Asia-Pacific journal of clinical oncology最新文献

{"title":"Breast Cancer Screening in Sarawak, Borneo: 10 Years' Community Outreach Program.","authors":"Lim Msh, Tan Ssn, Sulehan J, Jantan Z, Sharifah Ashrina Wan Ali, Mat Ali Na, Bujang Ma, Augustin Y","doi":"10.1111/ajco.70004","DOIUrl":"https://doi.org/10.1111/ajco.70004","url":null,"abstract":"<p><strong>Background: </strong>Sarawak isthe largest state in Malaysia, with a population of 2.9 millionwith 45% living more than 100 km from urban cities. These communities face the risk of delayed breast cancer diagnosis due to limited access to healthcare services. Sarawak has only four government hospitals with diagnostic mammogram facilities.</p><p><strong>Objective: </strong>Sarawak Breast Cancer Support Group (SBCSG) has spearheaded breast cancer education and early screening outreach since 2012, with a special focus on rural communities. This paper describes the results from our 10-year program.</p><p><strong>Methods: </strong>These programs were organized or co-organized by SBCSG from 2013 to 2023, involving local organizers and the Ministry of Health Malaysia. Women aged 18 years and above were invited to participate in clinical breast examination, and those with abnormal findings were referred to the nearest clinic or hospital for further management.</p><p><strong>Results: </strong>We screened 2050 women, with 7.1% exhibiting abnormal breast findings. Urban screening sites reported higher abnormal findings in (9% [85/949] vs. 5% [61/1101]; p = 0.003), Malays demonstrated the highest percentage of abnormal breast findings (9.5%, 28/296). Women with fewer than three children were more likely to exhibit abnormal findings (8.3% [85/1021] vs. 5.9% [61/1029]; p = 0.003). Subjects screened at urban sites and between the ages of 30-59 were 1.6 and 2.3 times more likely to exhibit abnormal findings, respectively.</p><p><strong>Conclusion: </strong>Screening site was the strongest independent variable for detecting breast abnormality, which could be linked to reproductive health, as women in rural areas tend to have more children, a trend that can be attributed to socioeconomic and cultural norms.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Care of Locally Advanced Mucosal Head and Neck Cancer: An Australian Perspective.","authors":"June Corry, Daniel Brungs, Jia Liu, Lachlan McDowell, Rob Thornton, Gary Mar, Tracey Nicholls, Eng H Ooi","doi":"10.1111/ajco.70005","DOIUrl":"https://doi.org/10.1111/ajco.70005","url":null,"abstract":"<p><p>Locally advanced mucosal head and neck squamous cell carcinoma (LA-HNSCC) is associated with several key risk factors including smoking, alcohol, and human papillomavirus (HPV) infection. Unfortunately, the current treatment modalities for LA-HNSCC, which can include combinations of surgery, radiotherapy, and systemic therapy, may result in substantial treatment-related toxicity and functional consequences for patients with a significant impact on quality of life. Due to the complex nature of the disease and acute and delayed treatment-related morbidity, treatment of LA-HNSCC requires a multidisciplinary approach that is optimally funded and accessible for patients regardless of geography. This review discusses the importance of a multidisciplinary approach throughout optimal care pathways for LA-HNSCC. Additionally, it identifies and discusses key unmet clinical needs associated with the multidisciplinary approach for LA-HNSCC in Australia. This includes further investigations into pre-habilitation and individualized follow-up protocols, and the development of biomarkers to enable selection of patients for the most appropriate treatment modality and predict response and relapse. Furthermore, there are inadequate supports to enable critical survivorship care and significant inequity in access to care across Australia. This is especially true in regional and rural areas, and urgent interventions to improve equity of access and surveillance in these populations are required.