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Journal articles on the topic 'Cancer Research Center of Hawaii'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Fukui, Jami Aya, Shirley Cheng, Shannon Lim, John Shepherd, Paulette Yamada, and Cheri Teranishi-Hashimoto. "The effect of longitudinal exercise programming in breast cancer patients." Journal of Clinical Oncology 38, no. 15_suppl (2020): TPS12124. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.tps12124.

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TPS12124 Background: Obesity and weight gain are significant concerns for breast cancer survivors. Obesity at diagnosis is an established negative prognostic factor and studies suggest that post-diagnosis weight gain may increase risk for recurrence and decrease disease free survival. Various interventions such as dietary modification, physical activity, individualized counseling, cognitive behavioral therapy, and combinations of these interventions have been studied in order to identify strategies for weight loss in breast cancer survivors. However, one of the main challenges have been to show sustainability in these interventions. Given the adverse consequences of weight gain after diagnosis, continued efforts to identify appropriate weight management interventions aimed at promoting overall health and long term survivorship are needed. Methods: We have opened an investigator initiated Breast Cancer Exercise Study that provides a tailored exercise program and body health assessments for breast cancer patients along their treatment journey. We are enrolling women diagnosed with breast cancer up to 2 years after their diagnosis into a two 12-week exercise program. Participants’ biometrics and physical assessments will be assessed at baseline to determine the appropriate exercise intensity to implement. Women will attend private 1:1, 90min sessions, 3 days/week. At the end of the initial 12-week program, biometric assessments are again performed and participants are then randomized to either: a) continue with individual exercise classes, 2 days/week or b) continue with group exercise classes, 2 days/week. The study follows their long term outcomes including cancer recurrence, exercise adherence as well as quality of life symptoms. The functional health assessment and subsequent personalized exercise program utilizes kinesiology students from University of Hawaii-Manoa during their clinical practicum and is based at our community partner facility the Rehabilitation Hospital of the Pacific. Body assessments and other biomarkers are evaluated through expertise at University of Hawaii Cancer Center. Collectively, our study exemplifies our partnership with community facilities, utilizes cutting edge research and incorporates local students, to provide an important health program for cancer patients all the while enriching our understanding of the unique patient population. The results of this project may help to develop standardized exercise protocols for breast cancer survivors and provide insights to other important health concerns. Clinical trial information: NCT04013568 .

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Palafox, N., R. Leon Guerrero, H. Robinett, J. Peterson, D. Ward, and C. W. Vogel. "Advancing Cancer Health Equity in Pacific Islanders: A 15-Year Investment in Cancer Research, Training and Outreach in Guam, Hawaii and the U.S. Associated Pacific Islands." Journal of Global Oncology 4, Supplement 2 (2018): 17s. http://dx.doi.org/10.1200/jgo.18.32100.

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Background: Pacific Islanders (PI) in Guam (GU), Hawaii (HI), and the U.S. associated Pacific Islands (USAPI) experience greater cancer health disparities compared with majority populations in GU, HI, and the U.S. continent. Social determinants including geographic, socio-cultural, and economic factors are barriers to health and health care, leading to late stage diagnosis and poor survival outcomes. PIs are also highly underrepresented among cancer researchers. Aim: The University of Guam (UOG)/University of Hawaii Cancer Center (UHCC) partnership aims to grow cancer research capacity at UOG, develop cancer health disparities research at UHCC focusing on Pacific Islanders (PI), raise awareness of cancer and cancer prevention in GU, HI and the USAPI, and increase the number of cancer and biomedical scientists of PI ancestry in the U.S. Methods: An infrastructure comprised of five principal investigators and approximately 30 participating faculty, administrative staff, and community and scientific advisory members, supported by funds from the National Cancer Institute and the partnering institutions, has provided 15 years of support for cancer research, training, and outreach designed to reduce cancer health disparities and advance health equity among Pacific Islanders in GU, HI and the USAPI. Results: Fifteen collaborative research projects have been funded through the partnership. Many of these projects have focused on the prevention of unhealthy lifestyle behaviors that lead to increased cancer risk. Prepilot, pilot and full research projects address cancer health disparities of regional relevance and global importance, notably breast, cervical and oral cancers as well as tobacco and betel nut use. A betel nut cessation intervention, the first of its kind, shows promising quit rates. This research has resulted in over 80 publications, 100+ abstracts, and 9 grant awards. The partnership has recruited and trained 26 underrepresented graduate scholars in cancer health disparities, including two scholars who have since joined UOG's faculty and are now independently conducting research, participating in the partnership as investigators, and mentoring tomorrow's scientists. UOG faculty and early stage investigators continue to receive mentorship and career development support. Outreach activities have contributed to the introduction and passage of significant cancer prevention and control legislation in Guam and Saipan. Outcomes are communicated through the partnership's Website, social media, and community reports and seminars. Conclusion: The partnership has significantly increased research capacity at UOG and cultivated interest in cancer research among underrepresented minority students at the partnering institutions. A regional research infrastructure has been established, and research findings are informing public health policy and planning. Resources have been leveraged to address PI cancer health disparities in GU, HI, and the USAPI.

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Lee, Yu-Che, Ko-Yun Chang, and Judith Hurley. "Association between breast cancer mortality-to-incidence ratios and state health disparities in the United States." Journal of Clinical Oncology 37, no. 15_suppl (2019): 1548. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.1548.

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1548 Background: Breast cancer is the most commonly diagnosed cancer and second leading cause of cancer deaths among women in the United States. The cancer mortality-to-incidence ratio (MIR) provides a population-based indicator of cancer survival and has been established previously to evaluate healthcare variations among different countries. We aim to evaluate the association, which has not been investigated before, between MIR of breast cancer and state-level health disparities in the United States. Methods: We used United States Cancer Statistics (USCS) database to calculate 6-year average of MIRs for breast cancer from 2010 to 2015. America’s Health Rankings (AHR) is a platform using weighted measures in 5 different categories (Behaviors, Community & Environment, Policy, Clinical Care and Outcomes) to determine annual state health rankings. Six-year average (2010-2015) of health uninsured rate by state was obtained from the U.S. Census Bureau and 5-year average (2010-2014) of health spending per capita by state was obtained from Centers for Medicare & Medicaid Services. The correlations between breast cancer MIRs and state health variables were calculated by linear regression analyses. Results: From 2010 through 2015, 1,390,357 females were diagnosed with breast cancer and 246,671 females died from breast cancer in the United States. The 6-year average of age-adjusted incidence rate, mortality rate and MIRs were 124.2 ± 1.3 per 100,000 population, 21.1 ± 0.6 per 100,000 and 0.170 ± 0.007, respectively. Among fifty states we included for analyses, Hawaii had the lowest MIR (0.116 ± 0.014) and Nevada had the highest MIR (0.204 ± 0.004). AHR showed Hawaii had the highest health ranking (No. 1) whereas Louisiana had the lowest health ranking (No. 50) in 2015. In our analysis, states with better health rankings, lower health uninsured rates and higher health spending per capita were significantly correlated with lower MIRs (R2 = 0.695, 0.453 and 0.253, respectively; all P < 0.001). Conclusions: The difference of MIRs for breast cancer was strongly associated with state health diversities. These findings suggest that MIR of breast cancer can be an applicable measure to evaluate and reflect the state-level health disparities in the United States. [Table: see text]

