bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract B49: Factors affecting the treatment of young women with breast cancer at tertiary referral public and private hospitals
Authors: Patel Ami , Dhage Shubhada 
Published: February 2019

Abstract
Background: Disparities persist in receipt of treatment and outcomes of breast cancer patients with varying race, English proficiency, and socioeconomic backgrounds. This is confounded in young women (≤ 45 years old), as age becomes an additional factor. We sought to assess our surgical experience with young breast cancer patients, at a public safety-net hospital (BH) and a private cancer center (PCC) that are staffed by specialty trained providers from the same university.
Methods: We reviewed demographic and clinical-pathologic data from 275 breast cancer patients with invasive breast cancer (Stage I-III) 45 years old and younger from the public and private hospital IRB-approved databases. There were 69 patients in the BH group and 206 patients in the PCC group. Demographic variables (race, education, and primary language), surgery type, method of presentation, and stage were analyzed using Pearson's chi-square tests and binary logistics.
Results: At PC the patients were Caucasian (68%), Asian (11%), Hispanic (10%), and African American (8.7%). At BH patients were Spanish/Hispanic/Latino (47.8%), Asian (27.5%), and African American (10.1%). The majority of patients (82%) at PC had a college or graduate degree compared to 18.6% of the patients at BH (P&lt;0.001). All the patients at PC reported English as their primary language compared to 30% of patients at BHC (P&lt;0.001). There was a significant difference between the stages at which patients presented to either hospital (P = 0.042). At PC, most patients presented at Stage I (54.4%), while most presented at stage II at BH (42.0%). Additionally, a significantly higher number of patients at BHC (81.2%) than at PC (68.4%) presented with a palpable mass (P = 0.043). Hospital site was not a predictor of receipt of mastectomy (P = 0.502). Stage significantly affected the type of treatment received (P&lt;0.01); patients with higher stage were more likely to receive a mastectomy. A patient's race, primary language, and education level at both hospitals did not increase the likelihood of receiving a mastectomy. A majority of the mastectomy patients at both institutions received immediate cosmetic reconstruction 87% (BH) vs. 76%(PCC).
Conclusion: Young women with breast cancer treated at public hospital affiliated with an academic center had equivalent surgical treatment regardless of race, primary language, method or stage or presentation, and education level as young breast cancer patients treated at an academic private hospital.
Citation Format: Ami Patel, Shubhada Dhage. Factors affecting the treatment of young women with breast cancer at tertiary referral public and private hospitals [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B49.
Abstract B77: Panel testing to evaluate genetic predisposition to breast cancer in African American women
Authors: Blackburn Heather L. , Shriver Craig D. , Ellsworth Rachel E. 
Published: February 2019

Abstract
Background: Although the role of BRCA1 and BRCA2 has been well studied in women of European ancestry, the contribution of these and other genes associated with hereditary cancers remains unknown in other populations. Here, we utilized panel testing to analyze 94 cancer predisposition genes in African American women (AAW) diagnosed with invasive breast cancer.
Methods: 145 self-described AAW who enrolled in the Clinical Breast Care Project from 2001-2012 and had genomic DNA available were identified. Targeted sequencing was performed using the TruSight Cancer panel (Illumina). Pathogenic mutations were identified using VariantStudio and classified as pathogenic, uncertain significance (VUS), or benign using ClinVar.
Results: Mean age at diagnosis was 52.1 years (range 25-81 years), and 32% of AAW had a family history. The majority of tumors were ER+HER2- (53%) followed by triple-negative breast cancer (TNBC, 34%). Seven percent of AAW had pathogenic mutations in high-risk genes including BRCA1 (n=7), BRCA2 (n=3), and TP53 (n=1); VUS were detected in BRCA1 (n=1) and BRCA2 (n=2); and an additional woman had a private variant (D2965E) in BRCA2. A further 1% of AAW harbored mutations in the moderate-penetrance gene CHEK2. VUS were also detected in ATM (n=9), CDH1 (n=1), CHEK2 (n=2), MSH2 (n=1), MSH6 (n=5), NBN (n=1), PALB2 (n=4), PMS2 (n=3), RAD51C (n=1), SMAD4 (n=1), TP53 (n=1), and TSC2 (n=1).
Conclusions: Although 94 cancer predisposition genes were evaluated, pathogenic mutations in AAW were detected only in four well-established breast cancer predisposition genes (BRCA1, BRCA2, CHEK2, and TP53). Overall mutation frequency was 9%; however, an additional 25% of AAW harbored private variants and VUS, underscoring the critical need to establish the pathogenicity of these variants.
The opinions or assertions contained herein are the private ones of the author/speaker and are not to be construed as official or reflecting the views of the Department of Defense, the Uniformed Services University of the Health Sciences, or any other agency of the U.S. Government.
Citation Format: Heather L. Blackburn, Craig D. Shriver, Rachel E. Ellsworth. Panel testing to evaluate genetic predisposition to breast cancer in African American women [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B77.
Abstract B87: [Advocate Abstract:] Prostate cancer survivorship among African American males
Authors: Bowen Earl 
Published: February 2019

