bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 32: Characteristics of Hepatocellular Carcinoma in Nigerians with and without HIV
Authors: Davwar Pantong , Odeghe Emoubor , Duguru Mary , Oyeleke Ganiat , Nyam David , Okeke Edith , Lesi Olufunmi , Kim Kwang-youn , Imade Godwin , Akanmu Alani , Sagay Atiene , Robert Lewis , Hou Lifang , Murphy Rob , Hawkins Claudia 
Published: July 2021

Abstract
Purpose: Hepatocellular carcinoma (HCC) is a major public health problem in West African countries. HCC still has a strikingly high mortality in this region. Whether HIV also contributes to an increased risk of HCC is in this region is unclear. In this study we describe clinical, radiological and laboratory features as well as survival in Nigerians with HCC, with and without HIV infection, enrolled in an NCI-funded study.
Methods: This was a prospective, non-interventional study conducted at two Nigerian tertiary hospitals [Jos University Teaching Hospital and Lagos University Teaching Hospital. Subjects&gt;18 years with HCC diagnosed according to AASLD criteria were included.
Results: 204 participants were included in this study [males 144 (71%), median age 50 yrs (IQR 19, 86); HIV-infected (25 (12%)]. 51(27.6%) of all subjects were anti-HCV positive [HIV-uninfected 46 (28.4%) vs. HIV-infected 5(21.7%); p=0.62]. 62% of anti-HCV positive patients at JUTH were confirmed to have active infection (HCV RNA&gt;10IU/mL). Median CD4 T cell count among HIV-infected was 236.50 [61.00-479.00] cells/mm3. 72% of the HIV patients were on ART. Tumor mass diameter on computed tomography did not differ between subject groups [HIV-infected 6.5cm (1.80-80.00) vs. HIV-uninfected 8.9 cm (1-93.0); p=0.23). Overall median survival for both groups was 2.04 months CI (1.58, 4.47). The mean probability of survival at month 1 was 0.7 (95% CI, 0.6, 0.8).
Conclusion: A very short median survival was observed in this cohort of HIV-infected and uninfected Nigerian adults with HCC. Almost a third of all subjects were anti-HCV positive and two thirds of these subjects had active infection suggesting HCV infection is an important, risk factor for HCC in this setting.
Citation Format: Pantong Davwar, Emoubor Odeghe, Mary Duguru, Ganiat Oyeleke, David Nyam, Edith Okeke, Olufunmi Lesi, Kwang-youn Kim, Godwin Imade, Alani Akanmu, Atiene Sagay, Lewis Robert, Lifang Hou, Rob Murphy, Claudia Hawkins. Characteristics of Hepatocellular Carcinoma in Nigerians with and without HIV [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 32.
Abstract 36: Clinical Profiles and 1-Year Survival of Children with Acute Lymphoblastic Leukemia at Mbarara Regional Referral Hospital Cancer Unit
Authors: Zalwango Stella , Kalubi Peters , Atwiine Barnabas 
Published: July 2021

Abstract
Purpose: Acute lymphoblastic leukemia (ALL) is the commonest childhood cancer globally and mimics common childhood conditions, creating diagnostic challenges. We described the baseline feature at diagnosis and established 1-year overall survival.
Methods: In a retrospective cohort study, medical records of children &lt;16 years of age diagnosed with ALL between 1st June 2016 and 31st May 2020 were reviewed. The frequencies and proportions of symptoms, signs, laboratory findings and treatment outcomes were extracted and described. 1-year overall survival was estimated using Kaplan Meier curves. Research and Ethics Committee of Mbarara University of Science and Technology provided ethics approval.
Results: Fifty one (51) children had been diagnosed with ALL at MRRH. They presented with fever, 44 (86.3%), weight loss 34(66.7%), cough 28(54.9%), bleeding tendencies 21(41.2%), limb pains 20(39.4%), and abdominal distension 8(15.7%). The signs were pallor, 44(86.3%), lymphadenopathy 39(76.5%), hepatosplenomegaly 37(72.5%), pyrexia 18(35.3%), bone tenderness 12(23.5%) and petieche 11(21.6%). Thirty (58.8%) children had leukocytosis (WBC&gt;12 × 109/L), 15(29.4%) had WBC&gt;50,000 and all children had anemia (Hb&lt;11.0g/dl) at admission, 32 (62.7%) had severe anemia (Hb &lt;7.0g/dl). Forty eight (94.1%) children had thrombocytopenia (&lt;150.0 × 109/L), 32(62.7%) had severe thrombocytopenia (&lt;50 × 109/L). 1-year overall survival was 63.6% (95%CI (49.8-77.5).
Conclusion: Children with ALL present with non-specific clinical features that can mimic other illnesses and 1-year overall survival was low at MRRH. Children with a combination of fever, pallor, bleeding; and leukocytosis, anemia and thrombocytopenia should be actively investigated for acute lymphoblastic leukemia for early treatment initiation.
Citation Format: Stella Zalwango, Peters Kalubi, Barnabas Atwiine. Clinical Profiles and 1-Year Survival of Children with Acute Lymphoblastic Leukemia at Mbarara Regional Referral Hospital Cancer Unit [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 36.
Abstract 38: Setting up a Cancer Clinic in a Low-and-Middle-Income Country (LMIC) in Sub-Saharan Africa: A Case of Taita Taveta County in Kenya.
Authors: Kitur Gloria , Achieng Emmah , Mwakichako Rebecca , Kimotho Felix , Asirwa Chite 
Published: July 2021

