@Article{info:doi/10.2196/64809,
author="McElroy, A. Jane
and Smith, B. Jamie
and Everett, D. Kevin",
title="Monthly Variations in Colorectal Cancer Screening Tests Among Federally Qualified Health Center Patients in Missouri: Quality Improvement Project",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="19",
volume="11",
pages="e64809",
keywords="colorectal cancer screening",
keywords="federally qualified health center",
keywords="FQHC",
keywords="fecal immunochemical test",
keywords="FIT",
keywords="FIT-DNA",
keywords="colorectal cancer",
keywords="CRC",
keywords="cancer",
keywords="cancer screening",
keywords="colonoscopy",
keywords="United States",
keywords="health center",
keywords="quality improvement",
abstract="Background: Cancer is the second leading cause of death in the United States. Compelling evidence shows screening detects colorectal cancer (CRC) at earlier stages and prevents the development of CRC through the removal of precancerous polyps. The Healthy People 2030 goal for CRC screening is 68.3\%, but only 36.5\% of Missouri federally qualified health center patients aged 50?75 years are up-to-date on CRC screening. For average risk patients, there are three commonly used screening tests in the United States---two types of stool tests collected at home (fecal immunochemical test [FIT]--immunochemical fecal occult blood test [FOBT] and FIT-DNA, such as Cologuard) and colonoscopies completed at procedural centers. Objective: This study aims to examine variation by month for the three types of CRC testing to evaluate consistent patient care by clinical staff. Methods: Data from 31 federally qualified health center clinics in Missouri from 2011 to 2023 were analyzed. A sample of 34,124 unique eligible ``average risk'' patients defined as persons not having a personal history of CRC or certain types of polyps, family history of CRC, personal history of inflammatory bowel disease, and personal history of receiving radiation to the abdomen or pelvic to treat a previous cancer or confirmed or suspected hereditary CRC syndrome. Another eligibility criterion is that patients need to be seen at least once at the clinic to be included in the denominator for the screening rate calculation. Descriptive statistics characterize the sample, while bivariate analyses assess differences in screening types by month. Results: Completion of CRC screening yielded statistically significant differences for patients completing the different types of CRC screening by month. October-January had the highest proportions of patients (644-680 per month, 8.5\%?10.2\%) receiving a colonoscopy, while February-April had the lowest (509-578 per month, 6.9\%?7.8\%), with 614 being the average monthly number of colonoscopies. For FIT-FOBT, June-August had the higher proportions of patients receiving this test (563-613 per month, 8.9\%?9.6\%), whereas December-February had the lowest (453-495 per month, 7.1\%?8\%), with 541 being the average monthly number of FIT-FOBT kits used. For FIT-DNA, March was the most popular month with 11.3\% (n=261 per month) of patients using the Cologuard test, followed by April, May, and November (207-220 per month, 8.7\%?9.4\%), and January and June (168-171 per month, 7.2\%-7.3\%) had the lowest proportion of patients using Cologuard, with 193 being the average monthly number of FIT-DNA kits used. Combining all tests, February had the fewest CRC tests completed (1153/16,173, 7.1\%). Conclusions: Home-based tests are becoming popular, replacing the gold standard colonoscopy, but need to be repeated more frequently. Monthly variation of screening over the course of a year suggests that CRC screening efforts and patient care may be less than ideal. Months with lower rates of screening for each type of CRC test represent opportunities for improving CRC screening. ",
doi="10.2196/64809",
url="https://cancer.jmir.org/2025/1/e64809"
}


@Article{info:doi/10.2196/57414,
author="Lin, Shuangquan
and Duan, Lingxing
and Xu, Xiangda
and Cao, Haichao
and Lu, Xiongbing
and Wen, Xi
and Wei, Shanzun",
title="Analyzing Online Search Trends for Kidney, Prostate, and Bladder Cancers in China: Infodemiology Study Using Baidu Search Data (2011-2023)",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="14",
volume="11",
pages="e57414",
keywords="bladder cancer",
keywords="kidney cancer",
keywords="prostate cancer",
keywords="Baidu Index",
keywords="infodemiology",
keywords="public interest",
keywords="patients' concern",
abstract="Background: Cancers of the bladder, kidney, and prostate are the 3 major genitourinary cancers that significantly contribute to the global burden of disease (GBD) and continue to show increasing rates of morbidity and mortality worldwide. In mainland China, understanding the cancer burden on patients and their families is crucial; however, public awareness and concerns about these cancers, particularly from the patient's perspective, remain predominantly focused on financial costs. A more comprehensive exploration of their needs and concerns has yet to be fully addressed. Objective: This study aims to analyze trends in online searches and user information--seeking behaviors related to bladder, kidney, and prostate cancers---encompassing descriptive terms (eg, ``bladder cancer,'' ``kidney cancer,'' ``prostate cancer'') as well as related synonyms and variations---on both national and regional scales. This study leverages data from mainland China's leading search engine to explore the implications of these search patterns for addressing user needs and improving health management. Methods: The study analyzed Baidu Index search trends for bladder, kidney, and prostate cancers (from January 2011 to August 2023) at national and provincial levels. Search volume data were analyzed using the joinpoint regression model to calculate annual percentage changes (APCs) and average APCs (AAPCs), identifying shifts in public interest. User demand was assessed by categorizing the top 10 related terms weekly into 13 predefined topics, including diagnosis, treatment, and traditional Chinese medicine. Data visualization and statistical analyses were performed using Prism 9. Results revealed keyword trends, demographic distributions, and public information needs, offering insights into health communication and management strategies based on online information-seeking behavior. Results: Three cancer topics were analyzed using 39 search keywords, yielding a total Baidu Search Index (BSI) of 43,643,453. From 2011 to 2015, the overall APC was 15.2\% (P<.05), followed by --2.8\% from 2015 to 2021, and 8.9\% from 2021 to 2023, with an AAPC of 4.9\%. Bladder, kidney, and prostate cancers exhibited AAPCs of 2.8\%, 3.9\%, and 6.8\%, respectively (P<.05). The age distribution of individuals searching for these cancer topics varied across the topics. Geographically, searches for cancer were predominantly conducted by people from East China, who accounted for approximately 30\% of each cancer search query. Regarding user demand, the total BSI for relevant user demand terms from August 2022 to August 2023 was 676,526,998 out of 2,570,697,380 (15.74\%), representing only a limited total cancer-related search volume. Conclusions: Online searches and inquiries related to genitourinary cancers are on the rise. The depth of users' information demands appears to be influenced by regional economic levels. Cancer treatment decision-making may often involve a family-centered approach. Insights from internet search data can help medical professionals better understand public interests and concerns, enabling them to provide more targeted and reliable health care services. ",
doi="10.2196/57414",
url="https://cancer.jmir.org/2025/1/e57414"
}


@Article{info:doi/10.2196/65001,
author="Huang, Tracy
and Ngan, Chun-Kit
and Cheung, Ting Yin
and Marcotte, Madelyn
and Cabrera, Benjamin",
title="A Hybrid Deep Learning--Based Feature Selection Approach for Supporting Early Detection of Long-Term Behavioral Outcomes in Survivors of Cancer: Cross-Sectional Study",
journal="JMIR Bioinform Biotech",
year="2025",
month="Mar",
day="13",
volume="6",
pages="e65001",
keywords="machine learning",
keywords="data driven",
keywords="clinical domain--guided framework",
keywords="survivors of cancer",
keywords="cancer",
keywords="oncology",
keywords="behavioral outcome predictions",
keywords="behavioral study",
keywords="behavioral outcomes",
keywords="feature selection",
keywords="deep learning",
keywords="neural network",
keywords="hybrid",
keywords="prediction",
keywords="predictive modeling",
keywords="patients with cancer",
keywords="deep learning models",
keywords="leukemia",
keywords="computational study",
keywords="computational biology",
abstract="Background: The number of survivors of cancer is growing, and they often experience negative long-term behavioral outcomes due to cancer treatments. There is a need for better computational methods to handle and predict these outcomes so that physicians and health care providers can implement preventive treatments. Objective: This study aimed to create a new feature selection algorithm to improve the performance of machine learning classifiers to predict negative long-term behavioral outcomes in survivors of cancer. Methods: We devised a hybrid deep learning--based feature selection approach to support early detection of negative long-term behavioral outcomes in survivors of cancer. Within a data-driven, clinical domain--guided framework to select the best set of features among cancer treatments, chronic health conditions, and socioenvironmental factors, we developed a 2-stage feature selection algorithm, that is, a multimetric, majority-voting filter and a deep dropout neural network, to dynamically and automatically select the best set of features for each behavioral outcome. We also conducted an experimental case study on existing study data with 102 survivors of acute lymphoblastic leukemia (aged 15-39 years at evaluation and >5 years postcancer diagnosis) who were treated in a public hospital in Hong Kong. Finally, we designed and implemented radial charts to illustrate the significance of the selected features on each behavioral outcome to support clinical professionals' future treatment and diagnoses. Results: In this pilot study, we demonstrated that our approach outperforms the traditional statistical and computation methods, including linear and nonlinear feature selectors, for the addressed top-priority behavioral outcomes. Our approach holistically has higher F1, precision, and recall scores compared to existing feature selection methods. The models in this study select several significant clinical and socioenvironmental variables as risk factors associated with the development of behavioral problems in young survivors of acute lymphoblastic leukemia. Conclusions: Our novel feature selection algorithm has the potential to improve machine learning classifiers' capability to predict adverse long-term behavioral outcomes in survivors of cancer. ",
doi="10.2196/65001",
url="https://bioinform.jmir.org/2025/1/e65001",
url="http://www.ncbi.nlm.nih.gov/pubmed/40080820"
}


@Article{info:doi/10.2196/65820,
author="Song, Gao
and Zhang, Cai-qiong
and Bai, Zhong-ping
and Li, Rong
and Cheng, Meng-qun",
title="Assisted Reproductive Technology and Risk of Childhood Cancer Among the Offspring of Parents With Infertility: Systematic Review and Meta-Analysis",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="12",
volume="11",
pages="e65820",
keywords="assisted reproductive technology",
keywords="childhood cancer",
keywords="infertility",
keywords="subfertile",
keywords="risks",
keywords="systematic review",
abstract="Background: The relationship between assisted reproductive technology (ART) and childhood cancer risk has been widely debated. Previous meta-analyses did not adequately account for the impact of infertility, and this study addresses this gap. Objective: Our primary objective was to assess the relative risk (RR) of childhood cancer in infertile populations using ART versus non-ART offspring, with a secondary focus on comparing frozen embryo transfer (FET) and fresh embryo transfer (fresh-ET). Methods: A literature review was conducted through PubMed, Embase, Cochrane, and Web of Science, with a cutoff date of July 10, 2024. The study was registered with the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY 202470119). Inclusion criteria were based on the PICOS (Population, Intervention, Comparison, Outcomes, and Study Design) framework: infertile or subfertile couples (population), ART interventions (in vitro fertilization [IVF], intracytoplasmic sperm injection [ICSI], FET, and fresh-ET), non-ART comparison, and childhood cancer risk outcomes. Data abstraction focused on the primary exposures (ART vs non-ART and FET vs fresh-ET) and outcomes (childhood cancer risk). The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale, and the evidence quality was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Pooled estimates and 95\% CIs were calculated using random effects models. Results: A total of 18 studies were included, published between 2000 and 2024, consisting of 14 (78\%) cohort studies and 4 (22\%) case-control studies, all of which were of moderate to high quality. The cohort studies had follow-up periods ranging from 3 to 18 years. Compared with non-ART conception, ART conception was not significantly associated with an increased risk of childhood overall cancer (RR 0.95, 95\% CI 0.71?1.27; GRADE quality: low to moderate). Subgroup analyses of IVF (RR 0.86, 95\% CI 0.59?1.25), ICSI (RR 0.76, 95\% CI 0.26?2.2), FET (RR 0.98, 95\% CI 0.54?1.76), and fresh-ET (RR 0.75, 95\% CI 0.49?1.15) showed similar findings. No significant differences were found for specific childhood cancers, including leukemia (RR 0.99, 95\% CI 0.79?1.24), lymphoma (RR 1.22, 95\% CI 0.64?2.34), brain cancer (RR 1.22, 95\% CI 0.73?2.05), embryonal tumors (RR 1, 95\% CI 0.63?1.58), retinoblastoma (RR 1.3, 95\% CI 0.73?2.31), and neuroblastoma (RR 1.02, 95\% CI 0.48?2.16). Additionally, no significant difference was observed in a head-to-head comparison of FET versus fresh-ET (RR 0.99, 95\% CI 0.86?1.14; GRADE quality: moderate). Conclusions: In conclusion, this study found no significant difference in the risk of childhood cancer between offspring conceived through ART and those conceived through non-ART treatments (such as fertility drugs or intrauterine insemination) in infertile populations. While infertility treatments may elevate baseline risks, our findings suggest that whether individuals with infertility conceive using ART or non-ART methods, their offspring do not face a significantly higher risk of childhood cancer. Further research, especially comparing infertile populations who conceive naturally, is needed to better understand potential long-term health outcomes. Trial Registration: INPLASY 202470119; https://inplasy.com/?s=202470119 ",
doi="10.2196/65820",
url="https://cancer.jmir.org/2025/1/e65820"
}


@Article{info:doi/10.2196/53328,
author="Zippi, D. Zachary
and Cortopassi, O. Isabel
and Grage, A. Rolf
and Johnson, M. Elizabeth
and McCann, R. Matthew
and Mergo, J. Patricia
and Sonavane, K. Sushil
and Stowell, T. Justin
and Little, P. Brent",
title="Assessing Public Interest in Mammography, Computed Tomography Lung Cancer Screening, and Computed Tomography Colonography Screening Examinations Using Internet Search Data: Cross-Sectional Study",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="11",
volume="11",
pages="e53328",
keywords="lung cancer",
keywords="lung cancer screening",
keywords="breast cancer",
keywords="mammography",
keywords="colon cancer",
keywords="CT colonography",
keywords="Google search",
keywords="internet",
keywords="Google Trends",
keywords="imaging-based",
keywords="cancer screening",
keywords="search data",
keywords="noninvasive",
keywords="cancer",
keywords="CT",
keywords="online",
keywords="public awareness",
keywords="big data",
keywords="analytics",
keywords="patient education",
keywords="screening uptake",
abstract="Background: The noninvasive imaging examinations of mammography (MG), low-dose computed tomography (CT) for lung cancer screening (LCS), and CT colonography (CTC) play important roles in screening for the most common cancer types. Internet search data can be used to gauge public interest in screening techniques, assess common screening-related questions and concerns, and formulate public awareness strategies. Objective: This study aims to compare historical Google search volumes for MG, LCS, and CTC and to determine the most common search topics. Methods: Google Trends data were used to quantify relative Google search frequencies for these imaging screening modalities over the last 2 decades. A commercial search engine tracking product (keywordtool.io) was used to assess the content of related Google queries over the year from May 1, 2022, to April 30, 2023, and 2 authors used an iterative process to agree upon a list of thematic categories for these queries. Queries with at least 10 monthly instances were independently assigned to the most appropriate category by the 2 authors, with disagreements resolved by consensus. Results: The mean 20-year relative search volume for MG was approximately 10-fold higher than for LCS and 25-fold higher than for CTC. Search volumes for LCS have trended upward since 2011. The most common topics of MG-related searches included nearby screening locations (60,850/253,810, 24\%) and inquiries about procedural discomfort (28,970/253,810, 11\%). Most common LCS-related searches included CT-specific inquiries (5380/11,150, 48\%) or general inquiries (1790/11,150, 16\%), use of artificial intelligence or deep learning (1210/11,150, 11\%), and eligibility criteria (1020/11,150, 9\%). For CTC, the most common searches were CT-specific inquiries (1800/5590, 32\%) or procedural details (1380/5590, 25\%). Conclusions: Over the past 2 decades, Google search volumes have been significantly higher for MG than for either LCS or CTC, although search volumes for LCS have trended upward since 2011. Knowledge of public interest and queries related to imaging-based screening techniques may help guide public awareness efforts. ",
doi="10.2196/53328",
url="https://cancer.jmir.org/2025/1/e53328"
}


@Article{info:doi/10.2196/64020,
author="Takahashi, Noriaki
and Nakao, Mutsuhiro
and Nakayama, Tomio
and Yamazaki, Tsutomu",
title="Breast Cancer Screening Participation and Internet Search Activity in a Japanese Population: Decade-Long Time-Series Study",
journal="JMIR Cancer",
year="2025",
month="Mar",
day="4",
volume="11",
pages="e64020",
keywords="breast cancer",
keywords="cancer screening",
keywords="internet use",
keywords="mass media",
keywords="public health surveillance",
keywords="health belief model",
keywords="mammography",
keywords="awareness",
keywords="Japanese",
keywords="Google",
abstract="Background: Breast cancer is a major health concern in various countries. Routine mammography screening has been shown to reduce breast cancer mortality, and Japan has set national targets to improve screening participation and increase public attention. However, collecting nationwide data on public attention and activity is not easy. Google Trends can reveal changes in societal interest, yet there are no reports on the relationship between internet search volume and nationwide participation rates in Japan. Objective: This study aims to reveal and discuss the relationship between public awareness and actual behavior in breast cancer screening by examining trends in internet search volume for the keyword ``breast cancer screening'' and participation rates over a decade-long period. Methods: This time-series study evaluated the association between internet search volume and breast cancer screening participation behavior among women aged 60?69 years in Japan from 2009 to 2019. Relative search volume (RSV) data for the search term ``breast cancer screening (nyuugan-kenshin)'' were extracted from Google Trends as internet search volume. Breast cancer screening and further assessment participation rates were based on government municipal screening data. Joinpoint regression analyses were conducted with weighted BIC to evaluate the time trends. An ethics review was not required because all data were open. Results: The RSV for ``breast cancer screening (nyuugan-kenshin)'' peaked in June 2017 (100) and showed clear spikes in June 2016 (94), September (69), and October (77) 2015. No RSVs above 60 were observed except around these three specific periods, and the average RSV for the entire period was 30.7 (SD 16.2). Two statistically significant joinpoints were detected, rising in December 2013 and falling in June 2017. Screening participation rates showed a temporary increase in 2015 in a slowly decreasing trend, and no joinpoints were detected. Further assessment participation rates showed a temporary spike in 2015 in the middle of an increasing trend, with a statistically significant point of slowing increase detected in 2015. Post hoc manual searches revealed that Japanese celebrities' breast cancer diagnoses were announced on the relevant dates, and many Japanese media reports were found. Conclusions: This study found a notable association between internet search activity and celebrity cancer media reports and a temporal association with screening participation in breast cancer screening in Japan. Celebrity cancer media reports triggered internet searches for cancer screening, but this did not lead to long-term changes in screening participation behavior. This finding suggests what information needs to be provided to citizens to encourage participation in screening. ",
doi="10.2196/64020",
url="https://cancer.jmir.org/2025/1/e64020"
}


