patients with active MM cancer or precursor conditions to participate in an online survey curated through a partnership with the Cancer Support Community (CSC). Participants were asked to rate their level of concern (Not at All to Very Seriously) on 12 items assessing psychosocial, practical, and physical needs (selected from CSC’s CancerSupportSource® distress screening tool) during the COVID-19 pandemic. De-identified responses were aggregated and reviewed. The survey was determined to be exempt by the Western Institutional Review Board.
Results: 1,079 MM pts participated in the survey between April 15, 2020 and June 8, 2020. The percentages of patients responding moderately to very seriously concerned are reported here. Eating and nutrition (71%), sleep problems (49%), pain and/or physical discomfort (46%), and feeling too tired to do the things you need or want to do (44%) made up the physical/health concerns. Psychosocial/emotional concerns included worrying about the future and what lies ahead (46%), worry about family, children, and/or friends (44%), feeling irritable (37%), feeling sad or depressed (30%), feeling nervous or afraid (25%), feeling lonely or isolated (20%), and relationship problems with your spouse/partner (11%). Finally, 32% reported insurance or money concerns.
Conclusions: Respondents to our survey were most concerned with eating and nutrition, sleep problems, pain and/or physical discomfort, and worrying about the future. Informing patients and medical professionals of physical and psychosocial distress experienced by patients could create a unified approach to decreasing distress levels and increase patient overall health, even during a pandemic or when care is delayed. Patient-reported surveys via an online portal, like HealthTree, can help investigators assess the patient community and result in hypothesis-generating research questions to enhance patient outcomes.
Citation Format: Nathan W. Sweeney, Jenny Ahlstrom. Cancer-related distress among multiple myeloma patients during the COVID-19 pandemic [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-009.
Abstract PO-011: CiRCL: A psychosocial program facilitating communication and care to patients, families, and frontline health care teams during COVID-19
Authors: Ahmed Kauser , Phung Peter , Goldstein Noah , Glaspy John 
Published: December 2020

Abstract
The need for strict social distancing measures preventing visitors on inpatient oncology, ICU, and COVID units during the COVID-19 pandemic has had the unintended consequence of leading to significant psychological and spiritual distress for patients and families and “moral distress” for frontline health care teams tasked with supporting patients who are suffering or dying alone without the support of their loved ones. The trauma of these deaths is sometimes further compounded for families by their inability to provide the final rituals of patients’ faith communities in their last moments, leading to complicated and ongoing grief after the loss. To address these complex psychosocial needs among COVID-19 and advanced cancer oncology patients, and the health care teams caring for them, the Simms/Mann UCLA Center for Integrative Oncology, in collaboration with colleagues at the UCLA Anderson School of Business and a team of diverse faith leaders, developed an innovative digitally mediated program for connection, communication, and care. This program, CiRCL (Caring in Remote Communities of Love), leveraged ZOOM and smartphone recording technology to accomplish the following goals: 1) provide psychological support to family members and friends to facilitate the recording of meaningful personal messages to the patient, including curated playlists of evocative songs from the patient’s life to be played at the bedside; 2) facilitate more meaningful communication between loved ones and frontline workers, including messages of gratitude and support to reduce feelings of isolation and moral distress for frontline workers; and 3) create a liturgical library of recorded ecumenical and faith-based blessings from various traditions, available during illness and at time of dying. Blessings include and encompass the health care teams as well as patients. This program, recently developed and being piloted at UCLA, is intended to extend compassion to all within the health care system during the unique challenges of COVID-19 and, by facilitating connection and support among patients, families, and frontline teams, extend the definition of healing and mitigate the impact of loss and grief for all during the many phases of this pandemic.
Citation Format: Kauser Ahmed, Peter Phung, Noah Goldstein, John Glaspy. CiRCL: A psychosocial program facilitating communication and care to patients, families, and frontline health care teams during COVID-19 [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-011.