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Sayan M, Eren AA, Tuac Y, Langoe A, Alali B, Aynaci O, Mohammadipour S, Vahedi F, Daneshmand B, Abbas W, Hawsawi Y, Nader T, Joseph J, Wahby R, Ozgenc I, Mula-Hussain L, Moningi S, Orio PF, Atalar B, Eren MF. Prostate Cancer Awareness in the Middle East: A Cross-Sectional International Study. JCO Glob Oncol 2024; 10:e2400171. [PMID: 38991182 DOI: 10.1200/go.24.00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/18/2024] [Accepted: 06/10/2024] [Indexed: 07/13/2024] Open
Abstract
PURPOSE Prostate cancer has emerged as a significant public health challenge in the Middle East, characterized by rising incidence rates and a concerning mortality-to-incidence ratio. Yet, despite these alarming trends, data regarding prostate cancer awareness in the region remain limited. To address this critical knowledge gap, this study investigates prostate cancer awareness within the Middle East. MATERIALS AND METHODS A cross-sectional survey was performed among 5,913 men age 40 years and older across 14 Middle Eastern countries between January 1, 2022, and July 31, 2023. Excluding those with a history of prostate cancer, a validated questionnaire assessed prostate cancer awareness. Data were analyzed using frequencies and percentages for categorical variables, medians and ranges for continuous variables, and Pearson chi-square analysis for relationships between education levels and awareness of prostate cancer. RESULTS The survey achieved a 74.9% response rate, with 4,431 male participants. Regarding prostate cancer awareness, 83.8% of participants had heard of the disease. However, only 31.0% correctly identified it as the most common malignancy in men, and 21.8% believed it affects both sex. Awareness of screening was limited, with just 19.1% recognizing the prostate-specific antigen test's role. Additionally, participants had a pessimistic view, with a mean perception that 75% of patients with prostate cancer die from the disease, rather than from other causes. Higher education levels were associated with significantly increased awareness of prostate cancer (P < .001). CONCLUSION This study reveals that while general awareness of the disease exists, crucial knowledge deficits regarding risk factors, screening, and prognosis are evident. Addressing these knowledge gaps through culturally tailored education may improve early detection rates, treatment outcomes, and ultimately reduce the burden of prostate cancer in the Middle East.
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Affiliation(s)
- Mutlay Sayan
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Ayfer Ay Eren
- Kartal Dr Lütfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Yetkin Tuac
- Department of Statistics, Ankara University, Ankara, Turkey
| | | | | | | | | | | | | | - Wajid Abbas
- Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Jessie Joseph
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Ismail Ozgenc
- University of Nicosia Medical School, Egkomi, Cyprus
| | - Layth Mula-Hussain
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- College of Medicine, Ninevah University, Mosul, Iraq
| | - Shalini Moningi
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Peter F Orio
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | - Mehmet Fuat Eren
- Marmara University, Istanbul Pendik Education and Research Hospital, Istanbul, Turkey
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2
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Vanderpool RC, Ng D, Huang G, Dwyer LA, Kueppers G. Disparities in cancer clinical trials information-seeking: Findings from the National Cancer Institute's Cancer Information Service. PATIENT EDUCATION AND COUNSELING 2024; 127:108358. [PMID: 38936161 DOI: 10.1016/j.pec.2024.108358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/03/2024] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE To better understand cancer clinical trials (CCT) information-seeking, a necessary precursor to patient and provider engagement with CCT. METHODS Data from the National Cancer Institute's Cancer Information Service (CIS) were used to examine CCT information-seeking patterns over a 5-year period. Descriptive and logistic regression analyses were conducted to examine characteristics of CIS inquiries and their associations with having a CCT discussion. RESULTS Between September 2018 - August 2023, 117,016 CIS inquiries originated from cancer survivors, caregivers, health professionals, and the general public; 27.5 % of these inquiries included a CCT discussion (n = 32,160). Among CCT discussions, 35.5 % originated from survivors, 53.5 % from caregivers, 6.1 % from the public, and 4.9 % from health professionals. Inquiries in Spanish had lower odds of a CCT discussion (OR=.26, [.25-.28]), whereas inquiries emanating from the CIS instant messaging (OR=2.29, [2.22-2.37]) and email (OR=1.24, [1.18-1.30]) platforms were associated with higher odds of discussing CCT compared to the telephone. Individuals who were male, younger, insured, and had higher income and education had significantly higher odds of a CCT discussion while those who were non-Hispanic Black and living in rural locales had significantly lower odds. CONCLUSIONS Disparities in CCT information-seeking may contribute to downstream CCT participation. PRACTICE IMPLICATIONS Quality, language-concordant health information is needed to enable equitable awareness of - and ultimately engagement in - CCT.
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Affiliation(s)
- Robin C Vanderpool
- National Cancer Institute, Behavioral Research Program, Division of Cancer Control and Population Sciences, 9609 Medical Center Dr, Rockville, MD, USA.
| | - Diane Ng
- Westat, 1600 Research Blvd, Rockville, MD, USA
| | - Grace Huang
- Westat, 1600 Research Blvd, Rockville, MD, USA
| | - Laura A Dwyer
- Cape Cox Facilities Services, 7050 Infantry Ridge Rd, Manassas, VA, USA
| | - George Kueppers
- National Cancer Institute, Behavioral Research Program, Division of Cancer Control and Population Sciences, 9609 Medical Center Dr, Rockville, MD, USA
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3
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Loeb S, Langford AT, Bragg MA, Sherman R, Chan JM. Cancer misinformation on social media. CA Cancer J Clin 2024. [PMID: 38896503 DOI: 10.3322/caac.21857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/29/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Social media is widely used globally by patients, families of patients, health professionals, scientists, and other stakeholders who seek and share information related to cancer. Despite many benefits of social media for cancer care and research, there is also a substantial risk of exposure to misinformation, or inaccurate information about cancer. Types of misinformation vary from inaccurate information about cancer risk factors or unproven treatment options to conspiracy theories and public relations articles or advertisements appearing as reliable medical content. Many characteristics of social media networks-such as their extensive use and the relative ease it allows to share information quickly-facilitate the spread of misinformation. Research shows that inaccurate and misleading health-related posts on social media often get more views and engagement (e.g., likes, shares) from users compared with accurate information. Exposure to misinformation can have downstream implications for health-related attitudes and behaviors. However, combatting misinformation is a complex process that requires engagement from media platforms, scientific and health experts, governmental organizations, and the general public. Cancer experts, for example, should actively combat misinformation in real time and should disseminate evidence-based content on social media. Health professionals should give information prescriptions to patients and families and support health literacy. Patients and families should vet the quality of cancer information before acting upon it (e.g., by using publicly available checklists) and seek recommended resources from health care providers and trusted organizations. Future multidisciplinary research is needed to identify optimal ways of building resilience and combating misinformation across social media.