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The MASCC COG-IMPACT: The COSA Endorsement of a MASCC Developed Unmet Needs Assessment Tool for Cancer-Related Cognitive Impairment Impact.","authors":"Darren Haywood, Alexandre Chan, Raymond J Chan, Frank D Baughman, Evan Dauer MclinPsych, Haryana M Dhillon, Ashley M Henneghan, Blake J Lawrence, Maryam B Lustberg, Moira O'Connor, Janette L Vardy, Susan L Rossell, Nicolas H Hart","doi":"10.1111/ajco.70002","DOIUrl":"https://doi.org/10.1111/ajco.70002","url":null,"abstract":"","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Timeliness and Guideline-Concordant Treatment is Associated With Excess Mortality in Public Versus Private Lung Cancer Patients.","authors":"Jonathan Pham, Tiffany Lin, Eldho Paul, Margaret Brand, Sanuki Tissera, Matthew Conron, Gavin Wright, Michelle Caldecott, Gary Richardson, Phillip Antippa, Wasek Faisal, Susan Harden, John Zalcberg, Robert G Stirling","doi":"10.1111/ajco.14219","DOIUrl":"https://doi.org/10.1111/ajco.14219","url":null,"abstract":"<p><strong>Background: </strong>Previous literature has highlighted health inequality in lung cancer treatment, possibly related to differential healthcare delivery across public and private hospitals. In this study we assessed the association between public and private hospital receipt of guideline-concordant treatment (GCT) and survival.</p><p><strong>Methods: </strong>A retrospective study of patients in the Victorian Lung Cancer Registry was performed between April 2011 and March 2022. Models were adjusted for propensity score (age, sex, performance status, histology, ethnicity, smoking, hospital location, socioeconomic status, comorbidities, comorbid cancer). Main outcome measures were timeliness of treatment, receipt of GCT, and survival between private and public hospital-admitted patients.</p><p><strong>Findings: </strong>Of 11,396 patients, 9213 (81%) patients had treatment in public hospitals. Compared to private-hospital patients, public-hospital patients experienced substantial treatment delay (median referral-to-treatment interval: 48 vs. 29 days, p < 0.001). After adjusting for propensity score, private-hospital patients were more likely to receive GCT in all stages of non-small-cell lung cancer (NSCLC) except stage III (Stage I: OR 2.77, p < 0.001; Stage II: OR 3.43, p < 0.001; Stage III: 1.06, p = 0.73; Stage IV: OR 2.14, p < 0.001). The private-hospital patients had lower risk of death in NSCLC stages I, II and IV and a near-significant benefit in stage III (Stage I: OR 0.67, p < 0.001; Stage II: OR 0.54, p < 0.001; Stage III: 10.81, p = 0.06; Stage IV: OR 0.79, p < 0.001).</p><p><strong>Interpretation: </strong>Compared to private, the public-hospital patients experienced substantial delay in lung-cancer treatment, lower standard of GCT, and poorer survival rate. This study highlights substantial health inequity and disparity, demanding a need to evaluate, assess, and improve lung cancer treatment in Australian hospitals.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the Metrics: A Critical Lens on Neoadjuvant Therapy Implementation in Malaysia's Breast Cancer Landscape.","authors":"Muhammad Khubaib Iftikhar, Qurat Ul Ain Iftikhar","doi":"10.1111/ajco.70000","DOIUrl":"https://doi.org/10.1111/ajco.70000","url":null,"abstract":"","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding and Addressing Clinical Variation in Rectal Cancer Care: Application of an Analytic Framework.","authors":"Bernadette Bea Brown, Daniel Steffens, Michael Solomon, Cherry Koh, Jane Young","doi":"10.1111/ajco.14207","DOIUrl":"https://doi.org/10.1111/ajco.14207","url":null,"abstract":"<p><strong>Aim: </strong>There is substantial, protracted clinical variation in the use of neoadjuvant radiotherapy (with/without chemotherapy) prior to surgical resection for high-risk rectal cancer. In New South Wales (NSW), Australia, in 2018, this ranged from 25% to 59% across health districts. This study aimed to describe specialist clinicians' views about: the amount of clinical variation explained by patient factors and preference (warranted clinical variation) reasons for observed clinical variation solutions to address unwarranted clinical variation METHODS: A study-specific questionnaire was mailed to all rectal cancer specialists in NSW. Quantitative responses were summarized using descriptive statistics. Open-ended responses were analyzed thematically. Follow-up semi-structured interviews were conducted with a subset of participants. Proposed reasons were categorized against the Sutherland and Levesque analytic framework to assess if the observed clinical variation is warranted or unwarranted.