bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human papillomavirus (HPV) vaccine hesitancy trends in the United States.
Authors: Adjei Boakye Eric , Abouelella Dina K , Nair Mrudula , Osazuwa-Peters Nosayaba 
Published: June 2022

10550 Background: Despite the human papillomavirus (HPV) vaccine being safe and effective at preventing HPV-associated cancers, vaccine update is low. Several factors have been identified as barriers to getting the HPV vaccine. However, it is unclear if these factors have changed since vaccine licensure. Thus, we assessed trends in the top five reasons for vaccine hesitancy in the last decade in the US. Methods: We analyzed the 2010–2019 National Immunization Survey–Teen data, a national survey representative of the US adolescent population. We identified adolescents (n = 16,383) who had received zero dose of the HPV vaccine (unvaccinated adolescents). Parents of unvaccinated adolescents were asked how likely they will vaccinate their child in the next 12 months. Parents who responded with “not too likely”, “not likely at all” or “not sure/don’t know” (vaccine hesitant) were asked what the reasons are for their hesitancy. The top five most cited reasons for vaccine hesitancy: “not necessary”, “safety concerns”, “lack of recommendation”, “lack of knowledge”, and “not sexually active” were included in the study. Joinpoint regression estimated yearly increases/decreases in these reasons using annual percent changes. Results: The proportion of unvaccinated adolescents whose parents cited “safety concerns”’ as a reason for HPV vaccine hesitancy decreased from 2010 to 2012 but increased significantly from 2012 to 2019 at an average of 8.6% annually. The proportion of unvaccinated adolescents whose parents cited “not sexually active” as a reason for HPV vaccine hesitancy decreased on average by 33.1% from 2010-2012 and then at an average of 11.5% in the remaining years. The proportion of unvaccinated adolescents whose parents cited “not necessary” as a reason for HPV vaccine hesitancy decreased from 2010-2012 but significantly decreased by an average of 11.0% yearly from 2012-2019. The proportion of unvaccinated adolescents whose parents cited “lack of recommendation” and “lack of knowledge” as reasons for HPV vaccine hesitancy decreased over the 10-year period though not statistically significant. Conclusions: There was a decrease in most of the reasons cited by parents for vaccine hesitancy except vaccine safety which has been increasing from 2012 to 2019. These findings suggest an urgent need to combat the rising sentiment of safety concerns among parents of unvaccinated children to increase HPV vaccine confidence.
CDK4/6 inhibitors outcomes in patients with advanced breast cancer based on HER2-low expression.
Authors: Lapuchesky Laura Sabina , Bortz Marcos , Waisberg Federico , Enrico Diego Hernán , Bruno Luisina Ines , Ostinelli Cristian Alexis , Rivero Sergio Gabriel , Rodriguez Andres , Zarba Martin , Loza Martin , Fabiano Verónica Yamila , Amat Mora , Pombo Maria Teresa , Noro Maria Laura , Coló Federico Andrés , Chacon Reinaldo D. , Chacon Matias Rodrigo , Nadal Jorge Carlos , Nervo Adrian , Costanzo Maria Victoria 
Published: June 2022

