bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scenery of multilocus inherited neoplasia alleles syndrome (MINAS) in a single Brazilian institution.
Authors: Murad Andre Marcio , Casali-da-Rocha José Claudio , Carneiro Juliana Garcia 
Published: June 2022

10598 Background: Genetic testing of hereditary cancer using comprehensive gene panels can identify patients with more than one pathogenic mutation in high and/or moderate-risk-associated cancer genes. This phenomenon is known as multilocus inherited neoplasia alleles syndrome (MINAS), which has been potentially linked to more severe clinical manifestations.To determine the prevalence and clinical features of MINAS in a large cohort of adult patients with hereditary cancer homogeneously tested with the same gene panel. Methods: A cohort of 1,234 unrelated patients with suspicion of hereditary cancer was screened using a validated NGS panel including 20 genes associated with hereditary cancer. Results: One hundred and forty two (8.7%) patients harbouring probably pathogenic or pathogenic mutatations and 9 harbouring two pathogenic mutations in dominant cancer-predisposing genes were identified, representing 6.3% (9/142) of patients with pathogenic mutations. All (9/9) of these cases presented clinical manifestations associated with only one of the mutations identified. One case showed mutations in MEN1 and MLH1 and developed tumours associated with both cancer syndromes. Interestingly, three of the double mutants had a young age of onset or severe breast cancer phenotype and carried mutations in moderate to low-risk DNA damage repair-associated genes; two of them presented biallelic inactivation of CHEK2. We included these two patients for the sake of their clinical interest although we are aware that they do not exactly fulfil the definition of MINAS since both mutations are in the same gene. Conclusions: Genetic analysis of a broad cancer gene panel identified the largest series of patients with MINAS described in a single study. Overall, our data do not support the existence of more severe manifestations in double mutants at the time of diagnosis although they do confirm previous evidence of severe phenotype in biallelic CHEK2 and other DNA repair cancer-predisposing genes.
Hereditary cancer screening at an urban safety net hospital.
Authors: Brehany Sydney , Colton Meryl D. , Duarte Cassandra , Baliton Michael , Okuyama Sasaki Sonia 
Published: June 2022

10604 Background: Individuals with hereditary cancer syndromes (HCS) have a high lifetime risk of developing cancer. However, the rate at which at-risk individuals undergo genetic evaluation is low, particularly for individuals that belong to populations that are historically underserved. We sought to characterize the demographic factors that may be associated with receipt of recommended HCS evaluation and follow-up. Methods: All patients with pathologically confirmed breast, ovarian, or fallopian tube cancers and qualifying for hereditary breast and ovarian cancer (HBOC) testing based on NCCN guidelines from 2016 to 2021 at an urban safety-net hospital were included in this analysis. Institutional review board approval was obtained. Demographic and oncologic data, as well as HBOC genetic testing outcomes were collected through retrospective chart review using a standardized data collection tool. Univariate logistic regression models were constructed to test the association of variables with receiving hereditary cancer genetic testing. Results: A total of 312 patients were included in the analysis, 90% of which had breast cancer. Forty percent were non-English speaking, 31% were non-White, and 25% were uninsured. Overall, 70% of patients were referred for genetic counseling and 65% underwent testing. Our analysis showed higher association of genetic testing uptake with Spanish language [odds ratio (95% confidence interval)] [1.74 (1.04, 2.93)], stage II disease [2.15 (1.11, 4.16)], and having a referral to genetic counseling [9.21 (5.32, 15.96)]. A lower rate of genetic testing was associated with patients identifying as Black [0.36 (1.87, 0.70)], having Medicare insurance [0.29 (0.14, 0.61)], a higher Charlson Comorbidity Index [0.31 (0.13, 0.73)], and older age [0.94 (0.92, 0.96)]. Uninsured patients had a similar association with genetic testing uptake as patients with Medicaid. Variables seeming to have no association with genetic testing uptake include family history of cancer, type of cancer, performance status, substance use, and Latinx ethnicity. A pathologic variant was found in 13% of our population. A variant of unknown significance (VUS) was found in 33% of Hispanic or Latinx patients and in 46% of non-Hispanic or Latinx patients who received testing, for a combined VUS prevalence of 39%. Conclusions: Our analysis shows that genetic testing rates for patients meeting HBOC syndrome criteria at an urban, safety-net institution were higher than expected, particularly for Spanish speaking patients and those with Medicaid or no insurance. We hypothesize this may be due to the emphasis our institution places on the care of uninsured patients through programs to make services accessible, as well as strong engagement with the Spanish speaking community. These results can help guide future interventions to target patient groups with lower rates of genetic testing, as well as maintain the successes seen among our diverse population.