Abstract
Purpose: Quality Cancer treatment is expensive and not accessible to all in LMIC settings in sub-Saharan Africa including Kenya. Despite having a cancer diagnosis, patients and their families not living in major towns and cities, have to travel far to seek treatment incurring cost in transport, upkeep during treatment and out of pocket expenditure to access care.
Methods: International Cancer Institute in Eldoret-Kenya, partnered with Taita Taveta County to implement a cancer and other non-communicable disease (NCD) project in August 2020. Taita Taveta County established a technical working group (TWG) in September 2020 to oversee the project activities and identified space and staff to set up a new cancer clinic. ICI provided technical support in project planning, budgeting, capacity/needs assessment, training and mentorship of healthcare providers; and running joint cancer clinics.
Results: Periodic review meetings between ICI and Taita Taveta County TWG identified lack of: qualified staff to provide cancer care; cancer screening supplies; and drug stock-outs. In September 2020, ICI and its strategic partners supported Taita Taveta County to launch a Cancer Clinic to provide basic Cancer care. ICI offered trainings and continuous medical education on cancer for 91 healthcare providers both online (26) and on-site (65); ICI provided cervical, breast and prostate cancer screening supplies; established a revolving fund pharmacy as a stop gap measure to drug stock-outs; and held joint cancer clinics twice a month where mentorship and skills training for county staff paired with ICI staff across various disciplines was achieved resulting in the first patient receiving chemotherapy in November 2020; histopathology support was provided for 151 samples.
Conclusion: The process of setting up a cancer clinic in a low resource setting requires a systematic needs assessment approach; identifying a core team early that outlines output measures of interest; and having strategic partnership guiding step-by-step developments.
Citation Format: Gloria Kitur, Emmah Achieng, Rebecca Mwakichako, Felix Kimotho, Chite Asirwa. Setting up a Cancer Clinic in a Low-and-Middle-Income Country (LMIC) in Sub-Saharan Africa: A Case of Taita Taveta County in Kenya. [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 38.
Abstract 41: International Collaborative Rwanda Endoscopy Week Conferences Demonstrate Feasibility and identify H. pylori Testing as an Important Target for Capacity-Building Interventions
Authors: Gangasani Nikitha , Rutaganda Eric , Shikama Felcien , Bensen Steve , Dusabejambo Vincent , Chamberlin Mary 
Published: July 2021

Abstract
Purpose: Gastrointestinal (GI) endoscopy is a growing field in Rwanda, a country of 12.6 million with significant GI morbidity and mortality. Endoscopy alongside Helicobacter pylori identification and eradication aids in GI cancer prevention and diagnosis in this population. Our collaborative training-focused endoscopy conference provides preliminary data to focus future training and capacity building programs in Rwanda to improve oncologic outcomes.
Methods: Since 2017, ‘Rwanda Endoscopy Week' (REW) is held annually at multiple hospitals throughout Rwanda. It consists of several days of didactic training in endoscopy, oncology and research, followed by a week of endoscopy procedures performed jointly by visiting and hosting endoscopists, and ending with a summary of results of didactic and endoscopic activity.
Results: Four (4) hospitals performed 244 training endoscopies in 2017 and 448 cases in 2018. In 2019 this expanded to 668 endoscopies performed at 7 hospitals, including academic, district, and private hospitals. The case distribution remained similar over 3 years at 86.0% (1170/1360) upper endoscopies, 13.2% (180/1360) colonoscopies, and 0.7% (10/1360) endoscopic retrograde cholangiopancreatographies. Thirty-nine (5.8%, 39/668) patients had a tumor finding suspicious for gastric (4.0%, 27/668), colorectal (1.5%,10/668), ampullary (0.1%, 1/668), or gallbladder (0.1%, 1/668) malignancy. 54% of patients receiving endoscopy were tested for H. Pylori (367/669); 38% of those tested had inconclusive results (141/367) and 20% were positive (74). There were 2 non-serious bleeding events.
Conclusions: Participation by Rwandan urban, district, public and private hospitals in a cooperative international GI training conference has experienced a nearly three-fold increase in patients and identified malignant pathology while maintaining safe endoscopic care over a three-year period. H. pylori, ubiquitous in this population, is an important risk factor for gastric cancer and gastric diseases. Necessary next steps include increased training and capacity-building interventions to improve the quality of the testing and surveillance of those treated.
Citation Format: Nikitha Gangasani, Eric Rutaganda, Felcien Shikama, Steve Bensen, Vincent Dusabejambo, Mary Chamberlin. International Collaborative Rwanda Endoscopy Week Conferences Demonstrate Feasibility and identify H. pylori Testing as an Important Target for Capacity-Building Interventions [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 41.
Abstract 42: Patient-Provider Communication in the Setting of Advanced Cancer: Experience and Views from Rwanda
Authors: Uwamahoro Pacifique , Tuyishime Hubert , Cubaka Vincent , Mpanumusingo Egide , Ho Anita , Van Loon Katherine , DeBoer Rebecca J. 
Published: July 2021

