Exploring Gender Differences in Receipt of the 5As for Smoking Cessation for Recently-Diagnosed Cancer Patients (ECOG-ACRIN EAQ171CD).

Introduction: Smoking cessation is important for men and women diagnosed with cancer. Oncology clinicians should encourage all patients to quit and offer resources to help them do so, following the 5As framework (Ask, Advise, Assess, Assist, and Arrange follow-up).

Method: This study tests gender differences in self-reported receipt of the 5As by an oncology provider among 306 recently-diagnosed male and female cancer patients.

Impact of Lung Biomarker Testing on Out-Of-Pocket Costs for Metastatic Non-Small-Cell Lung Cancer.

Background: Biomarker testing in metastatic non-small lung cancer (NSCLC) is critical for appropriate treatment. Claims-based datasets offer real-world information on the use and cost of biomarker testing.

Materials And Methods: We used 2013-2021 data from Optum's de-identified Clinformatics Data Mart Database.

Financial Toxicity Screening Preferences in Patients With Breast Cancer.

Purpose: Financial toxicity is an important issue in cancer that affects quality of life and treatment adherence. Screening can identify patients at risk but consensus on appropriate timing or methods is lacking.

Methods: We sent an anonymous survey to e-mail subscribers of a nationwide breast cancer-specific philanthropic organization in July 2023 asking about financial toxicity screening preferences.

Patient and Provider Characteristics Associated with Receipt of Image-guided Interventions for Low Back Pain.

Background And Purpose: Low back pain commonly causes disability, often managed with conservative image-guided interventions before surgery. Research has documented racial disparities with these and other non-pharmacologic treatments. We posited that individual chart reviews may provide insight into the disparity of care types through documented patient/provider discussions and their effect on treatment plans.

Optimal Large Language Model Characteristics to Balance Accuracy and Energy Use for Sustainable Medical Applications.

Background Large language models (LLMs) for medical applications use unknown amounts of energy, which contribute to the overall carbon footprint of the health care system. Purpose To investigate the tradeoffs between accuracy and energy use when using different LLM types and sizes for medical applications. Materials and Methods This retrospective study evaluated five different billion (B)-parameter sizes of two open-source LLMs (Meta's Llama 2, a general-purpose model, and LMSYS Org's Vicuna 1.

Differential Access to Breast Magnetic Resonance Imaging Compared with Mammography and Ultrasound.

Introduction: For high-risk women, breast magnetic resonance (MR) is the preferred supplemental imaging option, but spatial access differences may exacerbate disparities in breast care.

Methods: This was a cross-sectional study examining distance between ZIP codes and the nearest breast imaging facility (MR, mammography, ultrasound) using 2023 data from the Food and Drug Administration and the American College of Radiology. Linear regression was used to assess distance differences controlling for Area Deprivation Index (ADI), urbanicity, and population size.

Short-Term Out-of-Pocket and Total Costs of Care After Ablation, Resection, or Transplant for Early-Stage Hepatocellular Carcinoma: A National SEER-Medicare Cost Comparison.

Differences in survival and morbidity among treatment options (ablation, surgical resection, and transplant) for early-stage hepatocellular carcinoma (HCC) have been well studied. Additional understanding of the costs of such care would help to identify drivers of high costs and potential barriers to care delivery. The purpose of this article was to quantify total and patient out-of-pocket costs for ablation, surgical resection, and transplant in the management of early-stage HCC and to identify factors predictive of these costs.

Reproductive Outcomes of Patients Undergoing Uterine Artery Embolization for Uterine Fibroids: Proceedings from The Dr. James B. Spies Summit for Uterine Fibroid Research-A Society of Interventional Radiology Foundation Research Consensus Panel.

Reproductive outcomes after uterine artery embolization (UAE) for the treatment of uterine fibroids are challenging to study, leaving several unanswered questions surrounding the future fertility of patients undergoing the procedure. Subject matter experts from interventional radiology, diagnostic radiology, obstetrics and gynecology, and reproductive medicine participated in a Society of Interventional Radiology (SIR) Foundation Research Consensus Panel to discuss and prioritize critical research topics focusing on fertility and reproductive outcomes in patients undergoing UAE for symptomatic uterine fibroids. After presentations and discussion of research ideas, the panelists prioritized the following topics for further investigation: (a) a prospective study of factors that influence implantation and gene expression in patients undergoing UAE or myomectomy over 1 year; (b) refinement of a classification system for uterine fibroids that can allow for more focused study design, which may include burden of fibroid disease; and (c) conjoint analysis/discrete choice experiments to better characterize those patients for whom fertility preservation is a high priority.