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Affiliation(s)
- Stacy Loeb
- Department of Urology, New York University Langone Health, New York, New York, USA
- Department of Population Health, New York University Langone Health, New York, New York, USA
- Department of Surgery, Manhattan Veterans Affairs Medical Center, New York, New York, USA
| | - Aisha T Langford
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Marie A Bragg
- Department of Population Health, New York University Langone Health, New York, New York, USA
- Marketing Department, Stern School of Business, New York University, New York, New York, USA
| | - Robert Sherman
- Stakeholder Advisory Board, New York University Langone Health, New York, New York, USA
| | - June M Chan
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Department of Urology, University of California San Francisco, San Francisco, California, USA
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4
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Yavari B, Kolbehdari N, Gann L, Portillo M, Rumschlag A, Aldridge M, Mellon W, Alcaraz GM, Richker H, Sarkissian M, Compton ZT, Aktipis A, Maley C, Baciu C. The Digital Health Revolution: Exploring the Impact of Online Cancer Information on Self-Reported Preventive Behaviors. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.20.24307517. [PMID: 38826228 PMCID: PMC11142276 DOI: 10.1101/2024.05.20.24307517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Cancer, one of the leading causes of death worldwide, is a disease characterized by uncontrolled cell growth within the body. While there have been many improvements in the treatment of cancer clinically, there is now an urgent need to improve cancer-related communication. This study explores the impact of online health information, specifically cancer-related information and prevention, among members of the general public. Through a randomized survey, we examined what information leads people to take action to minimize their cancer risk and communicate with their providers. Through evaluation of the various modes of communication, we were able to provide insight into which are more effective and better received by members of the general public. Through this, ways of bettering these avenues of communication and strengthening the bond between them will be highlighted and more easily elaborated on by future studies. The results of our study indicated that 60% of participants asserted that they are motivated by online preventive information to take steps to limit their cancer risk, while only roughly 44% of participants overall agreed that their doctor has communicated with them about when proper cancer screenings should be scheduled for the future. Although patients may be turning to the Internet now more than ever due to various reasons, when comparing self-reported rates of comprehension among the study participants, 35% agreed that the cancer-related information they can access online is confusing, while fewer than 22% of participants agreed that the cancer-related information they receive directly from their doctor is confusing. This is indicative of the limitations the Internet may have when undertaking the role of being a medical resource, especially when acting as a replacement for in-person medical appointments where patients can communicate directly with their physicians. Ultimately, these results provide a unique perspective into how people receive, evaluate, and implement cancer-preventive steps and general health-related information in a post-COVID-19 world, where the Internet is now strongly embedded in healthcare.
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Affiliation(s)
- Bryan Yavari
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Nilofar Kolbehdari
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Lindsay Gann
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Mercedes Portillo
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | | | - Melaine Aldridge
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Walker Mellon
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | | | - Harley Richker
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | | | - Zachary T Compton
- Arizona Cancer Evolution Center
- University of Arizona Cancer Center
- University of Arizona College of Medicine
| | - Athena Aktipis
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Carlo Maley
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
| | - Cristina Baciu
- Arizona Cancer Evolution Center
- Biodesign Institute, Arizona State University
- W.P. Carey School of Business, Arizona State University
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5
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Efstathiou E, Merseburger A, Liew A, Kurtyka K, Panda O, Dalechek D, Heerdegen ACS, Jain R, De Solda F, McCarthy SA, Brookman-May SD, Mundle SD, Yu Ko W, Krabbe LM. Perception of cure in prostate cancer: human-led and artificial intelligence-assisted landscape review and linguistic analysis of literature, social media and policy documents. ESMO Open 2024; 9:103007. [PMID: 38744101 PMCID: PMC11108859 DOI: 10.1016/j.esmoop.2024.103007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Understanding stakeholders' perception of cure in prostate cancer (PC) is essential to preparing for effective communication about emerging treatments with curative intent. This study used artificial intelligence (AI) for landscape review and linguistic analysis of definition, context and value of cure among stakeholders in PC. MATERIALS AND METHODS Subject-matter experts (SMEs) selected cure-related key words using Elicit, a semantic literature search engine, and extracted hits containing the key words from Medline, Sermo and Overton, representing academic researchers, health care providers (HCPs) and policymakers, respectively. NetBase Quid, a social media analytics and natural language processing tool, was used to carry out key word searches in social media (representing the general public). NetBase Quid analysed linguistics of key word-specific hit sets for key word count, geolocation and sentiments. SMEs qualitatively summarised key word-specific insights. Contextual terms frequently occurring with key words were identified and quantified. RESULTS SMEs identified seven key words applicable to PC (number of acquired hits) across four platforms: Cure (12429), Survivor (6063), Remission (1904), Survivorship (1179), Curative intent (432), No evidence of disease (381) and Complete remission (83). Most commonly used key words were Cure by the general public and HCPs (11815 and 224 hits), Survivorship by academic researchers and Survivor by policymakers (378 hits each). All stakeholders discussed Cure and cure-related key words primarily in early-stage PC and associated them with positive sentiments. All stakeholders defined cure differently but communicated about it in relation to disease measurements (e.g. prostate-specific antigen) or surgery. Stakeholders preferred different terms when discussing cure in PC: Cure (academic researchers), Cure rates (HCPs), Potential cure and Survivor/Survivorship (policymakers) and Cure and Survivor (general public). CONCLUSION This human-led, AI-assisted large-scale qualitative language-based research revealed that cure was commonly discussed by academic researchers, HCPs, policymakers and the general public, especially in early-stage PC. Stakeholders defined and contextualised cure in their communications differently and associated it with positive value.
