bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic background in relation to stage at diagnosis in women with breast cancer.
Authors: Ariza Juan Manuel , Cowppli-Bony Anne , Billon Solenne , Ayrault-Piault Stephanie , Blanc-Lapierre Audrey , Florence Molinie Florence 
Published: June 2021

10574 Background: Breast cancer (BC) has been associated with socioeconomic deprivation and rural residence. However, it’s still unclear how these factors interplay to affect the frequency and incidence of early and advanced BC. Methods: Taking advantage of the Loire-Atlantique/Vendée cancer registry (France), we investigated the association between early (TNM stage < 2) and advanced (TNM stage ≥2) BC and the socio-economic background (SB) of women diagnosed in the study region from 2008 to 2015. Socioeconomic status was studied using the residence information of every patient linked to the European Deprivation Index (EDI), an ecological index constructed to reflect individual deprivation experienced at the smallest geographical unit of France (IRIS = 2000 inhabitants). To investigate SB, we created a composite variable using the EDI and the urban/rural context information, to define 4 categories: affluent-urban, affluent-rural, deprived-urban, and deprived-rural. Two statistical approaches were implemented: i) mixed-effects logistic regression models to examine the likelihood (relative risk, RR) of being diagnosed with advanced BC, and ii) Poisson regression for modeling incidence rates of early and advanced stages. Analyses were stratified by age ( < 45, 45 to 74, > 75 years) with a random intercept at the IRIS level. For the strata 45 to 74, the models were adjusted for organized screening. Results: During the study period, 14,542 BC cases were recorded. Compared to the women diagnosed in the most affluent-urban areas, a higher proportion of cancer diagnosed at an advanced stage was observed in the women living in more deprived-rural areas (aged < 45 years, RR = 1.48 95% CI 1.17 - 1.73; aged 45 to 74 years, RR = 1.22, 95% CI 1.02-1.42; aged > 74 years, RR = 1.08, 95% CI 0.85-1.27). Furthermore, while in the population under 74 years, incidence rates of early BC in deprived-rural women were reduced by 25-85 % in comparison to affluent-urban women (IRR: 0.33 to 0.97 95% CI 0.16 -0.98), the rates of advanced BC were unaffected by deprivation-rurality (Deprived rural vs Affluent urban, IRR: 1.06 to 1.13 95% CI 0.79 -1.72). For the population over 74 years, we were unable to detect any associations between SB and BC incidence by stage at diagnosis. Conclusions: Advanced stage at diagnosis was more frequent among deprived–rural women aged under 74 years and coincided with the low incidence rates of early stages in this population. No disparities in the incidence rates of advanced BC were detected according to their SB in any age classes, suggesting other factors may be stronger contributors to the advanced stage at diagnosis. Future research should investigate whether screening practices may influence the disparities in the early stage at diagnosis for women under 74.
A comprehensive literature review and meta-analysis on prevalence of BRCAm, HRRm and HRD+ across tumor types.
Authors: Shao Changxia , Wan Jun , Tang Huilin , Marley Andrew , Miller Chelsey , Brown Madeline , Song Yiqing , Han Jiali , Adeboyeje Gboyega 
Published: June 2021

10589 Background: Poly (ADP-ribose) polymerase inhibitor (PARPi) may have broad application in the treatment of cancer patients with mutations in BRCA (BRCAm) or other homologous recombination repair genes (HRRm) or with homologous recombination deficiency positive (HRD+). A literature review and meta-analysis were conducted to evaluate the prevalence of BRCAm, HRRm, and HRD+ across tumor types. Methods: Comprehensive searches for eligible studies in Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane reviews were performed in May 2020 to capture studies published in English, within 10 years for manuscripts and 3 years for abstracts across geographic regions. A weighted summary estimate was calculated for BRCAm. A summary estimate with corresponding 95% CI was calculated using random-effects models for HRD+ and HRRm. Results: A total of 342 eligible studies with at least 100 samples were included in the review of BRCA1/2m prevalence, containing a total of over 469,000 samples across 24 tumor types. The most frequent indications examined in the included studies were breast (study number n = 144), ovarian (53), prostate (17) and pancreatic (11) cancers. The prevalence of germline BRCA1m (gBRCA1m) and