@Article{info:doi/10.2196/67794,
author="Wellman, L. Mariah
and Owens, M. Camilla
and Holton, E. Avery
and Kaphingst, A. Kimberly",
title="Examining BRCA Previvors' Social Media Content Creation as a Form of Self and Community Care: Qualitative Interview Study",
journal="J Med Internet Res",
year="2025",
month="Mar",
day="3",
volume="27",
pages="e67794",
keywords="BRCA",
keywords="breast cancer",
keywords="genetic testing",
keywords="social media",
keywords="breast cancer gene",
keywords="content creation",
keywords="self care",
keywords="community care",
keywords="qualitative interview",
keywords="qualitative",
keywords="interview",
keywords="previvors",
keywords="cancer previvors",
keywords="genetic mutations",
keywords="online",
keywords="content",
keywords="interviews",
keywords="thematic analysis",
abstract="Background: Genetic testing has become a common way of identifying a woman's risk of developing hereditary breast and ovarian cancer; however, not all medical providers have the necessary information to support patients interested in genetic testing, nor do they always have the proper information for patients once they have been diagnosed. Therefore, many ``previvors''---the name given to those who have tested positive for the BRCA genetic mutation---have taken to social media to inform others about the importance of genetic testing and explain to them how to understand their test results. Historically, those desiring to speak about their medical issues online have sought out structured support groups or chat rooms; however, many previvors today are instead posting on their own personal social media accounts and creating more niche communities. Objective: This study aimed to examine why BRCA previvors are sharing content on their personal social media accounts and how posting online in this way serves a purpose for their larger community. Methods: A total of 16 semistructured interviews were conducted with individuals who posted about their experience being diagnosed with the BRCA genetic mutation and their subsequent treatment on their personal social media accounts, specifically for followers interested in their medical journey. The interviews were recorded, transcribed, and coded by an experienced qualitative researcher and a graduate student using inductive techniques, and a reflexive thematic analysis was applied to the transcripts. Results: The results suggest BRCA previvors want to control the narrative around their personalized medical experiences rather than participating in existing groups or chat rooms. Controlling their own story, rather than adding to existing narratives, gives previvors a sense of control. It also allows them to set boundaries around the types of experiences they have online when sharing their medical journey. Finally, previvors said they feel they are serving the larger BRCA community by each sharing their individual journeys, to hopefully avoid stereotyping and homogenizing the experience of patients with BRCA genetic mutations. Conclusions: Research with the objective of understanding the experiences of BRCA previvors should include exploring how and why they talk about their journeys, especially due to the lack of knowledge BRCA previvors say many of their medical providers have. We suggest further research should examine how other patients with the BRCA genetic mutation, especially racial and ethnic minority patients, are navigating their own content creation, especially considering content moderation policies that social media platforms are continuing to implement that directly impact users' ability to share about their medical experiences. ",
doi="10.2196/67794",
url="https://www.jmir.org/2025/1/e67794",
url="http://www.ncbi.nlm.nih.gov/pubmed/40053732"
}


@Article{info:doi/10.2196/59483,
author="Yang, Hongwu
and Zhu, Chuangying
and Zhou, Chunyan
and Huang, Ruibin
and Huang, Lipeng
and Chen, Peifen
and Zhu, Shanshan
and Wang, Huanpeng
and Zhu, Chunmin",
title="Evaluation of Douyin Short Videos on Mammography in China: Quality and Reliability Analysis",
journal="JMIR Cancer",
year="2025",
month="Feb",
day="19",
volume="11",
pages="e59483",
keywords="breast cancer",
keywords="mammography",
keywords="Douyin",
keywords="information quality",
keywords="social media",
keywords="video",
keywords="DISCERN",
keywords="Global Quality Score",
keywords="web-based education",
keywords="cancer screening",
keywords="health information",
keywords="medical content",
abstract="Background: Breast cancer is the most common malignant tumor and the fifth leading cause of cancer death worldwide, imposing a significant disease burden in China. Mammography is a key method for breast cancer screening, particularly for early diagnosis. Douyin, a popular social media platform, is increasingly used for sharing health information, but the quality and reliability of mammography-related videos remain unexamined. Objective: This study aimed to evaluate the information quality and reliability of mammography videos on Douyin. Methods: In October 2023, a search using the Chinese keywords for ``mammography'' and ``mammography screening'' was conducted on Douyin. From 200 retrieved videos, 136 mammography-related videos were selected for analysis. Basic video information, content, and sources were extracted. Video content was assessed for comprehensiveness across 7 categories: conception, examination process, applicable objects, precautions, combined examinations, advantages, and report. Completeness was evaluated using a researcher-developed checklist, while reliability and quality were measured using 2 modified DISCERN (mDISCERN) tool and the Global Quality Score (GQS). Correlations between video quality and characteristics were also examined. Results: Among the video sources, 82.4\% (112/136) were attributed to health professionals, and 17.6\% (24/136) were attributed to nonprofessionals. Among health professionals, only 1 was a radiologist. Overall, 77.2\% (105/136) of the videos had useful information about mammography. Among the useful videos, the advantages of mammography were the most frequently covered topic (53/105, 50.5\%). Median values for the mDISCERN and GQS evaluations across all videos stood at 2.5 (IQR 1.63?3) and 2 (IQR 1?2), respectively. Within the subgroup assessment, the median mDISCERN score among the useful and professional groups stood at 2 (IQR 2?3) and 3 (IQR 2?3), respectively, surpassing the corresponding score for the unhelpful and nonprofessional groups at 0 (IQR 0?0) and 0 (IQR 0?0.75; P<.001). Likewise, the median GQS among the useful and professional groups was evaluated at 2 (IQR 1.5?2) and 2 (IQR 1?2), respectively, eclipsing that of the unhelpful and nonprofessional groups at 1 (IQR 1?1) and 1 (IQR 1?1.37; P<.001). The GQS was weak and negatively correlated with the number of likes (r=?0.24; P=.004), comments (r=?0.29; P<.001), and saves (r=?0.20; P=.02). The mDISCERN score was weak and negatively correlated with the number of likes (r=?0.26; P=.002), comments (r=?0.36; P<.001), saves (r=?0.22; P=.009), and shares (r=?0.18; P=.03). Conclusions: The overall quality of mammography videos on Douyin is suboptimal, with most content uploaded by clinicians rather than radiologists. Radiologists should be encouraged to create accurate and informative videos to better educate patients. As Douyin grows as a health information platform, stricter publishing standards are needed to enhance the quality of medical content. ",
doi="10.2196/59483",
url="https://cancer.jmir.org/2025/1/e59483"
}


@Article{info:doi/10.2196/62703,
author="Fridman, Ilona
and Boyles, Dahlia
and Chheda, Ria
and Baldwin-SoRelle, Carrie
and Smith, B. Angela
and Elston Lafata, Jennifer",
title="Identifying Misinformation About Unproven Cancer Treatments on Social Media Using User-Friendly Linguistic Characteristics: Content Analysis",
journal="JMIR Infodemiology",
year="2025",
month="Feb",
day="12",
volume="5",
pages="e62703",
keywords="linguistic characteristics",
keywords="linguistic features",
keywords="cancer",
keywords="Linguistic Inquiry and Word Count",
keywords="misinformation",
keywords="X",
keywords="Twitter",
keywords="alternative therapy",
keywords="oncology",
keywords="social media",
keywords="natural language processing",
keywords="machine learning",
keywords="synthesis",
keywords="review methodology",
keywords="search",
keywords="literature review",
abstract="Background: Health misinformation, prevalent in social media, poses a significant threat to individuals, particularly those dealing with serious illnesses such as cancer. The current recommendations for users on how to avoid cancer misinformation are challenging because they require users to have research skills. Objective: This study addresses this problem by identifying user-friendly characteristics of misinformation that could be easily observed by users to help them flag misinformation on social media. Methods: Using a structured review of the literature on algorithmic misinformation detection across political, social, and computer science, we assembled linguistic characteristics associated with misinformation. We then collected datasets by mining X (previously known as Twitter) posts using keywords related to unproven cancer therapies and cancer center usernames. This search, coupled with manual labeling, allowed us to create a dataset with misinformation and 2 control datasets. We used natural language processing to model linguistic characteristics within these datasets. Two experiments with 2 control datasets used predictive modeling and Lasso regression to evaluate the effectiveness of linguistic characteristics in identifying misinformation. Results: User-friendly linguistic characteristics were extracted from 88 papers. The short-listed characteristics did not yield optimal results in the first experiment but predicted misinformation with an accuracy of 73\% in the second experiment, in which posts with misinformation were compared with posts from health care systems. The linguistic characteristics that consistently negatively predicted misinformation included tentative language, location, URLs, and hashtags, while numbers, absolute language, and certainty expressions consistently predicted misinformation positively. Conclusions: This analysis resulted in user-friendly recommendations, such as exercising caution when encountering social media posts featuring unwavering assurances or specific numbers lacking references. Future studies should test the efficacy of the recommendations among information users. ",
doi="10.2196/62703",
url="https://infodemiology.jmir.org/2025/1/e62703"
}


@Article{info:doi/10.2196/66269,
author="Shan, Rui
and Li, Xin
and Chen, Jing
and Chen, Zheng
and Cheng, Yuan-Jia
and Han, Bo
and Hu, Run-Ze
and Huang, Jiu-Ping
and Kong, Gui-Lan
and Liu, Hui
and Mei, Fang
and Song, Shi-Bing
and Sun, Bang-Kai
and Tian, Hui
and Wang, Yang
and Xiao, Wu-Cai
and Yao, Xiang-Yun
and Ye, Jing-Ming
and Yu, Bo
and Yuan, Chun-Hui
and Zhang, Fan
and Liu, Zheng",
title="Interpretable Machine Learning to Predict the Malignancy Risk of Follicular Thyroid Neoplasms in Extremely Unbalanced Data: Retrospective Cohort Study and Literature Review",
journal="JMIR Cancer",
year="2025",
month="Feb",
day="10",
volume="11",
pages="e66269",
keywords="follicular thyroid neoplasm",
keywords="machine learning",
keywords="prediction model",
keywords="malignancy",
keywords="unbalanced data",
keywords="literature review",
abstract="Background: Diagnosing and managing follicular thyroid neoplasms (FTNs) remains a significant challenge, as the malignancy risk cannot be determined until after diagnostic surgery. Objective: We aimed to use interpretable machine learning to predict the malignancy risk of FTNs preoperatively in a real-world setting. Methods: We conducted a retrospective cohort study at the Peking University Third Hospital in Beijing, China. Patients with postoperative pathological diagnoses of follicular thyroid adenoma (FTA) or follicular thyroid carcinoma (FTC) were included, excluding those without preoperative thyroid ultrasonography. We used 22 predictors involving demographic characteristics, thyroid sonography, and hormones to train 5 machine learning models: logistic regression, least absolute shrinkage and selection operator regression, random forest, extreme gradient boosting, and support vector machine. The optimal model was selected based on discrimination, calibration, interpretability, and parsimony. To address the highly imbalanced data (FTA:FTC ratio>5:1), model discrimination was assessed using both the area under the receiver operating characteristic curve and the area under the precision-recall curve (AUPRC). To interpret the model, we used Shapley Additive Explanations values and partial dependence and individual conditional expectation plots. Additionally, a systematic review was performed to synthesize existing evidence and validate the discrimination ability of the previously developed Thyroid Imaging Reporting and Data System for Follicular Neoplasm scoring criteria to differentiate between benign and malignant FTNs using our data. Results: The cohort included 1539 patients (mean age 47.98, SD 14.15 years; female: n=1126, 73.16\%) with 1672 FTN tumors (FTA: n=1414; FTC: n=258; FTA:FTC ratio=5.5). The random forest model emerged as optimal, identifying mean thyroid-stimulating hormone (TSH) score, mean tumor diameter, mean TSH, TSH instability, and TSH measurement levels as the top 5 predictors in discriminating FTA from FTC, with the area under the receiver operating characteristic curve of 0.79 (95\% CI 0.77?0.81) and AUPRC of 0.40 (95\% CI 0.37-0.44). Malignancy risk increased nonlinearly with larger tumor diameters and higher TSH instability but decreased nonlinearly with higher mean TSH scores or mean TSH levels. FTCs with small sizes (mean diameter 2.88, SD 1.38 cm) were more likely to be misclassified as FTAs compared to larger ones (mean diameter 3.71, SD 1.36 cm). The systematic review of the 7 included studies revealed that (1) the FTA:FTC ratio varied from 0.6 to 4.0, lower than the natural distribution of 5.0; (2) no studies assessed prediction performance using AUPRC in unbalanced datasets; and (3) external validations of Thyroid Imaging Reporting and Data System for Follicular Neoplasm scoring criteria underperformed relative to the original study. Conclusions: Tumor size and TSH measurements were important in screening FTN malignancy risk preoperatively, but accurately predicting the risk of small-sized FTNs remains challenging. Future research should address the limitations posed by the extreme imbalance in FTA and FTC distributions in real-world data. ",
doi="10.2196/66269",
url="https://cancer.jmir.org/2025/1/e66269"
}


@Article{info:doi/10.2196/56791,
author="Mourato, Beatriz Maria
and Pratas, Nuno
and Branco Pereira, Andreia
and Tar{\'e}, Filipa
and Chan{\c{c}}a, Raphael
and Fronteira, In{\^e}s
and Dinis, Rui
and Areia, Miguel",
title="Effectiveness of Gastric Cancer Endoscopic Screening in Intermediate-Risk Countries: Protocol for a Systematic Review and Meta-Analysis",
journal="JMIR Res Protoc",
year="2025",
month="Feb",
day="3",
volume="14",
pages="e56791",
keywords="gastric cancers",
keywords="endoscopic screening",
keywords="intermediate-risk countries",
keywords="neoplasia",
keywords="early detection",
keywords="diagnosis",
keywords="cancer screening",
keywords="survival",
keywords="meta-analysis",
keywords="gastrointestinal cancers",
abstract="Background: Gastric cancer (GC) is the fifth most prevalent neoplasm worldwide and the fourth with the highest mortality, and its geographical distribution is not homogeneous with high-risk, intermediate-risk (IR), and low-risk areas. Advanced stages at diagnosis are related to high mortality, but early detection greatly increases the chances of survival. Upper endoscopy with biopsy is the gold standard for GC diagnosis. Several studies have investigated the relevance of endoscopic screening and how to implemente it in IR countries. However, most Western societies recommend screening only in selected populations with high-risk factors for GC. No systematic reviews on GC endoscopic screening in IR countries exist. Objective: We aimed to determine the effectiveness of endoscopic GC screening in IR countries. Methods: We will include randomized and nonrandomized controlled trials, cohort studies, case-control studies, cross-sectional studies, and economic studies focusing on endoscopic screening of GC in the asymptomatic population of IR countries. The search will be conducted in MEDLINE, SCOPUS, Embase, and Web of Science. Other gray literature sources will be additionally searched. Studies published in English, Portuguese, or Spanish until September 2024 will be included. Two independent reviewers will screen the titles and abstracts of all search results. The selected studies will then be fully analyzed, and the data will be collected and coded in a database. To minimize the risk of bias, the included studies will undergo a quality analysis according to Cochrane risk of bias tools, RoB 2 of randomized trials and ROBINS-I for nonrandomized trials; Newcastle-Ottawa Quality Assessment Scale for case-control and cohort studies; and National Heart, Lung and Blood Institute study quality assessment tools for cross-sectional studies. The data collected will be cataloged in 2 categories: efficacy or effectiveness data and economic data, and separate meta-analyses will be performed for each category if appropriate. Results: This study is expected to provide results on the efficacy, effectiveness, and cost-effectiveness of endoscopic screening in an IR population. To date, 969 studies were screened for title and abstract, 75 were selected for full-text screening, and 44 were retained for data analysis. Additionally, 2 studies were selected from our manual search. Currently, the study is in the early stages of data extraction and risk of bias assessment and is expected to be published in the first quarter of 2025. Conclusions: To our knowledge, this review will be the first to provide evidence on the effectiveness of endoscopic GC screening in IR countries. In doing so, we believe we will help guide future research, inform health care decisions and assist policy makers in this area, and support future decisions to implement GC screening programs in this type of population. Trial Registration: PROSPERO CRD42024502174; https://www.crd.york.ac.uk/prospero/display\_record.php?RecordID=502174 International Registered Report Identifier (IRRID): DERR1-10.2196/56791 ",
doi="10.2196/56791",
url="https://www.researchprotocols.org/2025/1/e56791",
url="http://www.ncbi.nlm.nih.gov/pubmed/39545590"
}


