bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 30: Development of a Breast Cancer Survivorship Health System Needs Assessment Questionnaire (BSH-Q) for Malaysian Health Institutions
Authors: Islam Tania , Azmi Syahidatul Akmal , Jamarish Suniza , Shaharuddin Fatiha Hana , Engkasan Julia Patrick , Taib Nur Aishah 
Published: June 2023

Abstract
Purpose: There is a need to develop and implement a Breast Cancer Survivorship Care Plan in Malaysia based on the available healthcare resources and services. The objective of the study is to develop a Breast Cancer Survivorship Health System Needs Assessment Questionnaire (BSH-Q) using the Delphi method.
Methods: The three rounds of e-Delphi surveys were conducted from November, 2020 to April, 2021. Development of BSH-Q was accomplished amongst key stakeholders (multidisciplinary healthcare professionals involved in cancer care in public hospitals, NGOs and breast cancer survivors). The first Delphi round was intended to explore the barriers, facilitators and needs of healthcare providers focused on five main survivorship care domains. The questions were open ended, allowing expert participants to brainstorm their ideas. Delphi round two involved a ranking exercise of the newly developed questionnaire based on the first Delphi round. A five point Likert scale was used to rate the importance of each item. This was followed with a pilot study to determine the feasibility of the research process, and face validity of the questionnaire. The pilot study was tested on healthcare providers working in University Malaya Medical Centre representing the five respective domains: Rehabilitation, life-style, psychosocial, financial, and genetic counselling. The participants were selected based on their involvement in managing the healthcare issues related to the five domains.
Results: A total of 55 participants responded to the Delphi survey. Following the first Delphi survey, a total of 95 questions were developed in the domains of psychosocial, lifestyle, financial, rehabilitation, genetic counselling, cancer surveillance and management. In the second Delphi survey, 39 participants responded, they selected a total of 196 questions as important and finally 182 relevant questions were developed for the final BSH-Q version. The newly developed BSH-Q underwent a pilot study with no major modifications to the questionnaire.
Conclusion: The Delphi survey method is suitable to develop the BSH-Q questionnaire. The newly developed BSH-Q is a valuable tool for Malaysia to analyse existing services in the country to provide a needs assessment too for the development of an implementation framework cancer survivorship care in Malaysia.
Citation Format: Tania Islam, Syahidatul Akmal Azmi, Suniza Jamarish, Fatiha Hana Shaharuddin, Julia Patrick Engkasan, Nur Aishah Taib. Development of a Breast Cancer Survivorship Health System Needs Assessment Questionnaire (BSH-Q) for Malaysian Health Institutions [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 30.
Abstract 42: Hematopoietic Stem Cell Transplants and Treatment of Severe Blood Disorders: Role of Providers in Medical Tourism
Authors: Khanna Deepika , Rondelli Damiano 
Published: June 2023

Abstract
Purpose: Medical tourism provides international patients with medical services, but little data is present on the role of medical tourism in regard to hematopoietic stem cell transplant (HSCT) services. Over the last 10 years, the University of Illinois at Chicago Blood & Marrow Transplant program has established an international network (GlobalBMT) of LMIC centers, that includes hospitals in Nepal, India, Nigeria, Tanzania, Bolivia, Cuba, Argentina, Ukraine. This project involves each hospital of the GlobalBMT network to: 1. qualitatively assess the current role of medical providers in international care of HSCT patients and 2. quantitatively and qualitatively assess the current policies of medical institutions for sending and accepting international transplant candidates.
Methods: This is a mixed-methods cross-sectional study with a quantitative component (questionnaire) and a qualitative component (interview). A questionnaire was disseminated to 12 medical providers in 8 countries, who either refer or accept international HSCT patients, to assess the demographics, volume, and frequency of international referrals. We also conducted semi-structured virtual interviews with willing healthcare providers to qualitatively assess the current infrastructure in medical tourism for international HSCT candidates, as well as elicit ways in which this structure can be improved.
Results: Here we will report on the results of the mixed-methods cross-sectional study that was conducted within the GlobalBMT network. In the setting of this research project, we suggest a need for a formalized provider-to-provider framework in the sphere of medical tourism for HSCT patients to be sent outside of their home countries to receive a HSCT, diminishing the impact of third party brokers and misinformation. Our data have uncovered themes in the existing structure of third-party agents searching for a profit, difficulty connecting with home physicians to coordinate care, and limited information for patients on the procedure.
Conclusion: The data collected in this project provide an example of existing structures in medical tourism for HSCT in some LMICs. Gaps in center-to-center patient information, role of middle-men directly contacting patient families, or lack of advanced medical care in LMIC, are some of the relevant findings that based on this initial study could be exploited in a large multicenter international registry study.
Citation Format: Deepika Khanna, Damiano Rondelli. Hematopoietic Stem Cell Transplants and Treatment of Severe Blood Disorders: Role of Providers in Medical Tourism [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 42.
Abstract 48: Identifying Temporal Patterns in Healthcare Service-Use Trajectories of Long-Term Breast Cancer Survivors
Authors: Giannoula Alexia , Comas Mercè , Gonzalez José Martín Solorzano , Sanz Ferrán , Castells Xavier , Sala Maria 
Published: June 2023

