bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 24: Compliance with Referral for Evaluation of Breast Abnormalities among HIV-Clinic Patients in Eswatini
Authors: O'Neil Daniel , Nxumalo Sifiso , Ngcamphalala Cebisile , Tharp G , Jacobson Judith , Nuwagaba-Biribonwoha Harriet , Dlamini Xolisile , Neugut Alfred , Harris Tiffany 
Published: July 2021

Abstract
Purpose: Women living with HIV (WLHIV) are living longer and are at increasing risk for breast cancer (BC). Earlier detection of BC is essential to reduce late-stage diagnosis and BC mortality in sub-Saharan Africa, the region most heavily impacted by HIV. We implemented a pilot BC early detection program in Eswatini HIV clinics and studied patients' compliance with referral for evaluation of breast abnormalities.
Methods: Nurses at five Eswatini HIV clinics were trained to ask all WLHIV aged ≥18 years about breast symptoms, to offer clinical breast exam (CBE) to symptomatic women, and to refer for further evaluation if appropriate. Referred, consenting patients completed baseline demographic questionnaires and questionnaires at 30- and 60-days post-enrollment, regarding referral outcomes. We used chi-squared testing to identify patient characteristics associated with completing referral.
Results: From June 2019-April 2020, 9,502 WLHIV were screened for breast symptoms: 150 (1.6%) underwent CBE; 93 (62.0%) of those were referred for further evaluation; and 90 (96.7%) were enrolled in the evaluation. Of enrolled WLHIV, median age was 39 (range: 20-65) years, 54 (61.0%) reported completing referral. Referral completion was not associated with age, employment status, relationship status, or various prior experiences related to BC (all p&gt;0.05). Of those who completed referral, 42 (80.7%) reported having no illness identified, 3 (5.8%) reported a new BC diagnosis, 1 (1.9%) reported a breast abscess, and 6 (11.5%) were still undergoing evaluation; diagnosis was missing for 2. The most common reasons cited for not completing referral were cost of transport or care, conflicting employment-related commitments, other conflicting commitments, and the breast clinic not accommodating the patient upon presentation.
Conclusion: In this pilot BC screening program, 60% of WLHIV completed referral for further evaluation. Efforts to improve compliance with referral could focus on reducing the time and cost entailed by obtaining specialized breast care.
Citation Format: Daniel O'Neil, Sifiso Nxumalo, Cebisile Ngcamphalala, G Tharp, Judith Jacobson, Harriet Nuwagaba-Biribonwoha, Xolisile Dlamini, Alfred Neugut, Tiffany Harris. Compliance with Referral for Evaluation of Breast Abnormalities among HIV-Clinic Patients in Eswatini [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 24.
Abstract 28: Steroid Hormone Biosynthesis Metabolism Is Associated with Fatigue Related to Androgen Deprivation Therapy for Prostate Cancer
Authors: Allen Hannah , Feng Li Rebekah , Saligan Leorey 
Published: July 2021

Abstract
Purpose: Androgen deprivation therapy (ADT) is a common and effective treatment for prostate cancer. However, multiple adverse effects such as fatigue are associated with this therapy. The purpose of this study was to characterize the metabolic profile associated with cancer-related fatigue specific to ADT.
Methods: 160 participants with non-metastatic prostate cancer who were receiving (+ADT, n = 58) or were not receiving neoadjuvant ADT (-ADT), n = 102) before undergoing radiotherapy were included in this study. Plasma samples were taken from all participants, and metabolites were identified and quantified using ultrahigh performance liquid chromatography/mass spectrometry. Partial least square discriminant analysis was used to identify discriminant metabolite features, and diagnostic performance of selected classifiers was quantified using AUROC curve analysis. Pathway enrichment analysis was performed using metabolite sets enrichment analyses.
Results: Particular metabolic pathways were found to be significantly over-represented in the +ADT group compared to the -ADT group, thereby creating a distinct metabolic profile associated with each group. These pathways were steroid hormone biosynthesis pathways, including androstenedione metabolism and androgen and estrogen metabolism, as well as amino acid metabolism, glutathione metabolism, and carnitine synthesis. Of all these pathways, steroid hormone biosynthesis was most significantly correlated with fatigue severity. It was also found that sleep-related impairment was highly correlated with severity of fatigue and inversely correlated with ADT-induced reduction in androsterone sulfate.
Conclusion: Individuals who received ADT reported significantly higher levels of fatigue. This finding may be due to sleep-related impairment associated with changes in steroid hormone biosynthesis. This result paves the way for future research on cancer-related fatigue and changes in sleep patterns due to alterations in steroid hormones. It may also help patients and clinicians make a more precise cost-benefit analysis when deciding on a prostate cancer treatment plan.
Citation Format: Hannah Allen, Li Rebekah Feng, Leorey Saligan. Steroid Hormone Biosynthesis Metabolism Is Associated with Fatigue Related to Androgen Deprivation Therapy for Prostate Cancer [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 28.
Abstract 37: Enhancing Cancer Diagnostics through Provision of Pathology Support for Hospitals in Low and Middle-Income Countries: A Case of International Cancer Institute (ICI), Kenya
Authors: Kitur Gloria , Achieng Emmah , Gitau George , Asirwa Chite 
Published: July 2021