1056 Background: HER2-low expression, defined as HER2 immunohistochemistry (IHC) score of 1+ or 2+ with negative in situ hybridization assay (FISH), accounts for 50% of breast cancers. There is limited and conflicting evidence regarding the efficacy of cyclin-dependent kinase (CDK) 4 and 6 inhibitors in patients with ER+ and HER2-low tumors. This study aimed to investigate the prognostic value of HER2-low expression in patients with ER+/HER2-negative advanced breast cancer treated with CDK 4/6 inhibitors. Methods: We retrospectively selected consecutive patients with ER+/HER2-negative advanced breast cancer treated with CDK 4/6 inhibitors plus endocrine therapy in our institution from May 2015 to Feb 2020. Two cohorts were compared, including HER2-0 (IHC score) and HER2-low (HER2 IHC score 1+ and 2+ [negative FISH]) tumors. Comparisons in progression-free survival (PFS) and overall survival (OS) were performed using a log-rank test. The prognostic value of HER2-low was investigated by the Cox regression model. Results: Among the 186 patients included, median age at treatment was 55 (r 27-84), and majority had ECOG 0 (126, 67.8%). Progesterone receptor was positive in 155 (83.3%) tumors. Of note, most patients received CDK4/6 inhibitors and endocrine therapy as first-line setting (131, 70.4%). Mostly received palbociclib (161, 86.6%), while ribociclib and abemaciclib were used in 23 (12.4%) and 2 (1.08%) patients, respectively. Overall, 27 patients (14.5%) had de novo metastatic disease, 68 (36.6%) had only bone metastases, and 69 (37.1%) had visceral disease. Of the total population, 64 (34.4%) tumors were HER2-low (43 [23.1%] HER2-1+, and 21 [11.3%] HER2-2+), and 122 (65.6%) were HER2-0. Median PFS among patients with HER2-0 and HER-low were 19 mo. (95% CI, 13.9-24.1), and 15.6 mo. (95% CI, 11.1-20.0), p = 0.074, respectively. In patients treated with CDK 4/6 in the first-line setting, no statistically significant differences were observed in terms of PFS and OS between HER2-0 and HER2-low (PFS HR 0.73 [95% CI, 0.47-1.13; p = 0.160], and OS HR 1.04 [95% CI, 0.51-2.14; p = 0.909]). Conclusions: In our study, HER2-low expression did not show a statistically significant impact on patients with ER+/HER2-negative advanced breast cancer treated with CDK 4/6 inhibitors. Our study supports the necessity of real-world evidence and the design of pooled analysis to understand the real implication of this biomarker in patients with ER+/HER2-negative tumors.
Patient-reported disruptions to cancer care in the U.S. during the COVID-19 pandemic: A national cross-sectional study.
Authors: Iyer Sharanya , Lang Jacob , Narendrula Aparna , Zanotti Kristine M. , Sindhwani Puneet , Mossialos Elias , Ekwenna Obi 
Published: June 2022

10561 Background: Disruptions to cancer care during the COVID-19 pandemic due to disease mitigation efforts, supply-chain issues, and fear of COVID-19 have all been reported, but study of their extent has been limited. The purpose of this study is to evaluate the extent and associations with patient reported disruptions to cancer treatment and other care during the COVID-19 pandemic using nationally representative data. Methods: This cross-sectional study uses data from the 2020 National Health Interview Survey (NHIS), an annual, cross-sectional survey of US adults. Adults who reported requiring current cancer treatment or other care related to their cancer in the second half of 2020 were included. Rates of patients with self-reported changes, delays, or cancellations to cancer treatment or other cancer-related care due to the COVID-19 pandemic were calculated and their associations with demographic and other variables were analyzed. All data were adjusted using sample weights and specific variables to account for stratification and other survey characteristics using the Stata svy command. Chi-square testing was used to compare proportions across variable groups. Univariable logistic regression analysis was utilized to assess variable associations with change, delay, or cancellations to cancer care during the COVID-19 pandemic. Multivariable logistic regression analysis was used to create a model adjusted for select demographic variables. Results: A sample-weighted 2,867,326 adults (n=574) reported requiring cancer treatment and/or other cancer care since the start of the COVID-19 pandemic. Of these, 189 (32.1%) reported any change, delay, or cancellation due to the pandemic. On univariable analysis, patients who were younger, female, had comorbidities, and uninsured were significantly more likely to report care disruptions. On adjusted analysis, younger age and female sex remained significant predictors. In a sample-weighted subset of 1,600,587 patients (n=331), 291 (87.9%) reported virtual appointment use. There was no association with disruptions across breast, prostate, lung, and colorectal cancer groups. Conclusions: Approximately 1/3 of patients experienced disruptions to cancer care during the COVID-19 pandemic. Patients with younger age or female sex were more likely to have disruptions in care, which may reflect risk stratification strategies in the early stages of the pandemic. The longitudinal impact of these disruptions on outcomes merits further study. [Table: see text]
Factors associated with the occurrence of myocardial infarction in patients treated for melanoma.
Authors: Pan Xianying , Verma Devashish , Zhang Jiayin , Zhang Yifan , Ma Xiaomei 
Published: June 2022