Challenges faced by female oncologists in sub-Saharan Africa.
Authors: Mutebi Miriam Claire , Aryeetey Naa Adorkor , Carson Laura M. , Mwanzi Sitna Ali , Lombe Dorothy Chilambe , Woldetsadik Edom Seife , Msadabwe Susan Citonje , Lasebikan Nwamaka , Mohamed Zainab , Ramogola-Masire Doreen , Alemu Haimanot Kasahun , Jalink Matthew , Jagsi Reshma , Vanderpuye Verna D. , Hammad Nazik 
Published: June 2022

11001 Background: Recent articles by ASCO and ESMO have identified challenges facing female oncologists in western contexts. The challenges female oncologists face in sub-Saharan Africa (SSA) have yet to be explored. This study was launched by the AORTIC Education and Training Committee to determine the most common and substantial challenges faced by female oncologists in SSA and identify potential solutions. Methods: A diverse panel of 32 female oncologists from 20 countries in SSA was recruited through professional and personal networks. Following an initial meeting to review terminology, a modified three-round Delphi process took place. Participants iteratively reviewed a list of previously identified challenges facing women in oncology in SSA and identified new challenges. The survey was conducted via REDCap, a secure-web-based software platform. Participants reflected on personal experiences or those of colleagues, and were asked to indicate their agreement with each listed challenge, as well as propose solutions. Descriptive statistics identified the most common challenges. Following the third survey, a focus group was held to enrich study data. A thematic analysis is being conducted on the focus group transcript to identify key themes, and a subsequent modified Delphi process is being executed to build consensus around potential solutions to identified challenges. Results: Response rates for the 3 modified Delphi rounds were 66%, 66%, and 53%. The challenge with the greatest agreement was, “pressure to maintain a work-family life balance and meet social obligations”. These were felt to be unique to women in SSA due to an extended family network with several responsibilities beyond the nuclear family. The next two top-scored challenges were “lack of female support and networks”, and “micro-aggressions” (Table). Conclusions: Female oncologists in SSA experience many of the challenges that have been previously identified by similar studies in other regions, with different degrees of perceived importance. Some challenges have a different lived experience for female oncologists in SSA. The second part of this study will include thematic analysis of the recent focus group and explore potential solutions to mitigate these challenges, which will add insight and potential paths forward to optimizing a diverse workforce in SSA.[Table: see text]
Seeking racial equity in hematology and oncology: A fellow-led educational series to promote reflection and action.
Authors: Stein Jacob Newton , Gaddy Jacquelyne Janean , Sorah Jonathan D , Wooten Melissa , Gibson Keisha , Collichio Frances A. 