Abstract
Purpose: Caring for patients with advanced cancer involves complex patient-provider communication (PPC), including disclosure of diagnosis, discussion of prognosis, decision-making about treatment, delivery of bad news, and transitions in goals of care. Values and norms that influence PPC differ across diverse cultural and socioeconomic contexts. We aimed to characterize PPC experiences and preferences among patients and providers at Butaro Hospital in Rwanda, understand facilitators and barriers to high quality PPC, and collect suggestions for improvement.
Methods: We conducted semi-structured interviews with a purposive sample of 11 oncology providers and 11 adult patients with advanced cancer. Interviews were recorded, transcribed, translated to English, coded using software, and analyzed using framework thematic analysis.
Results: Participants reported both strengths and opportunities for improvement in PPC at Butaro. Strengths include routine explanation of diagnosis, treatment plan, and potential side effects, aided by a consent form and a dedicated counselor. Patients reported that PPC focuses on symptoms and treatment plan discussion, but is limited in truth telling about prognosis, especially when goals of care transition from curative to palliative. Facilitators to quality PPC include multidisciplinary team commitment, patient trust toward providers, provider communication style, and strong resilience in distressing clinical situations. While patients perceived power imbalance between patients and providers as the main barrier to PPC, providers cited inadequate time due to work overload, discomfort facing sad situations, and unfavorable physical environment as main barriers. Suggestions to improve PPC include training providers in communication skills, patient and family education and empowerment, more time and private spaces, and standardizing approaches to harmonize PPC.
Conclusion: PPC at Butaro works well though there is room for improvement. Understanding how cultural norms and values regarding poor prognoses influence patient and provider communication preferences can inform strategies to improve PPC and ensure patient-centered care in Rwanda and similar settings.
Citation Format: Pacifique Uwamahoro, Hubert Tuyishime, Vincent Cubaka, Egide Mpanumusingo, Anita Ho, Katherine Van Loon, Rebecca J. DeBoer. Patient-Provider Communication in the Setting of Advanced Cancer: Experience and Views from Rwanda [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 42.
Abstract 50: Factors Affecting the Aggressiveness of Hepatocellular Carcinoma among Hepatitis C Related Cirrhosis Patients
Authors: Elmoneim Randa Salah Abd , Sedki Fathalla , Mohey Aida , Hassouna Ehab , Tayae Eman 
Published: July 2021

Abstract
Purpose: The study was conducted to assess possible epidemiological, clinical and laboratory factors predicting the aggressiveness of Hepatocellular carcinoma (HCC) in HCV-related liver cirrhosis patients.
Methods: A comparative hospital-based cross-sectional study was conducted. Exclusion criteria were HBsAg positive patients, and patients undergoing any treatment modalities for HCC. Complete history was taken focusing on signs and symptoms of the chronic liver disease, and clinical examination was done.
Results: Among 173 patients, only 14.4% of the patients were classified as Child A. In near percentages, patients with Child B represented 43.4%, and patients with Child C were 42.2% of the studied patients. Most of the patients were males (75.7%), while the rest were females (24.3%). Patients were divided to 2 groups: group (I) included 36 patients with non-aggressive HCC (score = 4), and group (II) included 137 patients with aggressive HCC (score &gt; 4) according to the aggressiveness index (AgI) described by Carr et al that takes in count AFP, Maximum Tumor Diameter, number of nodules and presence of portal vein thrombosis. HCC patients in group (II) were 1.9 times more likely to have positive HBc Ab as compared to patients in group (I) where (OR = 1.9, CI = 1.3 - 3.6). Multiple logistic regression analysis for predicting the aggressiveness of HCC explains that 86.7% of factors (age, Child Pugh score, BCLC staging, Gamma glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), Platelets, HBcore ab and AFP) were contributing to aggressiveness among HCC-Hepatitis C related cirrhosis patients (R 2 = 0.867) with overall significant where chi-square = 21.876, p = 0.001.
Conclusion: In conclusion, age, platelets, Child Pugh score, BCLC staging, HBcore ab, ALP, GGT and AFP are significant predictors for the aggressiveness of HCC.
Citation Format: Randa Salah Abd Elmoneim, Fathalla Sedki, Aida Mohey, Ehab Hassouna, Eman Tayae. Factors Affecting the Aggressiveness of Hepatocellular Carcinoma among Hepatitis C Related Cirrhosis Patients [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 50.
Abstract 52: Pediatric, Adolescent, and Young Adult Cancer in an HIV-Infected Rural Sub-Saharan African Population
Authors: Johnson Kimberly , Bahar Ozge Sensoy , Nattabi Jennifer , Migadde Herbert , Ssentumbwe Vicent , Damulira Christopher , Kivumbi Apollo , Niyonzima Nixon , Ssewamala Fred 
Published: July 2021