@Article{info:doi/10.2196/66655,
author="Cui, Zixuan
and Suo, Chen
and Zhao, Yidan
and Wang, Shuo
and Zhao, Ming
and Chen, Ruilin
and Lu, Linyao
and Zhang, Tiejun
and Chen, Xingdong",
title="Spatiotemporal Correlation Analysis for the Incidence of Esophageal and Gastric Cancer From 2010 to 2019: Ecological Study",
journal="JMIR Cancer",
year="2025",
month="Jan",
day="29",
volume="11",
pages="e66655",
keywords="spatiotemporal analysis",
keywords="spatiotemporal correlation",
keywords="esophageal cancer",
keywords="gastric cancer",
keywords="cancer",
keywords="global burden of disease",
keywords="GBD",
keywords="average annual percentage change",
keywords="incidence",
keywords="epidemiology",
abstract="Background: Esophageal and gastric cancer were among the top 10 most common cancers worldwide. In addition, sex-specific differences were observed in the incidence. Due to their anatomic proximity, the 2 cancers have both different but also shared risk factors and epidemiological features. Exploring the potential correlated incidence pattern of them, holds significant importance in providing clues in the etiology and preventive strategies. Objective: This study aims to explore the spatiotemporal correlation between the incidence patterns of esophageal and gastric cancer in 204 countries and territories from 2010 to 2019 so that prevention and control strategies can be more effective. Methods: The data of esophageal and gastric cancer were sourced from the Global Burden of Disease (GBD). Spatial autocorrelation analysis using Moran I in ArcGIS 10.8 (Esri) was performed to determine spatial clustering of each cancer incidence. We classified different risk areas based on the risk ratio (RR) of the 2 cancers in various countries to the global, and the correlation between their RR was evaluated using Pearson correlation coefficient. Temporal trends were quantified by calculating the average annual percent change (AAPC), and the correlation between the temporal trends of both cancers was evaluated using Pearson correlation coefficients. Results: In 2019, among 204 countries and territories, the age-standardized incidence rates (ASIR) of esophageal cancer ranged from 0.91 (95\% CI 0.65-1.58) to 24.53 (95\% CI 18.74-32.51), and the ASIR of gastric cancer ranged from 3.28 (95\% CI 2.67-3.91) to 43.70 (95\% CI 34.29-55.10). Malawi was identified as the highest risk for esophageal cancer (male RR=3.27; female RR=5.19) and low risk for gastric cancer (male RR=0.21; female RR=0.23) in both sexes. Spatial autocorrelation analysis revealed significant spatial clustering of the incidence for both cancers (Moran I>0.20 and P<.001). A positive correlation between the risk of esophageal and gastric cancer was observed in males (r=0.25, P<.001). The ASIR of both cancers showed a decreasing trend globally. The ASIR for esophageal and gastric cancer showed an AAPC of ?1.43 (95\% CI ?1.58 to ?1.27) and ?1.76 (95\% CI ?2.08 to ?1.43) in males, and ?1.93 (95\% CI ?2.11 to ?1.75) and ?1.79 (95\% CI ?2.13 to ?1.46) in females. In addition, a positive correlation between the temporal trends in ASIR for both cancers was observed at the global level across sexes (male r=0.98; female r=0.98). Conclusions: Our study shows that there was a significant spatial clustering of the incidence for esophageal and gastric cancer and a positive correlation between the risk of both cancers across countries was observed in males. In addition, a codescending incidence trend between both cancers was observed at the global level. ",
doi="10.2196/66655",
url="https://cancer.jmir.org/2025/1/e66655"
}


@Article{info:doi/10.2196/60033,
author="Niu, Zheyu
and Hao, Yijie
and Yang, Faji
and Jiang, Qirong
and Jiang, Yupeng
and Zhang, Shizhe
and Song, Xie
and Chang, Hong
and Zhou, Xu
and Zhu, Huaqiang
and Gao, Hengjun
and Lu, Jun",
title="Quality of Pancreatic Neuroendocrine Tumor Videos Available on TikTok and Bilibili: Content Analysis",
journal="JMIR Form Res",
year="2024",
month="Dec",
day="11",
volume="8",
pages="e60033",
keywords="pancreatic neuroendocrine tumors",
keywords="short videos",
keywords="quality analysis",
keywords="TikTok",
keywords="Bilibili",
keywords="social media",
abstract="Background: Disseminating disease knowledge through concise videos on various platforms is an innovative and efficient approach. However, it remains uncertain whether pancreatic neuroendocrine tumor (pNET)-related videos available on current short video platforms can effectively convey accurate and impactful information to the general public. Objective: Our study aims to extensively analyze the quality of pNET-related videos on TikTok and Bilibili, intending to enhance the development of pNET-related social media content to provide the general public with more comprehensive and suitable avenues for accessing pNET-related information. Methods: A total of 168 qualifying videos pertaining to pNETs were evaluated from the video-sharing platforms Bilibili and TikTok. Initially, the fundamental information conveyed in the videos was documented. Subsequently, we discerned the source and content type of each video. Following that, the Global Quality Scale (GQS) and modified DISCERN (mDISCERN) scale were employed to appraise the educational value and quality of each video. A comparative evaluation was conducted on the videos obtained from these two platforms. Results: The number of pNET-related videos saw a significant increase since 2020, with 9 videos in 2020, 19 videos in 2021, 29 videos in 2022, and 106 videos in 2023. There were no significant improvements in the mean GQS or mDISCERN scores from 2020 to 2023, which were 3.22 and 3.00 in 2020, 3.33 and 2.94 in 2021, 2.83 and 2.79 in 2022, and 2.78 and 2.94 in 2023, respectively. The average quality scores of the videos on Bilibili and Tiktok were comparable, with GQS and mDISCERN scores of 2.98 on Bilibili versus 2.77 on TikTok and 2.82 on Bilibili versus 3.05 on TikTok, respectively. The source and format of the videos remained independent factors affecting the two quality scores. Videos that were uploaded by professionals (hazard ratio=7.02, P=.002) and recorded in specialized popular science formats (hazard ratio=12.45, P<.001) tended to exhibit superior quality. Conclusions: This study demonstrates that the number of short videos on pNETs has increased in recent years, but video quality has not improved significantly. This comprehensive analysis shows that the source and format of videos are independent factors affecting video quality, which provides potential measures for improving the quality of short videos. ",
doi="10.2196/60033",
url="https://formative.jmir.org/2024/1/e60033"
}


@Article{info:doi/10.2196/51936,
author="Noggle, Brendan
and Cheng, Hui
and Sarkar, Mohamadi",
title="Oral Cancer Incidence Among Adult Males With Current or Former Use of Cigarettes or Smokeless Tobacco: Population-Based Study",
journal="JMIR Cancer",
year="2024",
month="Nov",
day="6",
volume="10",
pages="e51936",
keywords="tobacco harm reduction",
keywords="oral cancer",
keywords="smokeless tobacco",
keywords="smoking",
keywords="cancer epidemiology",
keywords="cancer registry",
keywords="population-based study",
keywords="oral cancer incidence",
keywords="cancer cases",
abstract="Background: Tobacco use has been identified as a risk factor for oral cancer worldwide. However, relative oral cancer incidence among adults who smoke cigarettes, use smokeless tobacco products (ST), have transitioned from cigarettes to ST, quit cigarettes and/or ST (``quitters''), or never used tobacco has not been well studied. Objective: We aim to present population-based oral cancer incidence rates for adults who smoke cigarettes, use ST, are former smokers who now use ST, or quit. Methods: We estimated cross-sectional incidence rates and incidence rate ratios (IRRs) using data from statewide cancer registries (Colorado, Florida, North Carolina, and Texas) and population counts derived from national surveys using combined data from 2014?2017. A random-effect meta-analysis approach was used to summarize estimates among these groups, based on multiple imputation-based IRR estimates by state and age group while considering potential heterogeneity. Results: A total of 19,536 oral cancer cases were identified among adult males 35 years and older in the study geographies and period. The oral cancer incidence rate among adults who smoke was significantly higher than the ST group (2.6 times higher, 95\% CI 2.0?3.3, P<.001), 3.6 (95\% CI 3.2?4.1, P<.001) times higher than the never users, and 2.4 (95\% CI 1.8?3.1, P<.001) times higher compared to former smokers who now use ST. The IRR among the ST group relative to never users was 1.4 (95\% CI 1.1?1.9, P=.02). The IRR between former smokers who now use ST and those who quit was 1.4 (95\% CI 1.0?2.1, P=.08). Conclusions: Findings from this population-based study with a large number of oral cancer cases support significantly high oral cancer incidence among adults who smoke and a lower risk of oral cancer incidence among never users, quitters, users of ST, and former smokers who now use ST compared to cigarettes. Future studies with detailed control of tobacco history and other relevant confounders are needed to confirm these findings. ",
doi="10.2196/51936",
url="https://cancer.jmir.org/2024/1/e51936"
}


@Article{info:doi/10.2196/57840,
author="Mubarik, Sumaira
and Naeem, Shafaq
and Shen, Hui
and Mubarak, Rabia
and Luo, Lisha
and Hussain, Rija Syeda
and Hak, Eelko
and Yu, Chuanhua
and Liu, Xiaoxue",
title="Population-Level Distribution, Risk Factors, and Burden of Mortality and Disability-Adjusted Life Years Attributable to Major Noncommunicable Diseases in Western Europe (1990-2021): Ecological Analysis",
journal="JMIR Public Health Surveill",
year="2024",
month="Oct",
day="17",
volume="10",
pages="e57840",
keywords="mortality",
keywords="smoking",
keywords="Western Europe",
keywords="CVDs",
keywords="cardiovascular disease",
keywords="HDI",
keywords="Human Development Index",
keywords="neoplasms",
keywords="cancer",
keywords="DALYs",
keywords="disability-adjusted life years",
abstract="Background: Cardiovascular diseases (CVDs) and neoplasms are leading causes of mortality worldwide. Objective: This study aims to provide a comprehensive analysis of the mortality burden and disability-adjusted life years (DALYs) attributable to CVDs and neoplasms in Western Europe, investigate associated risk factors, and identify regional disparities. Additionally, the study evaluates the effectiveness of the Action Plan for the Prevention and Control of Non-Communicable Diseases (NCDs) in promoting healthier lives in the region. Methods: The study collected data on mortality and DALYs due to CVDs and cancers from 24 Western European countries using the Global Burden of Disease Study 2021. The analysis explored age, sex, and country-specific patterns, as well as risk factors contributing to these deaths. Additionally, the study examined time trends by calculating the annual percent change in mortality rates from 1990 to 2021 by region and cause. Results: In 2021, CVDs and neoplasms accounted for 27.8\% and 27.1\% of total deaths in Western Europe, with age-standardized death rates of 106.8 and 125.8 per 100,000, respectively. The top two CVDs in this region were ischemic heart disease and stroke, with age-standardized death rates of 47.27 (95\% uncertainty interval [UI] 50.42-41.45) and 27.06 (95\% UI 29.17-23.00), respectively. Similarly, the top two neoplasms were lung cancer and colorectal cancer, with age-standardized death rates of 26.4 (95\% UI 27.69-24.47) and 15.1 (95\% UI 16.25-13.53), respectively. Between 1990 and 2021, CVD mortality rates decreased by 61.9\%, while cancer rates decreased by 28.27\%. Finland had the highest CVD burden (39.5\%), and Monaco had the highest rate of cancer-related deaths (34.8\%). Gender differences were observed, with males experiencing a higher burden of both CVDs and cancer. Older individuals were also more at risk. Smoking had a stronger impact on CVD mortality and DALYs in males, while a higher Human Development Index was associated with increased cancer deaths and DALYs in females. Conclusions: The study findings highlight the substantial burden of NCDs, particularly CVDs and cancer, in Western Europe. This underscores the critical need for targeted interventions and effective implementation of the Action Plan for the Prevention and Control of NCDs to achieve the goal of ensuring healthy lives for all. ",
doi="10.2196/57840",
url="https://publichealth.jmir.org/2024/1/e57840"
}


@Article{info:doi/10.2196/54891,
author="Huang, Yanqun
and Chen, Siyuan
and Wang, Yongfeng
and Ou, Xiaohong
and Yan, Huanhuan
and Gan, Xin
and Wei, Zhixiao",
title="Analyzing Comorbidity Patterns in Patients With Thyroid Disease Using Large-Scale Electronic Medical Records: Network-Based Retrospective Observational Study",
journal="Interact J Med Res",
year="2024",
month="Oct",
day="3",
volume="13",
pages="e54891",
keywords="thyroid disease",
keywords="comorbidity patterns",
keywords="prevalence",
keywords="network analysis",
keywords="electronic medical records",
abstract="Background: Thyroid disease (TD) is a prominent endocrine disorder that raises global health concerns; however, its comorbidity patterns remain unclear. Objective: This study aims to apply a network-based method to comprehensively analyze the comorbidity patterns of TD using large-scale real-world health data. Methods: In this retrospective observational study, we extracted the comorbidities of adult patients with TD from both private and public data sets. All comorbidities were identified using ICD-10 (International Classification of Diseases, 10th Revision) codes at the 3-digit level, and those with a prevalence greater than 2\% were analyzed. Patients were categorized into several subgroups based on sex, age, and disease type. A phenotypic comorbidity network (PCN) was constructed, where comorbidities served as nodes and their significant correlations were represented as edges, encompassing all patients with TD and various subgroups. The associations and differences in comorbidities within the PCN of each subgroup were analyzed and compared. The PageRank algorithm was used to identify key comorbidities. Results: The final cohorts included 18,311 and 50,242 patients with TD in the private and public data sets, respectively. Patients with TD demonstrated complex comorbidity patterns, with coexistence relationships differing by sex, age, and type of TD. The number of comorbidities increased with age. The most prevalent TDs were nontoxic goiter, hypothyroidism, hyperthyroidism, and thyroid cancer, while hypertension, diabetes, and lipoprotein metabolism disorders had the highest prevalence and PageRank values among comorbidities. Males and patients with benign TD exhibited a greater number of comorbidities, increased disease diversity, and stronger comorbidity associations compared with females and patients with thyroid cancer. Conclusions: Patients with TD exhibited complex comorbidity patterns, particularly with cardiocerebrovascular diseases and diabetes. The associations among comorbidities varied across different TD subgroups. This study aims to enhance the understanding of comorbidity patterns in patients with TD and improve the integrated management of these individuals. ",
doi="10.2196/54891",
url="https://www.i-jmr.org/2024/1/e54891",
url="http://www.ncbi.nlm.nih.gov/pubmed/39361379"
}


@Article{info:doi/10.2196/55937,
author="Zhao, Keyang
and Li, Xiaojing
and Li, Jingyang",
title="Cancer Prevention and Treatment on Chinese Social Media: Machine Learning--Based Content Analysis Study",
journal="J Med Internet Res",
year="2024",
month="Aug",
day="14",
volume="26",
pages="e55937",
keywords="social media",
keywords="cancer information",
keywords="text mining",
keywords="supervised machine learning",
keywords="content analysis",
abstract="Background: Nowadays, social media plays a crucial role in disseminating information about cancer prevention and treatment. A growing body of research has focused on assessing access and communication effects of cancer information on social media. However, there remains a limited understanding of the comprehensive presentation of cancer prevention and treatment methods across social media platforms. Furthermore, research comparing the differences between medical social media (MSM) and common social media (CSM) is also lacking. Objective: Using big data analytics, this study aims to comprehensively map the characteristics of cancer treatment and prevention information on MSM and CSM. This approach promises to enhance cancer coverage and assist patients in making informed treatment decisions. Methods: We collected all posts (N=60,843) from 4 medical WeChat official accounts (accounts with professional medical backgrounds, classified as MSM in this paper) and 5 health and lifestyle WeChat official accounts (accounts with nonprofessional medical backgrounds, classified as CSM in this paper). We applied latent Dirichlet allocation topic modeling to extract cancer-related posts (N=8427) and identified 6 cancer themes separately in CSM and MSM. After manually labeling posts according to our codebook, we used a neural-based method for automated labeling. Specifically, we framed our task as a multilabel task and utilized different pretrained models, such as Bidirectional Encoder Representations from Transformers (BERT) and Global Vectors for Word Representation (GloVe), to learn document-level semantic representations for labeling. Results: We analyzed a total of 4479 articles from MSM and 3948 articles from CSM related to cancer. Among these, 35.52\% (2993/8427) contained prevention information and 44.43\% (3744/8427) contained treatment information. Themes in CSM were predominantly related to lifestyle, whereas MSM focused more on medical aspects. The most frequently mentioned prevention measures were early screening and testing, healthy diet, and physical exercise. MSM mentioned vaccinations for cancer prevention more frequently compared with CSM. Both types of media provided limited coverage of radiation prevention (including sun protection) and breastfeeding. The most mentioned treatment measures were surgery, chemotherapy, and radiotherapy. Compared with MSM (1137/8427, 13.49\%), CSM (2993/8427, 35.52\%) focused more on prevention. Conclusions: The information about cancer prevention and treatment on social media revealed a lack of balance. The focus was primarily limited to a few aspects, indicating a need for broader coverage of prevention measures and treatments in social media. Additionally, the study's findings underscored the potential of applying machine learning to content analysis as a promising research approach for mapping key dimensions of cancer information on social media. These findings hold methodological and practical significance for future studies and health promotion. ",
doi="10.2196/55937",
url="https://www.jmir.org/2024/1/e55937"
}


