bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and implementation of an Internet-based cancer risk assessment tool: Use over 10 years.
Authors: Lariviere Michael Joseph , Chao Hann-Hsiang , Amaniera Isabella , Vachani Carolyn , Hampshire Margaret K. , Bach Christina , Arnold-Korzeniowski Karen , Metz James M. , Hill-Kayser Christine E. 
Published: May 2019

e13075 Background: Prevention and early intervention can improve survival and quality of life across all cancers. Patient understanding of risk factors, and associated actionable lifestyle changes and screening programs, is not well understood by clinicians. Methods: The Internet-based OncoLink “Reduce My Risk” tool was created in 2009 to provide information about cancer risk after individuals responded to a comprehensive survey regarding demographics and cancer risk factors. Research related to these data has been IRB-approved. Results: 28,001 surveys were submitted. Median age among respondents ≥18y was 26y (18-101). 60% were female, 87% lived in North America, and 76% were White/Non-Hispanic. 37% had at least a bachelor’s degree, and 22% had household income > $100,000/y; most lived in a city/suburb (81%). 13% were current smokers, 23% previous smokers, 10% used cigars or pipe tobacco (10%), 6% used oral snuff/chew/quid, and 29% reported secondhand smoke exposure. Other substance use included marijuana (22% former users, 10% current users), alcohol (52% current users, 8% of those ≥14 drinks/w), and areca nut, betel leaf, or exotic smoking (1%). BMI was ≥30 in 19%. 74% reported dietary risks and 36% infrequent exercise. Early intercourse and > 10 sexual partners were reported by 43% and 10%, respectively. Excess UV exposure was reported by 19%, and exposure to known carcinogens 14%; 1% were exposed to DES in utero, and < 1% took DES while pregnant. Nonmodifiable risk factors included family cancer history (64%) or genetic syndrome (3%), and cancer-predisposing health condition (26%). 31% of women began menstruating < 12y and 33% gave birth to a first child > 30y. Conclusions: This free, publicly accessible cancer risk assessment tool has a large user population with higher educational status, higher income, and smaller household than the general population. 97% of users report behaviors associated with cancer risk. Another 72% report non-modifiable risks. By understanding detailed characteristics of a large number of respondents, these data have the potential to answer many hypothesis-generating questions, with the ultimate goal of improving educational interventions to reduce cancer risk across the general public.
An analysis of the sociodemographic factors contributing to patient nonadherence to recommendations for screening mammograms.
Authors: Ansari Ahmer Mohammad , Pericot-Valverde Irene Mohammad , Merchant Krupa Mohammad 
Published: May 2019

e13077 Background: There were 2 million newly diagnosed cases of breast cancer in the United States during 2018 with 40,920 associated deaths1. The number of deaths has been decreasing over time due to effective breast cancer screening by mammogram. Routine mammograms lead to early recognition and treatment of breast cancer leading to an overall improvement in breast cancer outcomes. However, not all patients are adherent to screening mammogram schedules. The main aim of this study is to explore the current prevalence of breast cancer screening among women in the US. A secondary aim is to determine whether cancer screening is associated with identifiable sociodemographic determinants and cigarette smoking. Methods: Data were drawn from the Health Information National Trends Survey- (HINTS), a cross-sectional, nationally representative survey (N = 3,527) conducted in 2018. Responses from women aged 18-74 were used in this study. Descriptive analyses and chi-squared tests were conducted to estimate the prevalence of breast cancer screening by mammogram, as well as its association with certain sociodemographic characteristics and smoking status. Results: The survey sample included 1,722 women. The majority of the respondents were aged 45 years or older. A total of 5% of women had previously been diagnosed with breast cancer, most of them being between 65 and 74 years old. Overall, 22.1% of respondents reported that they had never had a mammogram. Breast cancer screening was significantly lower among young women aged 18 to 34 (76.0%), Hispanic (28.2%) and Asian (39.7%), and current smokers (24.6%). Conclusions: This study shows that there is a significant percentage of women in the US that do not adhere to screening recommendations for breast cancer. This study provides new and continuing evidence, regarding the profiles of women with poor adherence to these screening mammogram schedules. Overall, the findings from this study emphasize the importance of addressing racial and sociodemographic factors in an effort to improve screening mammogram adherence. References: 1. Cancer stat facts: Female breast cancer. Surveillance, Epidemiology, and End Results (SEER) Web site. https://seer.cancer.gov/statfacts/html/breast.html . Updated 2019. Accessed 02/10, 2019.
Renal cell carcinoma epidemiology in the era of widespread imaging.
Authors: Orlin Ido , Silverman Barbara G , Dekel Yoram , Stein Avi , Friedman Boris , Ben-Lasson Maya 
Published: May 2019

