Cancer Control最新文献

{"title":"Short- and Intermediate-Term Morbidity Following Total Pelvic Exenteration in Colorectal Cancer.","authors":"Christopher Guske, Nusheen Immen, Devon Conant, Jose Laborde, Joshua Linscott, Mitchell Hayes, Seyed Behzad Jazayeri, Adnan Fazili, Erin Siegel, Sophie Dessureault, Julian Sanchez, Amalia Stefanou, Brandon Manley, Seth Felder","doi":"10.1177/10732748251316598","DOIUrl":"10.1177/10732748251316598","url":null,"abstract":"<p><strong>Introduction: </strong>Total pelvic exenteration (TPE) for clinical T4b colorectal cancer (CRC) is associated with significant morbidity. Short (0-30 days)- and intermediate (31-90 days)-term temporal analysis of complication onset is not well described, yet needed, to better counsel patients considering TPE.</p><p><strong>Methods: </strong>A retrospective cohort study of consecutive patients with primary or recurrent clinical T4b pelvic CRC undergoing open TPE between 2014 and 2023 was conducted. Clinicopathologic variables were collected for each patient. Postoperative morbidity was classified according to the Clavien-Dindo (CD) grade system and stratified by time of onset within 90 days of surgery. Pearson's Chi-square test, Fisher's Exact test, and the Mann-Whitney U test were used to compare primary vs recurrent patient groups, and logistic regression assessed predictors of postoperative morbidity. Statistical analysis was performed using R with two-sided significance set at <0.05.</p><p><strong>Results: </strong>Twenty-seven patients were identified of which 24 (88.9%) were male with a median age of 60.4 years (interquartile range [IQR]: 56.3-70.5). Seventeen (63.0%) patients had primary disease and 10 (37.0%) had recurrent CRC. Twenty-three (85.2%) patients experienced at least one complication within 90 days of surgery, but no mortality was observed. Ten (37.0%) patients experienced a CD ≥ 3 event, of which 40% took place beyond 30 days. The most common complication overall was anemia requiring transfusion, while the most common major complication was pelvic abscess. No clinicopathologic variables analyzed were predictive of major postoperative complication within 90 days of TPE.</p><p><strong>Conclusion: </strong>TPE for clinical T4b CRC carries a high risk of postoperative morbidity in both the short- and intermediate-term after surgery, with a significant proportion of complications occurring after 30 days. Given the magnitude of operation, an extended recovery with high risk for complications is common. Although a single-center series, this annotated postoperative complication profile may assist patients and clinicians when reviewing informed consent for TPE.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251316598"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision-Making for Ablation of Colorectal Liver Oligometastases Patients: A 10-Year Retrospective Study of Survival Outcomes Based on Right-Versus Left-Sided Primary Tumor Location.","authors":"Xiao-Guang Qi, Jian-Ming Li, Jian-Ping Dou, Fang-Yi Liu, Zhen Wang, Zhao-He Zhang, Ping Liang, Jie Yu","doi":"10.1177/10732748251324627","DOIUrl":"10.1177/10732748251324627","url":null,"abstract":"<p><p>ObjectiveTo develop a prognostic model for optimizing management of colorectal liver oligometastases (CLOM) patients with different primary tumor locations who underwent thermal ablation (TA).Materials and MethodsThe reporting of this retrospective study conforms to STROBE guidelines. A total of 525 CLOM patients who underwent TA from 3 hospitals between 2011 and 2021 were enrolled. Firstly, intra and extrahepatic disease-free survival (DFS) and overall survival (OS) for CLOM patients with different primary tumor locations were analyzed. Then, cox regression models were used to identify independent factors predicting OS. Finally, a prognostic score was developed to identify CLOM patients benefiting from TA. All patient details were de-identified.ResultsA total of 423 eligible patients were identified, with 762 CLOM (121 male, median age 59 years) and a median follow-up of 45.8 (IQR, 7.3-114.8) months. Independent predictors of OS were identified, including multiple liver metastases (<i>P</i> = .0085), right-sided colon cancer (<i>P</i> = .0210), tumor size ≥2 cm (<i>P</i> = .0273), and lymph node metastasis of primary colorectal cancer (<i>P</i> = .0302), termed as the \"MRSL\" score. On the basis of the best separation of MRSL score, patients were divided into high-risk (cutoff value ≥8) and low-risk groups (cutoff value <8). Further stratified analysis indicated that right-sided CLOM patients had shorter OS than left-sided patients in the high-risk group (54.9 vs 92.5 months, <i>P</i> = .0156). However, no significant difference in OS was observed between right-sided and left-sided CLOM patients in the low-risk group (97.7 vs 102.2 months, <i>P</i> = .28).ConclusionThe MRSL score-based model helps in selecting potential right-sided CLOM patients who benefit from TA.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251324627"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning-Based Prediction of Unplanned Readmission Due to Major Adverse Cardiac Events Among Hospitalized Patients with Blood Cancers.","authors":"Nguyen Le, Sola Han, Ahmed S Kenawy, Yeijin Kim, Chanhyun Park","doi":"10.1177/10732748251332803","DOIUrl":"https://doi.org/10.1177/10732748251332803","url":null,"abstract":"<p><p>BackgroundHospitalized patients with blood cancer face an elevated risk for cardiovascular diseases caused by cardiotoxic cancer therapies, which can lead to cardiovascular-related unplanned readmissions.ObjectiveWe aimed to develop a machine learning (ML) model to predict 90-day unplanned readmissions for major adverse cardiovascular events (MACE) in hospitalized patients with blood cancers.DesignA retrospective population-based cohort study.MethodsWe analyzed patients aged ≥18 with blood cancers (leukemia, lymphoma, myeloma) using the Nationwide Readmissions Database. MACE included acute myocardial infarction, ischemic heart disease, stroke, heart failure, revascularization, malignant arrhythmias, and cardiovascular-related death. Six ML algorithms (L2-Logistic regression, Support Vector Machine, Complement Naïve Bayes, Random Forest, XGBoost, and CatBoost) were trained on 2017-2018 data and tested on 2019 data. The SuperLearner algorithm was used for stacking models. Cost-sensitive learning addressed data imbalance, and hyperparameters were tuned using 5-fold cross-validation with Optuna framework. Performance metrics included the Area Under the Receiver Operating Characteristics Curve (ROCAUC), Precision-Recall AUC (PRAUC), balanced Brier score, and F2 score. SHapley Additive exPlanations (SHAP) values assessed feature importance, and clustering analysis identified high-risk subpopulations.ResultsAmong 76 957 patients, 1031 (1.34%) experienced unplanned 90-day MACE-related readmissions. CatBoost achieved the highest ROCAUC (0.737, 95% CI: 0.712-0.763) and PRAUC (0.040, 95% CI: 0.033-0.050). The SuperLearner algorithm achieved slight improvements in most performance metrics. Four leading predictive features were consistently identified across algorithms, including older age, heart failure, coronary atherosclerosis, and cardiac dysrhythmias. Twenty-three clusters were determined with the highest-risk cluster (mean log odds of 1.41) identified by nonrheumatic/unspecified valve disorders, coronary atherosclerosis, and heart failure.ConclusionsOur ML model effectively predicts MACE-related readmissions in hospitalized patients with blood cancers, highlighting key predictors. Targeted discharge strategies may help reduce readmissions and alleviate the associated healthcare burden.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251332803"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis Challenges in Adult Leukemia: Insights From a Single-Center Retrospective Study in Qatar (2016-2021).","authors":"Hesham A B Aboelkhir, Yousra El Alaoui, Regina Padmanabhan, Majed Hadid, Adel Elomri, Tanvir Alam, Mohamed Amine Rejeb, Halima El Omri, Ruba Y Taha, Hesham Elsabah, Abdelfatteh El Omri","doi":"10.1177/10732748241275026","DOIUrl":"10.1177/10732748241275026","url":null,"abstract":"<p><p>ObjectivesWhile delays in leukemia detection remain an ongoing challenge in hematologic cancer care, little is known about the factors associated with these delays. This article focuses on identifying the barriers