Abstract
Purpose: Delays in diagnosis and treatment of cancers in low-and-middle-income countries (LMICs) attributable to provider and/or systemic factors are linked to poor patient outcomes. Pathology services are not available in most lower level facilities hence, there's delayed diagnosis and initiation of treatment for cancers. There is also limited availability of specialized pathology tests.
Methods: International Cancer Institute (ICI), conducts joint clinics and cancer screening with partner counties where same-day screening and on-site biopsing is conducted after which samples for cytology, histology and/or histochemistry are sent for processing in the ICI diagnostics and research laboratory at a subsidized cost with a turn-around-time for results being 14 days or less. Results get discussed virtually by a multi-disciplinary team (MDT) of both ICI and the outreach site and positive results are singled out for further diagnostics like computerized tomography (CT) scan and blood work ups.
Results: Between September and December 2020, a total of 146 samples for Cytology; 197 biopsy samples for histology and 66 samples for immunohistochemistry were shipped to the ICI Diagnostics and research laboratory from five ICI Outreach sites namely: Kisumu, Taita Taveta, Meru & Makueni counties and Sori Lakeside Hospital. In less than 28 days from date of screening, the MDT discussed positive results and gave recommendations; results were disseminated to outreach sites for patient counseling and drawing of treatment plans; and appropriate treatment was initiated at the outreach sites in established cancer clinics run jointly by ICI and the counties. The ICI Consultant Pathologist and Histotechnologist provide further technical support and consultation to the clinic team when necessary.
Conclusion: Better patient outcomes are assured when there is reduced turn-around time from screening to diagnosis and initiation of treatment for cancers in LMICs. Accessibility of pathology services through strengthening of existing health systems can be achieved through multi-sectoral partnerships.
Citation Format: Gloria Kitur, Emmah Achieng, George Gitau, Chite Asirwa. Enhancing Cancer Diagnostics through Provision of Pathology Support for Hospitals in Low and Middle-Income Countries: A Case of International Cancer Institute (ICI), 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 37.
Abstract 40: Pathology Training for Cancer Diagnosis in Africa: Perspectives from Two Virtual Courses
Authors: Seymour Daniel , Graef Katy , Iliyasu Yawale , Diomande Mohenou Isidore Jean-Marie , Jaquet Samuel , Kelly Melissa , Soles Ryan , Milner Dan 
Published: July 2021

Abstract
Purpose: The burden of cancer continues to grow in Africa, yet there are too few trained pathologists to manage the rising number of cancer cases. The shortage of resources in African countries, as well as the travel restrictions resulting from the COVID-19 pandemic, necessitate innovative means of training and supporting pathologists across the continent. In response to requests for training in cancer pathology, two virtual training courses were organized: one conducted in English for participants in Nigeria and another conducted in French for participants across several countries in Francophone Africa. Each course had weekly 90-minute sessions covering essential topics in cancer pathology led by global experts.
Methods: Two research questions were investigated for both courses: 1) did the participants improve their knowledge of the topics covered during the course? and 2) did the course participants appreciate the virtual training format?
Results: The Nigeria course enrolled 85 participants from 26 Nigerian states, while the Francophone Africa course enrolled 425 participants from 18 African countries. On the post course survey, 95.8% of Nigeria course respondents and 96.1% of Francophone Africa respondents reported being satisfied or very satisfied with the course's virtual format. In the pre-post technical assessment, participants increased their scores on average by 3.4% (p&gt;0.05) in the Nigeria course and by 13.1% (p&lt;0.001) in the Francophone Africa course.
Conclusion: Virtual training is a promising tool to improve cancer diagnosis in Africa, as the experience of the two courses illustrates participants appreciate the virtual format. However, continued training and mentorship are required to reinforce new skills and enable the participants to appropriately apply their new knowledge to their daily practice.
Citation Format: Daniel Seymour, MPA, Katy Graef, PhD, Yawale Iliyasu, MD, Mohenou Isidore Jean-Marie Diomande, MD, Samuel Jaquet, MD, Melissa Kelly, PhD, Ryan Soles, Dan Milner, MD, MSc, MBA. Pathology Training for Cancer Diagnosis in Africa: Perspectives from Two Virtual Courses [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 40.
Abstract 43: Global Burden of Cancer in 2020 Attributable to Alcohol Consumption: A Population-Based Study
Authors: Rumgay Harriet , Shield Kevin , Charvat Hadrien , Ferrari Pietro , Sornpaisarn Bundit , Obot Isidore , Islami Farhad , Lemmens Valery , Rehm Jürgen , Soerjomataram Isabelle 
Published: July 2021