@Article{info:doi/10.2196/52018,
author="Snyder, Jeremy
and Zenone, Marco
and Grewal, Ashmita
and Caulfield, Timothy",
title="Crowdfunding for Complementary and Alternative Cancer Treatments in Tijuana, Mexico: Content Analysis",
journal="JMIR Cancer",
year="2024",
month="Aug",
day="14",
volume="10",
pages="e52018",
keywords="cancer",
keywords="crowdfunding",
keywords="Tijuana",
keywords="CAM",
keywords="patient",
keywords="patients",
keywords="insurance",
keywords="crowdfunding platforms",
keywords="GoFundMe",
keywords="GiveSendGo",
keywords="cancer clinic",
keywords="Mexico",
keywords="campaigns",
keywords="cancer treatment",
keywords="medical intervention",
keywords="CAM cancer treatments",
keywords="misinformation",
keywords="alternate care",
keywords="women's health",
keywords="internet research",
keywords="international medical tourism",
keywords="alternative cancer therapy",
keywords="financial toxicity",
abstract="Background: Complementary and alternative (CAM) cancer treatment is often expensive and not covered by insurance. As a result, many people turn to crowdfunding to access this treatment. Objective: The aim of this study is to identify the rationales of patients with cancer seeking CAM treatment abroad by looking specifically at crowdfunding campaigns to support CAM cancer treatment in Tijuana, Mexico. Methods: We scraped the GoFundMe.com and GiveSendGo.com crowdfunding platforms for campaigns referencing CAM cancer clinics in Tijuana, initiated between January 1, 2022, and February 28, 2023. The authors created a coding framework to identify rationales for seeking CAM treatment in Tijuana. To supplement campaign metadata, we coded the beneficiary's cancer stage, type, age, specific treatment sought, whether the beneficiary died, gender, and race. Results: Patients sought CAM cancer treatment in Tijuana because the (1) treatment offers the greatest efficacy (29.9\%); (2) treatment offered domestically was not curative (23.2\%); (3) the clinic treats the whole person, and addresses the spiritual dimension of the person (20.1\%); (4) treatments are nontoxic, natural, or less invasive (18.2\%); and (5) clinic offers the newest technology (8.5\%). Campaigns raised US \$5,275,268.37 and most campaign beneficiaries were women (69.7\%) or White individuals (71.1\%). Conclusions: These campaigns spread problematic misinformation about the likely efficacy of CAM treatments, funnel money and endorsements to CAM clinics in Tijuana, and leave many campaigners short of the money needed to pay for CAM treatments while costing beneficiaries and their loved one's time, privacy, and dignity. This study affirms that Tijuana, Mexico, is a very popular destination for CAM cancer treatment. ",
doi="10.2196/52018",
url="https://cancer.jmir.org/2024/1/e52018"
}


@Article{info:doi/10.2196/49197,
author="Ramadan, Majed
and Aboalola, Doaa
and Aouabdi, Sihem
and Alghamdi, Tariq
and Alsolami, Mona
and Samkari, Alaa
and Alsiary, Rawiah",
title="Influence of Breast Cancer Awareness Month on Public Interest of Breast Cancer in High-Income Countries Between 2012 and 2022: Google Trends Analysis",
journal="JMIR Cancer",
year="2024",
month="Aug",
day="12",
volume="10",
pages="e49197",
keywords="Google Trends",
keywords="breast cancer",
keywords="pandemic",
keywords="awareness",
keywords="public interest",
keywords="cancer",
keywords="cancer awareness",
keywords="women",
keywords="mortality rate",
keywords="detection",
keywords="treatment",
keywords="social media",
keywords="tool",
keywords="education",
keywords="support",
keywords="internet users",
abstract="Background: Breast cancer is the most common cancer among women worldwide. High-income countries have a greater incidence and mortality rate of breast cancer than low-income countries. As a result, raising awareness about breast cancer is crucial in increasing the chances of early detection and treatment. Social media has evolved into an essential tool for Breast Cancer Awareness Month campaigns, allowing people to share their breast cancer stories and experiences while also providing a venue for education and support. Objective: The aim of this study was to assess the level of public interest in searches linked to breast cancer among a sample of high-income nations with a sizable internet user base from 2012 to 2022. We also sought to compare the proportional search volume for breast cancer during Breast Cancer Awareness Month with that during other months of the year. Methods: Google Trends was used to retrieve data on internet user search behaviors in the context of breast cancer from 2012 to 2022. Seven countries were evaluated in this study: Australia, Canada, Ireland, New Zealand, the United Kingdom, Saudi Arabia, and the United States, in addition to global data. Breast cancer relative search volume trends were analyzed annually, monthly, and weekly from 2012 to 2022. The annual percent change (APC) was calculated for each country and worldwide. Monthly and weekly data were used to identify potential trends. Results: A fluctuating pattern in APC rates was observed, with a notable increase in 2018 and a significant decrease in 2020, particularly in Saudi Arabia. Monthly analysis revealed a consistent peak in search volume during October (Breast Cancer Awareness Month) each year. Weekly trends over a 20-year period indicated significant decreases in Australia, Canada, New Zealand, and the United States, while increases were noted in Ireland. Heatmap analysis further highlighted a consistent elevation in median search volume during October across all countries. Conclusions: These findings underscore the impact of Breast Cancer Awareness Month and suggest potential influences of governmental COVID-19 pandemic control measures in 2020 on internet search behavior. ",
doi="10.2196/49197",
url="https://cancer.jmir.org/2024/1/e49197"
}


@Article{info:doi/10.2196/54967,
author="Gan, Ting
and Liu, Yunning
and Bambrick, Hilary
and Zhou, Maigeng
and Hu, Wenbiao",
title="Liver Cancer Mortality Disparities at a Fine Scale Among Subpopulations in China: Nationwide Analysis of Spatial and Temporal Trends",
journal="JMIR Public Health Surveill",
year="2024",
month="Aug",
day="8",
volume="10",
pages="e54967",
keywords="liver cancer",
keywords="mortality",
keywords="year of life lost",
keywords="spatial distribution",
keywords="temporal trend",
abstract="Background: China has the highest number of liver cancers worldwide, and liver cancer is at the forefront of all cancers in China. However, current research on liver cancer in China primarily relies on extrapolated data or relatively lagging data, with limited focus on subregions and specific population groups. Objective: The purpose of this study is to identify geographic disparities in liver cancer by exploring the spatial and temporal trends of liver cancer mortality and the years of life lost (YLL) caused by it within distinct geographical regions, climate zones, and population groups in China. Methods: Data from the National Death Surveillance System between 2013 and 2020 were used to calculate the age-standardized mortality rate of liver cancer (LASMR) and YLL from liver cancer in China. The spatial distribution and temporal trends of liver cancer were analyzed in subgroups by sex, age, region, and climate classification. Estimated annual percentage change was used to describe liver cancer trends in various regions, and partial correlation was applied to explore associations between LASMR and latitude. Results: In China, the average LASMR decreased from 28.79 in 2013 to 26.38 per 100,000 in 2020 among men and 11.09 to 9.83 per 100,000 among women. This decline in mortality was consistent across all age groups. Geographically, Guangxi had the highest LASMR for men in China, with a rate of 50.15 per 100,000, while for women, it was Heilongjiang, with a rate of 16.64 per 100,000. Within these regions, the LASMR among men in most parts of Guangxi ranged from 32.32 to 74.98 per 100,000, whereas the LASMR among women in the majority of Heilongjiang ranged from 13.72 to 21.86 per 100,000. The trend of LASMR varied among regions. For both men and women, Guizhou showed an increasing trend in LASMR from 2013 to 2020, with estimated annual percentage changes ranging from 10.05\% to 29.07\% and from 10.09\% to 21.71\%, respectively. Both men and women observed an increase in LASMR with increasing latitude below the 40th parallel. However, overall, LASMR in men was positively correlated with latitude (R=0.225; P<.001), while in women, it showed a negative correlation (R=0.083; P=.04). High LASMR areas among men aligned with subtropical zones, like Cwa and Cfa. The age group 65 years and older, the southern region, and the Cwa climate zone had the highest YLL rates at 4850.50, 495.50, and 440.17 per 100,000, respectively. However, the overall trends in these groups showed a decline over the period. Conclusions: Despite the declining overall trend of liver cancer in China, there are still marked disparities between regions and populations. Future prevention and control should focus on high-risk regions and populations to further reduce the burden of liver cancer in China. ",
doi="10.2196/54967",
url="https://publichealth.jmir.org/2024/1/e54967"
}


@Article{info:doi/10.2196/55657,
author="Yuan, Yingchao
and Liu, Chang
and Guo, Moning
and Xin, Zhong
and Chen, Guanjie
and Yang, Yue
and Zheng, Jianpeng
and Zang, Bai
and Yang, Jinkui",
title="Exploring Cancer Incidence Trends by Age and Sex Among 14.14 Million Individuals in China From 2007 to 2021: Population-Based Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Aug",
day="7",
volume="10",
pages="e55657",
keywords="cancer",
keywords="incidence",
keywords="trend",
keywords="sex-based",
keywords="women",
abstract="Background: Sex is a crucial factor in the development, progression, and treatment of cancer, making it vital to examine cancer incidence trends by sex for effective prevention strategies. Objective: This study aimed to assess the incidence of cancer in China between 2007 and 2021, with a focus on sex-based trends. Methods: A population-based cancer registry comprising 14.14 million individuals was maintained between 2007 and 2021 by the Beijing Municipal Health Big Data and Policy Research Center. The age-standardized rates (ASRs) of cancers were calculated using the Segi population. The average annual percentage of change (AAPC) was evaluated using the joinpoint regression model, while the Bayesian age-period-cohort model was used to predict cancer incidence in the next 10 years. Results: From 2007 to 2021, the study included 651,342 incident patients with cancer, of whom 51.2\% (n=333,577) were women. The incidence indicated by the ASR for all cancers combined was 200.8 per 100,000 for women and 184.4 per 100,000 for men. The increase in incidence indicated by AAPC for all malignancies combined significantly increased in women between 2007 and 2021 (AAPC=3.1\%; P<.001), whereas it remained constant in men (AAPC=0.3\%; P=.30). Although the overall incidence of all cancers indicated by AAPC increased in young men (AAPC=3.2\%; P=.01), the greatest increase was observed among young women (AAPC=6.1\%; P<.001). The incidence rate ratio for cancer in women increased among subsequent younger generations compared with patients born in the 1962-1966 cohort. The ASR in women will increase 1.6-fold over the next 10 years, with women having twice the incidence rate of men by 2031. Conclusions: The rising incidence of cancer among women in China has become a growing concern, emphasizing the need for increased efforts in cancer prevention and early screening, especially among young women. ",
doi="10.2196/55657",
url="https://publichealth.jmir.org/2024/1/e55657"
}


@Article{info:doi/10.2196/48284,
author="Gwon, Nahyun
and Jeong, Wonjeong
and Kim, Hyun Jee
and Oh, Hee Kyoung
and Jun, Kwan Jae",
title="Effects of Intervention Timing on Health-Related Fake News: Simulation Study",
journal="JMIR Form Res",
year="2024",
month="Aug",
day="7",
volume="8",
pages="e48284",
keywords="disinformation",
keywords="fenbendazole",
keywords="cancer information",
keywords="simulation",
keywords="fake news",
keywords="online social networking",
keywords="misinformation",
keywords="lung cancer",
abstract="Background: Fake health-related news has spread rapidly through the internet, causing harm to individuals and society. Despite interventions, a fenbendazole scandal recently spread among patients with lung cancer in South Korea. It is crucial to intervene appropriately to prevent the spread of fake news. Objective: This study investigated the appropriate timing of interventions to minimize the side effects of fake news. Methods: A simulation was conducted using the susceptible-infected-recovered (SIR) model, which is a representative model of the virus spread mechanism. We applied this model to the fake news spread mechanism. The parameters were set similarly to those in the digital environment, where the fenbendazole scandal occurred. NetLogo, an agent-based model, was used as the analytical tool. Results: Fake news lasted 278 days in the absence of interventions. As a result of adjusting and analyzing the timing of the intervention in response to the fenbendazole scandal, we found that faster intervention leads to a shorter duration of fake news (intervention at 54 days = fake news that lasted for 210 days; intervention at 16 days = fake news that lasted for 187 days; and intervention at 10 days = fake news that lasted for 157 days). However, no significant differences were observed when the intervention was performed within 10 days. Conclusions: Interventions implemented within 10 days were effective in reducing the duration of the spread of fake news. Our findings suggest that timely intervention is critical for preventing the spread of fake news in the digital environment. Additionally, a monitoring system that can detect fake news should be developed for a rapid response ",
doi="10.2196/48284",
url="https://formative.jmir.org/2024/1/e48284"
}


@Article{info:doi/10.2196/55011,
author="Lee, JinWook
and Park, JuWon
and Kim, Nayeon
and Nari, Fatima
and Bae, Seowoo
and Lee, Ji Hyeon
and Lee, Mingyu
and Jun, Kwan Jae
and Choi, Son Kui
and Suh, Mina",
title="Socioeconomic Disparities in Six Common Cancer Survival Rates in South Korea: Population-Wide Retrospective Cohort Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Jul",
day="22",
volume="10",
pages="e55011",
keywords="cancer survival",
keywords="income level",
keywords="socioeconomic status",
keywords="deprivation index",
keywords="inequality",
keywords="nationwide analysis",
keywords="cancer",
keywords="South Korea",
keywords="public health",
abstract="Background: In South Korea, the cancer incidence rate has increased by 56.5\% from 2001 to 2021. Nevertheless, the 5-year cancer survival rate from 2017 to 2021 increased by 17.9\% compared with that from 2001 to 2005. Cancer survival rates tend to decline with lower socioeconomic status, and variations exist in the survival rates among different cancer types. Analyzing socioeconomic patterns in the survival of patients with cancer can help identify high-risk groups and ensure that they benefit from interventions. Objective: The aim of this study was to analyze differences in survival rates among patients diagnosed with six types of cancer---stomach, colorectal, liver, breast, cervical, and lung cancers---based on socioeconomic status using Korean nationwide data. Methods: This study used the Korea Central Cancer Registry database linked to the National Health Information Database to follow up with patients diagnosed with cancer between 2014 and 2018 until December 31, 2021. Kaplan-Meier curves stratified by income status were generated, and log-rank tests were conducted for each cancer type to assess statistical significance. Hazard ratios with 95\% CIs for any cause of overall survival were calculated using Cox proportional hazards regression models with the time since diagnosis. Results: The survival rates for the six different types of cancer were as follows: stomach cancer, 69.6\% (96,404/138,462); colorectal cancer, 66.6\% (83,406/125,156); liver cancer, 33.7\% (23,860/70,712); lung cancer, 30.4\% (33,203/109,116); breast cancer, 91.5\% (90,730/99,159); and cervical cancer, 78\% (12,930/16,580). When comparing the medical aid group to the highest income group, the hazard ratios were 1.72 (95\% CI 1.66?1.79) for stomach cancer, 1.60 (95\% CI 1.54?1.56) for colorectal cancer, 1.51 (95\% CI 1.45?1.56) for liver cancer, 1.56 (95\% CI 1.51?1.59) for lung cancer, 2.19 (95\% CI 2.01?2.38) for breast cancer, and 1.65 (95\% CI 1.46?1.87) for cervical cancer. A higher deprivation index and advanced diagnostic stage were associated with an increased risk of mortality. Conclusions: Socioeconomic status significantly mediates disparities in cancer survival in several cancer types. This effect is particularly pronounced in less fatal cancers such as breast cancer. Therefore, considering the type of cancer and socioeconomic factors, social and medical interventions such as early cancer detection and appropriate treatment are necessary for vulnerable populations. ",
doi="10.2196/55011",
url="https://publichealth.jmir.org/2024/1/e55011"
}


@Article{info:doi/10.2196/52156,
author="Pan, Peng
and Yu, Changhua
and Li, Tao
and Dai, Tingting
and Tian, Hanhan
and Xiong, Yaozu
and Lv, Jie
and Hu, Xiaochu
and Ma, Weidong
and Yin, Wenda",
title="Evaluating the Quality of Cancer-Related WeChat Public Accounts: Cross-Sectional Study",
journal="JMIR Cancer",
year="2024",
month="May",
day="30",
volume="10",
pages="e52156",
keywords="cancer",
keywords="big data",
keywords="social media",
keywords="health literacy",
keywords="WeChat",
keywords="China",
keywords="public health",
abstract="Background: WeChat (Tencent) is one of the most important information sources for Chinese people. Relevantly, various health-related data are constantly transmitted among WeChat users. WeChat public accounts (WPAs) for health are rapidly emerging. Health-related WeChat public accounts have a significant impact on public health. Because of the rise in web-based health-seeking behavior, the general public has grown accustomed to obtaining cancer information from WPAs. Although WPAs make it easy for people to obtain health information, the quality of the information is questionable. Objective: This study aims to assess the quality and suitability of cancer-related WeChat public accounts (CWPAs). Methods: The survey was conducted from February 1 to 28, 2023. Based on the WPA monthly list provided by Qingbo Big Data, 28 CWPAs in the WeChat communication index were selected as the survey sample. Quality assessment of the included CWPAs was performed using the HONcode instrument. Furthermore, suitability was measured by using the Suitability Assessment of Materials. A total of 2 researchers conducted the evaluations independently. Results: Of the 28 CWPAs, 12 (43\%) were academic and 16 (57\%) were commercial. No statistical difference was found regarding the HONcode scores between the 2 groups (P=.96). The quality of the academic and commercial CWPAs evaluated using the HONcode instrument demonstrated mean scores of 5.58 (SD 2.02) and 5.63 (SD 2.16), respectively, corresponding to a moderate class. All CWPAs' compliance with the HONcode principles was unsatisfactory. A statistically significant difference between the 2 groups was observed in the Suitability Assessment of Materials scores (P=.04). The commercial WPAs reached an overall 55.1\% (SD 5.5\%) score versus the 50.2\% (SD 6.4\%) score reached by academic WPAs. The suitability of academic and commercial CWPAs was considered adequate. Conclusions: This study revealed that CWPAs are not sufficiently credible. WPA owners must endeavor to create reliable health websites using approved tools such as the HONcode criteria. However, it is necessary to educate the public about the evaluation tools of health websites to assess their credibility before using the provided content. In addition, improving readability will allow the public to read and understand the content. ",
doi="10.2196/52156",
url="https://cancer.jmir.org/2024/1/e52156",
url="http://www.ncbi.nlm.nih.gov/pubmed/38814688"
}