10562 Background: Treatments for melanoma increasingly involve the use of immune checkpoint inhibitors (ICIs), which are associated with cardiac toxicities. Our study aims to examine predictors of myocardial infarction (MI) in melanoma patients receiving treatment. Methods: The United Healthcare (Optum Clinformatics) Closed Claims + Lab Results Database (01/2007 – 03/2021) was used to examine factors potentially associated with the occurrence of hospitalized MI in melanoma patients. Adult patients were included if they: 1) had ≥12 months of continuous insurance coverage at baseline; 2) had ≥2 outpatient or ≥1 inpatient claims with an International Classification of Diseases (ICD) code indicative of melanoma; 3) received ≥1 type of cancer treatment (surgery, chemotherapy, radiotherapy, ICI, or targeted therapy); 4) had a claim with a melanoma ICD code within 5 days before the first cancer treatment; and 5) had no history of MI at baseline. Baseline was defined as the year prior to the first date of treatment; MI occurrence was identified from inpatient claims. We conducted a time-to-event (MI) analysis using a multivariate Cox proportional hazards regression model, with backward selection and death as a competing risk. Results: A total of 42,101 patients (58.8% male; median age of 68 yrs at baseline) were included in the study. Of these, 954 patients (2.3%) experienced a MI, and 5,578 (13.2%) died before having a MI. Compared with patients who underwent surgery only, those who received multiple treatments with an ICI were more likely to have a MI (hazard ratio [HR] = 1.25, 95% confidence interval [CI]: 1.01-1.55; Table). Men had a higher risk than women (HR = 1.47, 95% CI: 1.27-1.71), as did older people (compared with 65-74-yr-olds, HRs were 0.24, 0.49, 1.41, and 2.06 for <55-, 55-64-, 75-84-, and ≥85-yr-olds, respectively; all P<.05). Being Asian and having certain comorbidities at baseline were also associated with a higher MI risk (Table). Conclusions: In this retrospective cohort analysis of patients with melanoma, we observed an increased risk of MI among patients who received multiple treatments with ICIs, compared with surgery only. More research is needed to further elucidate predictors of MI events related to cancer treatment. [Table: see text]
The increasing incidence of alcohol-related cancers in young adults in the United States: Who is most at risk?
Authors: Rohatgi Atharva , Liao Cheng-I , Caesar Michelle Ann , Johnson Caitlin Ruth , Chan Joshua Elbridge , Kapp Daniel Stuart , Chan John K 
Published: June 2022

10563 Background: To evaluate incidences and trends of alcohol-associated cancers in United States adults over the last 18 years. Methods: Data was extracted from the United States Cancer Statistics database from 2001 to 2018. SEER*Stat Joinpoint Regression program 4.8.1 was used to calculate incidences and trends. Average annual percentage change (AAPC) was used to describe trends. Based on the ICD-O-3 criteria, liver, colon, oral cavity, esophagus, and pharynx cancers were classified as alcohol-related cancers. Results: Over the last 18 years, the incidence of alcohol-associated cancers decreased overall in males and females by 0.9% every year (p < 0.001). Alcohol-associated cancers increased significantly in younger patients under the age of 39 years old (p < 0.001). Based on race, Black men and women had the highest incidence at 135.17/100,000 followed by 132.50 in White individuals, 105.84 in Hispanic individuals, and 104.28 in Asian individuals. By region, the incidence was found to be the highest in the Midwest at 132.89/100,000 and lowest in the West at 120.33. Based on cancer types, the most common alcohol related cancer was colorectal cancer with an incidence at 36.49/100,000 in 2018, followed by oral cavity cancers at 11.69, liver cancer at 6.76, esophagus cancer at 4.51, and larynx cancer at 2.92. Of all these types of cancers, liver cancer had the highest annual increase at 2.43% (p < 0.001). Using a projection model, we found that liver cancer is estimated to surpass colorectal cancer by the year 2035. On intersectionality analysis, White men and women in the Northeast between the ages of 75-79 had the highest incidence of alcohol-associated cancers at 584.10/100,000 in 2018. However, over the last 18 years, White men and women in the South between the ages of 20-24 had the highest annual increase at 4.08% (p < 0.001). Conclusions: Over the last 18 years, alcohol-related cancers increased in the younger patients, particularly those residing in the South. Liver cancer is increasing at the highest rate.
A five-year epidemiological profile of patients with cancer managed by a Haitian cancer program.
Authors: Bernard Joseph , Henderson Rebecca Rose , Pierre Lenz Sacha Christyl , Alexis Lynn Gabrielle , Gilbert Doukens Patrick , DeGennaro Vincent 
Published: June 2022