Abstract
Purpose: Alcohol use is causally linked to multiple cancer sites. We present global, regional and national estimates of alcohol-attributable cancer burden in 2020 to inform alcohol policy and cancer control across different settings globally.
Methods: In this population-based study, we calculated population attributable fractions (PAFs) using relative risk estimates and alcohol use prevalence by age, sex, and country. Assuming a 10-year latency period between alcohol consumption and cancer occurrence, we used alcohol consumption prevalence from 2010 and GLOBOCAN 2020 data to estimate new cancer cases attributable to alcohol consumption. We also calculated the contribution of moderate (&lt;20 g alcohol per day), risky (20 to 60 g per day), and heavy (&gt;60 g per day) drinking to the total alcohol-attributable cancer burden.
Results: Globally, an estimated 702 900, or 3.9%, of all new cases of cancer in 2020 were attributable to alcohol consumption. Males represented 71.1% of the total alcohol-attributable cancer cases. The cancer sites which contributed the most alcohol-attributable cases were cancers of the esophagus (183 000 cases), liver (142 600 cases), and breast (114 300 cases). PAFs were lowest in Northern Africa and Western Asia (less than 1%) in both sexes, and highest in Eastern Asia (7.7%) and Central and Eastern Europe (6.9%) in men, and in Central and Eastern Europe (3.8%), Western Europe (3.5%) and Australia and New Zealand (3.55%) in women. Risky and heavy drinking contributed most to the burden of alcohol-attributable cancers (42.6% and 42.5%, respectively), and moderate drinking contributed 14.9%.
Conclusion: Our findings highlight the need for effective policy and interventions to increase awareness of cancer risks associated with alcohol use and decrease overall alcohol consumption to avoid future rises in alcohol-attributable cancer burden in several regions of the world.
Citation Format: Harriet Rumgay, Kevin Shield, Hadrien Charvat, Pietro Ferrari, Bundit Sornpaisarn, Isidore Obot, Farhad Islami, Valery Lemmens, Jürgen Rehm, Isabelle Soerjomataram. Global Burden of Cancer in 2020 Attributable to Alcohol Consumption: A Population-Based Study [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 43.
Abstract 44: Global Incidence of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma in 2018
Authors: Rumgay Harriet , Ferlay Jacques , de Martel Catherine , Georges Damien , Ibrahim Amal Samy , Zheng Rongshou , Wei Wenqiang , Lemmens Valery , Soerjomataram Isabelle 
Published: July 2021

Abstract
Purpose: The two main subtypes of primary liver cancer are hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA). We aimed to produce worldwide and regional estimates of the distribution of these subtypes based on high quality data.
Methods: Population-based cancer registry data were used to compute sex-specific proportions of HCC, iCCA, and other specified histology. The proportions were applied to sex- and age-specific liver cancer estimates from GLOBOCAN 2018 and age-standardized incidence rates were calculated.
Results: Of an estimated 826,000 cases of liver cancer in 2018, 661,000 (80.0%) were HCC, 123,000 (14.9%) were iCCA and 42,000 (5.1%) were other specified histology. In nearly all world regions, HCC was more common than iCCA, except in women in Northern Europe where iCCA was more common than HCC. The highest rates of HCC were found in Eastern Asia (14.8 cases per 100,000 person-years), Northern Africa (13.2) and South-Eastern Asia (9.5). The highest rates of iCCA were in South-Eastern Asia (2.9), Eastern Asia (2.0), Northern Europe, the Caribbean and Central America, and Oceania (all 1.8). HCC was more often diagnosed in males (M:F rate ratio ranged from 1.6 to 5.0), while the sex difference in iCCA rates was much smaller (M:F between 0.7 and 1.7).
Conclusion: Uncovering the distinct patterns of HCC and iCCA by sex, country and world region is critical to further develop public health policy to reduce liver cancer burden and monitor progress in controlling the disease globally. Improved completeness of liver cancer histology registration would provide more reliable estimates for policymakers to base decisions on.
Citation Format: Harriet Rumgay, Jacques Ferlay, Catherine de Martel, Damien Georges, Amal Samy Ibrahim, Rongshou Zheng, Wenqiang Wei, Valery Lemmens, Isabelle Soerjomataram. Global Incidence of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma in 2018 [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 44.
Abstract 47: Survival of Breast Cancer in Women Treated Under Mexico's Seguro Popular
Authors: Bandala-Jacques Antonio , Huerta-Gutierrez Rodrigo , Zamora-Muñoz Salvador , Cabrera Paula , Mohar Alejandro , Lajous Martin 
Published: July 2021