</p><p><strong>Results: </strong>A total of 75 of 210 eligible specialists (36%) completed questionnaires. The majority strongly supported the use of neoadjuvant radiotherapy, with no evidence of equipoise. The maximum difference in the proportion of patients receiving neoadjuvant radiotherapy explained by patient factors or preference was estimated at 10%-20%, substantially less than reported. Proposed reasons for observed clinical variation were largely unwarranted and centered on five main themes: Multidisciplinary team (MDT)-related issues (capacity) Imaging-related issues (capacity) Workforce and practice patterns (capacity) Surgeon treatment preferences (agency) Data quality (evidence) CONCLUSIONS: Improving the consistency of MDT processes, uniform access to high-quality imaging, and improving data quality for performance reporting are focus areas with the potential to reduce unwarranted clinical variation in rectal cancer care.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":"e14207"},"PeriodicalIF":1.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Current Status of Circulating Tumor DNA Utilization in Australasia: A Survey of Thoracic Oncology Group Australasia Members.","authors":"Yifei Zhu, Danyon Lo, Deme Karikos, Malinda Itchins, Annie Wong","doi":"10.1111/ajco.14215","DOIUrl":"https://doi.org/10.1111/ajco.14215","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the current status of circulating tumor DNA (ctDNA) utilization for non-small cell lung cancer (NSCLC) among members of the Thoracic Oncology Group Australasia (TOGA), and to identify barriers to its implementation in clinical practice across Australia and New Zealand (ANZ).</p><p><strong>Methods: </strong>A 31-item electronic survey was distributed to TOGA members between December 2023 and August 2024. Responses were analysed descriptively to assess access, usage patterns, perceived barriers, and clinician attitudes toward ctDNA testing.</p><p><strong>Results: </strong>Thirty complete responses were analysed. Most respondents were medical oncologists working in metropolitan academic or public hospitals. While respondents estimated 83% of patients have access to molecular testing, only 12% were believed to have access to ctDNA testing. Only 33% reported routine ctDNA use, primarily in advanced disease settings. If more accessible, 83% indicated they would adopt ctDNA in advanced NSCLC. Key barriers to ctDNA utilization included cost (93%), logistical challenges (63%), limited knowledge (50%), and assay confidence (40%). Although over half of clinicians had patients inquire about ctDNA, fewer than 40% routinely discussed it. Most preferred are in-person or virtual workshops for education. Notably, 30% lacked access to a Molecular Tumor Board, and 70% did not provide pre-test counselling regarding incidental germline findings.</p><p><strong>Conclusion: </strong>Despite limited current use, there is strong interest in ctDNA testing for NSCLC in ANZ. Addressing funding, logistical barriers, and clinician education is essential to enabling equitable, widespread adoption of ctDNA into standard lung cancer care.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":"e14215"},"PeriodicalIF":1.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Real-World Evaluation of a Statewide Mainstream Model of Germline Genetic Testing for BRCA1/2 and Mismatch Repair Gene Variants (Lynch Syndrome).","authors":"Cally A Jennings, Kathryn Cornthwaite, Michael Osborn, Ganessan Kichenadasse, Eryn Dow","doi":"10.1111/ajco.14210","DOIUrl":"https://doi.org/10.1111/ajco.14210","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and evaluate an evidence-based mainstream germline genetic testing model to support cancer treatment including the BRCA1/BRCA2 and mismatch repair (MMR) genes across South Australia.</p><p><strong>Methods: </strong>Participatory action research (PAR) and implementation science principles were used to guide the development of the statewide mainstream pathway. To support the implementation of the mainstream pathway, genetic testing packages for clinicians and consumer support materials have been developed, and an education program has been delivered to clinicians. This quality improvement study used an independent sample t-test to compare the average number of monthly tests completed via mainstream and traditional pathways during two nonconsecutive 6-month periods. Acceptability among patients and clinicians and clinician knowledge, confidence, and experience measures were assessed.