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Affiliation(s)
| | - A Merseburger
- University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - A Liew
- Oxford PharmaGenesis Group Pty Ltd, Melbourne, Australia
| | - K Kurtyka
- Oxford PharmaGenesis Inc, Newtown, Pennsylvania, USA
| | - O Panda
- Oxford PharmaGenesis Inc, Newtown, Pennsylvania, USA
| | - D Dalechek
- Oxford PharmaGenesis Inc, Newtown, Pennsylvania, USA
| | - A C S Heerdegen
- Janssen Global Commercial Strategy Organization, Raritan, New Jersey, USA
| | - R Jain
- Janssen Global Commercial Strategy Organization, Raritan, New Jersey, USA
| | - F De Solda
- Janssen Global Commercial Strategy Organization, Raritan, New Jersey, USA
| | - S A McCarthy
- Janssen Research & Development, Raritan, New Jersey, USA
| | - S D Brookman-May
- Janssen Research & Development, Spring House, Pennsylvania, USA; Ludwig-Maximilians-University, Munich, Germany
| | - S D Mundle
- Janssen Research & Development, Raritan, New Jersey, USA
| | - W Yu Ko
- University of British Columbia Men's Health Research Program, Vancouver, British Columbia, Canada
| | - L-M Krabbe
- Vivantes Hospital Network for Health, Berlin, Germany
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6
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Swire-Thompson B, Johnson S. Cancer: A model topic for misinformation researchers. Curr Opin Psychol 2024; 56:101775. [PMID: 38101247 PMCID: PMC10939853 DOI: 10.1016/j.copsyc.2023.101775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023]
Abstract
Although cancer might seem like a niche subject, we argue that it is a model topic for misinformation researchers, and an ideal area of application given its importance for society. We first discuss the prevalence of cancer misinformation online and how it has the potential to cause harm. We next examine the financial incentives for those who profit from disinformation dissemination, how people with cancer are a uniquely vulnerable population, and why trust in science and medical professionals is particularly relevant to this topic. We finally discuss how belief in cancer misinformation has clear objective consequences and can be measured with treatment adherence and health outcomes such as mortality. In sum, cancer misinformation could assist the characterization of misinformation beliefs and be used to develop tools to combat misinformation in general.
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Affiliation(s)
- Briony Swire-Thompson
- Northeastern University, Network Science Institute, Department of Political Science, Department of Psychology, 177 Huntington Ave, Boston, USA.
| | - Skyler Johnson
- University of Utah, Huntsman Cancer Institute, 1950 Circle of Hope Dr, Salt Lake City, USA
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7
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Tan CE, Admodisastro N, Lau SCD, Tan KA, Teh KH, Lee CC, Mohd Sidik S. Development and user evaluation of an online caregiver education resource for Malaysian parents of children with leukemia or lymphoma. Asia Pac J Oncol Nurs 2024; 11:100363. [PMID: 38304227 PMCID: PMC10831254 DOI: 10.1016/j.apjon.2023.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/15/2023] [Indexed: 02/03/2024] Open
Abstract
Objective Malaysian parents of children diagnosed with leukemia or lymphoma stand to benefit from a comprehensive Malay-language online resource, complementing existing caregiver education practices. This study aimed to develop and assess the efficacy of e-Hematological Oncology Parents Education (e-HOPE), an online caregiver education resource in Malay, designed to enhance the knowledge of parents with children diagnosed with leukemia or lymphoma in Malaysia. Methods A user profile and topic list were established based on previous needs analysis studies. Content was developed for each identified topic. An expert panel assessed the content validity of both informational content and activity sections. Subsequently, the contents were presented via a learning management system to parents of children newly diagnosed with leukemia or lymphoma. Parents evaluated the quality of e-HOPE using the Website Evaluation Questionnaire (WEQ) after an 8-week period. Results The scale content validity index (S-CVI/Ave) achieved 0.996 for informational content and 0.991 for the activity section. Sixteen parents provided evaluations of e-HOPE after an 8-week usage period. Mean WEQ scores for various dimensions ranged from 4.23 for completeness to 4.88 for relevance. Conclusions E-HOPE was meticulously designed and developed to offer Malaysian parents a Malay-language resource complementing current caregiver education practices. It exhibited strong content validity and received positive user ratings for quality. Further assessment is warranted to evaluate its effectiveness in supporting parents of children with leukemia or lymphoma. The resource is anticipated to enhance information accessibility and support for Malaysian parents facing hematological cancers in their children. Trial registration Clinicaltrials.govNCT05455268.
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Affiliation(s)
- Chai-Eng Tan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Novia Admodisastro
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Sie Chong Doris Lau
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kit Aun Tan
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Kok Hoi Teh
- Department of Pediatrics, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Chee Chan Lee
- Department of Pediatrics, Hospital Tunku Azizah, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Sherina Mohd Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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8
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Lam CS, Hua R, Koon HK, Zhou KR, Lam TTN, Lee CP, Lin WL, Wong CL, Lau YM, Loong HHF, Chung VCH, Cheung YT. Can ChatGPT Provide Quality Information on Integrative Oncology? A Brief Report. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:196-205. [PMID: 37792344 DOI: 10.1089/jicm.2023.0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
This short report evaluated the accuracy and quality of information provided by ChatGPT regarding the use of complementary and integrative medicine for cancer. Using the QUality Evaluation Scoring Tool, a panel of 12 reviewers assessed ChatGPT's responses to 8 questions. The study found that ChatGPT provided moderate-quality responses that were relatively unbiased and not misleading. However, the chatbot's inability to reference specific scientific studies was a significant limitation. Patients with cancer should not rely on ChatGPT for clinical advice until further systematic validation. Future studies should examine how patients perceive ChatGPT's information and its impact on communication with health care professionals.