Abstract
African American survivors of prostate cancer and their families share common experiences yet express their reactions in widely divergent ways. Understanding what factors account for those differences helps explain why some survivors have coped extremely well after treatment and why others have struggled. This research is focused on what enabled victims to become successful survivors and its potential impact on subsequent generations. This study sheds new light on the coping and adaptation of survivors and their families from their own perspective. The study was conducted to describe the lived experiences of African American survivors of prostate cancer, to understand the phenomena in their own terms, to provide a description of their experiences with prostate cancer, and to identify interventions that are ethnically and culturally sensitive. The researcher administered a 49-question sociodemographic survey and conducted 25 in-depth interviews, which entailed descriptions of significant events that influenced the recovery process, perceptions of the health care delivery process and health care providers, and specific recommendations for program development and community outreach in African American communities.
Citation Format: Earl Bowen. [Advocate Abstract:] Prostate cancer survivorship among African American males [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B87.
Abstract C06: Adapting a breast cancer education program to reach Arab Muslim women
Authors: Gonzalez Evelyn T. , Salam Alia 
Published: February 2019

Abstract
Breast cancer (BC) is the most common cancer in women in the United States as well as in Arab countries. Yet, Arab women have lower mammography rates than women of other ethnicities. This is due to an array of barriers, including but not limited to lack of knowledge, cultural and linguistic barriers, and fear of discrimination. Moreover, Arab immigrants have been underserved by research and outreach efforts primarily because many Arabs are considered of the White (Caucasian) race. Given that there is a large Arab population in our catchment area (Philadelphia, PA) we customized a breast cancer education program specifically for Arab Muslim women. In the first phase of the project, 10 Arab Muslim women (ages 35 and older) living in Philadelphia were recruited to provide formative feedback regarding the appropriateness and clarity of the presentation. Participants were encouraged to communicate their thoughts, preferences, concerns, and questions surrounding breast health. Even though most participants indicated that they are insured, can find health information easily, and can understand what health professionals say, their discussion conveyed a strong need for breast health education in this community. After analyzing their input, we refined the presentation and evaluated its effectiveness in a second group of Arab Muslim women (n = 21). Knowledge, attitudes, and beliefs surrounding BC were captured at the beginning of the workshop and at the end using a pre/post-test. A paired t-test showed a significant increase in BC knowledge scores after the presentation (93.5%, SD = 8.46) than before the presentation (79.22%, SD = 17.37); t (20) = -4.088, p = 0.001. In addition, there was an improvement in attitudes and intent regarding self-awareness of breast health and mammography screening. To further augment the educational program, an Arab plain-language brochure was developed and reviewed with the participants. Results from Phase I and II will be reviewed during the session, including additional questions asked by participants during the formative evaluation process. The findings from this effort further indicate the need to expand education (and screening) services to this community.
Citation Format: Evelyn T. Gonzalez, Alia Salam. Adapting a breast cancer education program to reach Arab Muslim women [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C06.
Abstract C18: [Advocate Abstract:] The job or work of being a cancer patient: How to advocate for yourself and a loved one
Authors: Gelb Richard H. 
Published: February 2019