</p><p><strong>Results: </strong>The total number of BRCA1/2 tests did not increase from pre- to post-pathway implementation. However, there was a significant increase in both the number of tests ordered through the mainstream pathway (pre: mean 3.5, SD 2.07; post: mean 7, SD 2.53) and the proportion of total tests ordered via mainstreaming (pre: mean 14%, SD 9.25%; post: mean 25.0%, SD 5.48%). There were no changes in MMR gene testing patterns, with no mainstream tests ordered. Among clinicians (n = 20) who responded to the post-implementation survey, positive levels of acceptability were reported.</p><p><strong>Conclusion: </strong>This study showed that the implementation of a statewide mainstream genetic testing pathway in a public health system improved the uptake of mainstream testing for BRCA1/2. Further understanding of the barriers to uptake across settings is needed to support effective utilization.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":"e14210"},"PeriodicalIF":1.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Teletrials to Improve Equity of Access for Regional Patients With Cancer: Report From the Victorian Teletrial Collaborative.","authors":"Craig Underhill, A Woollett, Mark Buzza, Jessica Freeman, Will Evans, Jacqui McBurnie, Sam Harris, Kate Burbury, Kylie Shackleton, Linda Brown, Simonne Neil, Donna Long","doi":"10.1111/ajco.14209","DOIUrl":"https://doi.org/10.1111/ajco.14209","url":null,"abstract":"<p><strong>Aim: </strong>The uptake of telehealth, including for clinical trials (teletrials), accelerated during the pandemic and helps address inequity of access for underserved populations. This report discusses the work of experts in Victoria to implement teletrials in cancer clinical trials but has learnings for other jurisdictions and in other disease types.</p><p><strong>Methods: </strong>Three funded programs in Victoria (the Regional Trials Network Victoria, Trial Hub Alfred, and the Victorian Comprehensive Cancer Centre Alliance), each tasked with improving access to clinical trials for regional patients, formed the Victorian Teletrial Collaborative. In addition, they coordinated work with the Australian Teletrial Program and Safer Care Victoria. The Collaborative, backed with a Memorandum of Understanding and using a collective impact framework, held a workshop and developed a workplan and program logic. It met monthly to make progress against the workplan, which had four main themes: governance/logistics, education/training, advocacy/awareness, and operational Processes.</p><p><strong>Results: </strong>The Collaborative developed operational templates, toolkits for consumers and clinicians, education and training modules, and discussion papers to help overcome barriers to the implementation of teletrials. It conducted a workshop of national experts to consider barriers and enablers for the implementation of teletrials in early-phase clinical trials and developed a masterclass for clinicians. Future work plans focus on advocacy and communication about teletrials.</p><p><strong>Conclusion: </strong>The Victorian Teletrial Collaborative has utilized an evidence-based approach to develop a series of toolkits and recommendations aimed at facilitating the sustainable uptake of teletrials in our jurisdiction and elsewhere.</p>","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":"e14209"},"PeriodicalIF":1.4,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Survivorship Care for People Affected by Advanced or Metastatic Cancer: A Clinical Oncology Society of Australia Endorsement of the Joint Multinational Association of Supportive Care in Cancer and American Society of Clinical Oncology Care Standards and Practice Recommendations.","authors":"Nicolas H Hart, Michael Jefford, Bogda Koczwara, Larissa Nekhlyudov, Julia Lai-Kwon, Sarah Heynemann, Jasmine Yee, Gregory B Crawford, Andrea L Smith, Darren Haywood, Meera R Agar, Raymond J Chan","doi":"10.1111/ajco.14214","DOIUrl":"https://doi.org/10.1111/ajco.14214","url":null,"abstract":"","PeriodicalId":8633,"journal":{"name":"Asia-Pacific journal of clinical oncology","volume":" ","pages":"e14214"},"PeriodicalIF":1.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}