Patient-Reported Financial Burden of Treatment for Colon or Rectal Cancer.

Importance: The longitudinal experience of patients is critical to the development of interventions to identify and reduce financial hardship.

Objective: To evaluate financial hardship over 12 months in patients with newly diagnosed colorectal cancer (CRC) undergoing curative-intent therapy.

Design, Setting, And Participants: This prospective, longitudinal cohort study was conducted between May 2018 and July 2020, with time points over 12 months.

Interventions addressing health-related social needs among patients with cancer.

Health-related social needs are prevalent among cancer patients; associated with substantial negative health consequences; and drive pervasive inequities in cancer incidence, severity, treatment choices and decisions, and outcomes. To address the lack of clinical trial evidence to guide health-related social needs interventions among cancer patients, the National Cancer Institute Cancer Care Delivery Research Steering Committee convened experts to participate in a clinical trials planning meeting with the goal of designing studies to screen for and address health-related social needs among cancer patients. In this commentary, we discuss the rationale for, and challenges of, designing and testing health-related social needs interventions in alignment with the National Academy of Sciences, Engineering, and Medicine 5As framework.

Feasibility of Screening for Financial Hardship and Health-Related Social Needs at Radiology Encounters.

Objective: To evaluate the prevalence of financial hardship and health-related social needs (HRSNs) among outpatients undergoing advanced imaging services and assess the feasibility of screening for financial and social needs during radiology encounters.

Methods: Adult patients receiving CT, MRI, or PET/CT at outpatient imaging centers of an academic tertiary center were asked to complete a 15-minute survey with adapted validated questions inquiring about their experience of financial hardship related to imaging and HRSNs, and the appropriateness of screening for financial and social needs at radiology encounters. Logistic regression analyses were performed to assess factors associated with perceived appropriateness of screening and level of interest in meeting with financial counselors.

Economic and Environmental Costs of Cloud Technologies for Medical Imaging and Radiology Artificial Intelligence.

Radiology is on the verge of a technological revolution driven by artificial intelligence (including large language models), which requires robust computing and storage capabilities, often beyond the capacity of current non-cloud-based informatics systems. The cloud presents a potential solution for radiology, and we should weigh its economic and environmental implications. Recently, cloud technologies have become a cost-effective strategy by providing necessary infrastructure while reducing expenditures associated with hardware ownership, maintenance, and upgrades.

Predictors for Early Liver Cancer Survival After Ablation and Surgical Resection: A Surveillance, Epidemiology, and End Results Program-Medicare Study.

Objective: To identify independent predictors of all-cause and cancer-specific mortality after ablation or surgical resection (SR) for small hepatocellular carcinomas (HCCs), after adjusting for key confounders.

Methods: Using Surveillance, Epidemiology, and End Results Program-Medicare, HCCs less than 5 cm treated with ablation or SR in 2009 to 2016 (n = 956) were identified. Univariate and multivariable Cox regression models for all-cause and cancer-specific mortality were performed including demographics, clinical factors (tumor size, medical comorbidities, and liver disease factors), social determinants of health, and treatment characteristics.

The Implications of Racialized Economic Segregation and Allostatic Load on Mortality in Patients with Breast Cancer.

Background: The objective of this study was to examine the association between racialized economic segregation, allostatic load (AL), and all-cause mortality in patients with breast cancer.

Patients And Methods: Women aged 18+ years with stage I-III breast cancer diagnosed between 01/01/2012 and 31/12/2020 were identified in the Ohio State University cancer registry. Racialized economic segregation was measured at the census tract level using the index of concentration at the extremes (ICE).

Advancing Health Equity in Lung Cancer Screening and the Role of Humanomics.

Identifying and managing lung cancer, the leading cause of cancer-specific mortality, depend on multiple medical and sociodemographic factors. Humanomics is a model that acknowledges that negative societal stressors from systemic inequity affect individual health by altering pro-inflammatory gene expression. The same factors which may predispose individuals to lung cancer may also obstruct equitably prompt diagnosis and treatment.

The effect of neighborhood socioeconomic disadvantage on smoking status, quit attempts, and receipt of cessation support among adults with cancer: Results from nine ECOG-ACRIN Cancer Research Group trials.

Background: Tobacco use is associated with adverse outcomes among patients diagnosed with cancer. Socioeconomic determinants influence access and utilization of tobacco treatment; little is known about the relationship between neighborhood socioeconomic disadvantage (NSD) and tobacco assessment, assistance, and cessation among patients diagnosed with cancer.

Methods: A modified Cancer Patient Tobacco Use Questionnaire (C-TUQ) was administered to patients enrolled in nine ECOG-ACRIN clinical trials.