Published: June 2022

11004 Background: With the murder of George Floyd and health disparities laid bare by the COVID pandemic, the US is reckoning with racial injustice. Across medicine and oncology, institutions are grappling with how to address systemic racism and improve care for patients of color. At the University of North Carolina (UNC), trainees developed an educational curriculum to raise awareness of implicit bias and introduce methods to address racial inequities. We present our findings on feasibility and acceptability of a fellow-led course on racism in medicine at a major academic medical center. Methods: UNC oncology fellows adapted a curriculum on implicit bias and racism in medicine in spring 2021. Our aims were 1) to improve knowledge and awareness about implicit bias and systemic racism and 2) introduce methods to address racial inequities. We used lived experiences and collated materials from scientific literature and lay media to illustrate key points. Sessions were: 1) Introduction and Implicit Bias, 2) Implicit Bias in Action: A Case Study, 3) Race-Based Metrics: Journal Club, 4) Career Perspective on Equity in Oncology. Videos, journal articles, and group discussion were employed to appeal to many learning styles. Results: Four sessions were held virtually for the Divisions of Oncology and Hematology. Attendance ranged from 28 to 35 per session. A post curriculum survey assessed perception of racial inequality in medicine and the series’ effects using a Likert scale. Twenty-nine participants completed the survey, 12 of whom were fellows. Of all participants, 71% reported that the course improved knowledge or awareness of racial inequities "some" or "a great deal" and 61% reported that it improved their comfort level addressing racial inequities "some" or "a great deal." All participants endorsed at least “some” racial inequity in medicine. Notably, over 75% of participants indicated interest in further sessions. Conclusions: Formulation of an educational curriculum by fellows and delivered in a division wide setting was feasible and well received by participants with robust discussion and interest in further work. Fundamental to this series’ effectiveness was creating a space for discussion and reflection among colleagues. The goals of improving knowledge and introducing methods to address racial inequities were met. Importantly, our course was integrated alongside institutional efforts on DEI. We were limited by a lack of pre-course survey results due to a technical error. Given the current groundswell of interest and focus in improving racial equity in our society, we encourage other institutions to take similar steps to highlight issues of systemic racism and continue to move our field in the right direction.
Global oncology and cancer disparities education.
Authors: Forbes Victoria , Buteau Anne Christine , Hoxha Ilir , Ademi Islami Dafina , Palmer John P. , Chamberlin Mary D. 
Published: June 2022

11006 Background: Comprehensive patient care requires an understanding of medical guidelines and the intersectional context of the patient’s identity and experiences. Hematology/Oncology programs must explicitly teach topics addressing various disparities of care to prepare trainees for informed care. We have developed a Global Oncology and Disparities of Cancer Program to address this gap. Methods: The telementoring program was piloted in 2019 at Dartmouth and has evolved to include didactics, discussion, and evaluations. Participants from across the globe include medical students, residents, Hematology/Oncology Fellows, Faculty, Global Health Scholars, and cancer clinicians. US Hematology/Oncology trainees from Dartmouth and the University of Connecticut consistently participate in the international program. Monthly sessions from September 2021-June 2022 include: Esophageal and GI Cancers in Rwanda, HCC and Cholangiocarcinomas, Gastric Cancer, ASCO International, Global Med ED in Haiti, Breast Cancer in Kosovo, Breast Cancer Risk Factor Prediction Tools Research, Shared Decision Making in Breast Cancer, Hemoglobinopathies, and Health Disparities and Capacity-Building in Rwanda. A pre-course survey was sent to identify participant’s demographics, barriers, and expectations. We will administer a post-course survey. Results: We have preliminary data for our ongoing project. However, we anticipate complete data collection and analysis before the ASCO Meeting. 24 participants were enrolled. 12 (52%) of the participants were located outside of the US in locations such as Haiti, Kosovo, and France. Using a 5-point Likert scale, 11 (46%) participants were “not at all” or only “slightly” aware of obstacles faced by Oncology patients and caregivers in seeking access to healthcare in the US. 7 (29%) participants answered similarly regarding those in low- and middle-income countries. Meanwhile, participants rated ‘’gaining different perspectives’’ as their most important reason for attending with 19 (79%) rating this as “very important” or above. For anticipated improvement from the course, understanding risk factors and cancer biology internationally and recognizing disparities in healthcare between domestic and international settings were the highest rated with 18 (75%) expecting an improvement to a “large degree” or higher. Conclusions: We developed a virtual educational experience to enhance participants’ ability to address disparities of care through challenging Global Oncology topics. Our course is ongoing however initial surveys show a need and desire for this content from participants. We intend to analyze the course surveys to shape future courses. This program can serve as a model for Hematology-Oncology programs to address unmet needs in the curriculum and prepare trainees to provide more complete care to improve cancer outcomes.