hindering timely diagnosis of leukemia through a cohort analysis (2016-2021) of 220 Acute Myeloid Leukemia (AML), 161 Chronic Myeloid Leukemia (CML), 90 Acute Lymphocytic Leukemia (ALL), and 121 Chronic Lymphocytic Leukemia (CLL) patients in Qatar.MethodsOf the 592 patients used for the study, subsets were identified and analyzed for delay (423), risk stratification (437), and leukemia stage (282).ResultsThere was an increasing trend in leukemia cases, with 32% of patients being diagnosed in the high-risk category. Out of 423 (median delay = 28 days) patients, 45% reported delayed diagnosis (median delay = 44 days). Further analysis of the association of delayed leukemia diagnosis using the univariate <math><mrow><mi>χ</mi></mrow></math>2 independence test revealed significant associations to patient referral type, and the presence of certain comorbidities and symptoms.ConclusionSignificant delays in leukemia diagnosis were identified, though the exact cause remains unclear. These delays can be attributed to factors such as patient, primary care, referral, system, and physician delays. Therefore, further investigation is imperative for improving the detection, diagnosis, and referral processes in hematologic cancers.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748241275026"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Adenocarcinoma With Bone Metastases: Clinicogenomic Profiling and Insights Into Prognostic Factors.","authors":"Ahmed H Al Sharie, Rami K Jadallah, Mahmoud Z Al-Bataineh, Lana E Obeidat, Hanin Lataifeh, Mahmoud I Tarad, Mustafa Q Khasawneh, Walaa Almdallal, Tamam El-Elimat, Feras Q Alali","doi":"10.1177/10732748251325587","DOIUrl":"10.1177/10732748251325587","url":null,"abstract":"<p><p>IntroductionLung adenocarcinoma is the leading cause of cancer-related mortality worldwide. Understanding the clinicopathological profiles and genomic drivers of its metastatic patterns is a crucial step for risk stratification. Herein, we investigated the clinicogenomic features of bone metastases in lung adenocarcinoma and their prognostic value.MethodsA retrospective cohort study with a total of 4064 patients with various metastatic patterns of lung adenocarcinoma were included, obtaining relevant clinical data and genomic profiles. Patients were categorized based on the presence or absence of bone metastases. A comparative analysis of both groups in terms of demographics, disease status, somatic mutations, and microsatellite instability was carried out. Significantly different variables were tested for their association with bone metastases. Cox regression analyses were utilized to identify independent survival prognostic variables in the bone metastases sub-cohort.ResultsGender, concomitant metastases (to adrenal gland, nervous system, lymph nodes, liver, lung, mediastinum, pleura, and skin), and aberrations in <i>TP53</i>, <i>EGFR</i>, <i>KEAP1</i>, and <i>MYC</i> were associated with bone metastases in lung adenocarcinoma. Survival analyses within the bone metastases sub-cohort have illustrated the following variables to possess poor prognostic signature including age > 75, female gender, White ethnicity, distant metastases (adrenal gland, central nervous system, intra-abdominal, and liver), <i>EGFR</i> (wild type), <i>KEAP1</i> (mutant), <i>MYC</i> (mutant), <i>KRAS</i> (mutant), and <i>SMARCA4</i> (mutant).ConclusionKey clinical and genomic factors associated with lung adenocarcinoma bone metastases have been highlighted, providing exploratory insights into high-risk individuals. Future studies should be directed to validate these prognostic variables in larger, more diverse cohorts to enhance generalizability.