Abstract
Purpose: Youth living with HIV (YLWHIV) have an increased cancer risk. Although cancer risk has been greatly reduced in HIV-infected populations since anti-retroviral therapy (ART) became widely available, adherence is still an issue among YLWHIV. Our objective is to describe the prevalence of medical record (MR) reported suspected cancers in a contemporary cohort of YLWHIV aged 10 to 24 years in southern Uganda.
Methods: A cohort of YLWHIV was assembled through MR reviews of patients 10 to 24 years old on the day of data abstraction across 35 Ugandan HIV care health facilities. Clinical data were abstracted to identify suspected cancer cases and information about HIV care.
Results: Among 3728 YLWHIV, we identified eight suspected cancer cases. The most common suspected types were Kaposi sarcoma (n=4) followed by lymphoma (n=3). Challenges encountered in data abstraction were missing data for several variables and confirmatory cancer diagnostic information. In follow-up of suspected cases referred for diagnosis at the Uganda Cancer Institute (UCI), none had diagnosis records in UCI files. In addition, ~18% of patients (n=686) were lost-to-follow-up (LTF) defined as not having returned to the clinic in &gt;183 days and three patients died from presumed Kaposi sarcoma.
Conclusion: Although our results suggest that cancer is rare in YLWHIV, the possibility that the cancer burden is higher cannot be excluded due to incomplete information in MRs and high LTF rates. Further, our study raises concern that patients referred for diagnosis are not accessing potential life-saving care.
Citation Format: Kimberly Johnson, Ozge Sensoy Bahar, Jennifer Nattabi, Herbert Migadde, Vicent Ssentumbwe, Christopher Damulira, Apollo Kivumbi, Nixon Niyonzima, Fred Ssewamala. Pediatric, Adolescent, and Young Adult Cancer in an HIV-Infected Rural Sub-Saharan African Population [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 52.
Abstract 55: Cervical Cancer Prevention in sub-Saharan Africa: A Policy Analysis
Authors: Akanda Rifa , Moucheraud Corrina 
Published: July 2021

Abstract
Purpose: We analyzed the presence and comprehensiveness of cervical cancer control policies in sub-Saharan Africa, where cervical cancer is the leading cause of cancer death for women.
Methods: Publicly-available policies for primary, secondary, and tertiary cervical cancer prevention were collected, and scored for comprehensiveness based on elements included (e.g. vaccination schedule and target age, screening age interval and strategy, precancerous lesion removal method, cancer treatment approach, and presence of palliative care) (summed score, possible range 0- 12). We compared the median number of policy points for countries based on policy environment (availability of other non-communicable disease policy), health financing (external and domestic health expenditures), economic status (poverty prevalence and income inequality), health outcomes (life expectancy, HIV prevalence, cervical cancer mortality), and sub-region.
Results: Policies from 47 countries in sub-Saharan Africa were analyzed. Policies were generally most comprehensive for secondary and primary prevention; only 19 countries had any tertiary prevention policy. It was more common for policies to include information about target age (for primary and secondary prevention), vaccine schedule, and screening method, and less common to include information about awareness-raising or accompanying behavior change approaches. Countries with greater external financing for health had more comprehensive cervical cancer policies, as did countries with higher HIV prevalence.
Conclusion: Cervical cancer control policies in Africa are highly variable in comprehensiveness. External factors, like the role of global donors, and internal factors, like local disease burden, may influence relative priority of cervical cancer prevention and therefore affect policy comprehensiveness. Future research should use mixed methods to explore reasons for this variation and identify areas for policy strengthening.
Citation Format: Rifa Akanda, Corrina Moucheraud. Cervical Cancer Prevention in sub-Saharan Africa: A Policy Analysis [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 55.