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Affiliation(s)
- Chun Sing Lam
- School of Pharmacy, Faculty of Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Rong Hua
- School of Pharmacy, Faculty of Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Ho Kee Koon
- School of Chinese Medicine, and Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Keary Rui Zhou
- School of Pharmacy, Faculty of Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Teddy Tai Ning Lam
- School of Pharmacy, Faculty of Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Chui Ping Lee
- School of Pharmacy, Faculty of Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wai Ling Lin
- School of Chinese Medicine, and Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yat Ming Lau
- Department of Medical Oncology, The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, Australia
| | - Herbert Ho-Fung Loong
- Department of Clinical Oncology and The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Chi-Ho Chung
- School of Chinese Medicine, and Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
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9
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Elshami M, Abukmail H, Thalji M, Al-Slaibi I, Alser M, Radaydeh A, Alfuqaha A, Khader S, Khatib L, Fannoun N, Ahmad B, Kassab L, Khrishi H, Elhussaini D, Abed N, Nammari A, Abdallah T, Alqudwa Z, Idais S, Tanbouz G, Hajajreh M, Selmiyh HA, Abo-Hajouj Z, Hebi H, Zamel M, Skaik RN, Hammoud L, Rjoub S, Ayesh H, Rjoub T, Zakout R, Alser A, Albarqi SI, Abu-El-Noor N, Bottcher B. Myths and common misbeliefs about cervical cancer causation among Palestinian women: a national cross-sectional study. BMC Public Health 2024; 24:189. [PMID: 38229049 PMCID: PMC10790379 DOI: 10.1186/s12889-024-17733-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 01/10/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Cervical cancer (CC) myths and beliefs can negatively impact women's preventive behaviors, including vaccination against human papillomavirus and having regular screening tests. This study aimed to examine awareness of Palestinian women about myths related to CC causation and investigated factors associated with good awareness. METHODS A national cross-sectional study was conducted to recruit adult Palestinian women from hospitals, primary healthcare facilities, and public areas in 11 Palestinian governorates. A translated-into-Arabic version of the Cancer Awareness Measure-Mythical Causes Scale was used to collect data. Awareness level was determined based on the number of CC myths around CC causation recognized to be incorrect: poor (0-4), fair (5-9), and good (10-13). RESULTS A total of 7058 questionnaires were included. Myths unrelated to food were more commonly recognized as incorrect compared to those related to food. The most recognized food-unrelated myth was 'having a physical trauma' (n = 3714, 52.6%), whereas the least recognized was 'using mobile phones' (n = 2238, 31.7%). The most recognized food-related myth was 'drinking from plastic bottles' (n = 2708, 38.4%), whereas the least recognized was 'eating food containing additives' (n = 1118, 15.8%). Only 575 participants (8.1%) displayed good awareness and promptly recognized at least 10 out of 13 myths around CC causation as incorrect. Factors associated with lower likelihood of displaying good awareness of myths around CC causation included living in the West Bank and Jerusalem, being married, widowed or divorced, knowing someone with cancer, and visiting hospitals or primary healthcare centers. CONCLUSIONS A very small proportion of Palestinian women recognized 10 or more myths around CC causes as incorrect. Initiatives addressing CC myths are needed in the Palestinian community.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside 7100, Cleveland, OH, USA.
- Ministry of Health, Gaza, Palestine.
| | - Hanan Abukmail
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Harvard Medical School, Boston, MA, USA
- International Medical Corps, Gaza, Palestine
| | - Mariam Thalji
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | - Afnan Radaydeh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Alaa Alfuqaha
- Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine
| | - Salma Khader
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Lana Khatib
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Nour Fannoun
- Faculty of Pharmacy, Alazhar University of Gaza, Gaza, Palestine
| | - Bisan Ahmad
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Hiba Khrishi
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Deniz Elhussaini
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Nour Abed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Aya Nammari
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Zaina Alqudwa
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Shahd Idais
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
- Hebron Governmental Hospital, Hebron, Palestine
| | - Ghaid Tanbouz
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Haya Hebi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Manar Zamel
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Lama Hammoud
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Saba Rjoub
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Hadeel Ayesh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Toqa Rjoub
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Rawan Zakout
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Elshami M, Naji SA, Dwikat MF, Al-Slaibi I, Alser M, Ayyad M, Mohamad BM, Isleem WS, Shurrab A, Yaghi B, Qabaja YA, Hamdan FK, Sweity RR, Jneed RT, Assaf KA, Albandak ME, Hmaid MM, Awwad II, Alhabil BK, Alarda MN, Alsattari AS, Aboyousef MS, Aljbour OA, AlSharif R, Giacaman CT, Alnaga AY, Abu Nemer RM, Almadhoun NM, Skaik SM, Bottcher B, Abu-El-Noor N. Myths and Common Misbeliefs About Colorectal Cancer Causation in Palestine: A National Cross-Sectional Study. JCO Glob Oncol 2024; 10:e2300295. [PMID: 38166235 PMCID: PMC10803036 DOI: 10.1200/go.23.00295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/07/2023] [Accepted: 11/06/2023] [Indexed: 01/04/2024] Open
Abstract
PURPOSE To explore public awareness of myths around colorectal cancer (CRC) causation in Palestine and to examine factors associated with good awareness. MATERIALS AND METHODS Convenience sampling was used to recruit adult Palestinians from governmental hospitals, primary health care centers, and public spaces. Recognizing 13 myths around CRC causation was assessed using a translated-into-Arabic version of the Cancer Awareness Measure-Mythical Causes Scale. Awareness level was determined based on the number of CRC mythical causes recognized: poor (0-4), fair (5-9), and good (10-13). Multivariable logistic regression was used to examine the association between sociodemographic characteristics and displaying good awareness. It adjusted for age group, sex, education, occupation, monthly income, residence, marital status, having chronic diseases, being a vegetarian, knowing someone with cancer, and site of data collection. RESULTS Of 5,254 participants approached, 4,877 agreed to participate (response rate, 92.3%). A total of 4,623 questionnaires were included in the final analysis: 2,700 from the West Bank and Jerusalem (WBJ) and 1,923 from the Gaza Strip. Only 219 participants (4.7%) demonstrated good awareness of myths around CRC causation. WBJ participants were twice more likely than those from the Gaza Strip to display good recognition (5.9% v 3.1%). Male sex, living in the WBJ, and visiting hospitals were all associated with an increase in the likelihood of displaying good awareness. Conversely, knowing someone with cancer was associated with a decrease in the likelihood of displaying good awareness. Having a physical trauma was the most recognized CRC causation myth (n = 2,752, 59.5%), whereas eating food containing additives was the least (n = 456, 9.8%). CONCLUSION Only 4.7% displayed good ability to recognize myths around CRC causation. Future educational interventions are needed to help the public distinguish the evidence-based versus mythical causes of CRC.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
- Ministry of Health, Gaza, Palestine
| | | | | | | | - Mohammed Alser
- The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Gaza, Palestine
| | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | - Bashar Yaghi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | - Khayria Ali Assaf
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | | | - Iyas Imad Awwad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Rinad AlSharif
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | | | | | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Altmannshofer S, Flaucher M, Beierlein M, Eskofier BM, Beckmann MW, Fasching PA, Huebner H. A content-based review of mobile health applications for breast cancer prevention and education: Characteristics, quality and functionality analysis. Digit Health 2024; 10:20552076241234627. [PMID: 38528967 PMCID: PMC10962048 DOI: 10.1177/20552076241234627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/26/2024] [Indexed: 03/27/2024] Open
Abstract
Objective Mobile Health apps could be a feasible and effective tool to raise awareness for breast cancer prevention and to support women to change their behaviour to a healthier lifestyle. The aim of this study was to analyse the characteristics and quality of apps designed for breast cancer prevention and education. Methods We conducted a systematic search for apps covering breast cancer prevention topics in the Google Play and Apple App Store accessible from Germany using search terms either in German or in English. Only apps with a last update after June 2020 were included. The apps identified were downloaded and evaluated by two independent researchers. App quality was analysed using the Mobile Application Rating Scale (MARS). Associations of app characteristics and MARS rating were analysed. Results We identified 19 apps available in the Google Play Store and seven apps available in the Apple App Store that met all inclusion criteria. The mean MARS score was 3.07 and 3.50, respectively. Functionality was the highest-scoring domain. Operating system, developer (healthcare), download rates and time since the last update were significantly associated with overall MARS score. In addition, the presence of the following app functions significantly influenced MARS rating: breast self-examination tutorial, reminder for self-examination, documentation feature and education about breast cancer risk factors. Conclusions Although most of the apps offer important features for breast cancer prevention, none of the analysed apps combined all functions. The absence of healthcare professionals' expertise in developing apps negatively affects the overall quality.
