Journal of Cancer Education最新文献

Cancer is set to become the leading worldwide cause of premature death and mortality will be disproportionately greater in low-and-middle-income countries (LMIC) due to limitations in physical resources and oncology specialists. To address unmet workforce and educational needs, the Department of Radiation Oncology at Mayo Clinic developed the Global Oncology Fellowship, a 2-year multidisciplinary oncology training program for practicing physicians from LMIC. The fellowship was developed through collaboration with multiple institutional departments and external stakeholders. Eligible fellows are graduates of a recognized international medical school who have completed oncology training in a LMIC and confirm intent to practice in a LMIC. During the 2-year program, fellows rotate through Radiation Oncology, Medical Oncology, Palliative Care, Diagnostic Radiology, radiation dosimetry, research, and leadership development. The program design is flexible and can be tailored to fit the trainee's clinical needs and interests and focuses on malignancies and technologies that are common in LMIC. The Global Oncology Fellowship was successfully established and supported by benefactor funds. Recruitment of the first trainee faced challenges related to COVID pandemic, completion of medical licensing exams, and obtaining a United States visa. The first fellow started in February 2023 with training ongoing. With the formal approval of the Global Oncology Fellowship in 2024, the program is recruiting for the 2025-2027 academic years. Short- and-long term assessments of the program are ongoing. The Mayo Clinic Global Oncology Fellowship is a multi-disciplinary training program developed to address the educational needs of oncologists in low-and-middle income countries. We hope to contribute to the number of highly trained oncology specialists in LMIC, who will go on to be leaders in clinical care, education, and research.

Human papillomavirus (HPV) self-sampling was approved for use in clinical settings by the U.S. Food and Drug Administration (FDA) in May 2024 to identify high-risk HPV, responsible for most cervical cancer. This study explored patient and healthcare provider perspectives of HPV self-collection to assess perceived benefits, barriers, and facilitators to implementing this new screening service. Twenty patients at a cervical cancer screening event in the Bronx, NY, watched an instructional video and completed a survey regarding their willingness to use HPV self-sampling. Nine healthcare providers from the Montefiore Health System and affiliated Albert Einstein College of Medicine participated in semi-structured interviews to discuss their knowledge and beliefs toward adopting HPV self-sampling. Qualitative transcripts were coded in Dedoose and thematic analysis was used to identify emergent themes which were narratively described and supported by direct quotes. Patient participants were largely interested in HPV self-sampling and expressed willingness to use the modality at future screenings. Provider participants discussed anticipated benefits and concerns of HPV self-sampling, including expanding screening reach, prioritizing patients' needs, inadequate sampling, and losing opportunities for comprehensive care provided during pelvic exams. Patient and provider participants expressed enthusiasm about self-sampling improving access to cervical cancer screening, particularly for communities lacking access to current healthcare infrastructure. Provider participants critically questioned how HPV self-sampling could be introduced into their clinical practice. Both groups emphasized the need for further education to improve patient health literacy on self-sampling and for provider education through peer sharing, lectures, and information dissemination through heavily used mobile applications.

This study is to analyze academic success metrics of otolaryngology cancer research laboratory trainees. This is a retrospective analysis of trainee academic outcomes from 2000 to 2020. We examined careers of 99 trainees of the senior author's cancer research laboratory, including undergraduates, medical students, otolaryngology residents/fellows, and NIH T32 postdocs. We compared medical school matriculation rates, otolaryngology and head and neck surgery (OHNS) residency match rates, fellowship match rates, publication rates, and academic positions with publicly available data from the American Association of Medical Colleges (AAMC), National Resident Matching Program (NRMP), and others. Nine undergraduates achieved a 100% medical school matriculation rate compared with the AAMC rate of 43.4%. Of 22/53 medical students who applied to OHNS residency, students achieved a 100% match rate, compared with the NRMP match rate of 82.1%. Of 33 medical students who completed training, 45.4% became academicians, compared with 44.9% in an NIH R25E program cohort, which is notable. Interestingly, medical student trainees overall had more publications compared with incoming OHNS residents. Our residents achieved a 100% fellowship match rate compared with 79.0% average match rate across OHNS fellowship programs. Twelve of 25 (48%) residents earned advanced degrees (10 MS, 2 PhD), 11 of which were directly related to oncology. This was statistically significant compared to incoming otolaryngology residents via the NRMP data. Sixty percent (3/5) of surgical fellows entered academics. We observed multiple benefits from participation in our research laboratory at all levels of academic cancer training, specifically medical school and otolaryngology residency matriculation and academic faculty placement of former trainees.