Abstract
Purpose: Advances in the population screening programs and treatment efficacy, as well as, the rapidly aging global population, have led to a gradual increase of the number of long-term breast cancer survivors (BCS) in the past years. With the estimation for their survival rate to continue rising, it has become evident by the clinical and scientific community that BCS should be efficiently monitored in order to obtain a better understanding of their needs and subsequently, improve their medical care, further increase their survivorship and optimize the associated healthcare costs.
Methods: A novel data-mining methodology is proposed for the temporal analysis of healthcare service-use trajectories of long-term BCS. Specifically, an unsupervised clustering technique, based on Dynamic Time Warping, is applied on the extracted trajectories of a large longitudinal cohort (SURBCAN) of BCS and non-breast cancer (BC) women, with data on their contacts to all healthcare services. Introducing the time dimension permits the identification of complex time-dependent patterns (clusters) of the services that these women have used throughout the course of a five-year monitoring period. A comparison of the identified time patterns and the respective patient characteristics is also performed between the BCS (case) and non-BC (control) group.
Results: More than two hundred clusters representing temporal patterns of healthcare service use, were extracted for both the case and control group. It was found that the BCS group made a more complex and intense use of certain healthcare services, such as, radiology, outpatient care and hospital admission, than the control group. Furthermore, the corresponding mortality rates were significantly higher and a larger number of comorbidities (varying between different clusters) were registered at the beginning of the monitoring period in BCS. Additional patient characteristics and time information for certain paths of the extracted service-use network were reported and analyzed.
Conclusion: A flexible data-mining methodology was applied on a longitudinal cohort of long-term BCS for the identification of temporal patterns of healthcare service use, in an attempt to gain more insight into their needs, better predict their evolution, and subsequently, improve their received attention and eventually optimize the associated healthcare costs.
Citation Format: Alexia Giannoula, Mercè Comas, José Martín Solorzano Gonzalez, Ferrán Sanz, Xavier Castells, Maria Sala. Identifying Temporal Patterns in Healthcare Service-Use Trajectories of Long-Term 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 48.
Abstract 49: Impact of Multimorbidity on Adherence to Follow-Up Recommendations for Long-Term Breast Cancer Survivors
Authors: Domingo Laia , Abbad David , Comas Mercè , Santiá Paula , Jansana Anna , Castells Xavier , Sala Maria 
Published: June 2023