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Leon Guerrero, Rachael T., Neal A. Palafox, Margaret P. Hattori-Uchima, Hali R. Robinett, and Carl-Wilhelm Vogel. "Addressing Cancer Health Disparities in the Pacific Peoples of Hawai‘i, Guam, and the US Associated Pacific Islands Through Pacific-Focused Research Capacity Building." JCO Global Oncology, no. 6 (September 2020): 155–60. http://dx.doi.org/10.1200/go.19.00213.

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Sociocultural, geographic, and biologic factors contribute to cancer health disparities (CHDs) in Indigenous Pacific peoples (IPPs) in Guam, Hawai‘i, and the US Associated Pacific Islands (USAPI). IPPs experience a greater burden of CHDs that are associated with late-stage diagnosis and poor survival outcomes compared with majority populations in the United States. A 16-year partnership between the University of Guam (UOG) and University of Hawai‘i Cancer Center (UHCC) aims to advance health equity in Guam, Hawai‘i, and the USAPI through cancer research, training, and outreach. Investigators at collaborating institutions study issues of regional and cultural relevance in IPPs, including breast, cervical, liver, and oral cancers and use of tobacco and betel nuts (Areca nuts). Junior faculty with IPP ancestry or those who are focused on CHDs in IPPs receive mentorship and career development opportunities, academic fellowships are provided for graduate students, and Pacific Island communities are engaged through a participatory development process. The partnership has generated more than 90 peer-reviewed publications, more than 100 abstracts, and 11 grant awards. Thirty graduate scholars from under-represented minorities have been trained, including two who are now UOG faculty and are conducting independent research, contributing to the partnership, and mentoring scientists of tomorrow. Participatory community engagement has contributed to the passage of significant cancer prevention and control legislation in Hawai‘i, Guam, and Saipan. Research capacity at UOG has increased significantly, and research at UHCC has expanded to address issues unique to IPPs. Graduate students from under-represented minorities are pursuing careers in cancer research. A regional research infrastructure has been established to support team science, and research findings are informing public health policy and planning.

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Graffunder, Corinne M., Stephen W. Wyatt, Barbara Bewerse, Irene Hall, Barbara Reilley, and Rebeca Lee-Pethel. "Skin Cancer Prevention: The Problem, Responses, and Lessons Learned." Health Education & Behavior 26, no. 3 (1999): 308–16. http://dx.doi.org/10.1177/109019819902600303.

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Skin cancer is one of the most common forms of cancer and has rapidly increased during the past three decades in the United States. More than 1 million new cases of skin cancer are estimated to be diagnosed in the United States each year. The National Skin Cancer Prevention Education Program (NSCPEP) was launched by the Centers for Disease Control and Prevention (CDC) in 1994 as a national effort to address the Healthy People 2000 objectives for skin cancer prevention. The NSCPEP is a comprehensive, multidimensional public health approach that includes (1) primary prevention interventions; (2) coalition and partnership development; (3) health communications and education; and (4) surveillance, research, and evaluation. In 1994, through support from the CDC, state health departments in Arizona, California, Georgia, Hawaii, and Massachusetts initiated primary prevention intervention projects to conduct and evaluate skin cancer prevention education. This article discusses the comprehensive, multidimensional public health approach highlighting examples from the state demonstration projects.

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Cheung, Christabel K., Thuli Katerere-Virima, Laura E. Helbling, Bria N. Thomas, and Reginald Tucker-Seeley. "Capturing the financial hardship of cancer in military adolescent and young adult patients: A conceptual framework." Journal of Clinical Oncology 38, no. 29_suppl (2020): 163. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.163.

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163 Background: Cancer can be a setback for young active-duty military patients, with potential implications for their financial well-being, early career paths, and young families. Despite the assumption of sufficient material support for military patients, cancer and its treatments still result in substantial out-of-pocket expenses and lost-opportunity costs that can lead to financial hardship. Although prior cancer survivorship studies have put forth a material, psychosocial, and behavioral conceptual framework for describing financial hardship following a cancer diagnosis, it is unknown whether this framework adequately depicts the experience of financial hardship among military adolescent and young adult (AYA) patients. The primary aim of the current study was to extend this conceptual model of financial hardship following a cancer diagnosis for application among military AYA patients. Methods: Using Gale and colleagues’ Framework Method for qualitative multi-disciplinary health research, the investigator team conducted focus groups and key informant interviews (n=24) with active-duty AYA cancer patients, cancer care providers, and commanding officers at both a military medical center and a military post in Hawaii. Subsequently, content analysis and thematic abstraction produced results that were sorted to characterize the material, psychosocial, and behavioral domains of financial hardship. Finally, investigators employed health behavioral change theories to construct a conceptual framework. Results: Data analysis revealed that young active-duty military patients’ experiences of financial hardship following a cancer diagnosis occur within material, psychosocial, and behavioral domains that are uniquely situated within the environments of AYA development and military culture. Hence, we elaborated upon an existing conceptual framework of the financial hardship of cancer, by extending it to capture two meso-level contexts that emerged from our findings: (1) life course development and (2) occupational culture. Conclusions: Differentiating individual experiences of financial hardship within the contexts of life course development and occupational culture, may enable the development of interventions that are informed by the aspect of financial hardship most impacted by cancer care for this special population. Future research should further explicate the meso-level contexts in our study, and investigate the associations among and between factors within these social and environmental contexts.

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Park, Jae H., Sean Devlin, Charles Lynch, et al. "Impact of Treatment Center Characteristics on Early Death Rates in Patients with Newly Diagnosed Acute Promyelocytic Leukemia: Analysis of Data from the SEER Program." Blood 128, no. 22 (2016): 4008. http://dx.doi.org/10.1182/blood.v128.22.4008.4008.