gBRCA2m was 5% and 4% for breast, 12% and 5% for ovarian, 1% and 3% for prostate, and 1% and 4% for pancreatic cancer, respectively. The prevalence of somatic BRCA1m (sBRCA1m) and somatic BRCA2m (sBRCA2m) was 3% and 3% for breast, 7% and 5% for ovarian, 3% and 5% for prostate, and 1% and 3% for pancreatic cancer, respectively. Few studies evaluated endometrial, lung and colon cancers, the prevalence of gBRCA1m or gBRCA2m was generally less than 1%, and the prevalence of sBRCA1m and sBRCA2 ranged 1 to 3%. Seven publications were identified where HRD+ was defined by either BRCAm or genomic instability score (GIS) ≥ 42 across breast, ovarian and pancreatic cancers. The overall HRD+ prevalence was 56% (95%CI: 48, 64), with similar prevalence observed across the 3 tumor types and was 50% (34, 66) for the 3 studies only counting GIS≥ 42. 194 studies across 26 tumor types were identified that examined HRRm as mutations in one or more HRR genes other than BRCA1/2m. The definitions of HRRm varied substantially across the studies, and ATM (2.8%), CHEK2 (1.6%), and PALB2 (1.6%) accounted for most of the observed mutations among HRR genes. Conclusions: Prevalence of BRCAm, HRRm and HRD+ varied by cancer type. This comprehensive meta-analysis enriches the knowledge in this field and demonstrates the need to standardize the measurement of HRRm and HRD.Understanding the prevalence of these biomarkers could have important clinical implications.
Distribution of BRCA1/2 germline and somatic alterations across cancer type.
Authors: Chen Jingde , Quan Ming , Yan Zhengqing , Chen Shiqing , Huang Mei , Cui Jiujie , Chen Zhiqin , Gao Yong 
Published: June 2021

10590 Background: PARP inhibitors (e.g. Olaparib or niraparib) have been approved by FDA as a targeted therapy for many tumors harboring germline or somatic BRCA1/2 (g or sBRCA1/2), including ovarian cancer, prostate cancer, breast cancer and pancreases cancer. It is imperative to study the distribution of BRCA1/2 across cancer type. In this study, we aim to assess the landscape of BRCA1/2 alterations in solid tumors and evaluate the feasibility of circulating tumor DNA (ctDNA) tested by next-generation sequence (NGS) as a tool to detect BRCA1/2 alterations. Methods: For tissue specimen, genomic DNA from formalin fixed paraffin-embedded (FFPE) tumor specimens or fresh tumor tissues was used for sequence analysis. Genomic DNA (gDNA) from white blood cells was extracted using the QIAamp DNA Mini Kit (Qiagen). For ctDNA, cell-free DNA libraries were prepared using the KAPA Hyper Prep Kit following the manufacturer’s protocol. The captured libraries were loaded onto a NovaSeq 6000 platform (Illumina) for 100bp paired-end sequencing. The testing was performed in the College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA) -certified 3D Medicines Library. Results: A total of 27, 835 patients were tested using tumor tissue during Jan. 1th 2017 to June 1th 2020, including 43% (N = 12089) of non-small cell lung cancer, 19% (N = 5357) of colorectal cancer, 8% (N = 2181) of liver cancer, 6% (N = 1621) of gastric cancer, 5% (N = 1479) of biliary tract cancer, 4% (N = 1084) of kidney cancer, 4% (N = 1045) of pancreas cancer, 3% (N = 689) of breast cancer and 2% (N = 599) of ovarian cancer. Across all tumor types, the known or likely deleterious BRCA1/2 alterations were identified in 2147 (7.7%) patients. Ovarian cancer had the highest frequency of BRCA1/2 alteration (23.4%), followed by endometrial cancer (12.7%) and breast cancer (10.6%). BRCA1/2 alteration was found in 8.8% prostate cancer and 4.2% pancreas cancer respectively. Across all tumor types, the known or likely deleterious gBRCA1/2 alterations were identified in 369 (1.3%) patients. Notably, ovarian cancer had the highest frequency of gBRCA1/2 alteration (13.9%), followed by breast cancer (7%), prostate cancer (4.4%) and endometrial cancer (4.1%). No clear hotspot mutations and mutated codons were spread throughout g or sBRCA1/2 mutations. Additionally, among 15699 patients who suffered ctDNA sequencing, any known or likely deleterious sBRCA1/2 alterations were identified in 358 (2%) patients. Similar to the results of tissue sequencing, ovarian cancer had the highest frequency of sBRCA1/2 alteration (16.67%), followed by endometrial cancer (9.68%), prostate cancer (7.18%) and breast cancer (5.58%) in the blood cohort. Conclusions: BRCA1/2 alterations existed across tumor types and the landscape of g or sBRCA1/2 alterations varied according to cancer type. Furthermore, ctDNA can be used as a potential tool to detect BRCA1/2 alterations.