Abstract
Purpose: To determine 5-year survival for breast cancer among uninsured women treated under Mexico's Seguro Popular landmark health reform according to clinical stage and identify factors associated to survival.
Methods: We conducted a retrospective cohort study with data obtained from national reimbursement claims of patients treated under Seguro Popular from January 2007 to December 2016. Reimbursement data was cross-linked with a national mortality registry. We used the Kaplan-Meier method to estimate overall survival according to different variables and stratified them by clinical stage as early (I-IIA), locally advanced (IIB-IIIC), and metastatic (IV). We explored the relation between age, hospital patient volume, hospital infrastructure, and mortality. Hazard ratios and 95% confidence intervals (95%CI) were estimated, using the Cox proportional hazards model to adjust for clinical stage.
Results: A total of 57,175 patients with breast cancer were analyzed. The mean age was 43.4 (SD 12.4). Most patients had locally advanced disease at diagnosis (55.1%, n=31,559) and 9.5% (n=5,435) had metastatic disease. The distribution of clinical stage did not appear to change over time (11% in 2007 vs. 13% in 2015 for metastatic disease). Five-year survival was 88.9% (CI95% 88.3-89.5) for early-stage disease, 69.6% (CI95% 69-70.2) for locally advanced cancer, and 36.9% (CI95% 35.4-38.5) for metastatic disease. These survival estimates did not change over time. After adjustment for clinical stage, age &lt;40 years old (HR 1.17 [CI95% 1.12-1.23]), low hospital patient volume (≤248 patients/year, HR 1.21 [CI95% 1.17-1.25]), and treatment at a locally funded hospital (HR 1.15 [CI95% 1.11-1.2]) were associated with higher mortality.
Conclusions: While Seguro Popular provided access to treatment for breast cancer, a high proportion of women were treated at advanced stages and clinical stage at diagnosis and survival did not appear to change over a decade. Future programs should prioritize early detection and strengthen quality of care.
Citation Format: Antonio Bandala-Jacques, Rodrigo Huerta-Gutierrez, Salvador Zamora-Muñoz, Paula Cabrera, Alejandro Mohar, Martin Lajous. Survival of Breast Cancer in Women Treated Under Mexico's Seguro Popular [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 47.
Abstract 48: Characterization of Human Papillomavirus (HPV) Sequence and Integration and Analysis of Immune Response Genes for Application in Guatemalan Cervical Cancer
Authors: Rossi Nicole , Dean Michael 
Published: July 2021

Abstract
Purpose: Cervical cancer is a significant cause of mortality in Guatemala due to inefficient screening and late diagnosis. We are developing new technologies to improve the analysis of HPV-positive cervical tumors in Guatemala. The goal is to enhance understanding of HPV infection, tumor progression, and therapeutics development.
Methods: We established a cohort of 700 Guatemalan cervical cancer patients with blood, fresh-frozen tumors, and clinical data. To optimize techniques, we extracted DNA and RNA from 20 cervical cancer cell lines. Long-read whole genome and transcriptome sequencing, and long-range PCR, were performed on cervical cancer DNA. HPV and HLA gene sequences were aligned to reference genomes.
Results: Complete HPV sequences were compiled, HPV subtypes determined, and integration sites identified in cell lines with single and multiple integration events. HLA types of the class I genes were determined from the complete gene sequence, mutations detected, and HLA homozygosity. RNA was used for long-read whole transcriptome analysis of HPV and cellular genes. These results establish the use of long-read sequencing technology to characterize both HLA and host genomes. Paired Guatemalan tumor and blood DNA was successfully used for full HLA gene sequencing and mutation analysis. In addition, the complete HPV genome sequence was resolved. Binding of HPV peptides was predicted using the HPV and HLA sequences. These peptides identify the specific HPV epitopes potentially presented on the cell surface.
Conclusion: Long-read RNA and DNA sequencing technology allow the determination of the complete HPV sequence, integration, and HLA class I typing and mutation analysis. HLA typing provides essential information on an individual's immune response. These techniques and analyses are being applied to tumor samples from women in Guatemala to aid in the development of targeted treatments. These methods are portable and could be employed in low- and middle-income countries.
Citation Format: Nicole Rossi, Michael Dean. Characterization of Human Papillomavirus (HPV) Sequence and Integration and Analysis of Immune Response Genes for Application in Guatemalan Cervical Cancer [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 48.