This study aims to explore disparities in cancer treatment decision-making and the factors associated with the decision to pursue treatment. We used Behavioral Risk Factor Surveillance System (BRFSS) data collected between 2017 and 2022. We employed the PRECEDE-PROCEED model to guide our analysis of factors associated with treatment decisions. Descriptive statistics and multivariable logistic regression analysis were conducted to assess the association between treatment decision-making and the predisposing, enabling, and reinforcing factors (following the PRECEDE-PROCEED model). All analyses were weighted and adjusted for the demographic characteristics of the participants. Our sample included N = 19,388 cancer patients, 20.98% of whom refused treatment. American Indians, younger adults, and breast cancer patients were more likely to decide to go for treatment. Patients who had private insurance (OR = 1.25, P = .037) and those who did not have problems affording care (OR = 1.22, P = .02) were more likely to decide to get treatment. The more patients had regular doctors, the more they decided to continue to pursue treatment for cancer (Only one doctor: OR = 1.20, P = .042; More than one: OR = 1.28, P = .007). Finally, the more days patients experienced a bad health situation, the more they decided to have cancer treatment (for 14 + days with bad health: OR = 1.20, P < .001). The results suggest the need for enhanced patient education to improve cancer treatment adherence and informed decision-making. It highlights the importance of culturally tailored educational programs, age-related concerns, addressing financial barriers, and emphasizing the importance of regular healthcare visits for cancer patients.

Human papillomavirus is the most common sexually transmitted infection and causes anogenital and oropharyngeal cancers. Although HPV-related cancers can be prevented through vaccination, HPV vaccination rates are low compared to other vaccines. One of the strongest indicators for vaccination is provider recommendation, and dental health providers are well positioned to promote HPV vaccination among their patients. The purpose of this study was to determine if a continuing education (CE) course could improve dental hygienists' HPV-related knowledge and self-efficacy related to HPV vaccination recommendations. Data were collected from a sample of participants (n = 202) at a large dental hygiene conference in the southern US. A pre- and post-tests were administered with the CE course and differences in HPV vaccine knowledge and self-efficacy in counseling, recommending, and referring for the HPV vaccine were analyzed using SAS. HPV vaccine knowledge overall significantly increased post-CE (p < .001) and improvement was seen among several specific knowledge areas. However, knowledge regarding the common sites of HPV-related oral and oropharyngeal cancers remained moderate (82% correct) even after the CE intervention. There was no significant change from pre-test to post-test in participants' self-efficacy related to counseling patients about the HPV vaccine, recommending the HPV vaccine to patients, or referring patients for the vaccine. This study demonstrates that continuing education can improve dental hygienists' HPV-related knowledge. Since dental providers may play an important role in HPV-related cancer prevention, future work should develop continuing education tools that can motivate changes in self-efficacy and ultimately improve practice behaviors.

Over the last two decades, strides in cancer prevention, earlier detection, and novel treatments have reduced overall cancer mortality; however, cancer health disparities (CHD) persist among demographically diverse and intersecting populations. The development of a culturally responsive workforce trained in interdisciplinary, team-based science is a key strategy for addressing these cancer disparities. The Cancer Research - Scholarship and Training Experience in Population Sciences (C-STEPS) program at the University of New Mexico Comprehensive Cancer Center is designed to increase and diversify the biomedical and behavioral research workforce by providing specialized and experiential curricula that highlight team-oriented cancer control and population science. Undergraduate students interested in CHD and in pursuing STEM-H (science, technology, engineering, mathematics, and health) graduate or professional degrees are eligible for the program. C-STEPS students are paired with a UNM faculty mentor, who guides the student's 10-week summer research experience. They receive mentorship and support from three layers-faculty, near-peers (graduate students), and peers (undergraduates who have completed the C-STEPS program previously). Students generate five products, including a capstone presentation, grounded in the research they conduct with their faculty mentors. Since its founding in 2021, C-STEPS has trained three cohorts with a total of 32 students. The C-STEPS program provides a unique team-science approach with multilayer mentoring to create a sustainable pipeline for the development of students interested in STEM-H fields and CHD research. The capstone project led to 47% of students presenting their work at conferences, and two publishing their manuscripts in peer-reviewed journals. Overall, 89% of students were either "satisfied" or "very satisfied" with the program and the same percentage recommended the program to other undergraduates.