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Abstract Background: Acute promyelocytic leukemia (APL) is a unique subtype of AML with a high cure rate of 80-90% when treated with all-trans retinoic acid (ATRA)-based therapy. However, early death at presentation or during induction therapy due to hemorrhage remains the major cause for treatment failure. Using the Surveillance, Epidemiology, and End Results (SEER) data, we have previously reported an early death rate of 17.3% (Park J et al. Blood 2011;118:1248). We hypothesized that the early death may be associated with the expertise and availability of blood products at treatment centers and undertook a retrospective cohort study. Methods: APL patients diagnosed between 1992 and 2009 were identified using SEER 13 data. Patients with available survival and treatment center information were eligible for the study. Early death was defined as death within one month of diagnosis. The treatment center information was obtained from the American Hospital Association database and included the following characteristics: number of hospital beds (<200, 200-500, >500), presence of intensive care unit (ICU), presence of trauma center (as a surrogate indicator for availability of on-site blood products), and the teaching status (nonteaching, minor, major). Logistic regression was used to compare early death by selected hospital characteristics. Results: The full-set of pre-specified treatment center information were available from five SEER 13 cancer registries (Iowa, Utah, Detroit, Connecticut, Hawaii); from these registries, we identified 507 eligible patients ofwhom [154 patients (30%)] experienced an early death. Data on bed size, teaching status, ICU presence and trauma center were available in 460, 460, 445 and 434 patients, respectively. Most APL patients were treated at centers with ³200 hospital beds (n=345), dedicated ICU (n=442), trauma center (n=287) and at teaching hospitals (n=349) (see Table 1). Of the treatment center characteristics, analysis revealed that the presence of trauma center was statistically significantly associated with decreased odds of early death (odds ratio: 0.59, 95% CI: 0.39-0.91; p=0.02). Conclusions: Early death remains as the major cause of treatment failure in APL. To the best of our knowledge, this is the first and largest study reporting an association of treatment center characteristics with survival in APL, and suggests a prompt referral of APL patients to a large treatment center may further improve the outcome of these patients. Disclosures Park: Novartis: Consultancy; Baxalta: Consultancy; Juno Therapeutics: Research Funding; Amgen: Consultancy. Douer:Pfizer: Consultancy; Shire: Consultancy, Speakers Bureau; Spectrum: Consultancy; Jazz Pharmaceuticals: Honoraria; Gilled Sciences, Inc: Consultancy.

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Siegel, Robert D., Donna M. Bryant, Holley Stallings, et al. "Fertility preservation: Utilizing QOPI metrics in the quality improvement efforts of the NCI Community Cancer Centers Program (NCCCP)." Journal of Clinical Oncology 30, no. 15_suppl (2012): e16532-e16532. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e16532.

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e16532 Background: The NCCCP is a consortium of 30 community based institutions funded by the NCI. Quality of care has been a priority of the NCCCP with participation in the Quality Oncology Practice Initiative (QOPI) serving as a fundamental element in those efforts. QOPI provides both a metric for baseline assessment and a means for measuring improvement across the network. Participation in QOPI became required with expansion of the NCCCP in 2010. Utilizing QOPI methodology, we describe our efforts to optimize adherence to fertility preservation standards of care. NCI Contract No. HHSN261200800001E Methods: A data sharing agreement allows individual practice performance to be electronically forwarded to the NCI twice a year where it is aggregated with the other NCCCP QOPI participants. This allows for ongoing evaluation of group statistics as well as comparisons between participating institutions. Those practices scoring highest on individual parameters are queried for best practices. Results: In Spring 2011, 38 practices/23 NCCCP sites participated resulting in 2653 chart reviews. 258 charts were applicable to fertile individuals as defined by QOPI. 46 charts were in compliance with suggested standards (17.8%) compared with the national rate of 26.1%. Four practices performed well above the national average and became the NCCCP's leaders for establishing best practices. The NCCCP then embarked upon a process of defining barriers to compliance with the fertility preservation recommendations, created an assessment tool by which each practice could identify the degree it integrated fertility preservation into their care models, and began the process of integrating nationally available educational materials and speakers. QOPI metrics will be used to measure the impact of these interventions. Conclusions: QOPI is a useful tool for measuring quality within a network, identifying barriers to compliance with ASCO fertility preservation recommendations and assessing quality improvement efforts. This methodology has allowed us to proceed with quality initiatives despite the logistical challenges of working with institutions and physicians from Maine to Hawaii.

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Jewett, Patricia, Rachel I. Vogel, Rahel G. Ghebre, et al. "Telehealth: Reducing or increasing cancer care disparities?" Journal of Clinical Oncology 39, no. 15_suppl (2021): 1582. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.1582.

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1582 Background: During the COVID-19 pandemic, most cancer care in the United States transitioned to telehealth (phone or video visits) to reduce infection risks for patients and providers. Telehealth may simplify care logistics (e.g. reduce travel and waiting times), but it may also unintentionally exacerbate existing disparities in healthcare utilization by race/ethnicity, age, or rural/urban status. As telehealth will likely continue long-term, we examined telehealth use at a comprehensive cancer center during the COVID-19 pandemic across patient populations with established disparities in cancer treatment and outcomes. Methods: We retrospectively reviewed telehealth visits from March until December 2020 among individuals diagnosed with cancer at the University of Minnesota Masonic Cancer Center (MCC). We used Chi-squared tests and GEE logistic regression to compare video vs. phone visits by age, urban/rural status, and race/ethnicity (American Indian / American Native [AIAN], Asian, Non-Hispanic Black/African American [NH Black/AA], Hispanic, Multiple, Native Hawaiian / Pacific Islander [NHPI], NH White). Results: Over the study period, 42,171 telehealth visits were performed with 11,097 patients at the MCC. Patients had a mean age of 62.7±13.9 years; 59.2% were female; 88.7% lived in urban areas; 90.0% of patients were NH White, 4.4% NH Black/AA, 3.0% Asian, 1.5% Hispanic, 0.8% AIAN, 0.3% of multiple races, and 0.1% NHPI. The most common cancer sites were breast (24.1%), hematological (21.0%), gynecologic (10.0%), and lung (8.4%). NH White individuals were more likely (53.9%) to use video than AIAN (39.7%), Black/AA (37.8%), or NHPI individuals (34.9%). Video use was less common among rural (45.3%) than urban (53.7%; p<.0001) residents, and among individuals aged 65 or older (45.2%) vs. younger than 65 (59.5%; p<.0001). In a logistic regression, adjusted for continuous age and urban/rural status, all race/ethnic groups except Multiple were less likely to use video than NH White individuals (vs. phone; Table). Conclusions: Our findings underscore disparities in telehealth use for cancer care across historically underserved populations. Future research should evaluate potential underlying contributors to these disparities such as technology access, internet capability, and fear of discrimination. Additional research is also needed to determine whether video vs. phone visits affect cancer outcomes, therefore indicating true disparity.[Table: see text]

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Acoba, Jared David, Sharon Tamashiro, and Marci Chock. "Perceived value of cancer survivorship care among Asians and Native Hawaiian/Pacific Islanders." Journal of Clinical Oncology 38, no. 15_suppl (2020): e22522-e22522. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e22522.