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Affiliation(s)
- Stefanie Altmannshofer
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
| | - Madeleine Flaucher
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Milena Beierlein
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
| | - Hanna Huebner
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Comprehensive Cancer Center ER-EMN, Erlangen, Germany
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12
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Saab RH, Salvo G, Gonzales NR, Munsell MF, Shinn EH, Jhingran A, Bhosale P, Ramalingam P, Frumovitz M. Social media use is associated with higher levels of anxiety and depression in patients with neuroendocrine carcinoma of the cervix: A NeCTuR study. Gynecol Oncol 2023; 177:95-102. [PMID: 37657194 DOI: 10.1016/j.ygyno.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Neuroendocrine cervical carcinoma (NECC) is rare. Educational resources are limited for NECC patients, leading many to seek information online through patient-led social networks. We sought to characterize the relationships between anxiety and depression levels and social media use among NECC patients. METHODS Seven surveys assessing social media use, anxiety, and depression were distributed to living NECC patients enrolled in our NECC registry. The primary outcomes were associations between Social Network Time Use Scale (SONTUS) global score and Generalized Anxiety Disorder (GAD-7) and Center for Epidemiologic Studies Depression Scale (CESD) total scores. RESULTS Eighty-eight patients enrolled; 81 who completed at least 1 survey were included. Ninety-seven percent (70/72) of patients completing SONTUS were low-to-average social media users. Seventy-four percent (53/72) of patients visited a patient-led NECC support-group page on Facebook within the past 4 weeks, and of those, 79% (42/53) reported receiving useful information. Among the patients who did not visit the page, 47% (9/19) reported that the page elicited anxiety and/or sadness. The mean GAD-7 and CES-D scores for the entire cohort were 7.3 and 18.1, respectively. The Spearman correlations between social media use and these scores were significant (GAD-7: 0.23 [p = 0.05]; CESD: 0.25 [p = 0.04]). The estimated odds ratios for moderate/severe anxiety and depression as a function of SONTUS global score were 1.26 (95% CI 1.03-1.55; p = 0.03) and 1.23 (95% CI 1.01-1.49; p = 0.04), respectively. CONCLUSIONS NECC patients demonstrated low-to-average social media use and relatively high anxiety and depression. Increased social media use was associated with elevated anxiety and depression.
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Affiliation(s)
- Reem H Saab
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Gloria Salvo
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Naomi R Gonzales
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Mark F Munsell
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Eileen H Shinn
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Anuja Jhingran
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Priya Bhosale
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Preetha Ramalingam
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Michael Frumovitz
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Kohler RE, Hemler J, Wagner RB, Sullivan B, Macenat M, Tagai EK, Miller SM, Wen KY, Ayers C, Einstein MH, Hudson SV. Confusion and anxiety in between abnormal cervical cancer screening results and colposcopy: "The land of the unknown". PATIENT EDUCATION AND COUNSELING 2023; 114:107810. [PMID: 37244133 PMCID: PMC10527466 DOI: 10.1016/j.pec.2023.107810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Attendance to colposcopy after abnormal cervical cancer screening is essential to cervical cancer prevention. This qualitative study explored patients' understanding of screening results, their experiences of the time leading up to the colposcopy appointment, and colposcopy. METHODS We recruited women referred for colposcopy from two urban practices in an academic health system. Individual interviews (N = 15) with participants were conducted after colposcopy appointments about their cervical cancer screening histories, current results, and colposcopy experiences. A team analyzed and summarized interviews and coded transcripts in Atlas.ti. RESULTS We found that most women were confused about their screening results, did not know what a colposcopy was before being referred for one, and experienced anxiety in the interval between receiving their results and having their colposcopy. Most women searched for information online, but found "misinformation," "worst-case scenarios" and generic information that did not resolve their confusion. CONCLUSION Women had little understanding of their cervical cancer risk and experienced anxiety looking for information and waiting for the colposcopy. Educating patients about cervical precancer and colposcopy, providing tailored information about their abnormal screening test results and potential next steps, and helping women manage distress may alleviate uncertainty while waiting for follow-up appointments. PRACTICE IMPLICATIONS Interventions to manage uncertainty and distress in the interval between receiving an abnormal screening test result and attending colposcopy are needed, even among highly adherent patients.
