bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 40: Global Cancer Surgery in Low-Resource Settings: A Strengths, Weaknesses, Opportunities, and Threats Analysis
Authors: Sadler Samantha , Torio Erick , Golby Alexandra 
Published: June 2023

Abstract
Background: Cancer surgery is a resource-intensive yet essential component of cancer care. In the face of projected increase in cancer burden, the present gap in cancer surgery care in low-resource settings with stressed healthcare and surgical infrastructure risks further exacerbation. Understanding the current state of global cancer surgery is essential to determining the best way forward.
Purpose: The objectives of this report are to (1) describe the landscape of global cancer surgery literature and (2) characterize these findings through a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis.
Methods: A literature review was performed of global cancer surgery studies involving low-resource settings published since the landmark 2015 Lancet Commission on Global Surgery and Global Cancer Surgery. Studies were summarized and evaluated for themes, which were further grouped into SWOT categories for analysis.
Results: The online literature search yielded 123 articles, of which 46 articles met inclusion criteria for analysis. The majority of included studies were open access (n=34) and published between 2021 and 2022 (n=26).
Conclusion: The body of published global cancer surgery literature is growing, perhaps reflecting increased research attention and valuation. From the reviewed literature, Strengths of the global cancer surgery field include a body of studies investigating important aspects of cancer surgery in low-resource settings: local cancer epidemiology, local surgical and technological innovation, quality-of-life as a key surgical outcome metric, and advancements in cancer surgery through interdisciplinary work. Weaknesses include systems-level limitations (i.e. resources, perioperative services, broader health system gaps) and a paucity of detailed economic analyses. Opportunities include diverse local cancer management strategies, successful inter-setting collaborations supporting research, education, and surgical skills training, and thoughtful research expansion for an inclusive future. Threats include large-scale stresses on local healthcare infrastructure (i.e. COVID-19) and the risk of widening disparities posed by unchecked technological. Conclusion: This SWOT analysis may inform local intervention strategies and action plans to help LMIC stakeholders achieve cancer surgery goals. Similar analyses are needed locally to help elucidate best practices that might be applied or tailored to similar settings globally.
Citation Format: Samantha Sadler, Erick Torio, Alexandra Golby. Global Cancer Surgery in Low-Resource Settings: A Strengths, Weaknesses, Opportunities, and Threats Analysis [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 40.
Abstract 54: Influence of Neuro Oncology Capacity Development on Diagnosis of Pediatric Primary CNS Tumors in Northern Tanzania
Authors: Schroeder Kristin , Kerley Taryn , Lubuulwa James , Magambo Margreth , Kamanga Jacqueline , Joas Heronima 
Published: June 2023

Abstract
Purpose: The diagnosis of CNS tumors requires a multidisciplinary team including oncologists, neurosurgeons, radiologists and pathologists. We review the impact of expanding diagnostic capacity on the identification and diagnosis of primary pediatric CNS tumors at Bugando Medical Centre (BMC), the regional cancer referral hospital in the lake zone region of Mwanza Tanzania.
Methods: Patients who presented to BMC from 2016-2022 and received a radiographic or pathologic diagnosis of primary brain or spinal cord tumor were included a CNS tumor registry. Collected data included basic demographics, most specific diagnosis, and diagnostic method. Data was measured and compared before and after initiating key capacity development milestones: 2018 – installation of CT scan, 2020 – arrival of neurosurgical specialist, 2021 – initiation of multidisciplinary tumor board and WhatsApp chat.
Results: A total of 7 spinal and 71 brain tumors were diagnosed among patients aged &lt; 18yo, with (46%) female (n=31) and average age of 7 years. The number of cases per year increased from 3 in 2016, to 17 in 2022. Prior to availability of CT scan (2016-2017), there were an average of 2.5 cases/year, compared to 14.6/year in 2018-2022. With the arrival of the neurosurgeon in 2020, the number of diagnoses/year increased from 11 to 20 from the year prior, but only 50% of patients had a confirmed radiologic or histologic diagnosis. Following initiation of Multidisciplinary Tumor Board Discussion and WhatsApp group, 88% of patients registered in 2022 had a radiographic or histologic diagnosis.