@Article{info:doi/10.2196/54162,
author="Stimpson, P. Jim
and Park, Sungchul
and Pruitt, L. Sandi
and Ortega, N. Alexander",
title="Variation in Trust in Cancer Information Sources by Perceptions of Social Media Health Mis- and Disinformation and by Race and Ethnicity Among Adults in the United States: Cross-Sectional Study",
journal="JMIR Cancer",
year="2024",
month="May",
day="8",
volume="10",
pages="e54162",
keywords="cancer",
keywords="United States",
keywords="cross-sectional study",
keywords="trust",
keywords="consumer health information",
keywords="misinformation",
keywords="disinformation",
keywords="race",
keywords="ethnicity",
keywords="cancer information",
keywords="source",
keywords="sources",
keywords="perception",
keywords="perceptions",
keywords="social media",
keywords="health information",
keywords="cross-sectional data",
keywords="misleading",
abstract="Background: Mis- and disinformation on social media have become widespread, which can lead to a lack of trust in health information sources and, in turn, lead to negative health outcomes. Moreover, the effect of mis- and disinformation on trust in information sources may vary by racial and ethnic minoritized populations. Objective: We evaluated how trust in multiple sources of cancer information varied by perceptions of health mis- and disinformation on social media and by race and ethnicity. Methods: Cross-sectional, nationally representative survey data from noninstitutionalized adults in the United States from the 2022 Health Information National Trends Survey 6 (HINTS 6) were analyzed (N=4137). The dependent variable measured the level of trust in cancer information sources. The independent variables were perceptions about health mis- and disinformation on social media and race and ethnicity. Multivariable logistic regression models were adjusted for survey weight and design, age, birth gender, race and ethnicity, marital status, urban/rural designation, education, employment status, feelings about household income, frequency of social media visits, and personal and family history of cancer. We also tested the interaction effect between perceptions of social media health mis- and disinformation and participants' self-reported race and ethnicity. Results: Perception of ``a lot of'' health mis- and disinformation on social media, relative to perception of ``less than a lot,'' was associated with a lower likelihood of high levels of trusting cancer information from government health agencies (odds ratio [OR] 0.60, 95\% CI 0.47-0.77), family or friends (OR 0.56, 95\% CI 0.44-0.71), charitable organizations (OR 0.78, 95\% CI 0.63-0.96), and religious organizations and leaders (OR 0.64, 95\% CI 0.52-0.79). Among White participants, those who perceived a lot of health mis- and disinformation on social media were less likely to have high trust in cancer information from government health agencies (margin=61\%, 95\% CI 57\%-66\%) and family or friends (margin=49\%, 95\% CI 43\%-55\%) compared to those who perceived less than a lot of health mis- and disinformation on social media. Among Black participants, those who perceived a lot of health mis- and disinformation on social media were less likely to have high trust in cancer information from religious organizations and leaders (margin=20\%, 95\% CI 10\%-30\%) compared to participants who perceived no or a little health mis- and disinformation on social media. Conclusions: Certain sources of cancer information may need enhanced support against the threat of mis- and disinformation, such as government health agencies, charitable organizations, religious organizations and leaders, and family or friends. Moreover, interventions should partner with racial and ethnically minoritized populations that are more likely to have low trust in certain cancer information sources associated with mis- and disinformation on social media. ",
doi="10.2196/54162",
url="https://cancer.jmir.org/2024/1/e54162",
url="http://www.ncbi.nlm.nih.gov/pubmed/38717800"
}


@Article{info:doi/10.2196/52061,
author="Lau, Nancy
and Zhao, Xin
and O'Daffer, Alison
and Weissman, Hannah
and Barton, Krysta",
title="Pediatric Cancer Communication on Twitter: Natural Language Processing and Qualitative Content Analysis",
journal="JMIR Cancer",
year="2024",
month="May",
day="7",
volume="10",
pages="e52061",
keywords="cancer",
keywords="COVID-19",
keywords="Twitter",
keywords="communication",
keywords="child health",
keywords="caregivers",
keywords="social media",
keywords="tweet",
keywords="tweets",
keywords="sentiment",
keywords="oncology",
keywords="cancers",
keywords="pediatric",
keywords="pediatrics",
keywords="child",
keywords="children' youth",
keywords="experience",
keywords="experiences",
keywords="attitude",
keywords="attitudes",
keywords="opinion",
keywords="opinions",
keywords="perception",
keywords="perceptions",
keywords="perspective",
keywords="perspectives",
abstract="Background: During the COVID-19 pandemic, Twitter (recently rebranded as ``X'') was the most widely used social media platform with over 2 million cancer-related tweets. The increasing use of social media among patients and family members, providers, and organizations has allowed for novel methods of studying cancer communication. Objective: This study aimed to examine pediatric cancer--related tweets to capture the experiences of patients and survivors of cancer, their caregivers, medical providers, and other stakeholders. We assessed the public sentiment and content of tweets related to pediatric cancer over a time period representative of the COVID-19 pandemic. Methods: All English-language tweets related to pediatric cancer posted from December 11, 2019, to May 7, 2022, globally, were obtained using the Twitter application programming interface. Sentiment analyses were computed based on Bing, AFINN, and NRC lexicons. We conducted a supplemental nonlexicon-based sentiment analysis with ChatGPT (version 3.0) to validate our findings with a random subset of 150 tweets. We conducted a qualitative content analysis to manually code the content of a random subset of 800 tweets. Results: A total of 161,135 unique tweets related to pediatric cancer were identified. Sentiment analyses showed that there were more positive words than negative words. Via the Bing lexicon, the most common positive words were support, love, amazing, heaven, and happy, and the most common negative words were grief, risk, hard, abuse, and miss. Via the NRC lexicon, most tweets were categorized under sentiment types of positive, trust, and joy. Overall positive sentiment was consistent across lexicons and confirmed with supplemental ChatGPT (version 3.0) analysis. Percent agreement between raters for qualitative coding was 91\%, and the top 10 codes were awareness, personal experiences, research, caregiver experiences, patient experiences, policy and the law, treatment, end of life, pharmaceuticals and drugs, and survivorship. Qualitative content analysis showed that Twitter users commonly used the social media platform to promote public awareness of pediatric cancer and to share personal experiences with pediatric cancer from the perspective of patients or survivors and their caregivers. Twitter was frequently used for health knowledge dissemination of research findings and federal policies that support treatment and affordable medical care. Conclusions: Twitter may serve as an effective means for researchers to examine pediatric cancer communication and public sentiment around the globe. Despite the public mental health crisis during the COVID-19 pandemic, overall sentiments of pediatric cancer--related tweets were positive. Content of pediatric cancer tweets focused on health and treatment information, social support, and raising awareness of pediatric cancer. ",
doi="10.2196/52061",
url="https://cancer.jmir.org/2024/1/e52061",
url="http://www.ncbi.nlm.nih.gov/pubmed/38713506"
}


@Article{info:doi/10.2196/49861,
author="Nourallah, Abdulnaser
and Alshehri, Abdulrahman
and Alhejazi, Ayman
and Usman, Binyam
and ElGohary, Ghada
and Malhan, Hafiz
and Motabi, Ibraheem
and Al Farsi, Khalil
and Alshuaibi, Mohammed
and Siddiqui, Mustaqeem
and Ghonema, Rasha
and Taha, Yasin Ruba
and Abouzeid, Tarek
and Ahmed, Wesam
and Diab, Mohanad
and Alhuraiji, Ahmad
and Rabea, Magdy
and Chouikrat, Zahir Mohamed",
title="Real-World Registry on the Pharmacotherapy of Multiple Myeloma and Associated Renal and Pulmonary Impairments in the Greater Gulf Region: Protocol for a Retrospective Real-World Data Study",
journal="JMIR Res Protoc",
year="2024",
month="Apr",
day="24",
volume="13",
pages="e49861",
keywords="Greater Gulf region",
keywords="multiple myeloma",
keywords="pulmonary dysfunction",
keywords="renal impairment",
keywords="RRMM",
keywords="Real-world data",
abstract="Background: Multiple myeloma (MM) is the second-most common cancer among hematological malignancies. Patients with active disease may experience several comorbidities, including renal insufficiency and asthma, which may lead to treatment failure. The treatment of relapsed or refractory MM (RRMM) has been associated with multiple factors, causing a decline in progression-free survival as well as overall survival with subsequent lines of therapy. Data about the characteristics of this group of patients in the Greater Gulf region are lacking. Objective: The primary objective of this study is to describe the disease characteristics and various treatment approaches or regimens used in the management of patients with RRMM in the Greater Gulf region. Methods: We will conduct a regional, retrospective study collecting real-world and epidemiological data on patients with MM in countries of the Greater Gulf region. Medical records will be used to obtain the required data. Around 150 to 170 patients' records are planned to be retrospectively reviewed over 6 months without any cross-sectional or prospective intervention. Cases will be collected from Saudi Arabia, the United Arab Emirates, Kuwait, Oman, and Qatar. Descriptive as well as analytical statistics will be performed on the extracted data. The calculated sample size will allow us to estimate the percentages of RRMM cases with acceptable precision while complying with the challenges in light of data scarcity. We will obtain a comprehensive description of the demographic profile of patients with MM; treatment outcomes; the proportion of patients with MM with renal impairment and asthma, chronic obstructive pulmonary disease, or both at the time of diagnosis and any subsequent point; and data related to treatment lines, regimens, and MM-associated morbidities. Results: Patient medical records were reviewed between June 2022 and January 2023 for eligibility and data extraction. A total of 148 patients were eligible for study inclusion, of whom 64.2\% (n=95) were male and 35.8\% (n=53) were female. The study is currently in its final stages of data analysis. The final manuscript is expected to be published in 2024. Conclusions: Although MM is a predominant hematological disease, data on its prevalence and patients' characteristics in the Greater Gulf region are scarce. Therefore, this study will give us real-world insights into disease characteristics and various management approaches of patients with MM in the Greater Gulf region. International Registered Report Identifier (IRRID): DERR1-10.2196/49861 ",
doi="10.2196/49861",
url="https://www.researchprotocols.org/2024/1/e49861",
url="http://www.ncbi.nlm.nih.gov/pubmed/38657230"
}


@Article{info:doi/10.2196/56684,
author="O'Hagan, Ross
and Ngandjui, Jessie
and Ungar, Benjamin
and Ungar, Jonathan
and Gulati, Nicholas",
title="A Survey of Demographics and Treatments in Melanoma Case Reports: Retrospective Bibliometric Analysis",
journal="JMIR Dermatol",
year="2024",
month="Apr",
day="22",
volume="7",
pages="e56684",
keywords="melanoma",
keywords="surgery",
keywords="chemotherapy",
keywords="immunotherapy",
keywords="radiation therapy",
keywords="case reports",
doi="10.2196/56684",
url="https://derma.jmir.org/2024/1/e56684",
url="http://www.ncbi.nlm.nih.gov/pubmed/38648085"
}


@Article{info:doi/10.2196/46360,
author="Chen, Yi-Chu
and Chen, Yun-Yuan
and Su, Shih-Yung
and Jhuang, Jing-Rong
and Chiang, Chun-Ju
and Yang, Ya-Wen
and Lin, Li-Ju
and Wu, Chao-Chun
and Lee, Wen-Chung",
title="Projected Time for the Elimination of Cervical Cancer Under Various Intervention Scenarios: Age-Period-Cohort Macrosimulation Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Apr",
day="18",
volume="10",
pages="e46360",
keywords="age-period-cohort model",
keywords="population attributable fraction",
keywords="macrosimulation",
keywords="cancer screening",
keywords="human papillomavirus",
keywords="HPV",
keywords="cervical cancer",
keywords="intervention",
keywords="women",
keywords="cervical screening",
keywords="public health intervention",
abstract="Background: The World Health Organization aims for the global elimination of cervical cancer, necessitating modeling studies to forecast long-term outcomes. Objective: This paper introduces a macrosimulation framework using age-period-cohort modeling and population attributable fractions to predict the timeline for eliminating cervical cancer in Taiwan. Methods: Data for cervical cancer cases from 1997 to 2016 were obtained from the Taiwan Cancer Registry. Future incidence rates under the current approach and various intervention strategies, such as scaled-up screening (cytology based or human papillomavirus [HPV] based) and HPV vaccination, were projected. Results: Our projections indicate that Taiwan could eliminate cervical cancer by 2050 with either 70\% compliance in cytology-based or HPV-based screening or 90\% HPV vaccination coverage. The years projected for elimination are 2047 and 2035 for cytology-based and HPV-based screening, respectively; 2050 for vaccination alone; and 2038 and 2033 for combined screening and vaccination approaches. Conclusions: The age-period-cohort macrosimulation framework offers a valuable policy analysis tool for cervical cancer control. Our findings can inform strategies in other high-incidence countries, serving as a benchmark for global efforts to eliminate the disease. ",
doi="10.2196/46360",
url="https://publichealth.jmir.org/2024/1/e46360",
url="http://www.ncbi.nlm.nih.gov/pubmed/38635315"
}


@Article{info:doi/10.2196/36441,
author="Freeman, Eric
and Patel, Darshilmukesh
and Odeniyi, Folasade
and Pasquinelli, Mary
and Jain, Shikha",
title="Where Do Oncology Patients Seek and Share Health Information? Survey Study",
journal="J Med Internet Res",
year="2024",
month="Mar",
day="25",
volume="26",
pages="e36441",
keywords="oncology",
keywords="social media",
keywords="patient-physician relationship",
keywords="patient-physician",
keywords="patient-provider",
keywords="cancer",
keywords="information sharing",
keywords="information seeking",
keywords="information behavior",
keywords="technology access",
keywords="digital divide",
doi="10.2196/36441",
url="https://www.jmir.org/2024/1/e36441",
url="http://www.ncbi.nlm.nih.gov/pubmed/38526546"
}


@Article{info:doi/10.2196/50000,
author="Dong, Pei
and Mao, Ayan
and Qiu, Wuqi
and Li, Guanglin",
title="Improvement of Cancer Prevention and Control: Reflection on the Role of Emerging Information Technologies",
journal="J Med Internet Res",
year="2024",
month="Feb",
day="27",
volume="26",
pages="e50000",
keywords="emerging information technologies",
keywords="cancer",
keywords="prevention and control",
doi="10.2196/50000",
url="https://www.jmir.org/2024/1/e50000",
url="http://www.ncbi.nlm.nih.gov/pubmed/38412009"
}


@Article{info:doi/10.2196/50392,
author="Buller, B. David
and Sussman, L. Andrew
and Thomson, A. Cynthia
and Kepka, Deanna
and Taren, Douglas
and Henry, L. Kimberly
and Warner, L. Echo
and Walkosz, J. Barbara
and Woodall, Gill W.
and Nuss, Kayla
and Blair, K. Cindy
and Guest, D. Dolores
and Borrayo, A. Evelinn
and Gordon, S. Judith
and Hatcher, Jennifer
and Wetter, W. David
and Kinsey, Alishia
and Jones, F. Christopher
and Yung, K. Angela
and Christini, Kaila
and Berteletti, Julia
and Torres, A. John
and Barraza Perez, Yessenya Emilia
and Small, Annelise",
title="\#4Corners4Health Social Media Cancer Prevention Campaign for Emerging Adults: Protocol for a Randomized Stepped-Wedge Trial",
journal="JMIR Res Protoc",
year="2024",
month="Feb",
day="22",
volume="13",
pages="e50392",
keywords="cancer prevention",
keywords="young adults",
keywords="rural",
keywords="social media",
keywords="physical activity",
keywords="diet",
keywords="alcohol",
keywords="tobacco control",
keywords="sunburn",
keywords="human papillomavirus",
keywords="HPV vaccination",
abstract="Background: Many emerging adults (EAs) are prone to making unhealthy choices, which increase their risk of premature cancer morbidity and mortality. In the era of social media, rigorous research on interventions to promote health behaviors for cancer risk reduction among EAs delivered over social media is limited. Cancer prevention information and recommendations may reach EAs more effectively over social media than in settings such as health care, schools, and workplaces, particularly for EAs residing in rural areas. Objective: This pragmatic randomized trial aims to evaluate a multirisk factor intervention using a social media campaign designed with community advisers aimed at decreasing cancer risk factors among EAs. The trial will target EAs from diverse backgrounds living in rural counties in the Four Corners states of Arizona, Colorado, New Mexico, and Utah. Methods: We will recruit a sample of EAs (n=1000) aged 18 to 26 years residing in rural counties (Rural-Urban Continuum Codes 4 to 9) in the Four Corners states from the Qualtrics' research panel and enroll them in a randomized stepped-wedge, quasi-experimental design. The inclusion criteria include English proficiency and regular social media engagement. A social media intervention will promote guideline-related goals for increased physical activity, healthy eating, and human papillomavirus vaccination and reduced nicotine product use, alcohol intake, and solar UV radiation exposure. Campaign posts will cover digital and media literacy skills, responses to misinformation, communication with family and friends, and referral to community resources. The intervention will be delivered over 12 months in Facebook private groups and will be guided by advisory groups of community stakeholders and EAs and focus groups with EAs. The EAs will complete assessments at baseline and at 12, 26, 39, 52, and 104 weeks after randomization. Assessments will measure 6 cancer risk behaviors, theoretical mediators, and participants' engagement with the social media campaign. Results: The trial is in its start-up phase. It is being led by a steering committee. Team members are working in 3 subcommittees to optimize community engagement, the social media intervention, and the measures to be used. The Stakeholder Organization Advisory Board and Emerging Adult Advisory Board were formed and provided initial input on the priority of cancer risk factors to target, social media use by EAs, and community resources available. A framework for the social media campaign with topics, format, and theoretical mediators has been created, along with protocols for campaign management. Conclusions: Social media can be used as a platform to counter misinformation and improve reliable health information to promote health behaviors that reduce cancer risks among EAs. Because of the popularity of web-based information sources among EAs, an innovative, multirisk factor intervention using a social media campaign has the potential to reduce their cancer risk behaviors. Trial Registration: ClinicalTrials.gov NCT05618158; https://classic.clinicaltrials.gov/ct2/show/NCT05618158 International Registered Report Identifier (IRRID): PRR1-10.2196/50392 ",
doi="10.2196/50392",
url="https://www.researchprotocols.org/2024/1/e50392",
url="http://www.ncbi.nlm.nih.gov/pubmed/38386396"
}