Abstract
Purpose: To study the impact of comorbidities, multimorbidity, second primary cancers and socioeconomic determinants on adherence to follow-up recommendations for long-term breast cancer survivors (LTBCS), defined as women who survive 5 years or more after a primary breast cancer.
Methods: We identified women diagnosed with breast cancer between 2000-2006 and followed-up between 2012-2016, including those with at least one contact with health services (n=2,078). Follow-up recommendations for LTBCS in Spain include 1 annual visit plus 1 image test. A woman was considered adherent with &gt;50% of years with annual image test and visit throughout follow-up period. Multivariate logistic regression models were adjusted to determine the relationship between adherence and comorbidities and multimorbidity (2 or more chronic diseases) and other clinical and sociodemographic variables. A hierarchical cluster analysis was used to define specific multimorbidity clusters. A sensitivity analysis was conducted with mammogram as specific image test. Statistical significance was considered at 5% level.
Results: Adherence to recommendations was 79.5% and 63.3% when considering mammograms only. We observed a higher adherence among LTBCS with multimorbidity, in those &lt;70 years old, and with 5 to 9 years of survivorship. In the multivariate models, age under 40 years (OR=4.2; 95%CI: 2.3-7.6), a survivorship time between 5-9 years (OR=1.4; 95%CI: 1.1-1.8) and the metabolic and degenerative (OR=2.2 CI95%: 1.4-3.5) and thyroid disorders clusters (OR=2 IC95% 1.1-3.6) were associated with adherence. Similar results were observed in adjusted analyses by mammogram. In both analyses all multimorbidity clusters presented more adherence than LTBCS without chronic comorbidities. LTBCS with higher deprivation were found more adherent than LTBCS less deprived. Our results suggest a higher adherence among women experiencing second primary cancers, but the results were not statistically significant (OR=1.22; 95%CI: 0.8-2.0).
Conclusion: There are differences in adherence according to age, survivorship time, and presence of multimorbidity. These results suggest a moderate adherence to the current follow-up recommendations for certain groups, making it necessary to adapt clinical practice guidelines considering the comorbidities and characteristics of the patients.
Citation Format: Laia Domingo, David Abbad, Mercè Comas, Paula Santiá, Anna Jansana, Xavier Castells, Maria Sala. Impact of Multimorbidity on Adherence to Follow-Up Recommendations for Long-Term 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 49.
Abstract 52: Implementation of a Hospital-Based Peer Support Intervention Model for Cancer Patients: Results From a Pilot Study in Vietnam
Authors: Le PhuongThao , Taylor Carolyn , Monahan Rachel , Do Mai , Nguyen Linh , Phan Minh Tri , Wang Cong , Tran Huong , Ginsburg Ophira 
Published: June 2023

Abstract
Purpose: Provision of mental health psychosocial support can reduce psychological distress experienced by cancer patients, which can in turn improve their treatment adherence and outcomes. In this study, we present the results from the pilot trial of Stronger Together, a culturally adapted peer-to-peer support program, conducted in Vietnam.
Methods: We recruited eligible women from four hospitals in Vietnam (K3 National Cancer Hospital, Hue Central Hospital Oncology Center, Can Tho Oncology Hospital, and Hung Vong Women’s Hospital Oncology Unit). Participants were newly diagnosed with breast or gynecologic cancers, and self-selected into either the control (usual care) or intervention arm (mentees who were matched up with trained peer mentors).
Validated questionnaires were administered at baseline (0), 2-, 4-, and 6-months. We conducted a difference-in-difference (DID) analysis for the primary outcomes (assessed by the Depression, Anxiety, and Stress Scale [DASS-21]), comparing the difference in scores from baseline to 6 months and between intervention arms (mentees vs. usual care).
Results: The analytic sample included n=186 participants (mentees: 91; usual care: 95), with the majority having breast cancer (85.5%), followed by cervical cancer (7.5%) and ovarian cancer (7.0%). There were no statistically significant differences between study arms in demographic and cancer characteristics (cancer type and stage). DID analyses showed that compared to usual care participants, mentees (those who received peer support) showed greater reductions in depression, anxiety, and stress scores between baseline and 6 months. Adjusting for age, education, marital status, and cancer stage, statistically significant reductions in stress scores (β=-1.47; 95%CI: [-2.9,-0.02]; p=0.047) were observed. Among breast cancer patients only, adjusted models showed significant reductions in depression scores (β=-1.80; 95%CI: [-3.0,-0.48]; p=0.007) and stress scores (β=-1.9; 95%CI: [-3.3,-0.37; p=0.015).
Conclusion: The Stronger Together pilot study study shows that utilizing peer cancer survivors is a promising strategy to address the psychosocial needs of newly diagnosed cancer patients in low-resource settings. Future research should test this intervention model in larger samples or other similar populations and settings.
Citation Format: PhuongThao Le, Carolyn Taylor, Rachel Monahan, Mai Do, Linh Nguyen, Minh Tri Phan, Cong Wang, Huong Tran, Ophira Ginsburg. Implementation of a Hospital-Based Peer Support Intervention Model for Cancer Patients: Results From a Pilot Study in Vietnam [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 52.
Abstract 57: Knowledge and Recommendation of HPV Vaccination Among Providers Involved in Cervical Cancer Prevention Activities in Africa
Authors: Domgue Joel Fokom , Pande Mala , Manjuh Florence , Yu Robert , Kamgno Joseph , Shete Sanjay 
Published: June 2023