Conclusion: This retrospective study demonstrated the step wise influence of key development milestones on the diagnostic capacity for CNS tumors in a LMIC. While introduction of CNS imaging allowed the identification of more tumors, the multidisciplinary team discussion of the imaging, clinical presentation and pathology results had the greatest overall impact on diagnostic capacity in our setting and should be a key component in future program development.
Citation Format: Kristin Schroeder, Taryn Kerley, James Lubuulwa, Margreth Magambo, Jacqueline Kamanga, Heronima Joas. Influence of Neuro Oncology Capacity Development on Diagnosis of Pediatric Primary CNS Tumors in Northern Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 54.
Abstract 56: Integrated Breast and Cervical Cancer Prevention: What is the Cost of Cost Reduction?
Authors: Lawal Ishak , Shinkafi-Bagudu Zainab , Koko Nuhu , Mohammad Jamilu , Rano Abdullahi Bala , Suleiman Kabir Aliyu 
Published: June 2023

Abstract
Purpose: coupling of breast and cervical cancer prevention has been proposed as a possible low hanging fruit to accelerate simultaneous reduction in burden of both cancers in low resource settings but unfortunately the evidence on effectiveness of such strategy is limited. We have therefore documented and compared the implementation processes of 2 intervention programs in low resource settings with the aim of catalyzing further research into the effectiveness of coupling prevention of breast and cervical cancer in low resource settings.
Methods: Action research model was adopted in the implementation of coupling of breast cancer prevention strategies onto cervical cancer screening programs that End Cervical Cancer Nigeria Initiative (ECCNI) is involved in. This study compared the implementation processes and outcomes of leveraging two cervical cancer screening programs to prevent breast cancer in Kebbi State of Nigeria. Budget impact of the programs was projected and compared.
Results: Two thousand four hundred and sixty-six (2,466) women were screened for cervical cancer across 10healthcare facilities under the WHO/CHAI/MCF supported pilot HPV screening in Kebbi State while the number of women who had clinical breast examination could not be ascertained. At the police cottage hospital, 125 women were screened for cervical cancer using VIA and 131 women had clinical breast examination within the reporting period. The estimated financial cost of implementation (excluding economic cost) per center was $4,550 for cervical cancer screening and $1,850 for clinical breast examination-based prevention program. The implementation cost for the integrated breast and cervical cancer screening at the police cottage hospital was $4,550, implying that no additional funding is required to leverage clinical breast examination on budgeted cervical cancer screening at the primary healthcare level.
Conclusion: Integrated breast and cervical cancer prevention is a confirmed cost reducing strategy but further research is needed to determine cost effectiveness of the strategy.
Citation Format: Ishak Lawal, Zainab Shinkafi-Bagudu, Nuhu Koko, Jamilu Mohammad, Abdullahi Bala Rano, Kabir Aliyu Suleiman. Integrated Breast and Cervical Cancer Prevention: What is the Cost of Cost Reduction? [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 56.
Abstract 65: Oral Health Inequalities Among Tobacco Users in the Tea Plantation Workers, Nilgiri Hills, Tamilnadu, India
Authors: Francis Delfin Lovelina 
Published: June 2023

Abstract
Purpose: Tea is an important agro-industry of India, which contributes immensely to the countries economy. Poor socio-economic conditions, ignorance due to illiteracy, over-crowded and unhygienic living conditions in the residential colonies make tea garden population vulnerable. Hence this study was contemplated with an aim to assess the oral health status, tobacco use and cancer awareness among tea plantation workers, Nilgiri Hills, Tamil Nadu, India.