e13083 Background: Cancers of the kidney and renal pelvis are the third most commonly diagnosed urological cancers. Renal Cell Carcinoma (RCC) is the most common histological type. The age-standardized rate (ASR) of RCC world-wide is 4.4/100,000 with higher rates in higher income countries. One third of diagnosed RCC patients have metastatic disease at presentation, although recent reports indicate smaller proportions. It has been suggested that the widespread use of imaging performed for various reasons has led to a rise of incidentally diagnosed RCC. We conducted a retrospective analysis of trends in cancers of the kidney and renal pelvis in Israel. Methods: We selected all cases of renal cell carcinoma of the kidney and renal pelvis neoplasms reported to the Israel National Cancer Registry (INCR) for the years 2000-2015. Demographic and clinical variables extracted from the registry included gender, population group, dates of birth/death, tumor size, stage at presentation (according to the Surveillance, Epidemiology and End Results (SEER) summary staging manual 2000). We calculated the overall and population group age-standardized incidence, using the direct method and the Segi World Standard population. Results: A total of 9,595 cases of RCC were identified. The average ASR was 7.7/100,000. RCC incidence was highest in the seventh decade of life with a male/female ratio of 1.7:1. Incidence was higher in the Jewish population than in the Arab population. The proportion of cases with metastatic disease at time of diagnosis was 10%; this figure was unchanged during the study period. Masses smaller than 4 cm. comprised almost two thirds of localized tumors with a significant increase in trend during the period of the study (p < 0.001). Five-year overall survival for localized and metastatic disease was 86% and 12%, respectively. Survival was similar in the Arab and Jewish populations (p = 0.06). Conclusions: RCC incidence and survival in Israel mirror those of other western countries. The proportion of cases with distant spread at diagnosis is smaller than elsewhere reported. Small incidental renal masses (less than 4 cm) are increasingly diagnosed in the localized stages, possibly due to increased using of imaging.
Epidemiological profile of lung cancer in a Nepalese population: A single-institution review.
Authors: Piya Madan Kumar 
Published: May 2019

e13087 Background: Lung cancer is one of the common cancers worldwide, and is the commonest cancer in Nepal, with an incidence of 16%. There is a high incidence of smoking in Nepal, being highest in the mountain region in the north and lowest in the tarai region in the south. Smoking kills around 15,000 people per year. The prevalence of smoking in the urban population of Kathmandu over the age of 15 has been estimated at 64.6% in men and 14.2% in women. Nepal has diverse population with various ethnicities and different cultures. The aim of this study was to determine the relation of smoking, epidemiology of lung cancer and distribution of lung cancer in various ethnicities of Nepal. Methods: All patients attending National Hospital and Cancer Research Center in Kathmandu who were diagnosed with lung cancer between January 2012 and December 2018 were enrolled in the study. Informed consent was taken before enrollment and data was collected by the nursing staffs prospectively using a preset questionnaire for interviewing patients. Results: Data was collected from 250 patients over the seven years with histologically proven lung cancer. About 85.6 % of patients were male and 80% of them were smokers. 50% of men and 30 % of the women were smokers. Most common age to start smoking was in 11-20 years group (60%). 58% of patients were from Kathmandu valley, and 42% of patients from outside the valley. 38% of male were literate and 16% were illiterate where as 13.6% of female were literate and 32.4% were illiterate. Among the various ethnic groups, 44% were Newars, 20% Mongols, 18% in Chhetris and 18% Brahmins. The incidence of lung cancer was highest (57.6%) in the age 61-80 years age group. 14.4% of the patients had family history of cancer M = 8.6% and F = 6.0%). Squamous cell carcinoma was the highest (51.2%) followed by small cell carcinoma (22%) and adenocarcinoma (26.8%). Carcinoma of right lung was frequent (62%) compared to the left lung (38%). Local cigarette were used by 82.5% of the smokers and 54.5% of them used filtered cigarettes. 40% practiced relighting the butt ends. Conclusions: The study shows that smoking is a single major contributing factor observed in lung cancer in Nepal across various age groups as well as diverse ethnic groups. Given the high incidence of smoking starting before the age of 20, there is an urgent need for organized mass anti-smoking campaigns, especially in schools targeting the younger age group. Need of awareness against the smoking and the cause of lung cancer needs to emphasized to reduce the burden of the lung cancer.
Optimal body mass index cutoff point for predicting survival of colorectal cancer in Asian population: A National Health Information Database Analysis.
Authors: Song Nan , Shin Aesun , Huang Dan , Kim Minjung , Park Ji Won 
Published: May 2019