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e22522 Background: Numerous studies have evaluated the impact of cancer survivorship care. However, no study to date has focused on Asian or Native Hawaiian/Pacific Islander (NH/PI) cancer survivors. It has been well documented that Asian and NH/PI patients often suffer from inferior cancer outcomes compared to White patients, and differences in their experience with cancer survivorship care could contribute to this disparity. Methods: Surveys were sent to 1410 cancer survivors who were treated at a community cancer center with curative intent and who had received survivorship care plans between Jan 2014 and June 2018. The 26-item questionnaire evaluated patients’ perception of various aspects of their survivorship care plan and follow-up physician visits. All responses were anonymous. Results: Of the 360 patients who responded, 24% were White, 54% Asian, and 13% NH/PI. Compared to Whites, Asian and NH/PI patients were younger (p = 0.004), less educated (p = 0.004), and reported a lower income (p < 0.0005). Among all patients, 62% reported that the survivorship care plan was “very helpful” and 86% rated their satisfaction with physician follow-up visits as “very good” to “excellent.” There were no racial differences in satisfaction with either survivorship care plan or physician follow-up. In a multivariate binary logistic regression, Asians and NH/PI patients were significantly more likely to rate ongoing survivorship care as helpful compared to Whites, OR 4.08 (95%CI, 2.13-7.82). Conclusions: There were no racial differences in patient satisfaction with their survivorship care plans and follow-up care. However, Asian and NH/PI patients valued ongoing cancer survivorship care follow-up significantly more than White patients. Whether more extensive survivorship care would lead to improved outcomes among Asian and NH/PI cancer patients should be investigated further.

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Tan, A. D., P. J. Novotny, J. S. Kaur, et al. "Comparison of baseline quality of life between minority and non-minority patients participating in oncology clinical trials." Journal of Clinical Oncology 24, no. 18_suppl (2006): 8527. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.8527.

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8527 Background: Minority patients (MP) suffer deficits in access to care and socioeconomic status. This study uses a patient-level pooled analysis to explore whether these deficits translate into quality of life (QOL) differences between MP and non-MP on clinical trials. Method: Baseline QOL scores were combined from 47 clinical trials (6,513 patients) conducted either at the Mayo Clinic Cancer Center or in the North Central Cancer Treatment Group. QOL scales used were the Uniscale, Linear Analogue Self Assessment (LASA), Symptom Distress Scale (SDS), Profile of Mood States (POMS) and Functional Assessment of Cancer Therapy - General (Fact-G). Fisher’s Exact tests and linear regression adjusted for age, site, and performance score. Survival data was compared using the method of Kaplan-Meier. Results: Eight percent (531) of patients self-reported as MP (0.45% American Indian/Alaskan Native, 0.7% Asian, 5% Black/African American, 1.5% Hispanic, 0.1% Native Hawaiian and 0.3% Other). MP had no meaningful deficits in overall QOL or the SDS and were slightly worse on FACT-G total score, physical, social/family, functional, and SDS nausea severity. MP among lung cancer patients reported greater nausea (58 vs 69) and sleep problems (34 vs 54), with neurological cancers reported worse emotional well-being (53 vs 74), and with GI tumors had lower social/family well-being (60 vs 67). Regression models confirmed these results. Median survival time was shorter for MP (198 vs 310 days, p=0.001) but was not significant after adjusting for disease severity. Conclusions: MP on these clinical trials did not report large QOL deficits at baseline relative to non-MP. MP did indicate small deficits in physical, social, and emotional subscales. MP experienced large tumor-specific deficits for a few QOL domains that might bear further attention. [Table: see text] No significant financial relationships to disclose.

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Goodin, S., D. C. Vamos, M. P. Kane, et al. "Comparison of the demographics of patients enrolled (E) versus those not enrolled (NE) on therapeutic clinical trials at a comprehensive cancer center." Journal of Clinical Oncology 25, no. 18_suppl (2007): 17065. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.17065.

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17065 Background: In the U.S., representation of minorities and the elderly in clinical trials has been low yet few reports have evaluated this potential barrier to enrollment by comparing the demographics of patients E vs NE within an institution. Therefore, we compared these groups to determine if there were significant differences in demographics at our center. Methods: For all E patients, demographic data is collected in a clinical trial database. For evaluated NE patients, data was captured through a ‘non-protocol’ form. A univariate analysis was performed on the demographic data, including gender, age, race, and insurance status, for each year to determine if there were differences in patients E vs NE on a therapeutic clinical trial. Results: From June 2003 through December 2005, there were 912 E patients and data available on 474 NE patients. The results were consistent for each year from 2003 to 2005, and therefore combinable, with no statistical difference in any parameter for E patients versus NE patients during any year with the exception of gender (p=0.05; Chi-square). The distribution of patients E by gender is 52% (474/912) female vs 48% (438/912) male and NE is 69% (325/474) female vs 31% (149/474) male. The mean age of E patients was 55 vs 56 years for NE patients, with 32% vs 33% representing those >65years, respectively. For the E patients, 84% were white, 7.2% black, 4.6% Asian, 4.2% unknown, and 0.4% Hawaiian/Pacific Islander (H/PI). For the NE patients, where race was not consistently available, 65% were white, 9.3% black, 3.2% Asian, 20.5% unknown, and 2.1% H/PI. In both groups, most patients had private insurance (E 60%, NE 54%), followed by Medicare (E 27.5%, NE 29%), Medicaid (E 4%, NE 9%), self pay (E 7.5%, NE 7.4%), and unknown (E 1.3%, NE 0.4%). Conclusions: When comparing E vs NE patients, gender was the only factor that differed significantly. Although this result suggests that males were more likely to be E in a clinical trial, this finding should be interpreted with caution, since this difference might relate to differences in trial availability. While lower enrollment rates for the elderly and minority patients have been identified nationally, enrolling this group of patients does not appear to be a barrier at our center. No significant financial relationships to disclose.

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Perez Perez, Ariel, Nawid Mohammad Sarwari, Terra Warner, Liqiang Ni, and Danny Landau. "Enrollment disparities in cancer clinical trials: A single institution experience." Journal of Clinical Oncology 37, no. 15_suppl (2019): e18128-e18128. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e18128.