Methods: A cross-sectional descriptive study was conducted to assess the prevalence of head and neck cancers among tobacco use and cancer awareness among tea plantation workers, Nilgiri Hills. Data was collected using a pretested Questionnaire, which included Demographic data, tobacco habits, its frequency and form. Oral examination for potentially malignant and cancerous lesions was done by the examiner. The data collected was analysed using SPSS version 21.
Results: Results showed that among 900 study population, 57% had no formal education, 64.5% had indigenous brushing habits. Of those who had the habit of smoking, 26% smoked beedi, 10.9% smoked cigarette, 65% chewed raw tobacco, 18% chewed Hans and 28% had a combination of smoking and smokeless tobacco usage. 52% of oral mucosal and potentially malignant lesions, 6% oral cancers were observed. Prevalence of oral mucosal lesions in the study population was due to tobacco usage and lack of awareness regarding the deleterious effects of the products used.
Conclusion: The dangers from smoking and chewing tobacco are well documented within the literature but the public’s lack of knowledge of the risks is a concern. Health professionals are encouraged to ensure that the public is made aware of these risks, especially those within high-risk groups.
Citation Format: Delfin Lovelina Francis. Oral Health Inequalities Among Tobacco Users in the Tea Plantation Workers, Nilgiri Hills, Tamilnadu, India [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 65.
Abstract 67: Perceived Factors for Late Diagnosis in Women With Advanced Breast Cancer in Northern Tanzania
Authors: Msoka-Bright Elizabeth , Abraham Mackenzie , Zmijewski Polina , Serventi Furaha , Cyril Perry , Kitali Brenda , Saria Vivian , Kwayu Jackline , Kavishe Adelide , Masenga Gileard , Mmbaga Blandina , Gutnik Lily 
Published: June 2023

Abstract
Purpose: In Tanzania, women often present with advanced stage breast cancer leading to treatment delays and poor outcomes. Factors influencing late hospital presentation of breast cancer have not been investigated. In this study, we aimed to explore patient perception of factors contributing to the late diagnosis of breast cancer.
Methods: Women diagnosed with late- stage breast cancer in an outpatient cancer care center were identified by clinic nurses and recruited for study participation. Semi-structured interviews were conducted by a single proctor. Interviews were recorded, transcribed verbatim, and coded by three independent reviewers using NVivo 12. Themes were identified using a grounded theory approach.
Results: Twenty patients (10 rural and 10 urban) participated in the interviews. The average age was 56; 11 (55%) completed primary education, 10 (50%) were unemployed, and 5 (25%) were married. Fourteen (70 %) of the patients had stage 4 breast cancer, 3 (15%) had stage 3, and 3 (15%) had stage 2. Nineteen (95%) of our respondents misunderstood the etiology of breast cancer as well as its causes, signs, and symptoms. Misconceptions led to experiences of stigma in 19 (95%) participants. One participant stated: “…I failed to tell people because… once I tell them that I have problem they will start to run away from me and even if you ask for assistance they think that I cannot pay them back because they think they might help me today and I die tomorrow before I pay them back…” Fifteen (75%) of the participants experienced rejection from their partners. Thirteen (65%) participants expressed financial concerns and eighteen (90%) participants were initially treated by a traditional healer, both of which lead to delays in hospital presentation.
Conclusion: Lack of knowledge about breast cancer among patients, societal stigma, lack of spousal support, financial barriers, and initial treatment by traditional healers all contribute to delays in diagnosis and treatment of breast cancer in Northern Tanzania. Stigma reduction and educational interventions may reduce these delays, and further research is needed to improve access to cancer care in this population.
Citation Format: Elizabeth Msoka-Bright, Mackenzie Abraham, Polina Zmijewski, Furaha Serventi, Perry Cyril, Brenda Kitali, Vivian Saria, Jackline Kwayu, Adelide Kavishe, Gileard Masenga, Blandina Mmbaga, Lily Gutnik. Perceived Factors for Late Diagnosis in Women With Advanced Breast Cancer in Northern Tanzania [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 67.