Racial disparities in genetic testing of breast cancer patients.
Authors: Bayard Solange , Chen Yalei , Fasano Genevieve A. , Davis Melissa , Walker Eleanor M. , Bensenhaver Jessica Miley , Petersen Lindsay , Marti Jennifer , Simmons Rache M. , Swistel Alexander J. , Newman Lisa A. 
Published: June 2021

10591 Background: TNBC is disproportionately prevalent in African American (AA) populations and in women with BRCA-1 germline mutations. BRCA mutation carriers are candidates for targeted therapy with PARP-inhibitors, and testing results may influence risk-reducing surgery choice. Methods: We evaluated genetic testing patterns and outcomes for TNBC patients treated in the prospectively maintained databases of academic cancer programs in two metropolitan cities in the Northeast (New York City, NYC) and Midwest (Detroit, Det), 1998-2018. Median follow up was 3.73 years. Testing patterns were also analyzed by time, comparing pts diagnosed before versus after the mid-2013 Supreme Court ruling that expanded testing availability by banning gene patenting. Results: Of 810 pts, 600 were from NYC and 200 from Det; 202 were AA and 488 WA. Pts undergoing genetic testing were younger (median age 50 vs 62; p < 0.0001). Compared to WA, AA pts were less likely to undergo genetic testing overall (23.8% vs 42.0%; p < 0.0001) and within site (NYC: 25.6% vs 42.8%, p = 0.008; Det: 22.3% vs 38.6%, p = 0.025). No significant differences were seen in frequency of pathogenic BRCA mutations (AA-14.6%; WA-29.3%) or VUSs (AA-6.3%; WA- 4.9%); p = 0.20. Genetic testing disparities were reduced among pts diagnosed after mid-2013 (AA-31.4% vs WA-44.0%; p = 0.01) compared to pre-mid-2013 (AA-18.3% vs WA-40.7%; p < 0.0001). No differences were seen in local or distant recurrence free survival between patients with BRCA, BRCA variants of uncertain significance, non-BRCA mutations, and patients without genetic mutations (local recurrence p = 0.827; distant recurrence p = 0.574). This outcome equivalence was consistent when stratified by WA vs AA identity. Conclusions: Genetic testing has increased for TNBC pts following the mid-2013 Supreme Court ban on gene patenting, but race-associated disparities persist. Pts undergoing genetic testing are more likely to undergo risk-reducing mastectomy, but testing results do not affect survival outcomes, regardless of race. Addressing genetic testing disparities will become increasingly important as mutation-associated targeted therapies are identified through advances in precision medicine.
Perpetrators of workplace bullying and gender discriminations experienced by women gynecologic oncologists.