Abstract
The Job or Work of Being a Cancer Patient is the most important job a cancer patient will ever have; their life depends on it! The Job or Work entails learning how to acquire complicated scientific cancer information, becoming skilled at communicating, negotiating and problem-solving with a family, health care providers, insurance and pharmaceutical companies, government agencies and other cancer patients.
Personal Advocacy: is about taking charge of your disease/illness and your life; includes learning how to do research on your cancer diagnosis in order to gather information about the disease/illness.
Personal observations: importance of Developing a Relationship with your physicians where you are comfortable and able to have conversations about the following:
a. Medical narrative: domain of diagnosis, treatment and cures, i.e., of symptoms, tests, diet, and medications; but equally important.
b. Be able to identify Illness Beliefs and the role they play in a cancer patient's management of their illness; understand the difference between
c. Constraining Illness Beliefs, beliefs that negatively impact and limit the cancer patient's management of his/her disease and illness.
Citation Format: Richard H. Gelb. [Advocate Abstract:] The job or work of being a cancer patient: How to advocate for yourself and a loved one [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C18.
Abstract C38: Increasing colorectal cancer screening in rural populations: A systematic literature review
Authors: Atere-Roberts Joelle , Hall Ingrid J. , Smith Judith Lee 
Published: February 2019

Abstract
Background: Research demonstrates that early detection through recommended screening for colorectal cancer (CRC) yields favorable treatment outcomes; however, screening rates remain low, particularly in rural communities. Residents of rural communities have unique barriers to health care that often result in poorer health outcomes. Targeted interventions to increase CRC screening are needed to tackle barriers to preventive health behaviors among individuals in rural communities.
Methods: A systematic literature search of PubMed/Medline was performed to identify CRC screening interventions conducted in rural communities. English language articles from peer-reviewed journals published from January 2006 to December 2016 were included if they reported results for CRC screening interventions in rural communities in the United States.
Results: Of the 358 articles abstracted, 29 met the inclusion criteria. The studies detailed interventions in rural settings, particularly among populations with low CRC screening rates including American Indians/Alaska Natives, African Americans, and uninsured individuals. Studies varied in design and mode of intervention delivery; however, interventions emphasizing community-based participatory research principles yielded improved CRC screening adherence. Interventions to increase CRC screening included communication campaigns, home-based screening, and patient navigation. Few interventions included a theoretical foundation or information on cost-effectiveness.
Conclusions: More research is needed to examine the theoretical framework, design, delivery, and cost-effectiveness of CRC screening interventions for rural populations. Additional assessment is needed to determine how effectively these interventions can be translated to different types of rural settings. Synthesis of this literature may inform efforts to develop targeted interventions to increase CRC screening in rural populations.
Citation Format: Joelle Atere-Roberts, Ingrid J. Hall, Judith Lee Smith. Increasing colorectal cancer screening in rural populations: A systematic literature review [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C38.
Abstract C67: Addressing racial disparity in colorectal cancer screening with CT colonography: Experience in an African-American cohort
Authors: Fibus Todd , Moreno Courtney C. , Krupinski Elizabeth A. , Kim David H. , Pickhardt Perry J. 
Published: February 2019

Abstract
Purpose: Incidence and mortality from colorectal cancer (CRC) are higher among minorities, including African Americans, compared with non-Hispanic whites, and CRC screening rates for African Americans lag behind non-Hispanic whites. The purpose of this investigation was to evaluate computed tomographic (CT) colonography performance and outcome measures in an African-American cohort.
Materials and Methods: Institutional review board-approved and HIPAA-compliant study. Informed consent was waived. Retrospective evaluation of the African-American cohort from the Atlanta Veterans Affairs Medical Center CT colonography screening program. Colonoscopy referral rates and histologic diagnoses were evaluated.
Results: CT colonography studies (n = 2,490; mean age 59.5 years [range 50-80]; 85.5% male), were performed between 2007 and 2016. The per-patient positive rate of CT colonography was 9.8% for polyps 6-9 mm, 5.4% for polyps 10-29 mm, and 1.3% for masses &gt; 30 mm. Based on CT colonography findings and patient preference, 13.9% of patients were referred to optical colonoscopy and 2.9% were referred to CT colonography follow-up. Of patients recommended to undergo colonoscopy, 80.6% completed the procedure and colonic pathology was confirmed in 83.2% thereof. Histologic diagnoses were 221 tubular adenomas (161 6-9 mm; 60 &gt; 10 mm), 60 tubulovillous adenomas/villous adenomas (14 6-9 mm; 46 &gt; 10 mm), 31 hyperplastic polyps (26 6-9 mm; 5 &gt; 10 mm), 17 adenocarcinomas (all &gt; 10 mm), 10 adenomas with high-grade dysplasia (all &gt; 10 mm), and 3 serrated polyps (1 6-9 mm; 2 &gt; 10 mm). The per-patient positivity rate for patients who had optical colonoscopy (n = 279) was 71.3% for adenoma, 9.7% for hyperplastic polyp, and 6.1% for adenocarcinoma.
Conclusions: CT colonography is an effective screening modality for African-American adults and could potentially improve rates of colorectal screening in African-Americans.
Citation Format: Todd Fibus, Courtney C. Moreno, Elizabeth A. Krupinski, David H. Kim, Perry J. Pickhardt. Addressing racial disparity in colorectal cancer screening with CT colonography: Experience in an African-American cohort [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C67.
Abstract C92: A diagnostic review of barriers to and opportunities for improving HPV vaccination in Alabama
Authors: Dilley Sarah E. , Peral Sylvia , Straughn J. Michael , Scarinci Isabel 
Published: February 2019