Abstract 72: Socioeconomic Disparities Across the Cancer Care Continuum in Saint Lucia: A Community-Based Study
Authors: Auguste Aviane , Phillip Dorothy , Gabriel Owen , Catherine James St. , Radix Carlene 
Published: June 2023

Abstract
Purpose: Low socioeconomic status could contribute to insufficient access to care and the high cancer mortality in small developing island states (SIDS). However, disparities in care among cancer survivors are rarely studied in SIDS. We investigated for the first time the socioeconomic disparities across the cancer care continuum in Saint Lucia.
Methods: We used purposive and snowball sampling to recruit adult cancer survivors residing in Saint Lucia. Trained field investigators interviewed survivors face-to-face with a structured questionnaire ascertaining their care experience and health services accessed. We used univariate logistic regressions to estimate odds-ratios (OR) and their 95% confidence intervals (CI) measuring the association between socioeconomic status and cancer care. Socioeconomic status was modelled as binary outcome variables: educational level, private medical insurance and hot water at home (a proxy for income in Saint Lucia).
Results: We included 50 survivors (13 men, 37 women). The majority of survivors were black, and diagnosed with breast and prostate cancer. Survivors who were satisfied with the information provided during their diagnosis announcement were more likely to have hot water (OR=5.0, 95% CI=1.3-19.0). Concerning, sources of funds for treatment, private medical insurance and hot water were associated respectively with less financial contributions from family/friends (OR=0.2, 95% CI=0.1-0.9) and greater use of their own funds (OR=3.3, 95% CI=0.9-15.0). Patients who were provided with doctor’s contact information in case of concerns were more likely to have more than primary education (OR=6.3, 95% CI=1.3-31.1) and private medical insurance (OR=12.3, 95% CI=1.4-111.6). Overseas travel for cancer treatment was significantly associated with having private health insurance (OR=3.4, 95% CI=0.9-12.7) and hot water (OR=4.5, 95% CI=1.2-16.8). Having more than primary school education was associated with better perceived care experience (OR=13.5, 95% CI=2.2-84.0). Having private medical insurance was associated with greater access to supportive care services such as psychologists and physiotherapists (OR=3.6, 95% CI=0.9-14.5).
Conclusion: Despite our small sample size and potential confounding, we showed some evidence of socioeconomic disparities across the cancer care continuum in Saint Lucia. Low socioeconomic status should be taken into account when considering interventions to reduce of cancer mortality in SIDS.
Citation Format: Aviane Auguste, Dorothy Phillip, Owen Gabriel, James St. Catherine, Carlene Radix. Socioeconomic Disparities Across the Cancer Care Continuum in Saint Lucia: A Community-Based Study [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 72.
Abstract 76: The “Knowledge-To-Action” Process Model for Cancer Control Stakeholder Engagement for the REBUNG Selangor, Malaysia
Authors: Taib Nur Aishah , Sa’at Hamizah , Hadi Haireen Abdul , Lee Yew Kong , Lai Suat Yan , Lothfi Nurhyikmah , Saad Norhashimi , Chow Suet Yin , Ayadurai Vicky , Jamarish Suniza , See Boon Kiong , Abdullah Zainab , Munisamy Murallitharan , McCarthy Sylvia , Mustapha Wan Hilya Munira , Said Zakiah Mohd , Tamin Nor Saleha Ibrahim , Mustapha Feisul 
Published: June 2023

Abstract
Purpose: Stage at diagnosis for most cancers remains advanced, despite multiple efforts. Situational awareness is critical in implementing projects in the B40 community. REBUNG (Reducing Barriers in Cancer Early Diagnosis in Urban B40 Group) is a multi-sectoral complex intervention that studies a community and the processes of accessing early cancer diagnosis in a single-site urban poor pilot community in Taman Medan, Petaling Jaya.