e13098 Background: A U-shaped relationship between body mass index (BMI) and colorectal cancer mortality has been revealed. However, an optimal BMI range for predicting survival in Asian colorectal cancer patients is unknown. We established the most appropriate cut-off point of BMI for better survival in Asian colorectal cancer patients. Methods: Two cohorts of colorectal cancer patients were included in this study; 5,815 from the Seoul National University Hospital, Korea for development cohort and 54,043 colorectal cancer patients from the Korean National Health Information Database for validation cohort. To determine the optimal cut-off point of BMI at diagnosis, the systematic dichotomization based on log-rank test was performed by the method of Contal and O’Quigley. We evaluated the association between BMI at diagnosis and overall survival (OS) using the Cox proportional hazard model. Results: During a median follow-up of 5.7 years for hospital-based development cohort and 4.3 years for nation-wide validation cohort, 1,180 (20.3%) deaths and 10,244 (19.0%) deaths occurred, respectively. The optimal cut-off point of BMI at diagnosis was identified at 20.2 kg/m2 (log-rank statistic = 96.69, Q-statistic = 3.07, P< 0.01) for differentiating between the poorer and better OS in development cohort. When compared to the patients with BMI < 20.2 kg/m2, the patients with BMI ≥20.2 kg/m2 were significantly associated with the better OS in the Cox proportional hazard regression analysis (HR = 0.62, 95% CI = 0.54-0.72, P= 1.1×10-10). The association was validated in the nation-wide cohort showing the better OS in the patients with BMI ≥20.2 kg/m2. (HR = 0.64, 95% CI = 0.60-0.67, P< 0.01). Conclusions: We suggest the use of a BMI value of 20.2 kg/m2 to predict survival in Asian colorectal cancer patients.
Epidemiology and survival of lung cancer in a Latin American cohort.
Authors: Ruiz Rossana , Galvez Nino Marco , Morante Cruz Zaida , Valencia Fernando , Pacheco Cristian , Aliaga Llerena Karina Mayra , Olivera Mivael , Valdivieso Natalia , Amorin Edgar , Mas Luis 
Published: May 2019

e13101 Background: Lung cancer epidemiology and survival data is lacking in LA. This information is relevant for understanding regional cancer burden and for designing targeted interventions for cancer control. Methods: Retrospective analysis of lung cancer cases diagnosed at Instituto Nacional de Enfermedades Neoplasicas (INEN) from 2010 to 2014. Data was manually curated from clinical files. Results: 1384 patients were included. Median age at diagnosis was 64 years old (range 20-92) and 51.6% were females. The histologic type was adenocarcinoma, NOS carcinoma, squamous cell carcinoma and small-cell carcinoma in 72.3%, 12.8%, 9.4% and 3.5% of the cases, respectively. The adenocarcinoma/squamous cell carcinoma ratio was 7.7. Among NSCLC cases, most patients presented with advanced disease. Stage III (9.2%) and IV (85.5%) were the most frequent. With a median follow-up of 71.5 months, median overall survival (OS) was 9.2, 7.7 and 8.1 months for adenocarcinoma, NOS carcinoma and squamous carcinoma, respectively. Five-year OS for stage III was 6% and for stage 4, 4%. Detailed results are shown in the table. Conclusions: The epidemiological profile of lung cancer in Peruvian patients is different from that of other countries with a younger age at diagnosis, a preponderance of females over males and an unexpectedly high frequency of adenocarcinomas. This may be in concordance with the low prevalence of tobacco smoking and the high prevalence of EGFR mutations reported for our population as well as with particular exogenous exposures such as biomass fumes from inhouse cooking. The molecular characterization of this cohort of patients is ongoing. [Table: see text]
Burden and etiologies of 30-day readmission after bone marrow transplant: Insights from National Readmission Database.
Authors: Premnath Naveen , Sud Karan , Pondaiah Sathish Kumar , Gupta Arjun 
Published: May 2019