Authors: Hong Linda , Rubinsak Lisa , Benoit Michelle F. , Teoh Deanna Gek Koon , Ioffe Yevgenia , Chandavarkar Uma , Brockmeyer Amy , Stevens Erin E. , Temkin Sarah Madhu 
Published: June 2021

11013 Background: A high prevalence of gender discrimination and harassment has been described among gynecologic oncologists (GOs). This study examined the work environment for women GOs and delineated the perpetrators of negative behaviors. Methods: An internet-based, IRB exempt survey of members of a 472-member Facebook group “Women of Gynecologic Oncology (WGO)” was conducted. Using REDcap survey platform, members provided demographics, practice infrastructure, personal experience with workplace bullying, gender discrimination, microaggressions, and outcomes. Demographic, practice and work environments and perpetrators of negative behaviors were summarized using descriptive statistics. Results: Between 7/20 and 8/19/2020, 250 (53%) of active WGO members participated in this survey. Most respondents were younger than 50 years old (93.6%); white (82.2%) and non-Hispanic (94.3%). A majority were married (84.7%) with children (75.2%). Practice environments included academic (152, 61.0%), private practice (31, 12.4%), and hospital employed (57, 22.9%). 89.9% supervised trainees. 130 (52.0%) respondents reported bullying, 140 (56.0%) gender discrimination, and 83% having experienced gender-based microaggressions. Age, race, ethnicity, practice setting, division director or chair gender or department reporting structure were not significantly associated with these experiences. Perpetrators of bullying, gender discrimination, and microaggressions were widely distributed (Table). Of those reporting bullying, 61 (46.6%) reported a male perpetrator, 25 (19.1%) female and 45 (34.4%) an equal gender distribution; of those reporting discrimination 105 (74.5%) reported a male perpetrator, 9 (6.4%) female and 27 (19.1%) an equal gender distribution. 32.9% of survey respondents acknowledged having been written up for speaking up in a way that would have been tolerated from a male colleague. 18.3% of respondents have changed jobs because of bullying; 13.5% because of discrimination. Conclusions: Women GOs report high rates of workplace bullying, gender discrimination, and microaggressions regardless of practice setting that often impact their careers. Perpetrators of these behaviors are multiple and varied. Proactive and deliberate interventions to improve the work environments for women GOs are urgently needed.[Table: see text]
Prevalence and risk factors of burnout among female oncology professionals from the Middle East and North Africa (MENA).
Authors: Abusanad Atlal , Bensalem Assia , Shash Emad , Mula-Hussain Layth Y.I. , Benbrahim Zineb , Khatib Sami Ahmad , Abdelhafeiz Nafisa , Ansari Jawaher , Jradi Hoda , Alkattan Khaled , Jazieh Abdul-Rahman 
Published: June 2021

11016 Background: Burnout (BO) is a recognized challenge among oncology workforce. It affects both genders with a higher frequency among women. This study examined the factors contributing to the development of burnout among women in oncology from the Middle East and North Africa (MENA). Methods: An online cross-sectional survey was distributed to oncology professionals from different countries in the MENA region. The validated Maslach Burnout Inventory (MBI) of emotional exhaustion (EE), Depersonalization (DE), and Personal Achievement (PA) plus questions about demography/work-related factors and attitudes toward oncology were included. Data were analyzed to measure BO prevalence and related factors. Results: Between February 10 and March 15, 2020, 545 responses were submitted by female professionals. The responses pre-dated the COVID-19 pandemic emergence in the region. BO prevalence was 71% among female professionals. Women aged < 44 years represented 85% of the cohort. Sixty-two percent were married, 52% with children and one-third practiced a hobby. Two-thirds worked in medical oncology, worked for < 10 years and 35% worked in academia. The majority (73%) spent > 25% on administrative work daily. Nearly half of the respondents (49%) expressed a recurring thought of quitting oncology and 70% had no burnout support or education. Inability to deliver optimal care was reported as distressing for career development in 82%. Factors significantly influencing the BO risk are listed in Table. Marital status, having children, academia and years in practice did not impact the risk of BO among female oncologists form MENA. Conclusions: High BO prevalence was reported among female oncology professionals from MENA. The majority of women oncology workforce were young and early- to mid-career in this cohort. Younger age, practicing in North African countries, high administrative load and the recurring thought of quitting were associated with increased risk of burnout. Whereas, practicing a hobby and enjoying oncology communication decreased the BO risk. Burnout support and education specifically for women in oncology is needed.[Table: see text]
Impact of COVID-19 pandemic on well-being and work-related burnout among healthcare workers at an academic center.
Authors: Dawar Richa , Rodriguez Estelamari , Gawri Kunal , Kwon Deukwoo , Penedo Frank J. 