Abstract
Background: The human papillomavirus (HPV) vaccine is an important tool for cancer prevention. Vaccination rates in Alabama, a state with high rates of HPV-related cancers, remain below the national average. Our objective was to develop a comprehensive assessment of HPV vaccination in our state, with the goal to make recommendations for tailored multilevel interventions.
Methods: With the PRECEDE-PROCEED model as a theoretical framework, a multimodal approach with quantitative and qualitative data was used to determine barriers and facilitators to HPV vaccination in Alabama. This included a survey of pediatricians and family medicine providers as well as structured qualitative interviews with pediatricians, parents, nurses, and community stakeholders. Two separate investigators evaluated the interview transcripts for major themes that occurred in 65% or more interviews.
Results: Major barriers that overlapped between all groups in both qualitative and quantitative data included lack of parental knowledge, concerns about vaccine safety, and the link between the HPV vaccine and sexuality. Opportunities for increasing HPV vaccination identified include parental education, establishment of a reminder system, increasing access to HPV vaccine providers, and education for providers. Qualitative interviews further expanded on these themes and revealed barriers such as misinformation received from the Internet and parental vaccine hesitancy. Additional opportunities and facilitators revealed through interviews included the trust patients have in physicians, using the Internet or social media to propagate positive messaging about the HPV vaccine, provider education for both physicians and clinical staff, utilizing existing technology more effectively, highlighting nurses' roles as partners in HPV prevention, and the potential of schools as a venue for patient education and promotion of the vaccine.
Conclusion: Our data are consistent with prior research showing major barriers to HPV vaccination. There is an especially high resistance to vaccination due to the link between the vaccine and sexual activity, often attributed to religious beliefs. Several recommendations for optimizing HPV vaccination uptake in Alabama on the patient, provider, and system level are given.
Citation Format: Sarah E. Dilley, Sylvia Peral, J. Michael Straughn, Jr., Isabel Scarinci. A diagnostic review of barriers to and opportunities for improving HPV vaccination in Alabama [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C92.
Abstract IA10: Childhood cancer disparities: Past, present, and future
Authors: Scheurer Michael E. 
Published: February 2019

Abstract
With decades of progress in the successful treatment of many childhood cancers, overall survival now approaches 80%. However, there are persistent disparities in outcomes for several groups of children and adolescents, as well as a lack of research on the factors that contribute to these differences. This paucity of research greatly limits our efforts to address these important differences. We recently held a dedicated one-day symposium to increase awareness of the disparities that exist for childhood cancers, to stimulate the development of new research, and to begin to establish a research strategy for addressing key disparities. We discussed the genetic, environmental, social, and medical system factors associated with disparities in risk and outcomes, specifically for patients with leukemias and sarcomas. We also discussed factors specific to Hispanic and African-American children, to non-English-speaking families, and to children who live in rural or impoverished areas. Moving into the future, a plan was discussed for increasing research on disparities among children and adolescents across the cancer continuum.
Citation Format: Michael E. Scheurer. Childhood cancer disparities: Past, present, and future [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr IA10.