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Affiliation(s)
- Racquel E Kohler
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, 120 Albany St, New Brunswick, NJ 08901, USA.
| | - Jennifer Hemler
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 303 George St, New Brunswick, NJ 08901, USA
| | - Rachel B Wagner
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, 120 Albany St, New Brunswick, NJ 08901, USA
| | - Brittany Sullivan
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 303 George St, New Brunswick, NJ 08901, USA
| | - Myneka Macenat
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, 120 Albany St, New Brunswick, NJ 08901, USA
| | - Erin K Tagai
- Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | - Suzanne M Miller
- Cancer Prevention and Control, Fox Chase Cancer Center/Temple University Health System, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | - Kuang-Yi Wen
- Department of Medical Oncology, Thomas Jefferson University, 834 Chestnut Street, Philadelphia, PA 19107, USA
| | - Charletta Ayers
- Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, 125 Paterson St, New Brunswick, NJ 08901, USA
| | - Mark H Einstein
- Department of Obstetrics, Gynecology and Reproductive Health, Rutgers Biomedical and Health Sciences, 185 South Orange Avenue, Newark, NJ 07103, USA
| | - Shawna V Hudson
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, 120 Albany St, New Brunswick, NJ 08901, USA; Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 303 George St, New Brunswick, NJ 08901, USA
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Lazard AJ, Nicolla S, Vereen RN, Pendleton S, Charlot M, Tan HJ, DiFranzo D, Pulido M, Dasgupta N. Exposure and Reactions to Cancer Treatment Misinformation and Advice: Survey Study. JMIR Cancer 2023; 9:e43749. [PMID: 37505790 PMCID: PMC10422174 DOI: 10.2196/43749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 04/28/2023] [Accepted: 05/23/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Cancer treatment misinformation, or false claims about alternative cures, often spreads faster and farther than true information on social media. Cancer treatment misinformation can harm the psychosocial and physical health of individuals with cancer and their cancer care networks by causing distress and encouraging people to abandon support, potentially leading to deviations from evidence-based care. There is a pressing need to understand how cancer treatment misinformation is shared and uncover ways to reduce misinformation. OBJECTIVE We aimed to better understand exposure and reactions to cancer treatment misinformation, including the willingness of study participants to prosocially intervene and their intentions to share Instagram posts with cancer treatment misinformation. METHODS We conducted a survey on cancer treatment misinformation among US adults in December 2021. Participants reported their exposure and reactions to cancer treatment misinformation generally (saw or heard, source, type of advice, and curiosity) and specifically on social media (platform, believability). Participants were then randomly assigned to view 1 of 3 cancer treatment misinformation posts or an information post and asked to report their willingness to prosocially intervene and their intentions to share. RESULTS Among US adult participants (N=603; mean age 46, SD 18.83 years), including those with cancer and cancer caregivers, almost 1 in 4 (142/603, 23.5%) received advice about alternative ways to treat or cure cancer. Advice was primarily shared through family (39.4%) and friends (37.3%) for digestive (30.3%) and natural (14.1%) alternative cancer treatments, which generated curiosity among most recipients (106/142, 74.6%). More than half of participants (337/603, 55.9%) saw any cancer treatment misinformation on social media, with significantly higher exposure for those with cancer (53/109, 70.6%) than for those without cancer (89/494, 52.6%; P<.001). Participants saw cancer misinformation on Facebook (39.8%), YouTube (27%), Instagram (22.1%), and TikTok (14.1%), among other platforms. Participants (429/603, 71.1%) thought cancer treatment misinformation was true, at least sometimes, on social media. More than half (357/603, 59.2%) were likely to share any cancer misinformation posts shown. Many participants (412/603, 68.3%) were willing to prosocially intervene for any cancer misinformation posts, including flagging the cancer treatment misinformation posts as false (49.7%-51.4%) or reporting them to the platform (48.1%-51.4%). Among the participants, individuals with cancer and those who identified as Black or Hispanic reported greater willingness to intervene to reduce cancer misinformation but also higher intentions to share misinformation. CONCLUSIONS Cancer treatment misinformation reaches US adults through social media, including on widely used platforms for support. Many believe that social media posts about alternative cancer treatment are true at least some of the time. The willingness of US adults, including those with cancer and members of susceptible populations, to prosocially intervene could initiate the necessary community action to reduce cancer treatment misinformation if coupled with strategies to help individuals discern false claims.
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Affiliation(s)
- Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Sydney Nicolla
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hll, Chapel Hill, NC, United States
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hll, Chapel Hill, NC, United States
| | - Shanetta Pendleton
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hll, Chapel Hill, NC, United States
| | - Marjory Charlot
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Medicine, Division of Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Hung-Jui Tan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Urology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Dominic DiFranzo
- P.C. Rossin College of Engineering and Applied Science, Lehigh University, Bethlehem, PA, United States
| | - Marlyn Pulido
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Nabarun Dasgupta
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Zenone M, Snyder J, Bélisle-Pipon JC, Caulfield T, van Schalkwyk M, Maani N. Advertising Alternative Cancer Treatments and Approaches on Meta Social Media Platforms: Content Analysis. JMIR INFODEMIOLOGY 2023; 3:e43548. [PMID: 37256649 DOI: 10.2196/43548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/13/2023] [Accepted: 03/27/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Alternative cancer treatment is associated with a greater risk of death than cancer patients undergoing conventional treatments. Anecdotal evidence suggests cancer patients view paid advertisements promoting alternative cancer treatment on social media, but the extent and nature of this advertising remain unknown. This context suggests an urgent need to investigate alternative cancer treatment advertising on social media. OBJECTIVE This study aimed to systematically analyze the advertising activities of prominent alternative cancer treatment practitioners on Meta platforms, including Facebook, Instagram, Messenger, and Audience Network. We specifically sought to determine (1) whether paid advertising for alternative cancer treatment occurs on Meta social media platforms, (2) the strategies and messages of alternative cancer providers to reach and appeal to prospective patients, and (3) how the efficacy of alternative treatments is portrayed. METHODS Between December 6, 2021, and December 12, 2021, we collected active advertisements from alternative cancer clinics using the Meta Ad Library. The information collected included identification number, URL, active/inactive status, dates launched/ran, advertiser page name, and a screenshot (image) or recording (video) of the advertisement. We then conducted a content analysis to determine how alternative cancer providers communicate the claimed benefits of their services and evaluated how they portrayed alternative cancer treatment efficacy. RESULTS We identified 310 paid advertisements from 11 alternative cancer clinics on Meta (Facebook, Instagram, or Messenger) marketing alternative treatment approaches, care, and interventions. Alternative cancer providers appealed to prospective patients through eight strategies: (1) advertiser representation as a legitimate medical provider (n=289, 93.2%); (2) appealing to persons with limited treatments options (n=203, 65.5%); (3) client testimonials (n=168, 54.2%); (4) promoting holistic approaches (n=121, 39%); (5) promoting messages of care (n=81, 26.1%); (6) rhetoric related to science and research (n=72, 23.2%); (7) rhetoric pertaining to the latest technology (n=63, 20.3%); and (8) focusing treatment on cancer origins and cause (n=43, 13.9%). Overall, 25.8% (n=80) of advertisements included a direct statement claiming provider treatment can cure cancer or prolong life. CONCLUSIONS Our results provide evidence alternative cancer providers are using Meta advertising products to market scientifically unsupported cancer treatments. Advertisements regularly referenced "alternative" and "natural" treatment approaches to cancer. Imagery and text content that emulated evidence-based medical providers created the impression that the offered treatments were effective medical options for cancer. Advertisements exploited the hope of patients with terminal and poor prognoses by sharing testimonials of past patients who allegedly were cured or had their lives prolonged. We recommend that Meta introduce a mandatory, human-led authorization process that is not reliant upon artificial intelligence for medical-related advertisers before giving advertising permissions. Further research should focus on the conflict of interest between social media platforms advertising products and public health.