10564 Background: Cancer epidemiology in Haiti is poorly understood. The national cancer registry is not functional, and data reported by GLOBOCAN are estimations that do not totally reflect the reality of cancers in Haiti. The aim of this study was to present the five-year epidemiology of malignancies managed by one of the main cancer programs in Haiti. Methods: A retrospective study was conducted on patients aged 15 years old and above with pathological and/or clinical diagnosis of cancer managed from January 2016 to December 2020 at Innovating Health International (IHI), a cancer center located in Port-au-Prince, Haiti. The chart review collected variables such as age, gender, date of admission and cancer type in order to present this epidemiological profile of cancers. Results: Overall, 3060 patients with cancer were managed during the study period. 84.4% of the patients were female and 15.6% male. The mean and median ages of the study population were respectively 52.5 [range: 15 –92] and 53.0 years. Adolescents and young adults (15-39 years old) represented 18.9 % of this cohort and geriatric cases (≥ 65 years old) were 21.0%. Breast cancer was the most common type (n = 1391, 45.5%%), followed by gynecological cancers (n = 746, 24.4%) with cervical cancer representing 77.5 % of these cases (n = 578); gastrointestinal cancers (n = 252, 8.2%) dominated by colorectal (n = 92, 36.5%) and gastric cancer (n = 58, 23.0%); head and neck cancers (n = 129, 4.2%); hematological malignancies (n = 128, 4.2%) with lymphomas representing 60.9% of the cases (n = 78); sarcomas (n = 114, 3.7%), urological cancers (n = 73, 2.4%) with prostate cancer representing 56.1% of the cases; skin cancers including melanoma (n = 60, 1.9%); lung cancer (n = 24, 0.8%); thyroid cancer (n = 13, 0.4%) and central nervous system (CNS) cancers (n = 6, 0.2%). 4.1% of the patients (n = 124) had a cancer of unknown primary (CUP). Breast (53.5%), cervical (28.9%) and gastrointestinal (5.0%) cancers were the most common types among women, while gastrointestinal (25.8%), hematological (16.1%), head and neck (14.7%) and urological (12.6%) cancers were the most diagnosed among men. Conclusions: Cancer mainly affects Haiti’s young, active and female population. Breast and cervical cancers were the most prevalent in this retrospective cohort regardless of the age group. The under-representation of prostate and other urological malignancies, lung cancer, acute leukemias and CNS cancers was likely due to underdiagnosis, misdiagnosis, under-referral or early mortality. An active cancer registry is needed to better evaluate the real cancer burden in Haiti.
Exploring "the healthy immigrant effect" among elderly Asian patients with cancer: A nationwide population-based assessment.
Authors: Nayak Manan , Nguyen Paul , Braun Ilana , Schutt Russell K. 
Published: June 2022

10567 Background: Asian Americans are the fastest-growing immigrant group in the U.S. As the oldest immigrant group on average, they are at heightened risk for cancer and other diseases. This study explored whether the risk is mitigated by the healthy immigrant effect (HIE), an epidemiological phenomenon that has been well documented among Latino immigrants. Evidence of a healthy immigrant effect among Asians as a whole or in specific Asian subgroups is limited, and almost none focus on the elderly with a cancer diagnosis. This original research study examines the evidence for an HIE in a large ethnically diverse sample of elderly persons with a cancer diagnosis. Methods: This is a retrospective observational study utilizing data collected across 14 regions of the U.S. SEER-Medicare Health Outcomes Survey (SEER-MHOS), a linked dataset sponsored by the NCI and the Center for Medicare & Medicaid Services. Logistic regression analyses were conducted to examine HIE among Asians in the aggregate and subgroups of Asians for smoking and body mass index (BMI), using survey language and ethnic concentration as proxies for nativity. Results: Asians, in the aggregate, had comparable social backgrounds and had better health behaviors (i.e., lower smoking and BMI) than non-Hispanic Whites. When Asians were disaggregated, Hawaiians and Japanese had higher smoking and obesity rates than Chinese. A protective effect was observed among Asians in the aggregate living in an ethnic enclave with lower smoking prevalence and lower BMI. Chinese respondents opting to complete surveys in their native language or living in ethnic enclaves were less likely to be overweight, but no significant associations were found in relation to their smoking. Conclusions: Support for a healthy immigrant effect was largely consistent for Asians in the aggregate with respect to both language and ethnic concentration, but support was mixed among subgroups of Chinese patients. The presence of the HIE suggests that the health status and needs of recent Asian immigrants seeking oncologic care may be different than Asians who have been in the U.S. longer. These findings suggest a need for community-based efforts to encourage preservation of a healthier living style observed among first-generation immigrants.
The disproportionate burden of cancer associated with social behaviors in young women in the United States.
Authors: Johnson Caitlin Ruth , Liao Cheng-I , Chan Ava , Tian Chunqiao , Darcy Kathleen M. , Kapp Daniel Stuart , Chan John K 
Published: June 2022