Myeloma is the third most common blood cancer and one of the most complex and expensive cancers to treat. Black Americans face health disparities related to myeloma incidence, age at diagnosis, access to novel treatments, and mortality. To help reduce health disparities among Black Americans through education and outreach, the Leukemia & Lymphoma Society has implemented its Myeloma Link initiative. In 2022, a formative, qualitative evaluation was conducted across the 15 U.S. cities that implemented Myeloma Link to better understand the information and communication needs and preferences of three groups: patients, community members, and primary care providers (PCPs). Data collection included interviews with eight patients, two focus groups with a total of ten community members, and interviews with six PCPs. Patients expressed wanting information about treatment experiences, including clinical trials, and emotional and peer support services, particularly from other Black American patients. Community members were largely unfamiliar with myeloma and desired outreach via trusted community organizations about disease signs and symptoms. Both groups discussed the importance of self-advocacy within the current healthcare system and wanted actionable messaging, rather than messaging leading with disparities statistics. PCPs described systemic capacity and time challenges in the context of needing to address more frequently encountered health conditions; nonetheless, PCPs welcomed information and brief trainings about myeloma diagnosis and treatment options, referrals to specialists, and how to improve care, prognosis, and caregiver support. Findings underscore the importance of outreach initiatives such as Myeloma Link to help meet these needs and reduce health disparities.

Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer deaths in women in the USA. To serve under-insured breast cancer patients in South Texas, we designed a patient education program to improve health literacy of secondary dermatologic changes after completing radiation therapy. A needs assessment survey was distributed to better understand the patients' stage of treatment, experiences with radiation-induced dermatologic side effects, and over-the-counter skin products and home remedies used. Of the 33 patients that participated in this program, nearly all patients (93.94%, n = 31) are either currently undergoing treatment or have completed treatment. Of the 31 individuals, 74.19% of patients (n = 23) have completed treatment at least 9-12 months ago, 22.58% (n = 7) are currently receiving chemotherapy, and 3.23% (n = 1) are currently undergoing radiation therapy. Among the dermatologic side effects, patients experienced changes to skin color, redness, and burns/burning sensation at the greatest severity. The top products used by survey participants were prescription-strength topical corticosteroids (65.63%) followed by oral analgesics (28.13%) and compression sleeves (25.00%). Aloe vera (15.63%) was the most used complementary and alternative therapeutic treatment. By surveying experiences of radiation-induced dermatologic side effects in predominantly under-resourced and minority communities, we can better tailor patient education programs to reflect patients' experiences. Overall, this program can enhance clinicians' insight on under-resourced patient experiences to improve health literacy and dispel common misconceptions surrounding breast cancer treatment, management, and survivorship.

Pediatric cancer is one of the most burdensome chronic diseases, necessitating a variety of severe medical interventions. As a result, the disease and its treatment cause numerous acute and long-term medical, psychological, and socioeconomic strains for young patients and their families. Therefore, psychosocial care using evidence-based interventions (EBIs) before, during, and after medical treatments is essential to ensure that patients receive adequate information and to minimize the adverse emotional and psychosocial impacts such as insecurity, fear, and shame. The present study reports the first promising results of applying cancer-specific psychosocial methods developed in the quality improvement project "My Logbook." The four assessed tools are specifically designed to adequately prepare pediatric cancer patients for surgery, chemotherapy, radiotherapy, and stem cell transplantation. Self and proxy ratings were used to assess the patients' subjective knowledge and emotional well-being before and after each intervention session. The results showed that patient-centered interventions using various creative and developmentally adapted methodologies (e.g., psychoeducation, crafting, games) have the potential to effectively enhance patient health literacy (V = 120.5, p < .001, r = 0.33) and well-being as manifested in more positive (slope = 0.121, p = .016) and less negative (slope =  - 0.350, p < .001) or neutral emotions (slope =  - 0.202, p = .002). These findings highlight the importance of developing and implementing psychosocial tools in pediatric oncology to prevent psychological overload and negative emotions and to increase subjective control beliefs, autonomy, and empowerment. Moreover, the effective application and systematic evaluation of evidence-based psychosocial tools can facilitate the establishment of standardized guidelines for psychosocial care in pediatric oncology. Thereby, the final goal is to ensure the quality of care and to use education to increase the quality of life for all pediatric cancer patients.Trial registration: ClinicalTrials.gov Identifier: NCT04474678 (July 17, 2020).