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e18128 Background: The importance of population heterogeneity in clinical cancer research is universally recognized. This study aims to identify possible disparities in trial participation at UF Health Cancer Center at Orlando Health. Methods: Data on patients’ enrollment, during the period from 01/01/2016 to 12/31/2016, was obtained from our research C-base. We utilized descriptive statistics to characterize the main demographic variables. Pearson's Chi-squared and Z-tests were utilized to compare percentages of enrolled versus not enrolled patients by ethnicity, race and gender. Results: A total of 3704 cases were established as new patients during the study period, of which 369 (10%) were enrolled in cancer research studies (Table). Our analysis showed statistically significant differences in enrollment by racial category (χ2= 95.09, df = 3, p < 0.0000). American Indian (n = 6) and Native Hawaiian (n = 4), were excluded from the analysis due to small sample sizes and no enrollments. In addition we tested with the Z-stat whether the enrollment in each group was different from the population average (p = 0.10). The Caucasian group did not differ from the average (z = 0.3944; p < 0.6933), whereas both the African American (z = -4.2286; p < 0.0001) and the Asian group (z = -2.3102; p < 0.0209) were under enrolled. The Others group was above the average (z = 8.4632; p < 0.0001). There were also differences in enrollment by gender and ethnicity. Females were under enrolled as compared to Males (z = -7.0716; p < 0.0001). The Hispanic group enrollment was significantly below the population average (z = -4.17; p < 0.0001). Conclusions: We found significant differences in the enrollment of minorities in cancer trials in our institution. African Americans, Asians, Hispanics and Females were all under represented. The group labeled as Others requires further attention. [Table: see text]

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Evans, Kathryn S., Stefan Zdraljevic, Lewis Stevens, Kimberly Collins, Robyn E. Tanny, and Erik C. Andersen. "Natural variation in the sequestosome-related gene, sqst-5, underlies zinc homeostasis in Caenorhabditis elegans." PLOS Genetics 16, no. 11 (2020): e1008986. http://dx.doi.org/10.1371/journal.pgen.1008986.

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Zinc is an essential trace element that acts as a co-factor for many enzymes and transcription factors required for cellular growth and development. Altering intracellular zinc levels can produce dramatic effects ranging from cell proliferation to cell death. To avoid such fates, cells have evolved mechanisms to handle both an excess and a deficiency of zinc. Zinc homeostasis is largely maintained via zinc transporters, permeable channels, and other zinc-binding proteins. Variation in these proteins might affect their ability to interact with zinc, leading to either increased sensitivity or resistance to natural zinc fluctuations in the environment. We can leverage the power of the roundworm nematode Caenorhabditis elegans as a tractable metazoan model for quantitative genetics to identify genes that could underlie variation in responses to zinc. We found that the laboratory-adapted strain (N2) is resistant and a natural isolate from Hawaii (CB4856) is sensitive to micromolar amounts of exogenous zinc supplementation. Using a panel of recombinant inbred lines, we identified two large-effect quantitative trait loci (QTL) on the left arm of chromosome III and the center of chromosome V that are associated with zinc responses. We validated and refined both QTL using near-isogenic lines (NILs) and identified a naturally occurring deletion in sqst-5, a sequestosome-related gene, that is associated with resistance to high exogenous zinc. We found that this deletion is relatively common across strains within the species and that variation in sqst-5 is associated with zinc resistance. Our results offer a possible mechanism for how organisms can respond to naturally high levels of zinc in the environment and how zinc homeostasis varies among individuals.

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Miyazaki, Kyle S. Y., Jared David Acoba, and Takeo Fujii. "Inflammatory breast cancer (IBC) in native Hawaiians and Pacific Islanders: Frequency of IBC and impact of socioeconomic status on survival outcomes." Journal of Clinical Oncology 38, no. 15_suppl (2020): e19083-e19083. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19083.

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e19083 Background: IBC is one of the most aggressive types of breast cancer, accounting for only 1-4% of all breast cancer cases while causing 8-10% of breast cancer related deaths. Previous studies have demonstrated that IBC has distinct epidemiological characteristics, but the prevalence of IBC particularly in Native Hawaiian (NH) and Pacific Islander (PI) populations, and the socioeconomic disparities related to survival outcomes, are not fully understood. Our primary objective was to determine the frequency at which NH and PI breast cancer patients are diagnosed with IBC, and the association between socioeconomic status and overall survival (OS). Methods: Patients with newly-diagnosed primary invasive breast cancer were identified from January 1, 2000 through December 31, 2018 using Queen’s Medical Center Tumor Registry. Clinical T4d was used to differentiate IBC and non-IBC. OS was defined as the time from diagnosis to death or last follow-up. Patients who were alive at the date of last follow-up were censored. Univariate and multivariate cox proportional hazard models were used to assess the effects of variables of interest on OS. Results: A total of 3,715 patients were included in analysis. There were 98 (2.6%) patients with IBC and 3,617 (97.4%) with non-IBC. Proportion of IBC relative to non-IBC was significantly higher in PI (9.0%) than in White (W) (2.7%) (P < 0.001). Proportion of IBC was higher in NH (4.7%) than W but the difference was not statistically significant (P = 0.08). In multivariate analysis among the non-IBC group, OS was significantly shorter for both PI and NH than W (HR 1.72, [95%CI, 1.13-2.6]; P = 0.01, HR 1.48 [95% CI, 1.14-1.93]; P = 0.003, respectively). There were no significant racial differences seen in OS among IBC patients. Being under or uninsured was also significantly associated with short OS outcomes among patients with non-IBC but not those with IBC. Conclusions: PI have a significantly high proportion of IBC relative to non-IBC. Race and insurance status were not associated with OS in IBC although they were significantly associated with short OS in non-IBC. This result suggests that in IBC, the potential effect of racial disparity on OS is negated by the aggressive and insidious nature of the cancer. The effect of a relatively small sample size cannot be excluded, and further study in a larger population is warranted.

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Wilson, Britney N., Mary Sun, Mario E. Lacouture, and Sarah Noor. "Dermatologic diagnoses in oncology patients of color on anticancer therapy: Five-year retrospective review of outpatient dermatology consultations." Journal of Clinical Oncology 39, no. 15_suppl (2021): 12084. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.12084.

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12084 Background: Dermatologic toxicities from cancer treatments affecting patients from racial and ethnic minority backgrounds or skin of color (SOC) patients is an understudied area of research. These patients are also significantly underrepresented in therapeutic clinical trials, limiting complete understanding of toxicities associated with cancer therapies. Current treatment algorithms for dermatological adverse events (dAE) also do not take into account possible biologic differences in different skin types affecting toxicity presentation and treatment response. In this study we summarize the demographic, clinical, and treatment characteristics of oncology patients from racial and ethnic minority backgrounds who developed dermatologic adverse events related to cancer therapies. Methods: We performed a retrospective review of all SOC patients (Asian, Black, Hispanic) on active cancer therapy who received outpatient dermatology consultation at Memorial Sloan Kettering Cancer Center from January 1, 2014 to December 31, 2019. Electronic health record information for 2917 patients was obtained. A computational keyword-based text analysis of medical chart text, developed in consultation with a board-certified dermatologist, was performed to determine dermatologic diagnoses categories for each patient. All analyses were conducted using R statistical programming software, version 4.2.06. Results: There were 2917 outpatient dermatology consultations. Our population consisted of 1992 (68.29%) females and 925 (31.71%) males with a mean age of 53 (range 0-97). There were 35.55% Black, 41.28% Asian, 1.02% (30) Native American or Alaskan Native, 0.17% (5) Native Hawaiian or Other Pacific Islander. 729 were Hispanic ethnicity of which 641 were Caucasian. A total of 4,026 dermatologic diagnoses occurred in the study population. Bacterial infections were the most commonly observed, occurring in 15% of patients. Nail disorders were the second most common dAE, occurring in 14% of the study population, followed by eczema/eczematous reactions at 9%. In all racial groups, eczema/eczematous reactions, nail disorders, and dermatomyositis were in the top five most common observed dAEs. Asian patients made up the largest proportion of those who had morbilliform rash dAEs (55%) while Black patients made up the largest proportion of those with hyperpigmentation dAEs (54%) and vascular insufficiency dAEs (47%). Conclusions: The findings from our study indicate that pigmentary changes, bacterial infections, eczema/eczematous reactions, and nail disorders are the most common dAE types that occurred in our group of SOC patients. We hope to use this information to aid in the development of specific management strategies within the field of supportive oncodermatology to meet the needs of minority patient populations.