Methods: The project was guided by the “Knowledge-To-Action” (KTA) process to translate research into ‘real-world’ settings. The processes and dynamics of the health systems, financial support and political landscape were analysed to identify actors and drivers. Consultative engagement minutes, reports and existing cancer control documents were reviewed. These stakeholders were engaged through iterative meetings to invite them to participate in the REBUNG project and identify their roles. Snowballing technique was used to recruit decision-makers and program implementers.
Results: Sixty-two stakeholders made of health professionals, administrators, and organisations were pooled from 44 consultative meeting minutes. Manual methods were used to organise the themes. Theme 1: Main Stakeholders, Theme 2: Roles and Responsibilities, Theme 3: Changes in Roles and Processes. Through stakeholder management, community health promotion activities and optimal care pathways were supported by established cancer NGOs, community leaders and private and MOH health facilities.
Conclusion: REBUNG stakeholder engagement and management co-created access to screening and expedited early cancer diagnosis pathways in the pilot primary care community clinic in the urban B40 community. The sustainability of co-created care pathways would be necessary for structural stability and continuity of expedited early cancer diagnosis care pathways.
Citation Format: Nur Aishah Taib, Hamizah Sa’at, Haireen Abdul Hadi, Yew Kong Lee, Suat Yan Lai, Nurhyikmah Lothfi, Norhashimi Saad, Suet Yin Chow, Vicky Ayadurai, Suniza Jamarish, Boon Kiong See, Zainab Abdullah, Murallitharan Munisamy, Sylvia McCarthy, Wan Hilya Munira Mustapha, Zakiah Mohd Said, Nor Saleha Ibrahim Tamin, Feisul Mustapha. The “Knowledge-To-Action” Process Model for Cancer Control Stakeholder Engagement for the REBUNG Selangor, Malaysia [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 76.
Abstract 78: The Clinicopathological and Psychosocial Profile of A Cohort of Nigerian Breast Cancer Survivors
Authors: Wuraola Funmiola , Olasehinde Olalekan , Bernardo Matteo Di , Mango Victoria , Kingham T Peter , Adisa Adewale , Alatise Olusegun 
Published: June 2023

Abstract
Purpose: Breast cancer survivors are a distinct category of patients with peculiar characteristics and needs. The population of survivors is expected to increase given the rising incidence of breast cancer in Nigeria, and the improvements in breast cancer outcomes. This study evaluated the clinicopathologic characteristics and the psychosocial experiences of a cohort of Nigerian breast cancer survivors.
Methods: From an institutional breast cancer database, patients managed between January 2010 and December 2016 were evaluated. Clinico-pathological characteristics, treatment details, and survival estimates were assessed. These were compared to non-survivors managed during the same period. Survivors were defined as those who have been alive for at least 5 years from the date of presentation.
Qualitatively, a purposive sample of 20 survivors was evaluated using one-on-one in-depth interviews to assess their experiences and coping mechanisms following treatment.
Results: Of the 355 patients in the database during the study period, there were 163 survivors (45.9%), while 192 (54.1%) died. Age, stage at presentation, tumor size, and receipt of multiple treatment modalities were significantly associated with survival.
Six themes were identified in qualitative analysis: Initial reaction to diagnosis, Disclosures, Experiences during treatment, Social support, Coping strategies, and Advocacy. Strong family support and spirituality were prominent coping strategies identified in this cohort.
Conclusion: Despite obvious infrastructural and man power limitations, Nigerian patients who present early and receive multimodal therapy and different breast cancer treatments have better odds of survival. Survivors have some unmet psychosocial and physical needs requiring intervention.
Citation Format: Funmiola Wuraola, Olalekan Olasehinde, Matteo Di Bernardo, Victoria Mango, T Peter Kingham, Adewale Adisa, Olusegun Alatise. The Clinicopathological and Psychosocial Profile of A Cohort of Nigerian Breast Cancer Survivors [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 78.