Abstract
Purpose: Although cervical cancer burden in Africa is among the highest worldwide, HPV vaccination coverage remains low in this region. While provider recommendation is recognized as a key driver of HPV vaccination uptake globally, little is known about the knowledge and practices of African clinicians with regard to HPV vaccine.
Methods: A cross-sectional study was conducted in 2021-2022 among providers involved in cervical cancer prevention activities in Africa. Through an online survey administered by email, providers were invited to report the availability of HPV vaccine in their practice, whether they recommend HPV vaccine, and for those who did not recommend it, the reasons for not recommending it. Participants’ knowledge about HPV vaccine was assessed through three questions.
Results: Of the 104 providers from 18 African countries who responded to the survey, less than half (43.3%) reported having received prior training on how to educate their patients and the community about HPV vaccination, 38.8% indicated that HPV vaccine was available at the facility where they work. Most respondents (83.7%) reported that they recommend HPV vaccination, and this recommendation was frequently made to girls only (82.4%). Among those who did not recommend the HPV vaccine, unavailability of the vaccine (47.1%), lack of effective communication tools and information to give to patients (35.3%), and lack of adequate training (29.4%) were the most commonly reported reasons. Only 16.0% of respondents provided adequate responses to all the knowledge questions.
Conclusion: Despite a higher rate of HPV vaccine recommendation among providers in Africa, providers’ knowledge about HPV vaccine is limited and availability of the vaccine is reportedly low in the region. To increase HPV vaccine uptake in Africa, further training to improve providers’ knowledge and adapted educational material to facilitate communication with their patients and the community is needed. Ongoing efforts to make the HPV vaccine widely available in the region should be reinforced.
Citation Format: Joel Fokom Domgue, Mala Pande, Florence Manjuh, Robert Yu, Joseph Kamgno, Sanjay Shete. Knowledge and Recommendation of HPV Vaccination Among Providers Involved in Cervical Cancer Prevention Activities in Africa [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 57.
Abstract 6: Applying Next-Generation Sequencing to Improve Pediatric Cancer Diagnosis in Mexico
Authors: Ruiz-Cordero Roberto , Alcantara Ela , Quintanar-Alfaro Ana , Espinoza-Mendez Carlos A , Van Loon Katherine , Breithaupt Lindsay , Zajgla Jorge Melendez , Sweet-Cordero Alejandro 
Published: June 2023

Abstract
Purpose: In Mexico, cancer is the second leading cause of mortality among children between 4 to 15 years old. The overall cure rates remain below 50%, compared to &gt;90% in the United States. This discrepancy is in part explained by the limited access to methods for accurate diagnosis and identification of appropriate therapies in Mexico. Only 48% of large hospitals across Mexico report having the capacity to perform some of the complex testing necessary for subclassification of pediatric cancers. Pan-cancer next generation sequencing (NGS) panels are not available in Mexico. We developed a strategy to perform clinical NGS in pediatric cancer patients in Mexico for identification of single nucleotide variants, copy number changes, and fusion events that are useful for risk stratification and adjusted therapy.
Methods: We established collaborative agreements between UCSF and the National Institute for Genomic Medicine (INMEGEN) in Mexico City. We developed a pediatric cancer focused panel (IMOP) encompassing 200 genes and created a cloud-based bioinformatic and analysis pipeline for remote data interpretation. We established concordance by comparing the sequencing results of clinical cases obtained with the validated UCSF500 panel and the IMOP panel.
Results: The results of 8 clinical samples previously sequenced using the clinically validated UCSF500 panel were compared to results obtained using the IMOP panel. Clinically relevant SNVs and fusions were successfully detected by the IMOP panel at similar variant allelic frequencies. The IMOP panel was shipped to INMEGEN where two samples with prior sequencing results were successfully sequenced. Re-sequencing of the 8 clinical samples to establish concordance at INMEGEN is pending.
Conclusion: Our ongoing pilot proof-of-concept study shows feasibility of a strategy to implement clinical NGS testing in a middle-income country. We hypothesize that implementation of centralized NGS for pediatric cancers at INMEGEN will improve diagnostic accuracy. Moving forward, we plan to complete the clinical validation of the IMOP panel for routine sequencing of pediatric cancer patients. We will use the RE-AIM implementation science framework to assess the effectiveness of the assay in refining clinical diagnosis and treatment planning for pediatric cancer cases in Mexico.
Citation Format: Roberto Ruiz-Cordero, Ela Alcantara, Ana Quintanar-Alfaro, Carlos A Espinoza-Mendez, Katherine Van Loon, Lindsay Breithaupt, Jorge Melendez Zajgla, Alejandro Sweet-Cordero. Applying Next-Generation Sequencing to Improve Pediatric Cancer Diagnosis in Mexico [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 6.