@Article{info:doi/10.2196/47821,
author="Thapa, Luna
and Xia, Joyce
and Guo, William
and Usmani, Hunya
and Miller, Devin
and Lozeau, Daniel",
title="Rosacea and Its Association With Malignancy: Systematic Review",
journal="JMIR Dermatol",
year="2023",
month="Nov",
day="8",
volume="6",
pages="e47821",
keywords="rosacea",
keywords="malignancies",
keywords="skin cancer",
keywords="glioma",
keywords="breast cancer",
keywords="hepatic cancer",
keywords="thyroid cancer",
keywords="systematic review",
abstract="Background: Rosacea is a chronic inflammatory skin condition that predominantly manifests as facial flushing, irritation, and acne. Rosacea and cancer are thought to be linked by the commonality of inflammatory and immune response dysfunction. Studies that have looked into this possible association have reported mixed results. Objective: Given the conflicting literature on this topic, our study sought to evaluate the overall association between rosacea and several cancers commonly investigated in the literature. Methods: A systematic review was conducted using the Cochrane, PubMed, Embase, and Ovid databases. Studies were screened independently for inclusion of rosacea and glioma and breast, thyroid, hepatic, or skin cancers. Using information from the articles, rosacea and each cancer were categorized as having a positive, negative, or unclear association. Results: Our systematic review included 39 full-text studies that investigated the association between rosacea and various malignancies. Among the malignancies of concern, 41\% (16/39) of the studies reported an association with basal cell carcinoma, with 2 cohorts revealing an adjusted risk ratio (RR) of 1.50 (95\% CI 1.35-1.67) and 0.72 (95\% CI 0.56-0.93). In total, 33\% (13/39) of the studies reported an association with squamous cell carcinoma, with 2 cohorts revealing an adjusted RR of 1.4 (95\% CI 1.02-1.93) and 1.30 (95\% CI 0.90-1.88). A total of 8\% (3/39) of the studies reported an association between breast cancer and melanoma, with breast cancer cohorts revealing an adjusted RR of 8.453 (95\% CI 1.638-43.606), 1.03 (95\% CI 0.89-1.20), and 1.36 (95\% CI 1.18-1.58) and melanoma cohorts revealing an adjusted RR of 1.10 (95\% CI 0.95-1.27), 0.63 (95\% CI 0.47-0.85), and 0.96 (95\% CI 0.57-1.62). A total of 5\% (2/39) of the studies reported an association among nonmelanoma skin cancers, hepatic cancer, and thyroid carcinomas, with nonmelanoma skin cancer cohorts revealing an adjusted RR of 1.36 (95\% CI 1.26-1.47) and 2.66 (95\% CI 1.53-4.61), hepatic cancer cohorts revealing an adjusted RR of 1.42 (95\% CI 1.06-1.90) and 1.32 (95\% CI 0.89-1.95), and thyroid carcinoma cohorts revealing an adjusted RR of 1.06 (95\% CI 0.68-1.65) and 1.59 (95\% CI 1.07-2.36). Only 1 cohort reported an association with glioma, revealing an adjusted RR of 1.36 (95\% CI 1.18-1.58). According to our review, patients with rosacea were statistically more likely to have nonmelanoma skin cancers, breast cancer, and glioma. Rosacea was not found to be substantially associated with melanoma. The associations between rosacea and hepatic and thyroid cancers were unclear because of conflicting results. Conclusions: The current literature shows that rosacea is significantly associated with increased odds of nonmelanoma skin cancers, glioma, and breast cancer. Rosacea does not appear to be associated with melanoma. Further studies should be conducted to clarify the association between thyroid and hepatic cancers and rosacea. ",
doi="10.2196/47821",
url="https://derma.jmir.org/2023/1/e47821",
url="http://www.ncbi.nlm.nih.gov/pubmed/37938876"
}


@Article{info:doi/10.2196/40149,
author="Chen, Mu
and Li, Cheng
and Zhang, Jiwei
and Cui, Xin
and Tian, Wenqi
and Liao, Peng
and Wang, Qunshan
and Sun, Jian
and Luo, Li
and Wu, Hong
and Li, Yi-Gang",
title="Cancer and Atrial Fibrillation Comorbidities Among 25 Million Citizens in Shanghai, China: Medical Insurance Database Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Oct",
day="17",
volume="9",
pages="e40149",
keywords="cardiovascular",
keywords="malignancy",
keywords="arrhythmia",
keywords="cardio-oncology",
keywords="prevalence",
keywords="epidemiology",
keywords="atrial fibrillation",
abstract="Background: With population aging, the prevalence of both cancer and atrial fibrillation (AF) have increased. However, there is scarce epidemiological data concerning the comorbid state of cancer and AF in low- and middle-income countries, including China. Objective: We aimed to evaluate the site-, sex-, and age-specific profiles of cancer and AF comorbidities in Chinese populations. Methods: Data from the Shanghai Municipal Health Commission database between 2015 and 2020 were screened, covering all medical records of Shanghai residents with medical insurance. Site-specific cancer profiles were evaluated for the population with AF relative to the age- and sex-adjusted population of residents without AF. The sex distribution and peak age of cancer diagnosis were also assessed. Results: A total of 25,964,447 adult patients were screened. Among them, 22,185 patients presented cancers comorbid with AF (median 77, IQR 67-82 years of age; men: n=13,631, 61.44\%), while 839,864 presented cancers without AF (median 67, IQR 57-72 years of age; men: n=419,020, 49.89\%), thus yielding a higher cancer prevalence among residents with AF (8.27\%) than among those without AF (6.05\%; P<.001). In the population with AF, the most prevalent cancer type was lung cancer, followed by colorectal, male genital organ, stomach, breast, liver, bladder, thyroid, leukemia, and esophageal cancers. AF was associated with an average of nearly 1.4-fold (prevalence ratio [PR] 1.37, 95\% CI 1.35-1.38) increased prevalence of cancer after adjusting for age and sex. For site-specific analyses, an increased prevalence of cancer in the population with AF was observed in 20 of 21 cancer sites. This increased prevalence was most prominent for nonsolid tumors, including multiple myeloma (PR 2.56, 95\% CI 2.28-2.87), leukemia (PR 1.73, 95\% CI 1.57-1.90), and non-Hodgkin lymphoma (PR 1.59, 95\% CI 1.43-1.77); intrathoracic malignancies, including mediastinum (PR 2.34, 95\% CI 1.89-2.90), lung (PR 1.64, 95\% CI 1.59-1.69), and esophageal cancers (PR 1.41, 95\% CI 1.28-1.56); bone and soft tissue neoplasms (PR 1.56, 95\% CI 1.37-1.77); and kidney cancer (PR 1.53, 95\% CI 1.36-1.72). Cancer prevalence in the population with AF relative to that in the population without AF was higher in men than in women in 14 of 18 cancer sites, and female predominance was only observed for thyroid cancer. The peak age of index cancer diagnosis was lower in the population with AF (age group: 70-74 years) than in that without AF (age group: 75-79 years), especially for specific cancer types, including thyroid, central nervous system, mediastinum, esophageal, bladder, and biliary cancers. Conclusions: Patients with AF are associated with increased prevalence, heightened male predominance, and younger peak age of cancer. Further studies are needed to determine whether early screening of specific cancers is cost-effective and beneficial for patients with AF. ",
doi="10.2196/40149",
url="https://publichealth.jmir.org/2023/1/e40149",
url="http://www.ncbi.nlm.nih.gov/pubmed/37847541"
}


@Article{info:doi/10.2196/46051,
author="Li, Peng
and Jing, Jing
and Liu, Wenjun
and Wang, Jizhao
and Qi, Xin
and Zhang, Guangjian",
title="Spatiotemporal Patterns of Esophageal Cancer Burden Attributable to Behavioral, Metabolic, and Dietary Risk Factors From 1990 to 2019: Longitudinal Observational Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Oct",
day="6",
volume="9",
pages="e46051",
keywords="esophageal cancer",
keywords="age-standardized mortality rate",
keywords="disability-adjusted life years",
keywords="attributable risk",
keywords="average annual percentage change",
abstract="Background: Esophageal cancer (EC) is the sixth leading cause of cancer-related burden with distinct regional variations globally. Although the burden of EC has decreased, the specific reasons for this decline are still unclear. Objective: This study aims to uncover the spatiotemporal patterns of EC risk--attributable burden in 204 countries and territories from 1990 to 2019 so that prevention and control strategies of EC can be prioritized worldwide. Methods: We extracted EC risk--attributable deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMRs), and age-standardized DALY rates (ASDRs) from the global burden of disease (GBD) study from 1990 to 2019, in terms of behavioral, metabolic, and dietary factors by age, sex, and geographical location. Average annual percentage change (AAPC) was used to assess the long-term trends in the ASMRs and ASDRs of EC due to specific risk factors. Results: Between 1990 and 2019, the greatest decrease in EC burden was attributed to low intake of fruits and vegetables. An AAPC of --2.96 (95\% CI --3.28 to --2.63) and --3.12 (95\% CI --3.44 to --2.79) in ASMR and ASDR was attributable to a low-fruit diet, while an AAPC of --3.60 (95\% CI --3.84 to --3.36) and --3.64 (95\% CI --3.92 to --3.35) in ASMR and ASDR was attributed to a low-vegetable diet. However, the trends in ASMRs and ASDRs due to high BMI showed significant increases with an AAPC of 0.52 (95\% CI 0.29-0.75) in ASMR and 0.42 (95\% CI 0.18-0.66) in ASDR from 1990 to 2019 compared to significant decreases in other attributable risks with AAPC<0 (P<.05). East Asia had the largest decrease in EC burden due to low-vegetable diets, with an AAPC of --11.00 (95\% CI --11.32 to --10.67) in ASMR and --11.81 (95\% CI --12.21 to --11.41) in ASDR, followed by Central Asia, whereas Western Sub-Saharan Africa had the largest increase in ASMR and ASDR due to high BMI, with an AAPC of 3.28 (95\% CI 3.14-3.42) and 3.09 (95\% CI 2.96-3.22), respectively. China had the highest EC burden attributed to smoking, alcohol use, high BMI, and low-fruit diets. Between 1990 and 2019, there was a significant decrease in EC burden attributable to smoking, alcohol use, chewing tobacco, low-fruit diets, and low-vegetable diets in most countries, wherein a significant increase in the EC burden was due to high BMI. Conclusions: Our study shows that smoking and alcohol consumption are still the leading risk factors of EC burden and that EC burden attributable to low intake of fruits and vegetables has shown the largest decline recently. The risks of ASMRs and ASDRs of EC showed distinct spatiotemporal patterns, and future studies should focus on the upward trend in the EC burden attributed to high BMI. ",
doi="10.2196/46051",
url="https://publichealth.jmir.org/2023/1/e46051",
url="http://www.ncbi.nlm.nih.gov/pubmed/37801354"
}


@Article{info:doi/10.2196/48449,
author="Guo, Hui-Xiao
and Wang, Qi
and Wang, Can
and Yin, Chen Qing
and Huo, Zhi Hua
and Yin, Hua Bing",
title="Secular Trends in Gastric and Esophageal Cancer Attributable to Dietary Carcinogens From 1990 to 2019 and Projections Until 2044 in China: Population-Based Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Sep",
day="21",
volume="9",
pages="e48449",
keywords="esophageal cancer",
keywords="gastric cancer",
keywords="dietary carcinogens",
keywords="prediction",
keywords="temporal trends",
keywords="China",
abstract="Background: Little is known about trends in or projections of the disease burden of dietary gastric and esophageal cancer (GEC) in China. Objective: We aim to report GEC deaths and disability-adjusted life years (DALYs) from 1990 to 2019, predict them through 2044, and decompose changes in terms of population growth, population aging, and epidemiological changes. Methods: We retrieved dietary GEC data from the Global Burden of Disease (GBD) online database and used joinpoint regression and age-period-cohort models to analyze trends in dietary GEC deaths and DALYs from 1990 to 2019 in China. We used a Bayesian age period cohort model of integrated nested Laplace approximations to predict the disease burden of GEC through 2044 and obtained the estimated population of China from 2020 to 2050 from the Global Health Data Exchange website. Finally, we applied a recently developed decomposition method to attribute changes between 2019 and 2044 to population growth, population aging, and epidemiological changes. Results: The summary exposure values and age-standardized rates decreased significantly from 1990 to 1999, with percentage changes of --0.06\% (95\% CI --0.11\% to --0.02\%) and --0.05\% (95\% CI --0.1\% to --0.02\%), respectively. From 1990 to 2019, for dietary esophageal cancer, the percentage change in age-standardized mortality rate (ASMR) was --0.79\% (95\% CI --0.93\% to --0.58\%) and the percentage change in age-standardized DALY rate (ASDR) was --0.81\% (95\% CI --0.94\% to --0.61\%); these were significant decreases. For dietary stomach cancer, significant decreases were also observed for the percentage change in ASMR (--0.43\%, 95\% CI --0.55\% to --0.31\%) and the percentage change in ASDR (--0.47\%, 95\% CI --0.58\% to --0.35\%). In addition, data from both the joinpoint regression and annual percentage change analyses demonstrated significantly decreasing trends for the annual percentage change in ASMR and ASDR for GEC attributable to dietary carcinogens. The overall annual percentage change (net drift) was --5.95\% (95\% CI --6.25\% to --5.65\%) for dietary esophageal cancer mortality and --1.97\% (95\% CI --2.11\% to --1.83\%) for dietary stomach cancer mortality. Lastly, in 2044, dietary esophageal cancer deaths and DALYs were predicted to increase by 192.62\% and 170.28\%, respectively, due to age structure (121.58\% and 83.29\%), mortality change (76.81\% and 92.43\%), and population size (--5.77\% and --5.44\%). In addition, dietary stomach cancer deaths and DALYs were predicted to increase by 118.1\% and 54.08\%, with age structure, mortality rate change, and population size accounting for 96.71\% and 53.99\%, 26.17\% and 3.97\%, and --4.78\% and --3.88\% of the change, respectively. Conclusions: Although the predicted age-standardized rates of mortality and DALYs due to dietary GEC show downward trends, the absolute numbers are still predicted to increase in the next 25 years due to rapid population aging in China. ",
doi="10.2196/48449",
url="https://publichealth.jmir.org/2023/1/e48449",
url="http://www.ncbi.nlm.nih.gov/pubmed/37560940"
}


@Article{info:doi/10.2196/49452,
author="Kureyama, Nari
and Terada, Mitsuo
and Kusudo, Maho
and Nozawa, Kazuki
and Wanifuchi-Endo, Yumi
and Fujita, Takashi
and Asano, Tomoko
and Kato, Akiko
and Mori, Makiko
and Horisawa, Nanae
and Toyama, Tatsuya",
title="Fact-Checking Cancer Information on Social Media in Japan: Retrospective Study Using Twitter",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="6",
volume="7",
pages="e49452",
keywords="cancer",
keywords="fact-check",
keywords="misinformation",
keywords="social media",
keywords="twitter",
abstract="Background: The widespread use of social media has made it easier for patients to access cancer information. However, a large amount of misinformation and harmful information that could negatively impact patients' decision-making is also disseminated on social media platforms. Objective: We aimed to determine the actual amount of misinformation and harmful information as well as trends in the dissemination of cancer-related information on Twitter, a representative social media platform. Our findings can support decision-making among Japanese patients with cancer. Methods: Using the Twitter app programming interface, we extracted tweets containing the term ``cancer'' in Japanese that were posted between August and September of 2022. The eligibility criteria were the cancer-related tweets with the following information: (1) reference to the occurrence or prognosis of cancer, (2) recommendation or nonrecommendation of actions, (3) reference to the course of cancer treatment or adverse events, (4) results of cancer research, and (5) other cancer-related knowledge and information. Finally, we selected the top 100 tweets with the highest number of ``likes.'' For each tweet, 2 independent reviewers evaluated whether the information was factual or misinformation, and whether it was harmful or safe with the reasons for the decisions on the misinformation and harmful tweets. Additionally, we examined the frequency of information dissemination using the number of retweets for the top 100 tweets and investigated trends in the dissemination of information. Results: The extracted tweets totaled 69,875. Of the top 100 cancer-related tweets with the most ``likes'' that met the eligibility criteria, 44 (44\%) contained misinformation, 31 (31\%) contained harmful information, and 30 (30\%) contained both misinformation and harmful information. Misinformation was described as Unproven (29/94, 40.4\%), Disproven (19/94, 20.2\%), Inappropriate application (4/94, 4.3\%), Strength of evidence mischaracterized (14/94, 14.9\%), Misleading (18/94, 18\%), and Other misinformation (1/94, 1.1\%). Harmful action was described as Harmful action (9/59, 15.2\%), Harmful inaction (43/59, 72.9\%), Harmful interactions (3/59, 5.1\%), Economic harm (3/59, 5.1\%), and Other harmful information (1/59, 1.7\%). Harmful information was liked more often than safe information (median 95, IQR 43-1919 vs 75.0 IQR 43-10,747; P=.04). The median number of retweets for the leading 100 tweets was 13.5 (IQR 0-2197). Misinformation was retweeted significantly more often than factual information (median 29.0, IQR 0-502 vs 7.5, IQR 0-2197; P=.01); harmful information was also retweeted significantly more often than safe information (median 35.0, IQR 0-502 vs 8.0, IQR 0-2197; P=.002). Conclusions: It is evident that there is a prevalence of misinformation and harmful information related to cancer on Twitter in Japan and it is crucial to increase health literacy and awareness regarding this issue. Furthermore, we believe that it is important for government agencies and health care professionals to continue providing accurate medical information to support patients and their families in making informed decisions. ",
doi="10.2196/49452",
url="https://formative.jmir.org/2023/1/e49452",
url="http://www.ncbi.nlm.nih.gov/pubmed/37672310"
}