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Malhotra, Armaan Kush. "Cancer Prevention as the Key to Long Term Population Health: An Interview with Dr. Carolyn Gotay." University of Ottawa Journal of Medicine 6, no. 1 (2016): 8–10. http://dx.doi.org/10.18192/uojm.v6i1.1550.

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Dr. Carolyn Gotay is Professor and Canadian Cancer Society Chair in Cancer Primary Prevention at the University of British Columbia (UBC). Her training began at Duke University and continued with a PhD in Psychology from the University of Maryland. During her first position at the University of Calgary, she became interested in the relationship between psychology and cancer, which would become the focus of her subsequent work. Dr. Gotay has held positions at Gettysburg College, the University of Calgary, and the National Cancer Institute (U.S.) where she acted as a Health Scientist Administrator. Following these positions, she began at the University of Hawaii, where she worked as the Director of the Cancer Prevention and Control Program. Throughout these various roles, her primary prevention interests were multi-faceted; they included a focus on clinical trials investigating quality of life as well as understanding end-of-life care and the psychosocial wellbeing of patients. Dr. Gotay joined UBC in 2008 where she continued her primary prevention research through the School of Population and Public Health and the B.C. Cancer Agency. Currently, Dr. Gotay is a leader in the Cancer Prevention Centre where she and her colleagues look at modifiable cancer risk factors and the application and assessment of interventions to modify these behaviours in the population.Dre Carolyn Gotay est professeure et elle siège au sein de la Société canadienne du cancer dans le domaine de la prévention primaire du cancer à l’Université de la Colombie-Britannique. Son éducation universitaire a débuté à l’Université de Duke et elle a continué ses études doctorales en psychologie à l’Université de Maryland. Son premier poste fut à l’Université de Calgary et elle concentre ses recherches sur la relation entre la psychologie et le cancer. Dre Gotay a obtenu des postes à l’Université de Gettysburg, à l’Université de Calgary et à l’institut national du cancer (É.U.) où elle était administratrice scientifique de la santé. Par la suite, elle a travaillé à l’Université d’Hawaii, où elle a oeuvré en tant que directrice du programme de prévention et de contrôle du cancer. À travers son cheminement professionnel, Dre Gotay a étudié les soins primaires préventifs en lien avec la qualité de vie, les soins de fin de vie et le bien-être psychosocial des patients. En 2008, elle a eu la chance de continuer sa recherche en soins préventifs primaires à l’Université de la Colombie-Britannique dans le département de santé publique ainsi qu’à l’agence de cancer de la Colombie-Britannique. Dre Gotay demeure une leader au centre de prévention du cancer où elle travaille présentement avec ses collègues pour trouver des facteurs de risque modifiables du cancer et l’application d’interventions pour modifier ces comportements dans la population.

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Nomura, Abraham M. Y., Grant N. Stemmermann, and Po-Huang Chyou. "Gastric Cancer among the Japanese in Hawaii." Japanese Journal of Cancer Research 86, no. 10 (1995): 916–23. http://dx.doi.org/10.1111/j.1349-7006.1995.tb03001.x.

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Goodman, Marc T., Carl N. Yoshizawa, and Laurence N. Kolonel. "Descriptive epidemiology of thyroid cancer in Hawaii." Cancer 61, no. 6 (1988): 1272–81. http://dx.doi.org/10.1002/1097-0142(19880315)61:6<1272::aid-cncr2820610636>3.0.co;2-8.

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20

Long, Michael H., Cindy Brock, Graham Crookes, et al. "The University of Hawaii Center for Second Language Classroom Research Technical Reports." TESOL Quarterly 19, no. 3 (1985): 605. http://dx.doi.org/10.2307/3586281.

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21

Iwata, Ruth Y., Kent Fleming, and Scott Campbell. "COMPUTER-BASED INFORMATION TRANSFER FOR AGRICULTURE IN HAWAII." HortScience 27, no. 6 (1992): 674c—674. http://dx.doi.org/10.21273/hortsci.27.6.674c.

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AgNet-Hawaii is a computer-based information transfer system (CBIS) established at the Beaumont Agricultural Research Center in Hilo, Hawaii to improve communication among research, extension and farmers on the island of Hawaii and with the island of Oahu. AgNet-Hawaii is one node of a Pacific-wide network of CBIS nodes, whose hub is the Coconut Telegraph CBIS on the Manoa Campus of the University of Hawaii on Oahu. AgNet-Hawaii has file and conference areas, the capability of uploading and downloading files, issuing bulletins, and sending files attached to messages. Access is by computer and modem with the following modem protocols: Telephone (808) 969-3025 (AgNet-Hawaii), (808) 956-2626 (Coconut Telegraph), Data Bits: 8, Parity: N, Stop Bits: 1, Speed: 300/1200/2400/9600/14.4K bps.

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22

Patton, Amanda. "Center for Indigenous Cancer Research at Roswell Park Comprehensive Cancer Center." Oncology Issues 36, no. 3 (2021): 22–28. http://dx.doi.org/10.1080/10463356.2021.1901551.

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23

Goodman, Madeleine J. "Breast cancer in multi-ethnic populations: The Hawaii perspective." Breast Cancer Research and Treatment 18, S1 (1991): S5—S9. http://dx.doi.org/10.1007/bf02633519.

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24

Landgren, Ola, Susan Devesa, Pamela Mink, et al. "African-American Multiple Myeloma Patients Have a Better Survival Than Caucasian Patients: a Population-Based Study Including 28,636 Patients." Blood 114, no. 22 (2009): 1832. http://dx.doi.org/10.1182/blood.v114.22.1832.1832.