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251325587"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signal Mining and Analysis of Drug-Induced Myelosuppression: A Real-World Study From FAERS.","authors":"Kaiyue Xia, Shupeng Chen, Yingjian Zeng, Nana Tang, Meiling Zhang","doi":"10.1177/10732748251337362","DOIUrl":"10.1177/10732748251337362","url":null,"abstract":"<p><p>IntroductionDrug-induced myelosuppression (DIM) is a serious side effect of several medications, particularly chemotherapy, immunosuppressants, and targeted therapies, which can lead to infections, anemia, and bleeding. While these drugs are effective, their adverse effects can disrupt treatment plans and reduce quality of life. However, early identification of DIM remains challenging, as many associated drugs do not explicitly list this risk, complicating clinical monitoring.MethodsThis study utilized the FDA Adverse Event Reporting System (FAERS) database to perform signal mining and assess the risks of DIM. Reports from the first quarter of 2004 to the third quarter of 2024 were analyzed using signal detection algorithms such as Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM). These methods helped identify drug signals related to DIM and explore risk factors and occurrence patterns.ResultsThe study analyzed 21 380 adverse event reports related to DIM, showing a significant increase in the number of reports since 2019, peaking at 3501 in 2021. Among patients, 50.2% were female, 35.5% were male, and the majority (44.42%) were aged between 18 and 65. Breast cancer patients had the highest DIM incidence (10.6%). Geographically, China reported the most cases (57.4%), followed by Japan (12.4%), and the United States (6.76%). The drugs most frequently linked to DIM included trastuzumab, bevacizumab, venetoclax, methotrexate, and pertuzumab. Additionally, 12 new drug signals were identified that were not labeled for DIM risk, including PERTUZUMAB, SODIUM CHLORIDE, and MESNA, which showed particularly strong or unexpected associations.ConclusionThis study identifies new DIM-related drug signals and emphasizes the need for early detection to improve clinical management and optimize treatment regimens. The findings provide valuable evidence for drug safety monitoring and can help reduce DIM-related risks in cancer treatment.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251337362"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"<i>How am I Going to Live? How am I Going to Pay Rent?\"</i>: A Mixed Methods Investigation of Employment, Stigma, and Financial Hardship Among LGBTQ+ Cancer Caregivers.","authors":"Austin R Waters, Erin E Kent, Camille R Murray, Shaun R Jones, Echo L Warner, Lorinda A Coombs, Heidi Donovan, Hazel B Nichols, Stephanie B Wheeler, Donald L Rosenstein, Mya L Roberson, Kelly R Tan","doi":"10.1177/10732748251351105","DOIUrl":"10.1177/10732748251351105","url":null,"abstract":"<p><p>IntroductionEmployment changes among cancer caregivers are common and can result in financial hardship. Lesbian, gay, bisexual, transgender, queer, and other identities outside of cisgender heterosexual (LGBTQ+) individuals are more likely to live in poverty and experience workplace discrimination than non-LGBTQ+ individuals. This study aimed to assess the impact of caregiving-related employment changes and anti-LGBTQ+ stigma on financial hardship and describe lived experiences with financial hardship and related employment changes among LGBTQ+ cancer caregivers.MethodsAn explanatory mixed-methods study was conducted and included a national survey and individual interviews with survey participants. Multivariable logistic regression models were used to test the association of employment changes with financial hardship. An inductive qualitative analysis guided by two of the three domains of financial hardship (ie, material and behavioral) was conducted. Quantitative and qualitative data were integrated throughout the study.ResultsA total of N = 332 LGBTQ+ cancer caregivers participated in the survey, and N = 14 participated in an interview. The average modified COmprehensive Score for financial Toxicity and Caregiver Reaction Assessment financial sub-scale were 25.6 (SD: 9.9, Range: 1-44) and 2.99 (SD: 1.0, Range: 1-5). Employment changes (OR: 3.32, 95% CI: 1.73-6.36) and anti-LGBTQ+ stigma (OR: 2.21, 95% CI: 1.47-3.32) were associated with high financial hardship. Three overarching themes from the qualitative analysis included: 1) Financial Hardship: Increased Costs, Strained Finances, and Lost Wages; 2) Caregiving as an LGBTQ+ Person: Stigma, Outness, and Expectations; and 3) Financial Unmet needs and Recommendations.ConclusionLGBTQ+ cancer caregivers experience substantial financial hardship that is associated with employment changes and anti-LGBTQ+ stigma. LGBTQ + cancer caregivers reported varying levels of outness and acceptance that directly influenced their access to financial support. Cancer-related financial hardship interventions tailored to the needs of LGBTQ+ individuals are needed.