@Article{info:doi/10.2196/44073,
author="Li, Wenzhen
and Chen, Dajie
and Peng, Ying
and Lu, Zuxun
and Kwan, Mei-Po
and Tse, Ah Lap",
title="Association Between Metabolic Syndrome and Mortality: Prospective Cohort Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Sep",
day="5",
volume="9",
pages="e44073",
keywords="metabolic syndrome",
keywords="mortality",
keywords="heart disease",
keywords="diabetes mellitus",
keywords="cancer",
abstract="Background: Metabolic syndrome (MetS) is a common metabolic disorder that results from the increasing prevalence of obesity, which has been an increasing concern in recent years. Previous evidence indicated that MetS was associated with mortality; however, different definitions of MetS were used. In 2005, the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III updated the definition of MetS, which has since been widely adopted. Therefore, it is necessary to conduct a novel study among other populations and countries with a larger sample size using the updated definition of MetS and death code to examine the association of MetS with all-cause and cause-specific mortality. Objective: We aimed to examine the associations of MetS with all-cause and cause-specific mortality. Methods: A total of 36,414 adults were included in this study, using data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and the continuous NHANES (1999-2014) in the United States. Death outcomes were ascertained by linkage to National Death Index records through December 31, 2015. MetS was defined by the NCEP ATP III-2005 criterion. Complex survey design factors including sample weights, clustering, and stratification were considered for all analyses with instructions for using NHANES data. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95\% CIs for mortality from all causes, heart disease, diabetes, and cancer. Results: We observed 8494 deaths during the 16.71 years of follow-up. Compared with those without MetS, individuals with MetS were associated with a significantly elevated multiadjusted HR of 1.24 (95\% CI 1.16-1.33), 1.44 (95\% CI 1.25-1.66), and 5.15 (95\% CI 3.15-8.43) for all cause, heart diseases, and diabetes mellitus, respectively, whereas no significant association was found for cancer mortality (HR 1.17, 95\% CI 0.95-1.43). Conclusions: Our study provides additional evidence that MetS and its components are significantly associated with all-cause, heart disease, and diabetes mortality, but not with cancer mortality. Health care professionals should pay more attention to MetS and its individual component. ",
doi="10.2196/44073",
url="https://publichealth.jmir.org/2023/1/e44073",
url="http://www.ncbi.nlm.nih.gov/pubmed/37669100"
}


@Article{info:doi/10.2196/41999,
author="Qiu, Hang
and Wang, Liya
and Zhou, Li
and Wang, Xiaodong",
title="Comorbidity Patterns in Patients Newly Diagnosed With Colorectal Cancer: Network-Based Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Sep",
day="5",
volume="9",
pages="e41999",
keywords="colorectal cancer",
keywords="comorbidity patterns",
keywords="prevalence",
keywords="health status disparities",
keywords="network analysis",
keywords="routinely collected health data",
abstract="Background: Patients with colorectal cancer (CRC) often present with multiple comorbidities, and many of these can affect treatment and survival. However, previous comorbidity studies primarily focused on diseases in commonly used comorbidity indices. The comorbid status of CRC patients with respect to the entire spectrum of chronic diseases has not yet been investigated. Objective: This study aimed to systematically analyze all chronic diagnoses and diseases co-occurring, using a network-based approach and large-scale administrative health data, and provide a complete picture of the comorbidity pattern in patients newly diagnosed with CRC from southwest China. Methods: In this retrospective observational study, the hospital discharge records of 678 hospitals from 2015 to 2020 in Sichuan Province, China were used to identify new CRC cases in 2020 and their history of diseases. We examined all chronic diagnoses using ICD-10 (International Classification of Diseases, 10th Revision) codes at 3 digits and focused on chronic diseases with >1\% prevalence in at least one subgroup (1-sided test, P<.025), which resulted in a total of 66 chronic diseases. Phenotypic comorbidity networks were constructed across all CRC patients and different subgroups by sex, age (18-59, 60-69, 70-79, and ?80 years), area (urban and rural), and cancer site (colon and rectum), with comorbidity as a node and linkages representing significant correlations between multiple comorbidities. Results: A total of 29,610 new CRC cases occurred in Sichuan, China in 2020. The mean patient age at diagnosis was 65.6 (SD 12.9) years, and 75.5\% (22,369/29,610) had at least one comorbidity. The most prevalent comorbidities were hypertension (8581/29,610, 29.0\%; 95\% CI 28.5\%-29.5\%), hyperplasia of the prostate (3816/17,426, 21.9\%; 95\% CI 21.3\%-22.5\%), and chronic obstructive pulmonary disease (COPD; 4199/29,610, 14.2\%; 95\% CI 13.8\%-14.6\%). The prevalence of single comorbidities was different in each subgroup in most cases. Comorbidities were closely associated, with disorders of lipoprotein metabolism and hyperplasia of the prostate mediating correlations between other comorbidities. Males and females shared 58.3\% (141/242) of disease pairs, whereas male-female disparities occurred primarily in diseases coexisting with COPD, cerebrovascular diseases, atherosclerosis, heart failure, or renal failure among males and with osteoporosis or gonarthrosis among females. Urban patients generally had more comorbidities with higher prevalence and more complex disease coexistence relationships, whereas rural patients were more likely to have co-existing severe diseases, such as heart failure comorbid with the sequelae of cerebrovascular disease or COPD. Conclusions: Male-female and urban-rural disparities in the prevalence of single comorbidities and their complex coexistence relationships in new CRC cases were not due to simple coincidence. The results reflect clinical practice in CRC patients and emphasize the importance of measuring comorbidity patterns in terms of individual and coexisting diseases in order to better understand comorbidity patterns. ",
doi="10.2196/41999",
url="https://publichealth.jmir.org/2023/1/e41999",
url="http://www.ncbi.nlm.nih.gov/pubmed/37669093"
}


@Article{info:doi/10.2196/47579,
author="Zhang, Dong-Dong
and Lei, Min
and Wang, Yue
and Zeng, Pei-Ji
and Hong, Yong-Jun
and Cai, Cheng-Fu",
title="Cause of Death in Patients with Oropharyngeal Carcinoma by Human Papillomavirus Status: Comparative Data Analysis",
journal="JMIR Public Health Surveill",
year="2023",
month="Aug",
day="29",
volume="9",
pages="e47579",
keywords="oropharyngeal carcinomas",
keywords="human papillomavirus",
keywords="causes of death",
keywords="survival",
keywords="competing mortality",
keywords="comparative data",
keywords="analysis",
keywords="cell death",
keywords="carcinoma",
keywords="oropharyngeal carcinoma",
keywords="surveillance",
keywords="database",
keywords="human papillomavirus-related tumor",
abstract="Background: The incidence of oropharyngeal squamous cell carcinomas (OPSCC) has increased in recent decades, and human papillomavirus (HPV) infection is the main cause of OPSCC. The data regarding causes of death (CODs) are vitally important in informing follow-up strategies and revising treatment strategies to deal with any possible preventable treatment-related COD. However, limited studies have assessed the competing COD by HPV status in patients with OPSCC. Objective: We aimed to analyze the distribution of the competing COD according to HPV status in OPSCC. Methods: We retrospectively included stage I-IVB patients with OPSCC from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. The association between HPV status and head and neck cancer--specific mortality (HNCSM), second primary cancer mortality (SPCM), and noncancer-caused mortality (NCCM) were analyzed. The chi-square test, Kaplan-Meier analysis, and Fine and Gray model were used for statistical analysis. Results: We included 5852 patients in this study and 73.2\% (n=4283) of them had HPV-related tumors. A total of 1537 (26.3\%) patients died, including 789 (51.3\%), 333 (21.7\%), and 415 (27\%) patients who died from head and neck cancer, second cancer, and noncancer causes, respectively. The 5-year HNCSM, SPCM, NCCM, and overall mortality were 14.7\%, 6.5\%, 7.7\%, and 26.4\%, respectively. Those with HPV-positive disease had a lower cumulative incidence of HNCSM (subdistribution hazard ratio [sHR] 0.362, 95\% CI 0.315-0.417; P<.001), SPCM (sHR 0.400, 95\% CI 0.321-0.496; P<.001), and NCCM (sHR 0.460, 95\% CI 0.378-0.560; P<.001) than those with HPV-negative disease. The 5-year risk of HNCSM was 26.9\% and 10.7\% in those with HPV-negative and HPV-positive disease, respectively (P<.001). The 5-year risk of SPCM was 12.4\% and 4.6\% in those with HPV-negative and HPV-positive disease, respectively (P<.001). The 5-year risk of NCCM of death was 13.7\% and 5.8\% in those with HPV-negative and HPV-positive disease, respectively (P<.001). Using the Fine and Gray competing-risks model, our results show that those with HPV-negative tumors had a significantly higher risk of HNCSM (P<.001), SPCM (P<.001), and NCCM (P<.001) than those with HPV-negative tumors. Conclusions: HPV-positive OPSCC has a lower NCSM, SPCM, and NCCM as compared to those with HPV-negative OPSCC. HPV positivity is a favorable prognostic factor in the context of overcoming cancer as well as in terms of reducing the risk of other CODs in OPSCC. Our finding supports the need to tailor patient follow-up based on the HPV status of patients with OPSCC. ",
doi="10.2196/47579",
url="https://publichealth.jmir.org/2023/1/e47579",
url="http://www.ncbi.nlm.nih.gov/pubmed/37642982"
}


@Article{info:doi/10.2196/45198,
author="Memenga, Paula
and Baumann, Eva
and Luetke Lanfer, Hanna
and Reifegerste, Doreen
and Geulen, Julia
and Weber, Winja
and Hahne, Andrea
and M{\"u}ller, Anne
and Weg-Remers, Susanne",
title="Intentions of Patients With Cancer and Their Relatives to Use a Live Chat on Familial Cancer Risk: Results From a Cross-Sectional Web-Based Survey",
journal="J Med Internet Res",
year="2023",
month="Aug",
day="28",
volume="25",
pages="e45198",
keywords="live chat",
keywords="technology acceptance",
keywords="familial cancer risk",
keywords="Extended Unified Theory of Acceptance and Use of Technology",
keywords="cancer information seeking",
keywords="patients and relatives with cancer",
keywords="patients with cancer",
keywords="cancer risk",
keywords="genetic testing",
keywords="diagnosis",
keywords="severity",
keywords="cross-sectional survey",
abstract="Background: An important prerequisite for actively engaging in cancer prevention and early detection measures, which is particularly recommended in cases of familial cancer risk, is the acquisition of information. Although a lot of cancer information is available, not all social groups are equally well reached because information needs and communicative accessibility differ. Previous research has shown that a live chat service provided by health professionals could be an appropriate, low-threshold format to meet individual information needs on sensitive health topics such as familial cancer risk. An established German Cancer Information Service is currently developing such a live chat service. As it is only worthwhile if accepted by the target groups, formative evaluation is essential in the course of the chat service's development and implementation. Objective: This study aimed to explore the acceptance of a live chat on familial cancer risk by patients with cancer and their relatives (research question [RQ] 1) and examine the explanatory power of factors associated with their intentions to use such a service (RQ2). Guided by the Extended Unified Theory of Acceptance and Use of Technology (UTAUT2), we examined the explanatory power of the following UTAUT2 factors: performance expectancy, effort expectancy, social influence, facilitating conditions, and habit, supplemented by perceived information insufficiency, perceived susceptibility, perceived severity, and cancer diagnosis as additional factors related to information seeking about familial cancer. Methods: We conducted a cross-sectional survey via a German web-based access panel in March 2022 that was stratified by age, gender, and education (N=1084). The participants are or have been diagnosed with cancer themselves (n=144) or have relatives who are or have been affected (n=990). All constructs were measured with established scales. To answer RQ1, descriptive data (mean values and distribution) were used. For RQ2, a blockwise multiple linear regression analysis was conducted. Results: Overall, 32.7\% of participants were (rather) willing, 28.9\% were undecided, and 38.4\% were (rather) not willing to use a live chat on familial cancer risk in the future. A multiple linear regression analysis explained 47\% of the variance. It revealed that performance expectancy, social influence, habit, perceived susceptibility, and perceived severity were positively associated with the intention to use a live chat on familial cancer risk. Effort expectancy, facilitating conditions, information insufficiency, and cancer diagnosis were not related to usage intentions. Conclusions: A live chat seems promising for providing information on familial cancer risk. When promoting the service, the personal benefits should be addressed in particular. UTAUT2 is an effective theoretical framework for explaining live chat usage intentions and does not need to be extended in the context of familial cancer risk. ",
doi="10.2196/45198",
url="https://www.jmir.org/2023/1/e45198",
url="http://www.ncbi.nlm.nih.gov/pubmed/37639311"
}


@Article{info:doi/10.2196/48786,
author="Meksawasdichai, Sununtha
and Lerksuthirat, Tassanee
and Ongphiphadhanakul, Boonsong
and Sriphrapradang, Chutintorn",
title="Perspectives and Experiences of Patients With Thyroid Cancer at a Global Level: Retrospective Descriptive Study of Twitter Data",
journal="JMIR Cancer",
year="2023",
month="Aug",
day="2",
volume="9",
pages="e48786",
keywords="data mining",
keywords="internet",
keywords="natural language processing",
keywords="sentiment analysis",
keywords="social media",
keywords="thyroid neoplasms",
keywords="twitter",
keywords="tweet",
keywords="tweets",
keywords="neoplasm",
keywords="neoplasms",
keywords="cancer",
keywords="oncology",
keywords="thyroid",
keywords="NLP",
keywords="perspective",
keywords="perspectives",
keywords="sentiment",
keywords="sentiments",
keywords="experience",
keywords="experiences",
abstract="Background: Twitter has become a popular platform for individuals to broadcast their daily experiences and opinions on a wide range of topics and emotions. Tweets from patients with cancer could offer insights into their needs. However, limited research has been conducted using Twitter data to understand the needs of patients with cancer despite the substantial amount of health-related data posted on the platform daily. Objective: This study aimed to uncover the potential of using Twitter data to understand the perspectives and experiences of patients with thyroid cancer at a global level. Methods: ?This retrospective descriptive study collected tweets relevant to thyroid cancer in 2020 using the Twitter scraping tool. Only English-language tweets were included, and data preprocessing was performed to remove irrelevant tweets, duplicates, and retweets. Both tweets and Twitter users were manually classified into various groups based on the content. Each tweet underwent sentiment analysis and was classified as either positive, neutral, or negative. Results: A total of 13,135 tweets related to thyroid cancer were analyzed. The authors of the tweets included patients with thyroid cancer (3225 tweets, 24.6\%), patient's families and friends (2449 tweets, 18.6\%), medical journals and media (1733 tweets, 13.2\%), health care professionals (1093 tweets, 8.3\%), and medical health organizations (940 tweets, 7.2\%), respectively. The most discussed topics related to living with cancer (3650 tweets, 27.8\%), treatment (2891 tweets, 22\%), diagnosis (1613 tweets, 12.3\%), risk factors and prevention (1137 tweets, 8.7\%), and research (953 tweets, 7.3\%). An average of 36 tweets pertaining to thyroid cancer were posted daily. Notably, the release of a film addressing thyroid cancer and the public disclosure of a news reporter's personal diagnosis of thyroid cancer resulted in a significant escalation in the volume of tweets. From the sentiment analysis, 53.5\% (7025/13,135) of tweets were classified as neutral statements and 32.7\% (4299/13,135) of tweets expressed negative emotions. Tweets from patients with thyroid cancer had the highest proportion of negative emotion (1385/3225 tweets, 42.9\%), particularly when discussing symptoms. Conclusions: ?This study provides new insights on using?Twitter data as a valuable data source to understand the experiences of patients with thyroid cancer. Twitter may provide an opportunity to improve patient and physician engagement or apply as a potential research data source. ",
doi="10.2196/48786",
url="https://cancer.jmir.org/2023/1/e48786",
url="http://www.ncbi.nlm.nih.gov/pubmed/37531163"
}