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Affiliation(s)
- Marco Zenone
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jeremy Snyder
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | | | - May van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nason Maani
- Global Health Policy Unit, University of Edinburgh, Edinburgh, United Kingdom
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Robbins R, Epstein LJ, Iyer JM, Weaver MD, Javaheri S, Fashanu O, Loeb S, Monten K, Le C, Bertisch SM, Van Den Bulck J, Quan SF. Examining understandability, information quality, and presence of misinformation in popular YouTube videos on sleep compared to expert-led videos. J Clin Sleep Med 2023; 19:991-994. [PMID: 36794333 PMCID: PMC10152351 DOI: 10.5664/jcsm.10520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023]
Abstract
The Internet is a common source of sleep information but may be subject to commercial bias and misinformation. We compared the understandability, information quality, and presence of misinformation of popular YouTube videos on sleep to videos with credible experts. We identified the most popular YouTube videos on sleep/insomnia and 5 videos from experts. Videos were assessed for understanding and clarity using validated instruments. Misinformation and commercial bias were identified by consensus of sleep medicine experts. The most popular videos received, on average, 8.2 (± 2.2) million views; the expert-led videos received, on average, 0.3 (± 0.2) million views. Commercial bias was identified in 66.7% of popular videos and 0% of expert videos (P < .012). The popular videos featured more misinformation than expert videos (P < .001). The popular videos about sleep/insomnia on YouTube featured misinformation and commercial bias. Future research may explore methods for disseminating evidence-based sleep information. CITATION Robbins R, Epstein LJ, Iyer JM, et al. Examining understandability, information quality, and presence of misinformation in popular YouTube videos on sleep compared to expert-led videos. J Clin Sleep Med. 2023;19(5):991-994.
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Affiliation(s)
- Rebecca Robbins
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Lawrence J. Epstein
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jay M. Iyer
- Departments of Molecular and Cellular Biology and Statistics, Harvard University, Cambridge, Massachusetts
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Sogol Javaheri
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Olabimpe Fashanu
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Stacy Loeb
- Department of Urology and Population Health, New York University School of Medicine and Manhattan Veterans Affairs, New York, New York
| | | | - Colin Le
- Departments of Molecular and Cellular Biology and Statistics, Harvard University, Cambridge, Massachusetts
| | - Suzanne M. Bertisch
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jan Van Den Bulck
- Department of Media and Communication, University of Michigan, Ann Arbor, Michigan
| | - Stuart F. Quan
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
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Nicolas-Joseph M, Ould Brahim L, Boureanu MI, Frati FYE, Bourdache LR, Belzile E, Lambert SD. An evaluation of the suitability, readability, quality, and usefulness of online resources for patients with cancer receiving immunotherapy. PATIENT EDUCATION AND COUNSELING 2023; 110:107640. [PMID: 36736088 DOI: 10.1016/j.pec.2023.107640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To evaluate the suitability, readability, quality, and usefulness of available online resources about the side effects of immunotherapy. METHODS Resources were identified through online searches (Google, Microsoft Bing, and Yahoo search engines) and evaluated using the Suitability Assessment Materials (SAM), three readability formulae, the DISCERN tool (quality), and a checklist of symptom management strategies and self-management skills (usefulness). Hierarchical cluster analysis identified resources scoring highly for suitability and quality. Factors associated with the clusters were identified using Fischer's exact tests. RESULTS The 51 resources retained for evaluation were of low suitability and quality and exceeded recommended reading levels. Resources were lacking key features to support learning (e.g., illustrations) as well as information about the risks of treatments and the effect of treatments on quality of life. Few resources addressed key self-management skills of problem-solving and taking action. The cluster analysis identified "low" and "moderate" clusters for suitability and quality, and pamphlets and booklets were more likely to be in the moderate cluster as compared to webpages. CONCLUSION There is a lack of high-quality resources to support patients' learning to self-manage side effects of immunotherapy. PRACTICE IMPLICATIONS Results identify the best available online resources for self-managing side effects of immunotherapy and gaps for future work. Based on findings, a template for patient education materials was developed.
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Affiliation(s)
- Marrah Nicolas-Joseph
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, Qc H3A 2M7, Canada
| | - Lydia Ould Brahim
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, Qc H3A 2M7, Canada
| | - Mara Ioana Boureanu
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, Qc H3A 2M7, Canada
| | - Francesca Y E Frati
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, 845 Sherbrooke West, Montreal, Qc H3A 0G4, Canada
| | - Lydia Rosa Bourdache
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, Qc H3A 2M7, Canada
| | - Eric Belzile
- St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, Qc H3T 1M5, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montreal, Qc H3A 2M7, Canada; St. Mary's Research Centre, 3830 Lacombe Ave, Montreal, Qc H3T 1M5, Canada.