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251351105"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Distinct Research Gaps that Complement Previous Critiques of Militaristic Language in Relation to Cancer and Other Non-Military Topics.","authors":"Kari Almendingen","doi":"10.1177/10732748251349935","DOIUrl":"10.1177/10732748251349935","url":null,"abstract":"<p><p>Militaristic language is pervasive in cancer discourse across media, fundraising, politics, healthcare, and science, despite longstanding critiques from both civilian and military perspectives. Critics argue that framing cancer as a war or battle can lead to feelings of shame and inadequacy, particularly for those with metastatic cancer. This language often diverts focus from prevention and early detection strategies, complicating public perception and understanding of cancer. Two distinct research gaps related to the use of militaristic language in cancer discourse remain unaddressed: the role of dual-use technologies and the perspectives of individuals with wartime experience. Dual-use technologies, initially developed for military applications, have significantly advanced cancer diagnosis and treatment. Yet, their historical and ethical implications are largely absent from public discourse and scientific literature. Awareness of the complex role that dual-use technologies play in cancer diagnostics and treatment, as well as in other societal areas, could influence the prevalence of militaristic language used to describe challenges like cancer, drugs, poverty, and other civil issues. Secondly, studies have not examined opinions on the use of militaristic language among individuals with firsthand wartime experience, - such as civilian victims, military personnel, veterans, pacifists, and aid workers - compared to those without such experience. Both of these omissions may skew findings and overlook diverse perceptions. Addressing these research gaps could foster a more respectful public cancer discourse that takes into account the experiences of affected individuals. This commentary expands on existing critiques, urging professionals to adopt nuanced and inclusive language for cancer and other peaceful topics. Militaristic language is outdated, ethically questionable, and should not be used in science, healthcare, politics, fundraising, or other public contexts.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251349935"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing High-Risk Human Papillomavirus Self-Sampling for Cervical Cancer Screening in Ghana: A Study (CarciSCAN) Protocol.","authors":"Nadja Taumberger, Ibrahim Friko, Vera Mwinbe-Ere Der, Laura Burney Ellis, Amy MacDonald Shearer, Sarah J Bowden, Maria Kyrgiou, Teresa L Pan, Verena Lessiak, Neli Hofer, Elisabeth Rogatsch, Manurishi Nanda, Isabella Pfniss, Elmar Joura, Alper Cinar, Yalin Kilic, Murat Gultekin","doi":"10.1177/10732748251330698","DOIUrl":"https://doi.org/10.1177/10732748251330698","url":null,"abstract":"<p><p><b>Background:</b> The World Health Organization (WHO) aims to eliminate cervical cancer by 2030 through a global strategy, centred on high-risk Human papillomavirus (hrHPV)-based screening and treatment. Implementing these strategies in low-resource settings remains challenging, due to barriers associated with limited healthcare infrastructure and patient awareness. Self-sampling for hrHPV has shown higher acceptability and similar diagnostic accuracy compared to clinician-taken samples. This study proposes a protocol to evaluate the clinical efficacy of a cervical cancer screening program utilising hrHPV self-sampling in Ghana.