e13106 Background: With more centers getting accredited as a bone marrow transplant (BMT) unit, attention has shifted to healthcare care quality metrics such as readmissions. Previous studies have shown high rates of 30-day readmission to be associated with worse long term survival. Except a few single center studies there is no viable data for readmissions for patients undergoing BMT. Methods: This is a retrospective cohort study using the National Readmission Database (NRD) for 2014. All adults with index admission for BMT (autologous and allogenic) were included. Exclusion criteria was age < 18 years, mortality during index admission and inter-hospital transfers. ICD 9 codes were used to identify diagnoses and procedures. Results: A total of 3,972 admissions for BMT were identified. Among these 2,462 underwent autologous (AU) and 1,510 underwent allogenic (AL) transplant, respectively. 30-day readmission rate was 8.6% in AU and 8.2% in AL group. The mean age was 55.9 years and 47.8 years in the AU and AL group, respectively. About 40.5% were females in the AU group and 44.4% in the AL group. Major co-morbidities included Smoking (22.7% in AU and 19.1% in AL), diabetes (13.8% in AU and 12.4% in AL), chronic kidney disease (10% in AU and 4.3% in AL) and prior irradiation (5.7% in AU and 4.5% in AL). Mean length of stay during the index admission was 18 days in AU and 26 days in AL group. Principle diagnosis for undergoing transplant was found as multiple myeloma (59.2% in AU) and AML (25.2% in AL). Major etiologies for readmission were neutropenia (26.9% in AU and 15.8% in AL) followed by Infectious etiologies 26% in AU and 20.4% in AL group, nausea and vomiting 4.3% in AU and 3.2% in AL group. Dehydration accounted for 5.7% in AU group and mucositis 5.7% in AL group. Conclusions: There is a significant readmission rate in this study population. 30-day readmissions in this population are primarily due to neutropenia and infectious etiologies including sepsis and pneumonia. Nausea, vomiting and dehydration played a major role in both categories and remain a major targetable group. We believe there is a dire need for major studies to further evaluate risk factors and predictors for readmission and their impact on overall survival. [Table: see text]
Large cell neuroendocrine carcinoma of the lung: A population-based study.
Authors: Kinslow Connor J , May Michael S. , Wang Tony J. C. , Cheng Simon 
Published: May 2019

e13122 Background: In 2015, the World Health Organization dissolved the category of non-small cell lung cancer (NSCLC) that was previously known as “large cell carcinoma” into adeno- or squamous cell carcinomas, with the exception of large cell neuroendocrine carcinoma (LCNEC), which is now grouped with other neuroendocrine carcinomas of the lung. There is limited data on the epidemiology and best treatment practices for this malignancy, and studies comparing prognosis with SCLC and NSCLC have been conflicting. Methods: We reviewed the epidemiology of LCNEC using data from the Surveillance, Epidemiology and End Results Program from 2010 – 2015. Demographical features and overall survival were compared with SCLC and NSCLC. Trends in incidence and mortality rates were observed from 2004 – 2015. Results: We analyzed 195,148 cases of lung cancer, including 1,681 (0.9%) cases of LCNEC. Age-adjusted incidence of LCNEC was 0.31 per 100,000 people and had increased by 50% over the period studied. This increased incidence was primarily the result of increased incidence of stage IV disease. LCNEC was more likely to present with brain metastasis at diagnosis (19.2%) than either SCLC (16.7%, p = .01) or NSCLC (13.0%, p < .001). Survival patterns for LCNEC mirrored NSCLC in stage I – III disease and SCLC in stage IV disease. After adjusting for other clinical and demographic variables, survival for LCNEC was not different than SCLC but worse than NSCLC (HR = 0.88 for NSCLC vs. LCNEC, p < .001). Survival rates for LCNEC and SCLC did not significantly change over the time period studied, whereas survival rates for NSCLC significantly improved. Consistent with our findings of increased incidence of LCNEC with no change in survival patterns, age-adjusted incidence-based mortality increased by two-fold over the time period studied. Conclusions: LCNEC generally has a worse prognosis than NSCLC and better than SCLC. LCNEC presents with brain metastases more frequently than SCLC. Incidence of LCNEC is consistently increasing in the U.S. Despite this, it remains poorly studied and prognosis for LCNEC has not improved with time. LCNEC has, therefore, become an increasing cause of lung cancer mortality in the American population.
Validation of a comprehensive cancer genomic profiling assay based on massively parallel DNA sequencing.
Authors: Hong Yuanyuan , Chen Weizhi , Yan Huiting , Yan Linlin , Zeng Xuexia , Song Yipeng 
Published: May 2019