Mapping global oncology priorities: A survey of the directors of the NCI-designated cancer centers.
Authors: Prakash Laura , Estes Taylor , Garton Elise M. , Eldridge Linsey , Cira Mishka K. , Duncan Kalina , Gopal Satish , He Min , Ciolino Henry , Loehrer Patrick J. 
Published: June 2022

11008 Background: By 2040, an estimated 69% of all cancer deaths globally will occur in LMICs. Recognizing this, ASCO formed the Academic Global Oncology Task Force in 2017 to help formalize the global oncology (GO) field. Their recommendations included: better engagement with the National Cancer Institute (NCI) Center for Global Health (CGH), increased funding, and development of forums to highlight global cancer research and control activities. To further clarify how GO programs are defined and to better understand the perspectives and needs of cancer research leaders, CGH conducted a survey of the 71 Directors at the NCI-Designated Cancer Centers (NDCC). Methods: A 19-question survey was designed using Microsoft Forms and sent to the NDCC Directors via email. Responses were collected from July to September 2021. Two coders reviewed the qualitative responses to categorize the data into thematic areas. Analyses were conducted in Microsoft Excel. Results: Seventy of 71 (99%) NDCC Directors responded to the survey. 41 NDCCs (59%) reported dedicated GO programs or plans to create such a program within 5 years. Additionally, 16 Directors reported GO activities without a dedicated program, while 13 reported no GO activities. The Directors described GO as having high/extremely high (39%) or moderate (50%) importance relative to other priorities, across all types of NDCCs (basic, clinical, or comprehensive). Eight NDCCs (11%) described GO as a low priority or non-priority. 31 NDCCs (44%) reported dedicated funding for GO activities. Directors estimated interest in GO to be higher among junior faculty and trainees than senior and mid-career faculty. Future goals for established or developing GO programs included: recruitment of leadership, formalizing a strategic vision, establishing partnerships, and increasing the number of activities with international collaborations. Barriers noted were limited funding, limited capacity and expertise, and prioritizing the needs in domestic NDCC catchment areas. Conclusions: Despite variation across NDCCs, GO interest is strong as expressed by Center Directors. Strategic planning, increased funding, and improved collaboration within and between NDCCs were reported as necessary to strengthen GO at NDCCs. Continued leadership from ASCO, the NCI, and other international organizations can help facilitate dialogue and increase the prioritization of GO activities at NDCCs.
Online scaffolds: A constructivist approach to oncology fellow learning.
Authors: Brondfield Sam , Schwede Matthew , Johnson Tyler Paul , Arora Shagun 
Published: June 2022

11010 Background: Oncology is a vast and fast-paced field. Fellows must expend significant effort to learn and stay updated. Up-to-date learning tools covering core oncology content in a digestible manner are lacking. Additionally, passive lectures are common in oncology, while constructivist approaches that may improve learning are rare. Therefore, we piloted updatable online modules (“scaffolds”) as a learning tool for oncology fellows. Methods: Author SB, a University of California, San Francisco (UCSF) solid-tumor oncologist, designed 12 scaffolds (breast, non-small cell lung, small cell lung, head/neck, salivary/thyroid, upper gastrointestinal, lower gastrointestinal, germ cell, bladder/renal/adrenal, prostate, melanoma, and sarcoma) using Google Slides between 12/2018 and 6/2019. The scaffolds included bullet points and tables/figures synthesized from the ASCO self-evaluation program textbook’s solid tumor chapters and the National Comprehensive Cancer Network (NCCN) guidelines. We emailed scaffold links to all UCSF and Stanford oncology fellows in 2019-2020, including instructions for fellows to update the scaffolds without exceeding 20 slides per scaffold, 5 lines per slide, or 7 words per line. The scaffolds were reintroduced to new fellows at the beginning of each academic year. SB audited to ensure no erroneous information was added. In December 2021 we reviewed updates tracked in Google Slides and conducted one UCSF and one Stanford focus group with four 