Published: June 2021

11019 Background: COVID-19 pandemic has not only caused an unprecedented distress in the community, but also significant physical and psychological exhaustion amongst healthcare workers (HCWs), that could lead to serious effects on our healthcare system. This study was conducted to assess burnout among oncologists and other healthcare professionals at a large academic center. Methods: An electronic 10-minute questionnaire was sent to actively employed physicians, APRNs and PAs at the University of Miami. Survey items evaluated various personal and professional characteristics including COVID related stress. Burnout was examined with Maslach Burnout Inventory (MBI), which evaluated severity across two domains: emotional exhaustion and depersonalization. The logistic regression model was used to estimate association between study variables and high burnout levels. Odds ratio (ORs) and corresponding 95% confidence interval (CI) were obtained. Continuous variables were tested using two-sample t-test by high burnout status. Results: The survey was sent to 739 HCWs, out of which 182 (24.6%) completed the entire survey; 63.7% were physicians, 8.6% fellows, and 27.4% APRN or PA. The pandemic led to rescheduling of professional activities (22.2%), increased workload (59.5%), job insecurity (28.6%), and decreased leadership opportunities (32.2%). 62.3% of respondents reported decreased exercise; 44.8% reported new sleep disorder; 56.1% reported increased home responsibilities; childcare arrangements were affected in 60.6%; 61.4% struggled to maintain work-life balance. 70 of 182 respondents were broadly from the fields of Oncology and Palliative Care. 9 out of these 70 respondents reported high depersonalization, 27 reported high emotional exhaustion, and 33 reported overall high burnout symptoms on either emotional exhaustion or depersonalization scales. Amongst physicians holding positions from PGY4 through licensed attendings with less than 5 years’ experience, 62.5% (95%CI=35.4-84.8) showed high burnout rate (10 of 16), which was not statistically different from older physicians (11 of 27=40.7% (95%CI=22.4-61.2)). No difference in burnout was seen for other study variables including gender, marital status, and race/ethnicity. Conclusions: COVID-19 pandemic has incited not only an unmatched level of practice changes, but also extraordinary psycho-social uncertainty, leading to a considerable impact on HCWs’ wellbeing. Long working hours, lack of sleep, fear of losing job, transition to tele-medicine, risk of getting infection and putting their family at risk, lack of childcare, pressure of home schooling- all seem to have caused an increased physical and psychological pressure among HCWs and warrants an examination of potential coping mechanisms. This study sets the stage for more elaborate research to illustrate and guide the development of wellness programs imperative to the well-being of HCWs.
Factors associated with open access publishing costs in oncology journals.
Authors: Koong Alex , Gardner Ulysses , Burton Jason C. , Stewart Caleb , Thompson Petria , Fuller Clifton Dave , Ludmir Ethan B. , Rooney Michael Kevin 
Published: June 2021

11032 Background: The open access (OA) publishing model represents an exciting opportunity to facilitate dissemination of scientific information to global audiences. In contrast to many traditional models, which require readers to pay subscription fees or rely upon institutional subscriptions for article access, the OA model grants free access to all consumers. However, OA publication is often associated with significant article processing charges (APCs) for authors, which may thus serve as a barrier to publication. In this investigation, we aimed to identify journal-level factors associated with OA publication costs in oncology journals. Methods: We identified oncology journals using the SCImago Journal & Country Rank database. All journals under the “Oncology” category that offer an OA publishing option with APC data openly available were included. For all journals, we searched journal websites and tabulated journal characteristics, including APC amount (USD), OA model (hybrid vs full), journal 2-year impact factor (IF), H-index, number of citable documents, primary treatment modality (surgery, radiation, medical, non-specific), treatment site (e.g. breast, etc), and continent of origin. Pearson correlation was used to evaluate univariate linear relationships between variables; for variables with significant correlation, we generated a multiple regression model to identify journal characteristics independently associated with OA APC amount. Results: Of 367 oncology journals screened, 266 met final inclusion criteria. The median APC was 2810 USD (range 0 – 5200). On univariate linear correlation regression testing, journals with the full OA model (p < 0.001), higher journal IF (p < 0.001), higher H-index (p < 0.001), greater number of published articles (p < 0.001), and those from North America or Europe (p < 0.001) tended to have higher OA publishing costs. When these co-variates were analyzed in a multiple regression model, only full OA status (p < 0.001), higher IF (p < 0.001), and North American or European origin (p < 0.001) persisted as independently associated with greater OA APC. Conclusions: Large APCs may serve as a barrier to OA publication and therefore create or exacerbate disparities among scientific investigators seeking to share their research. In this investigation, we find that OA publication costs are greater in oncology journals that utilize the hybrid OA model, have higher IF, and are based in North America or Europe. These findings may inform targeted action to help the oncology community fully appreciate the benefits of open science.