10575 Background: To evaluate the incidences and trends of social determinant risk factor-associated cancers in the United States from 2001 to 2018. Methods: Social determinant risk factor-associated cancers, as classified by the CDC, were included: obesity, alcohol, tobacco, physical inactivity, and human papillomavirus (HPV). Data was obtained from the United States Cancer Statistics program from 2001-2018. SEER*Stat 8.3.9.2 and Joinpoint regression program 4.9.0.0 were used to calculate incidences and trends of cancers per 100,000. The age-adjusted incidence (AAI) was adjusted by the US 2000 standard population. Results: Over the 17-year study period, a total of 28,175,859 cancers were identified. Of these, 51.4% developed in men and 48.6% in women. Over 65.8% were risk factor-associated cancers and 34.2% were unrelated to these factors. Of note, over 60.1% of risk factor-related cancers developed in women compared to 39.9% in men. Although the incidence of risk factor associated cancers did not significantly change at 413.2/100,000 in women, this incidence decreased by 1.15% annually ( P< 0.001). The age-specific incidences decreased in older (> 50 years) men and women. Of the younger (20-45 years) group, these risk factor-associated cancers increased from 91.5 to 97.3/100,000 with an annual increase of 0.4% ( P< 0.001) in younger women; there was no change for younger men on trend analyses over the study period. Conclusions: Over 65% of cancers in the US were associated with social determinants of health. There is a disproportionate burden of risk factor-associated cancers in women with increasing rates in younger age groups. Further research is needed to better understand the rationale of these important trends.
Patient-reported outcomes among males undergoing prostate cancer germline testing: Interim results from the Prostate Cancer Genetic Risk, Experience, and Support Study (PROGRESS) Registry.
Authors: Giri Veda N. , Hartman Rebecca L. , Gross Laura , Keith Scott W. 
Published: June 2022

10595 Background: Indications for prostate cancer (PCA) germline testing (GT) have greatly expanded, necessitating thousands of men to seek genetic evaluation through traditional genetic counseling and alternate delivery approaches. Therefore, there is an important need for patient-reported outcomes among men undergoing genetic testing which has been understudied. PROGRESS (Prostate Cancer Genetic Risk, Experience, and Support Study) was therefore developed to garner men’s experience with PCA germline testing. Here we provide an interim update on recruitment and results from registry participants. Methods: PROGRESS is a patient-driven registry of clinical, genetic, and patient-experience information among men undergoing PCA genetic testing. Survey covers demographic information, PCA history, mode of genetic counseling, satisfaction, decisional conflict, intention to share genetic results with family and physicians, attitude towards genetic testing, knowledge of cancer genetics, medical literacy, and numeracy. Descriptive statistics summarized results with counts and percentages for categorical variables and mean and standard deviation for continuous variables. All analyses were performed with SAS 9.4 (Cary, NC). Results: Current enrollment is 217 participants. Among 140 men with complete demographics, 93.57% are White, 98.6% non-Hispanic/Latino, 85% with bachelor’s degree or higher. Among 143 respondents, 60% reported a diagnosis of PCA. Among 85 men who reported on Gleason score, 24.7% had Gleason > = 8. Regarding family history, 23.5% reported a 1st/2nd degree relative with PCA and 58.1% reported a 1st/2nd degree relative with any cancer. Among 150 men who reported genetic results, 40.7% had a genetic mutation, 18% reported having a VUS, and 10.7% reported not knowing their results. Among 185 men who reported on mode of genetic evaluation, 58.4% met with a genetics professional and 21.7% reported their doctor had discussed genetic testing. Satisfaction was high (n = 121) (highest score 30; mean score 27.92 + 2.73) and decisional conflict was low (n = 138) (mean score 26.07 + 10.18; range 16-80). Majority of 140 respondents discussed their results with their family (93.6%). Knowledge of cancer genetics was modest, with correct responses among 140 respondents of 50.1% + 28.1. Conclusions: Current participants of the PROGRESS Registry report high satisfaction with their genetic evaluation process. However, resources are needed to increase knowledge and understanding of genetic results. Greater engagement of African American males is critically needed to garner diverse perspectives and develop resources for men and their families applicable across populations. Target goal of the registry is 500 males; men can be referred to participate in the PROGRESS Registry at www.progressregistry.com .