<b>Methods and Analysis:</b> 1000 non-pregnant women aged 30-65 years will be invited to self-collect hrHPV samples. Those testing hrHPV positive will undergo visual inspection with acetic acid. Those diagnosed with high-grade squamous intraepithelial lesions will be offered ablation. In any case where there is a suspicion of invasion, or equivocal diagnosis, biopsies will be taken. Follow-up for women who are test positive for hrHPV and/or undergo treatment, will involve hrHPV self-sampling after 6 months. HrHPV-negative women will rescreen after 3 years. Biopsies will be taken where immediate treatment is not suitable, and women with confirmed or suspected invasive cervical carcinoma will be referred for surgical and/or oncological care. The primary outcome will be the proportion of women successfully screened, defined as the proportion of women with a valid HPV test result out of those invited to attend cervical screening. Secondary outcomes include screening uptake, disease detection rate, hrHPV genotype prevalence, treatment acceptance rate, successful treatment response, missed disease during treatment, number lost to follow-up, and disease recurrence.<b>Discussion:</b> In low-resource settings, hrHPV self-sampling offers an accessible method to increase screening uptake. This study will inform strategies for broader implementation of cervical cancer screening and contribute to achieving the WHO's goal of elimination by 2030.<b>Trial Registration:</b> Ethical approval for this study was obtained from the Kintampo Health Research Centre Institutional Ethics Committee (IEC), Bono East, Ghana, West Africa, on 24 May 2024 (IEC IRB Registration No. 0004854; Study ID: KHRCIEC/2024-03).</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251330698"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Competency-Based Ultrasound-Guided Breast Biopsy Training Program for Radiologists From Low-and-Middle-Income Countries that Leverages Mobile Health Technology (NCT04501419): A Study Protocol.","authors":"Adeleye Dorcas Omisore, Adedeji Ayoola Egberongbe, Lydia Eleanor Pace, Sughra Raza, Rachael Adeyanju Akinola, Millicent Olubunmi Obajimi, Varadan Sevilimedu, Yolanda Bryce, Victoria Lee Mango, Olusegun Isaac Alatise, T Peter Kingham, Elizabeth Anne Morris, Elizabeth Jane Sutton","doi":"10.1177/10732748251334435","DOIUrl":"https://doi.org/10.1177/10732748251334435","url":null,"abstract":"<p><p>IntroductionWhile ultrasound-guided breast biopsy (UGBB) performed by a radiologist is the standard of care in high-income countries for diagnosing breast cancer, blind or surgical biopsy has been the norm in low-and middle-income countries (LMIC) in part because LMIC radiologists lack the skill to perform UGBB. We present the study protocol of a competency-based UGBB training program for LMIC Nigerian radiologists that leverages mobile health technology.MethodsThis institutional review board-approved prospective multi-institutional single-arm clinical trial (ClinicalTrials.gov identifier: NCT04501419) involves 13 Nigerian radiologists from eight tertiary hospitals in South West and South East Nigeria. Our training program is unique because it uses a competency-based curriculum developed specifically for LMIC radiologists. The competency-based curriculum incorporates blended learning (e-learning and trainer-led), simulation (supervised and unsupervised), and patient biopsy (supervised and unsupervised) components. The study time frame is two years: 1 year for the trainees to complete active training and patient recruitment and another 1 year for patient follow-up. Primary outcome measures include trainees' competency (measured using the Ottawa Surgical Competency Operating Room Evaluation (O-SCORE)), the radiology-pathology concordance rate, and the complication rate. Secondary outcome measures include the diagnostic interval and the positive predictive value of UGBB.ConclusionBuilding capacity for UGBB in Nigeria and other LMIC can potentially improve breast cancer outcomes through early diagnosis. This training program is part of an implementation multi-component strategy package in Nigeria to improve breast cancer outcomes. This training program can also be adapted for other image-guided procedures that could impact global cancer control through diagnosis, therapeutic intervention, and/or palliation.</p>","PeriodicalId":49093,"journal":{"name":"Cancer Control","volume":"32 ","pages":"10732748251334435"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}