e13138 Background: Validation is very important for diagnostic assays, here we describe a validation process of a comprehensive cancer genomic profiling assay based on massively parallel DNA sequencing. This assay can detect base substitutions, short insertions and deletions, copy number alterations, tumor mutation burden (TMB) and microsatellite instability (MSI) across 543 cancer-related genes from tumor specimens or plasma. Methods: Analytical validation was conducted with 20 cell line pools whose mutation were verified by digital droplet PCR (ddPCR). Clinical validation was conducted with Proficiency Test samples and clinical samples whose mutation were verified by ddPCR. Sensitivity, positive predictive value (PPV) and precision of tumor specimens and plasma were assessed across the reportable range of the assay. For measurement of TMB， NGS libraries of a cohort of tumor samples were tested by whole exosome panel (WES) and this assay respectively. And clinical tumor tissue samples whose MSI status were identified by fluorescent PCR-capillary electrophoresis were also tested by this assay. Results: The SNV/Indel LOD95 was 0.6% for hot-spot variants, and 1.3% for panel-wised variants of tumor tissue samples with high specificity (PPV >99%). The SNV/Indel LOD95 was 0.4% for hot-spot variants, and 1.1% for panel-wised variants of plasma samples (cfDNA≥15ng), with PPV >99%. LOD95 of CNV was 2.2-2.3, with PPV>99%. Precision of CNV was higher than 95%, precision of SNV/Indel was higher than 97%. Concordance between TMB results tested by WES and this assay was 0.94. MSI results identified by this assay was the same as fluorescent PCR-capillary electrophoresis method. Conclusions: In summary, we present the analytical and clinical validation of a comprehensive NGS-based diagnostic assay for comprehensive tumor genomic profiling.
Performance and validation of a tumor mutation profiling, based on artificial intelligence annotation, to assist oncology decision making.
Authors: Mitne Neto Miguel , Fornari Alexandre Ricardo , Moreira Luciana Peniche , Burger Matheus , Oku Andre , Pereira Luciana Guilhermino , Stabellini Raquel , Valim Gabriela Rampazzo , Eulalio Otavio Jose , Colleoni Gisele Wally , Santoro Ilka Lopes , Pintão Maria Carolina , Stiepcich Monica Maria Agata , Felipe-Silva Aloisio Souza , Ramalho Rodrigo Fernandes , Marco Antonio David Santos , Fraga Ana Maria , Ferreira Elisa Napolitano 
Published: May 2019

e13148 Background: Tumor mutation profiling has become a key component for orienteering the treatment of oncologic patients. A crucial step for this is the correct identification and classification of pathogenic and actionable variants. In the present work we aimed at the development and validation of a tumor mutation profiling panel, based on NGS, which uses artificial intelligence for variant annotation. Methods: We designed a hybrid capture panel, containing 366 genes to evaluate somatic SNVs, INDELs and CNVs, and to calculate TMB, using a customized bioinformatics pipeline. MSI status was determined by fragment analysis using capillary electrophoresis. Analytical performance was determined using reference cell lines. FFPE samples from 70 tumors were accessed and 53 were sequenced. Variant annotation was performed by IBM Watson for Genomics (WfG) platform. Assay performance on clinical samples was defined based on orthogonal assays using Agilent CGH+SNParray 400K (for CNVs only) and Foundation One test (Foundation Medicine) (F1). Results: Breast, colon and lung were the most common tumor origins. Fifty-three samples were successfully sequenced, while 41 of them could also be analyzed by F1 test. A summary of the assay performance is presented in Table 1. Our pipeline detected 1219 variants and 290 (23%) were classified as Pathogenic, Likely Pathogenic or Actionable, according to WfG. Thirty-five samples (66%) presented a variant that could drive the treatment, with 37.7% of samples being sensitive to targeted therapies, while 22.6% were resistant; additionally, 86% had an indication for a clinical trial. Conclusions: The developed assay presented a good overall sensitivity and allele frequency correlation, with TMB and MSI having the best rates. Comparisons with F1 had reduced values of concordance; however, SNVs and INDELs presented a similar frequency. Differences on CNVs identification may rely on distinct thresholds established by the different groups. The high percentage of samples that could benefit from mutational profiling highlights the importance of such approach in the clinical routine. Additionally, the high number of variants features the need for updated information for annotation. [Table: see text]