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18
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Bylund CL, Mullis MD, Alpert J, Markham MJ, Onega T, Fisher CL, Johnson SB. Clinician Communication With Patients About Cancer Misinformation: A Qualitative Study. JCO Oncol Pract 2023; 19:e389-e396. [PMID: 36626708 DOI: 10.1200/op.22.00526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Clinicians regularly face conversations about information that patients have found online. Given the prevalence of misinformation, these conversations can include cancer-related misinformation, which is often harmful. Clinicians are in a key position as trusted sources of information to educate patients. However, there is no research on clinician-patient conversations about cancer-related misinformation. As a first step, the objective of this study was to describe how cancer clinicians report communicating with patients about online cancer misinformation. METHODS We used convenience and snowball sampling to contact 59 cancer clinicians by e-mail. Contacted clinicians predominately worked at academic centers across the United States. Clinicians who agreed participated in semistructured interviews about communication in health care. For this study, we focused specifically on clinicians' experiences discussing online cancer-related misinformation with patients. We conducted a thematic analysis using a constant comparative approach to identify how clinicians address misinformation during clinical visits. RESULTS Twenty-one cancer clinicians participated in the study. Nineteen were physicians, one was a physician assistant, and one was a nurse practitioner. The majority (62%) were female. We identified four themes that describe how cancer clinicians address misinformation: (1) work to understand the misinformation; (2) correct misinformation through education; (3) advise about future online searches, and (4) preserve the clinician-patient relationship. CONCLUSION Our study identified four strategies that clinicians use to address online cancer-related misinformation with their patients. These findings provide a foundation for future research, allowing us to test these strategies in larger samples to examine their effectiveness.
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Affiliation(s)
- Carma L Bylund
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Michaela D Mullis
- College of Journalism and Communications, University of Florida, Gainesville, FL
| | - Jordan Alpert
- College of Journalism and Communications, University of Florida, Gainesville, FL
| | - Merry Jennifer Markham
- Division of Hematology and Oncology, Department of Medicine, University of Florida, Gainesville, FL
| | - Tracy Onega
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, UT
| | - Carla L Fisher
- College of Journalism and Communications, University of Florida, Gainesville, FL
| | - Skyler B Johnson
- Department of Radiation Oncology, School of Medicine, University of Utah, Salt Lake City, UT
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Beltrán Ponce S, McAlarnen LA, Teplinsky E. Challenges of Reaching Patients With Cancer on Social Media: Lessons From the Failed #CancerRealTalk Experience. JCO Oncol Pract 2023; 19:63-65. [PMID: 36260831 DOI: 10.1200/op.22.00515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sara Beltrán Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Lindsey A McAlarnen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI
| | - Eleonora Teplinsky
- Valley-Mount Sinai Comprehensive Cancer Care, Valley Health System, Paramus, NJ
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Paytubi S, Benavente Y, Montoliu A, Binefa G, Brotons M, Ibáñez R, Ochoa C, Peremiquel-Trillas P, Serrano B, Travier N, Alemany L, Costas L. Everything causes cancer? Beliefs and attitudes towards cancer prevention among anti-vaxxers, flat earthers, and reptilian conspiracists: online cross sectional survey. BMJ 2022; 379:e072561. [PMID: 36543351 PMCID: PMC9768817 DOI: 10.1136/bmj-2022-072561] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate, using an online non-probability sample, the beliefs about and attitudes towards cancer prevention of people professing vaccination scepticism or conspiracy theories. DESIGN Cross sectional survey. SETTING Data collected mainly from ForoCoches (a well known Spanish forum) and other platforms, including Reddit (English), 4Chan (English), HispaChan (Spanish), and a Spanish language website for cancer prevention (mejorsincancer.org) from January to March 2022. PARTICIPANTS Among 1494 responders, 209 were unvaccinated against covid-19, 112 preferred alternative rather than conventional medicine, and 62 reported flat earth or reptilian beliefs. MAIN OUTCOME MEASURES Cancer beliefs assessed using the Cancer Awareness Measure (CAM) and Cancer Awareness Measure Mythical Causes Scale (CAM-MYCS) (both validated tools). RESULTS Awareness of the actual causes of cancer was greater (median CAM score 63.6%) than that of mythical causes (41.7%). The most endorsed mythical causes of cancer were eating food containing additives or sweeteners, feeling stressed, and eating genetically modified food. Awareness of the actual and mythical causes of cancer among the unvaccinated, alternative medicine, and conspiracy groups was lower than among their counterparts. A median of 54.5% of the actual causes was accurately identified among each of the unvaccinated, alternative medicine, and conspiracy groups, and a median of 63.6% was identified in each of the three corresponding counterparts (P=0.13, 0.04, and 0.003, respectively). For mythical causes, medians of 25.0%, 16.7%, and 16.7% were accurately identified in the unvaccinated, alternative medicine, and conspiracy groups, respectively; a median of 41.7% was identified in each of the three corresponding counterparts (P<0.001 in adjusted models for all comparisons). In total, 673 (45.0%) participants agreed with the statement "It seems like everything causes cancer." No significant differences were observed among the unvaccinated (44.0%), conspiracist (41.9%), or alternative medicine groups (35.7%), compared with their counterparts (45.2%, 45.7%, and 45.8%, respectively). CONCLUSIONS Almost half of the participants agreed that "It seems like everything causes cancer," which highlights the difficulty that society encounters in differentiating actual and mythical causes owing to mass information. People who believed in conspiracies, rejected the covid-19 vaccine, or preferred alternative medicine were more likely to endorse the mythical causes of cancer than their counterparts but were less likely to endorse the actual causes of cancer. These results suggest a direct connection between digital misinformation and consequent erroneous health decisions, which may represent a further preventable fraction of cancer.
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Affiliation(s)
- Sonia Paytubi
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Yolanda Benavente
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Alexandra Montoliu
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Gemma Binefa
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Cancer Prevention and Control Program, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Maria Brotons
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Raquel Ibáñez
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Cristian Ochoa
- eHealth ICOnnecta't and Psycho-oncology Services, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Beatriz Serrano
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Noémie Travier
- Cancer Prevention and Control Program, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laura Costas
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Abemaciclib for malignant pleural mesothelioma. Lancet Oncol 2022; 23:e237. [DOI: 10.1016/s1470-2045(22)00276-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/17/2022]
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