Annual Meeting Proceedings Part 1 - American Society of Clinical ...

6126 General Poster Session (Board #12D), Mon, 1:15 PM-5:15 PM
Caring for Alaska native prostate cancer survivors in primary care: A survey
of Alaska Tribal Health System providers. Presenting Author: Jon C. Tilburt,
Mayo Clinic, Rochester, MN
Background: Little is known about the actual constraints of doing so in the
distinctive geographic context of Alaska. We performed a survey of primary
care providers (PCPs) within the Alaska Tribal Health System (ATHS) to
learn more about their attitudes and practices surrounding prostate cancer
(PC) survivorship care. Methods: We surveyed primary care physicians,
nurse practitioners, and physician assistants practicing in the ATHS. We
administered surveys to assess attitudes about PSA monitoring, responsibility
for long-term surveillance, supporting emotional health and medical
needs, their degree of confidence in managing patients on androgen
deprivation therapy (ADT), as well as their comfort level in managing
common side effects of treatment. Results: Of the 221 providers surveyed,
114 responded (52%). Most PCPs indicated a preference for annual PSA
monitoring (69%), but several (27%) indicated monitoring every 6 months,
and a few (4%) indicated monitoring every 24 months. Most (60%) thought
PCPs should manage cancer surveillance, but many (40%) thought a
specialist (urologist or medical oncologist) should perform that function.
When asked about supporting patients’ emotional needs, PCPs indicated
that support groups (63%) followed by survivorship clinics (16%) or on-site
specialist visits (14%) were the most appropriate venues to address these
concerns. Most respondents thought that medical needs of PC survivors
could be addressed locally with appropriate specialty input (71%) or
potentially through dedicated survivorship clinics (14%). Only 46% indicated
being �moderately� or �very� confident managing ADT. Most PCPs
indicated being moderately or very comfortable monitoring for recurrence
(59%), managing erectile dysfunction (66%), addressing urinary incontinence
(63%), and addressing emotional needs (61%). Conclusions: PCPs
practicing in the ATHS express comfort with monitoring for PC recurrence,
but express some concerns about the full range of issues in PC survivorship.
Constructing cancer survivor care models in geographically dispersed and
resource-limited contexts for Alaska Natives is an ongoing clinical and
policy challenge.
6128 General Poster Session (Board #12F), Mon, 1:15 PM-5:15 PM
Financial relationships with commercial interests (COI) among abstracts at
the ASCO Annual Meeting. Presenting Author: Angela R. Bradbury, Clinical
Genetics, Fox Chase Cancer Center, Philadelphia, PA
Background: ASCO has a formal policy that requires disclosure of COI with
entities having a commercial interest in research. There are limited data
describing the frequency and type of COI reported in cancer research and
how these have changed over time. Methods: We reviewed author-reported
COI for abstracts submitted for the ASCO Annual Meeting in 2006 and
2008–2011. COI are classified as employment, stock, consultant, honoraria,
research, expert witness, and other. Logistic regression models were
used to evaluate the association between COI and acceptance at the annual
meeting and change over time. Results: 37% of all abstracts reported at
least one author with a COI. Any COI increased significantly from 33% in
2006 to 39% in 2011 (p�0.001). Any COI and all categories of COI were
significantly more prevalent among abstracts accepted for presentation
compared to those accepted for publication only (Table). Among abstracts
accepted for presentation, any COI increased from 39% in 2006 to 48% in
2011 (p�0.001) Increases by year were statistically significant for overall
(p�0.001), honoraria (p�0.045), and research (p�0.002) COI.
Conclusions: Many authors submitting abstracts accepted for presentation
at the ASCO Annual Meeting disclose COI. Reported COI have increased
over time and are significantly more frequent among abstracts accepted for
presentation than for publication only. These data suggest either that
cancer research increasingly involves relationships with industry or that
COI reporting has become more common. Policies to manage and foster
these relationships will continue to be required and revised.
COI among abstracts submitted for the ASCO Annual Meeting (n�21,108).
COI
Accepted for
presentation
(n�12,448)
Publication
only
(n�8,660)
OR (CI)
in 2006
Multiplicative
increase in OR (CI)
for each year
post-2006
Any COI 45% 25% 2.0 (1.8-2.3) * 1.06 (1.03-1.10)*
Employment 24% 13% 2.1 (1.8-2.5)* 1.01 (0.97-1.06)
Stock 19% 9% 2.2 (1.8-2.6)* 1.03 (0.98-1.08)
Consultant 27% 12% 2.5 (2.1-2.9)* 1.09 (0.99-1.09)
Honoraria 23% 10% 2.4 (2.0-2.8)* 1.05 (1.001-1.10)***
Research 29% 13% 2.2 (1.9-2.5)* 1.07 (1.03-1.12)**
Expert witness 1.7% 0.5% 3.1 (1.6-5.8)* 1.0 (0.9-1.3)
*p�0.001, **p� 0.02, ***p�0.002.
Health Services Research
413s
6127 General Poster Session (Board #12E), Mon, 1:15 PM-5:15 PM
Geographic and socioeconomic determinants of participation by elderly
patients in surgical oncology trials. Presenting Author: John H. Stewart,
Wake Forest School of Medicine, Winston-Salem, NC
Background: A recent report by our group demonstrated that �0.5% of
elderly patients with breast, prostate and lung cancer participate in surgical
oncology trials. However, little work to date has evaluated the roles of
regional healthcare infrastructure and socioeconomic factors on clinical
trial participation in this cohort. Methods: The NCI Cooperative Group
Surgical Oncology Trial (CGSOT) database was queried for patients treated
for breast, prostate and lung cancer cancer between 2000 and 2008
(n�13,541). Geographical Information Systems data were used to evaluate
proximity to healthcare facilities while regional socioeconomic characteristics
were obtained from the 2000 US Census and Area Resource file.
Counts were used to create a proportion of respondents with the corresponding
95% confidence interval calculated using the central limit theorem.
Independent t-tests were used to assess differences in outcome measures
between the two age groups. Results: We found that 4136 participants in
the NCI CGSOT database were 65 years of age or older. Interestingly,
92.7% of this cohort was white and 85.7% was female. Socioeconomic
determinants of participation are shown in the table. Conclusions: The work
presented herein suggests that elderly minority patients are less likely to
participate in surgical oncology trials than their white counterparts.
Furthermore, elderly participants tend to reside in less affluent areas.
Future work will utilize interventions that improve the recruitment of elderly
patients to these trials.
Geographic