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Abstract Abstract 1832 Poster Board I-858 Background Multiple myeloma is the most common hematologic malignancy in African-Americans with twice the incidence of Caucasians. Prior single center studies have reported poorer survival among African-American multiple myeloma patients. In contrast, recent data based on multiple myeloma patients who received autologous transplantation in an equal access health care system, showed comparable survival between African-Americans and Caucasians, suggesting that the reportedly poorer outcome for African-Americans may be due to inequalities in access to care. Also, based on publicly available cancer registry data, several publications have reported excess mortality rates for African-American multiple myeloma patients. We conducted a large population-based study including almost 30,000 multiple myeloma patients to evaluate survival patterns by race. Methods. Patient information was obtained from the Surveillance, Epidemiology and End Results (SEER) cancer registries of the National Cancer Institute. Data were drawn from the original nine SEER registries (Atlanta, Connecticut, Detroit, Hawaii, Iowa, New Mexico, San Francisco-Oakland, Seattle-Puget Sound, and Utah), which collectively cover approximately 10% of the U.S. population. Using the SEER*Stat statistical software package, we calculated 1-, 5-, and 10-year relative survival rates (RSR) of multiple myeloma patients diagnosed 1973-2004. We applied four calendar periods (1973-1979, 1980-1986, 1987-1993, and 1994-2004), follow-up through 2005 was included, and age at diagnosis was grouped into three strata (<50, 50-64, and 65+ years). Results We identified a total of 28,636 multiple myeloma patients (4,855 African-American; 23,781 Caucasian); 64% were 65 years or greater at diagnosis. When we included all patients, a comparison of survival rates in African-American and Caucasian males showed that African-American males had significantly better 5-year (32.2% vs. 28.7%) and 10-year (16.4% vs. 11.5%) RSRs (p<0.05). Similarly, African-American females had significantly better 1-year (73.3% vs. 70.2%) and 5-year (31.1% vs. 27.7%) RSRs than Caucasian females (p<0.05). When we examined survival patterns by calendar period (between 1973-1979 and 1994-2004), we found Caucasian patients to have significant improvements in the 1-year (from 67.1 to 72.4%), 5-year (from 24.1% to 31.7%), and 10-year RSR (from 9.9% to 14.9%). African-Americans also showed significantly improved 1-year RSRs (from 68.5% in 1973-1979 to 74.9% in 1994-2004) but the improvements in 5- and 10-year RSRs were not significant. When we examined survival patterns by age group, in the youngest age group (<50 years), both African-Americans and Caucasians improved 5- and 10-year RSRs, while 1-year RSR was improved for Caucasians only (from 80.9% to 84.9%). For patients 50-64 years, Caucasians had significantly improved 1-, 5-, and 10-year RSR; for African-Americans only 1-year RSR improvement was significant. Among patients 65+, there was no significant improved survival for African-Americans while Caucasians had improved 1-year (from 61.4% to 66.9%) and 5-year (from 19.6% to 24.7%) RSRs. Conclusions This large study of almost 30,000 patients found African-American multiple myeloma patients to have a significantly better prognosis than Caucasian patients, suggesting there is disease heterogeneity by race. After the introduction of newer therapies (autologous transplant, IMiDs, and bortezomib), Caucasian multiple myeloma patients showed a more pronounced survival benefit which might reflect inequalities in access to modern care; however, still African-Americans showed similar/better survival compared to Caucasians. Clinicians should be aware that the excess mortality rates for multiple myeloma among African-Americans, to a major degree, is a reflection of the fact that multiple myeloma is 2- to 3-fold more common among African-Americans. Future studies are needed to improve our understanding of the molecular basis for racial disparity patterns in multiple myeloma. Ultimately, such efforts will facilitate an improved understanding regarding disease subtype-specific benefits for individual agents, as well as mechanistic insights into drug sensitivity and resistance. Disclosures Weiss: The Binding Site, Inc.: Research Funding.

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Kagan, A. Robert, and Richard J. Steckel. "The American Cancer Center." American Journal of Clinical Oncology: Cancer Clinical Trials 24, no. 2 (2001): 209–10. http://dx.doi.org/10.1097/00000421-200104000-00022.

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26

&NA;. "Arizona Cancer Center Meetings." American Journal of Clinical Oncology 11, no. 5 (1988): 606. http://dx.doi.org/10.1097/00000421-198810000-00026.

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27

Rubio, Carlos A., Grant N. Stemmermann, and Takuji Takuji. "Ciliated Gastric Cells among Japanese Living in Hawaii." Japanese Journal of Cancer Research 82, no. 1 (1991): 86–89. http://dx.doi.org/10.1111/j.1349-7006.1991.tb01750.x.

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28

Mahaney, F. X. "Pittsburgh Cancer Institute: New Clinical Cancer Center." JNCI Journal of the National Cancer Institute 80, no. 12 (1988): 894. http://dx.doi.org/10.1093/jnci/80.12.894.

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29

Bosch, Xavier. "Spain to build new cancer research center." Nature Medicine 5, no. 7 (1999): 722. http://dx.doi.org/10.1038/10435.

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30

Acoba, J. D., M. P. Palalay, J. Cho, and D. Chow. "Ethnic variation of prognostic factors among breast cancer patients in Hawaii." Journal of Clinical Oncology 22, no. 14_suppl (2004): 9512. http://dx.doi.org/10.1200/jco.2004.22.14_suppl.9512.

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31

Stemmermann, Grant N., Ann Catts, Francis H. Fukunaga, Akio Horie, and Abraham M. Y. Nomura. "Breast cancer in women of Japanese and Caucasian ancestry in Hawaii." Cancer 56, no. 1 (1985): 206–9. http://dx.doi.org/10.1002/1097-0142(19850701)56:1<206::aid-cncr2820560135>3.0.co;2-0.

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32

Goodman, Marc T., Carl N. Yoshizawa, and Laurence N. Kolonel. "Ethnic patterns of childhood cancer in Hawaii between 1960 and 1984." Cancer 64, no. 8 (1989): 1758–63. http://dx.doi.org/10.1002/1097-0142(19891015)64:8<1758::aid-cncr2820640834>3.0.co;2-5.

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33

Acoba, J. D., M. P. Palalay, J. Cho, and D. Chow. "Ethnic variation of prognostic factors among breast cancer patients in Hawaii." Journal of Clinical Oncology 22, no. 14_suppl (2004): 9512. http://dx.doi.org/10.1200/jco.2004.22.90140.9512.

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34

Issell, Brian F., Gertraud Maskarinec, Ian Pagano, and Carolyn C. Gotay. "Breast Cancer Treatment Among Women of Different Ethnicity in Hawaii." Cancer Investigation 23, no. 6 (2005): 497–504. http://dx.doi.org/10.1080/07357900500201442.

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35

&NA;. "Arizona Cancer Center Winter Symposium." American Journal of Clinical Oncology 10, no. 4 (1987): 368. http://dx.doi.org/10.1097/00000421-198708000-00024.