1st-3rd year fellows each. Results: Between 7/2019 and 12/2021, fellows made 60 updates to the scaffolds, with a mean of 5 updates per scaffold ranging from new trials to changes in management. During the same period, the auditor made 9 updates and found no erroneous fellow updates. Fellow updates occasionally exceeded specified limits, requiring correction. Content analysis revealed that fellows considered the scaffolds to be accessible and succinct learning tools that 1) addressed a dearth of similar resources, 2) served as effective preparation for clinical work and examinations, 3) provided structured information for rapid review, and 4) made subsequent interactions with complex resources such as NCCN guidelines easier. Barriers to fellows updating the scaffolds included lack of ownership and low confidence in judgment regarding appropriate updates. Conclusions: In this two-institution pilot, oncology fellows used and subsequently updated online scaffolds in a constructivist fashion. This model has the potential to fill a crucial gap in available learning resources and can be applied to other specialties. Assigning scaffolds to fellows with faculty mentorship may facilitate ownership and bolster fellow confidence in updating these tools. Individual institutions may update their own versions of the scaffolds to align with institution-specific needs.
Impact of social media on the emotional health and burnout of pediatric and adult oncology professionals: A SWOG and COG survey.
Authors: Moerdler Scott , Barry Maura Meredith , Henry Elizabeth , Lucas Tiffany Lin , Marshall Ariela Lucy , Dizon Don S. ,   Collaboration for Outcomes using Social Media in Oncology (COSMO)
Published: June 2022

11013 Background: Social media (SoMe) engagement is common in oncology, especially for patients and support groups, allowing for education and support. However the impact on oncology professionals remains unknown. The purpose of this study was to evaluate professional SoMe use and its potential associations with wellbeing and burnout. Methods: An electronic survey was developed and piloted by pediatric and adult oncologists. Questions included demographics, details of SoMe use, and emotional health assessments including a 2-item burnout questionnaire. The survey was distributed to all members of SWOG Cancer Research Network and Children’s Oncology Group via Qualtrics. Data was analyzed as of 2/6/2022. Results: The initial survey demographic and emotional health questions were completed by 1558 individuals. Of these, 1069 (68%) reported not using SoMe professionally, while 489 (31%) did. SoMe engagers were primarily female, born 1976–1984, attendings, from academic institutions, and balanced across adult and pediatrics (Table). Among those who use SoMe professionally, 54% (267/489) reported burnout, compared to 66% (701/1069) in the non-SoMe group (p = 0.0001). Remaining emotional health outcomes were similar between groups: choosing this job/career again, time for personal/family life, and career satisfaction (p > 0.1 for all). An additional section on the impact of SoMe on emotional health was completed by 473 SoMe engagers. While 49% (233/473) reported that SoMe has no impact on burnout, 18% (86/473) felt that SoMe helps alleviate burnout. SoMe use was reported to have somewhat/extremely positive impact on wellness (defined as physical, mental, emotional, spiritual wellness) by 28% (131/473). Networking and recognized shared experiences were the top areas of SoMe that improved wellness. Close to half (208/473, 44%) responded that SoMe does not negatively impact wellness. Professional anxiety, amount of time spent online, and keeping up to maintain an online presence were the most frequently noted aspects that negatively impact wellness. Nearly half (232/473, 49%) somewhat/strongly agree that SoMe provides a sense of community. One limitation includes distribution to engaged cooperative group members which may impact results. Conclusions: This analysis suggests that social media engagement might help provide a positive impact on the wellness and reduce burnout among oncology professionals. We hope to further explore themes with qualitative interviews to better understand the impact of SoMe on our emotional health. Our goal is to develop educational interventions based on these salient positive and negative factors. [Table: see text]