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36

Smigel, K. L. "Michigan Named Clinical Cancer Center." JNCI Journal of the National Cancer Institute 80, no. 17 (1988): 1360. http://dx.doi.org/10.1093/jnci/80.17.1360.

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37

Fei-Zhang, David J., Chunshun Li, and Shugeng Cao. "Hawaii natural compounds are promising to reduce ovarian cancer deaths." Cancer Biology & Therapy 17, no. 7 (2016): 709–12. http://dx.doi.org/10.1080/15384047.2016.1178428.

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38

Frisch, Morten, and Marc T. Goodman. "Human papillomavirus-associated carcinomas in Hawaii and the mainland U.S." Cancer 88, no. 6 (2000): 1464–69. http://dx.doi.org/10.1002/(sici)1097-0142(20000315)88:6<1464::aid-cncr26>3.0.co;2-o.

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39

Penson, Richard T., Lidia Schapira, Sally Mack, Marjorie Stanzler, and Thomas J. Lynch. "Connection: Schwartz Center Rounds at Massachusetts General Hospital Cancer Center." Oncologist 15, no. 7 (2010): 760–64. http://dx.doi.org/10.1634/theoncologist.2009-0329.

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40

Steimle, S. "Will Spain's First National Cancer Center Boost Research?" JNCI Journal of the National Cancer Institute 91, no. 7 (1999): 584–85. http://dx.doi.org/10.1093/jnci/91.7.584.

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41

Madrid, S. D., J. W. Dearing, R. E. Glasgow, B. A. Rabin, K. Mazor, and E. H. Wagner. "PS2-10: The CRN Cancer Communication Research Center." Clinical Medicine & Research 8, no. 1 (2010): 34. http://dx.doi.org/10.3121/cmr.8.1.34.

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42

Javdan, Bahar, and Barrie Cassileth. "Acupuncture Research at Memorial Sloan Kettering Cancer Center." Journal of Acupuncture and Meridian Studies 8, no. 3 (2015): 115–21. http://dx.doi.org/10.1016/j.jams.2015.03.005.

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43

Prager, Diane, Joy Muir, Laura M. Miller, et al. "SmartCare at a community cancer center." Journal of Clinical Oncology 33, no. 15_suppl (2015): e17535-e17535. http://dx.doi.org/10.1200/jco.2015.33.15_suppl.e17535.

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44

Kreeger, K. "America's First Cancer Center Celebrates Centennial." JNCI Journal of the National Cancer Institute 96, no. 3 (2004): 171–72. http://dx.doi.org/10.1093/jnci/96.3.171.

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45

Vanchieri, C. "What is a Freestanding Cancer Center?" JNCI Journal of the National Cancer Institute 81, no. 3 (1989): 183–85. http://dx.doi.org/10.1093/jnci/81.3.183.

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46

Newman, M. E. "UNC Cancer Center Receives Comprehensive Designation." JNCI Journal of the National Cancer Institute 82, no. 15 (1990): 1243–44. http://dx.doi.org/10.1093/jnci/82.15.1243.

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47

Holcombe, Randall F., Jeff Tom, Michael Morimoto, et al. "Effect of COVID-19-related reductions in cancer screening in Native Hawaiians and across urban and rural communities in Hawaii." Journal of Clinical Oncology 39, no. 28_suppl (2021): 109. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.109.

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109 Background: The COVID-19 pandemic has disrupted medical care in all areas of the US and had a profound impact on cancer screening, with a concern that this may lead to excess cancer-related deaths over the next decade. There are existing disparities in cancer mortality among rural US residents and Native Hawaiians (NHs) due to access issues, lower socioeconomic status and lack of a sufficient provider workforce. A reduction in cancer screening may therefore have an oversized impact on these populations. In this study, we examine the effects of the COVID-19 pandemic on cancer screening frequency among NHs and in urban and rural populations in Hawaii. Methods: De-identified data on the frequencies of breast cancer (BCS), cervical cancer (CCS) and colorectal cancer (CRCS) screenings for 2019 and 2020 were obtained for Hawaii residents from several sources, including Hawaii Medical Services Association, the largest private and Medicaid provider in Hawaii, and the two largest state-wide health systems, Queen’s Health Systems and Hawaii Pacific Health. Data was analyzed using Rural-Urban Continuum Codes (RUCC) and Rural-Urban Commuting Area (RUCA) codes to define rurality and, along with health system facility location, to ascertain whether there was a differential impact on cancer screening rates for rural populations due to the pandemic. Cancer screening data for NHs in comparison to other groups was analyzed separately. Results: Overall, reductions in cancer screening during the pandemic were seen, with the degree of reduction varying widely across regions of the state and among different ethnic populations. Annual reductions in BCS, CCS and CRCS ranged from 4.0-30.2%, 2.7-3.0% and 9.4-13.2%, respectively, depending on the data source. BCS reductions were greatest in rural areas (p = 0.09) and among NHs (p = 0.0005). The island of Kauai, which is rural but was minimally affected by COVID-19, saw no reduction in BCS. CCS reductions had a reverse urban vs. rural pattern, with reductions of 4.5% urban and 0.8% rural (p = 0.02). CRCS reductions were most profound in rural residents (17.1%; p = 0.0001); reductions in CRCS among NHs were 1.5x greater than other groups. The differential impact across urban and rural areas was consistent for both RUCC and RUCA analysis. The extent of reduction was most significant for CRCS and was directly proportional to the degree of rurality. Conclusions: BCS and CRCS were impacted more significantly by the COVID-19 pandemic than CCS. For BCS and CRCS, greater reductions were seen in rural compaed to urban populations and in NHs. The lack of correlation with rurality for CCS may be because this population is generally younger and screening is often provided as a component of primary care. The greater pandemic-related reduction in screening among rural residents and Native Hawaiians may exacerbate existing cancer mortality disparities in these vulnerable populations.

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Choynzonov, E. L., Т. Ya Kucherova, I. N. Udintseva, et al. "Cancer Research Institute, Tomsk National Research Medical Center of the RAS." Head and Neck Tumors (HNT) 9, no. 2 (2019): 66–70. http://dx.doi.org/10.17650/2222-1468-2019-9-2-66-70.

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Vanchieri, C. "Basic Breast Cancer Research Is Focus of New British Research Center." JNCI Journal of the National Cancer Institute 85, no. 6 (1993): 432. http://dx.doi.org/10.1093/jnci/85.6.432.

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50

Stemmermann, G. N., L. K. Heilbrun, A. Nomura, K. Yano, and T. Hayashi. "Adenomatous polyps and atherosclerosis: An autopsy study of Japanese men in Hawaii." International Journal of Cancer 38, no. 6 (1986): 789–94. http://dx.doi.org/10.1002/ijc.2910380602.

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