@Article{info:doi/10.2196/43749,
author="Lazard, J. Allison
and Nicolla, Sydney
and Vereen, N. Rhyan
and Pendleton, Shanetta
and Charlot, Marjory
and Tan, Hung-Jui
and DiFranzo, Dominic
and Pulido, Marlyn
and Dasgupta, Nabarun",
title="Exposure and Reactions to Cancer Treatment Misinformation and Advice: Survey Study",
journal="JMIR Cancer",
year="2023",
month="Jul",
day="28",
volume="9",
pages="e43749",
keywords="cancer",
keywords="misinformation",
keywords="social media",
keywords="prosocial intervening",
keywords="treatment",
keywords="false information",
keywords="alternative medicine",
keywords="information spread",
keywords="dissemination",
keywords="infodemiology",
keywords="mobile phone",
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. ",
doi="10.2196/43749",
url="https://cancer.jmir.org/2023/1/e43749",
url="http://www.ncbi.nlm.nih.gov/pubmed/37505790"
}


@Article{info:doi/10.2196/41594,
author="Filipponi, Chiara
and Chichua, Mariam
and Masiero, Marianna
and Mazzoni, Davide
and Pravettoni, Gabriella",
title="Cancer Pain Experience Through the Lens of Patients and Caregivers: Mixed Methods Social Media Study",
journal="JMIR Cancer",
year="2023",
month="Jul",
day="3",
volume="9",
pages="e41594",
keywords="pain",
keywords="cancer",
keywords="quality of life",
keywords="social support",
keywords="emotion",
keywords="personality",
keywords="decision-making",
abstract="Background: Cancer pain represents a challenge for cancer patients and their family members. Despite progression in pain management, pain is still underreported and undertreated, and there is limited information on the related needs that patients and caregivers may have. Online platforms represent a fundamental tool for research to reveal the unmet needs of these users and their emotions outside the medical setting. Objective: This study aimed to (1) reveal the unmet needs of both patients and caregivers and (2) detect the emotional activation associated with cancer pain by analyzing the textual patterns of both users. Methods: A descriptive and quantitative analysis of qualitative data was performed in RStudio v.2022.02.3 (RStudio Team). We analyzed 679 posts (161 from caregivers and 518 from patients) published over 10 years on the ``cancer'' subreddit of Reddit to identify unmet needs and emotions related to cancer pain. Hierarchical clustering, and emotion and sentiment analysis were conducted. Results: The language used for describing experiences related to cancer pain and expressed needs differed between patients and caregivers. For patients (agglomerative coefficient=0.72), the large cluster labeled unmet needs included the following clusters: (1A) reported experiences, with the subclusters (a) relationship with doctors/spouse and (b) reflections on physical features; and (1B) changes observed over time, with the subclusters (a) regret and (b) progress. For caregivers (agglomerative coefficient=0.80), the main clusters were as follows: (1A) social support and (1B) reported experiences, with the subclusters (a) psychosocial challenges and (b) grief. Moreover, comparison between the 2 groups (entanglement coefficient=0.28) showed that they shared a common cluster labeled uncertainty. Regarding emotion and sentiment analysis, patients expressed a significantly higher negative sentiment than caregivers (z=?2.14; P<.001). On the contrary, caregivers expressed a higher positive sentiment compared with patients (z=?2.26; P<.001), with trust (z=?4.12; P<.001) and joy (z=?2.03; P<.001) being the most prevalent positive emotions. Conclusions: Our study emphasized different perceptions of cancer pain in patients and caregivers. We revealed different needs and emotional activations in the 2 groups. Moreover, our study findings highlight the importance of considering caregivers in medical care. Overall, this study increases knowledge about the unmet needs and emotions of patients and caregivers, which may have important clinical implications in pain management. ",
doi="10.2196/41594",
url="https://cancer.jmir.org/2023/1/e41594",
url="http://www.ncbi.nlm.nih.gov/pubmed/37399067"
}


@Article{info:doi/10.2196/45455,
author="Yu, Yushuai
and Xu, Zelin
and Shao, Tinglei
and Huang, Kaiyan
and Chen, Ruiliang
and Yu, Xiaoqin
and Zhang, Jie
and Han, Hui
and Song, Chuangui",
title="Epidemiology and a Predictive Model of Prognosis Index Based on Machine Learning in Primary Breast Lymphoma: Population-Based Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Jun",
day="8",
volume="9",
pages="e45455",
keywords="primary breast lymphoma",
keywords="epidemiology",
keywords="prognosis",
keywords="machine learning",
keywords="disparities",
abstract="Background: Primary breast lymphoma (PBL) is a rare disease whose epidemiological features, treatment principles, and factors used for the patients' prognosis remain controversial. Objective: The aim of this study was to explore the epidemiology of PBL and to develop a better model based on machine learning to predict the prognosis for patients with primary breast lymphoma. Methods: The annual incidence of PBL was extracted from the surveillance, epidemiology, and end results database between 1975 and 2019 to examine disease occurrence trends using Joinpoint software (version 4.9; National Cancer Institute). We enrolled data from 1251 female patients with primary breast lymphoma from the surveillance, epidemiology, and end results database for survival analysis. Univariable and multivariable analyses were performed to explore independent prognostic factors for overall survival and disease-specific survival of patients with primary breast lymphoma. Eight machine learning algorithms were developed to predict the 5-year survival of patients with primary breast lymphoma. Results: The overall incidence of PBL increased drastically between 1975 and 2004, followed by a significant downward trend in incidence around 2004, with an average annual percent change (AAPC) of ?0.8 (95\% CI ?1.1 to ?0.6). Disparities in trends of PBL exist by age and race. The AAPC of the 65 years or older cohort was about 1.2 higher than that for the younger than 65 years cohort. The AAPC of White patients is 0.9 (95\% CI 0.0-1.8), while that of Black patients was significantly higher at 2.1 (95\% CI ?2.5 to 6.9). We also identified that the risk of death from PBL is multifactorial and includes patient factors and treatment factors. Survival analysis revealed that the patients diagnosed between 2007 and 2015 had a significant risk reduction of mortality compared to those diagnosed between 1983 and 1990. The gradient booster model outperforms other models, with 0.752 for sensitivity and 0.817 for area under the curve. The important features established with the gradient booster model were the year of diagnosis, age, histologic type, and primary site, which were the 4 most relevant variables to explain 5-year survival status. Conclusions: The incidence of PBL started demonstrating a tendency to decrease after 2004, which varied by age and race. In recent years, the prognosis of patients with primary breast lymphoma has been remarkably improved. The gradient booster model had a promising performance. This model can help clinicians identify the early prognosis of patients with primary breast lymphoma and therefore improve the clinical outcome by changing management strategies and patient health care. ",
doi="10.2196/45455",
url="https://publichealth.jmir.org/2023/1/e45455",
url="http://www.ncbi.nlm.nih.gov/pubmed/37169516"
}


@Article{info:doi/10.2196/39105,
author="Tan, Ying Si
and Tang, Sun Matilda Swee
and Ong, Johnny Chin-Ann
and Tan, Mien Veronique Kiak
and Shannon, Brian Nicholas",
title="Impact of COVID-19 on Public Interest in Breast Cancer Screening and Related Symptoms: Google Trends Analysis",
journal="JMIR Cancer",
year="2023",
month="Jun",
day="6",
volume="9",
pages="e39105",
keywords="breast cancer screening",
keywords="breast cancer symptoms",
keywords="COVID-19",
keywords="public interest",
keywords="Google Trends",
keywords="screening",
keywords="breast cancer",
keywords="symptoms",
keywords="cancer",
keywords="trend",
keywords="mammography",
keywords="monitoring",
abstract="Background: The COVID-19 pandemic has led to a decrease in cancer screening due to the redeployment of health care resources and public avoidance of health care facilities. Breast cancer is the most common cancer diagnosed in female individuals, with improved survival rates from early detection. An avoidance of screening, resulting in late detection, greatly affects survival and increases health care resource burden and costs. Objective: This study aimed to evaluate if a sustained decrease in public interest in screening occurred and to evaluate other search terms, and hence interest, associated with that. Methods: This study used Google Trends to analyze public interest in breast cancer screening and symptoms. We queried search data for 4 keyword terms (``mammogram,'' ``breast pain,'' ``breast lump,'' and ``nipple discharge'') from January 1, 2019, to January 1, 2022. The relative search frequency metric was used to assess interest in these terms, and related queries were retrieved for each keyword to evaluate trends in search patterns. Results: Despite an initial drastic drop in interest in mammography from March to April 2020, this quickly recovered by July 2020. After this period, alongside the recovery of interest in screening, there was a rapid increase in interest for arranging for mammography. Relative search frequencies of perceived breast cancer--related symptoms such as breast lump, nipple discharge, and breast pain remained stable. There was increase public interest in natural and alternative therapy of breast lumps despite the recovery of interest in mammography and breast biopsy. There was a significant correlation between search activity and Breast Cancer Awareness Month in October. Conclusions: Online search interest in breast cancer screening experienced a sharp decline at the beginning of the COVID-19 pandemic, with a subsequent return to baseline interest in arranging for mammography followed this short period of decreased interest. ",
doi="10.2196/39105",
url="https://cancer.jmir.org/2023/1/e39105",
url="http://www.ncbi.nlm.nih.gov/pubmed/37163461"
}


@Article{info:doi/10.2196/45408,
author="Lam, Sing Chun
and Zhou, Keary
and Loong, Ho-Fung Herbert
and Chung, Chi-Ho Vincent
and Ngan, Chun-Kit
and Cheung, Ting Yin",
title="The Use of Traditional, Complementary, and Integrative Medicine in Cancer: Data-Mining Study of 1 Million Web-Based Posts From Health Forums and Social Media Platforms",
journal="J Med Internet Res",
year="2023",
month="Apr",
day="21",
volume="25",
pages="e45408",
keywords="traditional",
keywords="complementary",
keywords="integrative",
keywords="social media",
keywords="cancer",
keywords="forums, digital health",
keywords="traditional, complementary, and integrative medicine",
keywords="TCIM",
keywords="perceptions",
keywords="machine learning",
keywords="cancer care",
abstract="Background: Patients with cancer are increasingly using forums and social media platforms to access health information and share their experiences, particularly in the use of traditional, complementary, and integrative medicine (TCIM). Despite the popularity of TCIM among patients with cancer, few related studies have used data from these web-based sources to explore the use of TCIM among patients with cancer. Objective: This study leveraged multiple forums and social media platforms to explore patients' use, interest, and perception of TCIM for cancer care. Methods: Posts (in English) related to TCIM were collected from Facebook, Twitter, Reddit, and 16 health forums from inception until February 2022. Both manual assessments and natural language processing were performed. Descriptive analyses were performed to explore the most commonly discussed TCIM modalities for each symptom and cancer type. Sentiment analyses were performed to measure the polarity of each post or comment, and themes were identified from posts with positive and negative sentiments. TCIM modalities that are emerging or recommended in the guidelines were identified a priori. Exploratory topic-modeling analyses with latent Dirichlet allocation were conducted to investigate the patients' perceptions of these modalities. Results: Among the 1,620,755 posts available, cancer-related symptoms, such as pain (10/10, 100\% cancer types), anxiety and depression (9/10, 90\%), and poor sleep (9/10, 90\%), were commonly discussed. Cannabis was among the most frequently discussed TCIM modalities for pain in 7 (70\%) out of 10 cancer types, as well as nausea and vomiting, loss of appetite, anxiety and depression, and poor sleep. A total of 7 positive and 7 negative themes were also identified. The positive themes included TCIM, making symptoms manageable, and reducing the need for medication and their side effects. The belief that TCIM and conventional treatments were not mutually exclusive and intolerance to conventional treatment may facilitate TCIM use. Conversely, TCIM was viewed as leading to patients' refusal of conventional treatment or delays in diagnosis and treatment. Doctors' ignorance regarding TCIM and the lack of information provided about TCIM may be barriers to its use. Exploratory analyses showed that TCIM recommendations were well discussed among patients; however, these modalities were also used for many other indications. Other notable topics included concerns about the legalization of cannabis, acupressure techniques, and positive experiences of meditation. Conclusions: Using machine learning techniques, social media and health forums provide a valuable resource for patient-generated data regarding the pattern of use and patients' perceptions of TCIM. Such information will help clarify patients' needs and concerns and provide directions for research on integrating TCIM into cancer care. Our results also suggest that effective communication about TCIM should be achieved and that doctors should be more open-minded to actively discuss TCIM use with their patients. ",
doi="10.2196/45408",
url="https://www.jmir.org/2023/1/e45408",
url="http://www.ncbi.nlm.nih.gov/pubmed/37083752"
}


@Article{info:doi/10.2196/43126,
author="Chen, T. Annie
and Huey, Jennifer
and Coe, Sandra
and Kaganovsky, Jailanie
and Malouf, A. Emily
and Evans, D. Heather
and Daker, Jill
and Harper, Elizabeth
and Fordiani, Olivia
and Lowe, E. Emma
and Oldroyd, McGraw Caileigh
and Price, Ashlyn
and Roth, Kristlynn
and Stoddard, Julie
and Crandell, N. Jill
and Shirts, H. Brian",
title="Extended Family Outreach in Hereditary Cancer Using Web-Based Genealogy, Direct-to-Consumer Ancestry Genetics, and Social Media: Mixed Methods Process Evaluation of the ConnectMyVariant Intervention",
journal="JMIR Cancer",
year="2023",
month="Apr",
day="20",
volume="9",
pages="e43126",
keywords="familial cancer",
keywords="hereditary cancer",
keywords="family history",
keywords="pedigree building",
keywords="cascade screening",
keywords="distant relatives",
keywords="breast cancer",
keywords="BRCA1",
keywords="BRCA2",
keywords="partner and localizer of BRCA2",
keywords="PALB2",
keywords="Facebook",
keywords="patient advocacy",
abstract="Background: Cascade screening, defined as helping at-risk relatives get targeted genetic testing of familial variants for dominant hereditary cancer syndromes, is a proven component of cancer prevention; however, its uptake is low. We developed and conducted a pilot study of the ConnectMyVariant intervention, in which participants received support to contact at-risk relatives that extended beyond first-degree relatives and encourage relatives to obtain genetic testing and connect with others having the same variant through email and social media. The support that participants received included listening to participants' needs, assisting with documentary genealogy to find common ancestors, facilitating direct-to-consumer DNA testing and interpretation, and assisting with database searches. Objective: We aimed to assess intervention feasibility, motivations for participating, and engagement among ConnectMyVariant participants and their families. Methods: We used a mixed methods design including both quantitative and qualitative evaluation methods. First, we considered intervention feasibility by characterizing recruitment and retention using multiple recruitment mechanisms, including web-based advertising, dissemination of invitations with positive test results, provider recruitment, snowball sampling, and recruitment through web-based social networks and research studies. Second, we characterized participants' motivations, concerns, and engagement through project documentation of participant engagement in outreach activities and qualitative analysis of participant communications. We used an inductive qualitative data analysis approach to analyze emails, free-text notes, and other communications generated with participants as part of the ConnectMyVariant intervention. Results: We identified 84 prospective participants using different recruitment mechanisms; 57 participants were ultimately enrolled in the study for varying lengths of time. With respect to motivations for engaging in the intervention, participants were most interested in activities relating to genealogy and communication with others who had their specific variants. Although there was a desire to find others with the same variant and prevent cancer, more participants expressed an interest in learning about their genealogy and family health history, with prevention in relatives considered a natural side effect of outreach. Concerns about participation included whether relatives would be open to communication, how to go about it, and whether others with a specific variant would be motivated to help find common ancestors. We observed that ConnectMyVariant participants engaged in 6 primary activities to identify and communicate with at-risk relatives: sharing family history, family member testing, direct-to-consumer genealogy genetic testing analysis, contacting (distant) relatives, documentary genealogy, and expanding variant groups or outreach. Participants who connected with others who had the same variant were more likely to engage with several extended family outreach activities. Conclusions: This study demonstrated that there is an interest in extended family outreach as a mechanism to improve cascade screening for hereditary cancer prevention. Additional research to systematically evaluate the outcomes of such outreach may be challenging but is warranted. ",
doi="10.2196/43126",
url="https://cancer.jmir.org/2023/1/e43126",
url="http://www.ncbi.nlm.nih.gov/pubmed/37079361"
}


@Article{info:doi/10.2196/43609,
author="Bui, Tam Kim
and Li, Zoe
and Dhillon, M. Haryana
and Kiely, E. Belinda
and Blinman, Prunella",
title="Scanxiety Conversations on Twitter: Observational Study",
journal="JMIR Cancer",
year="2023",
month="Apr",
day="19",
volume="9",
pages="e43609",
keywords="anxiety",
keywords="cancer",
keywords="medical imaging",
keywords="oncology",
keywords="psycho-oncology",
keywords="social media",
keywords="twitter",
keywords="tweet",
keywords="scanxiety",
keywords="mental health",
keywords="sentiment analysis",
keywords="thematic analysis",
keywords="screen time",
keywords="scan",
keywords="hyperawareness",
keywords="radiology",
abstract="Background: Scan-associated anxiety (or ``scanxiety'') is commonly experienced by people having cancer-related scans. Social media platforms such as Twitter provide a novel source of data for observational research. Objective: We aimed to identify posts on Twitter (or ``tweets'') related to scanxiety, describe the volume and content of these tweets, and describe the demographics of users posting about scanxiety. Methods: We manually searched for ``scanxiety'' and associated keywords in cancer-related, publicly available, English-language tweets posted between January 2018 and December 2020. We defined ``conversations'' as a primary tweet (the first tweet about scanxiety) and subsequent tweets (interactions stemming from the primary tweet). User demographics and the volume of primary tweets were assessed. Conversations underwent inductive thematic and content analysis. Results: A total of 2031 unique Twitter users initiated a conversation about scanxiety from cancer-related scans. Most were patients (n=1306, 64\%), female (n=1343, 66\%), from North America (n=1130, 56\%), and had breast cancer (449/1306, 34\%). There were 3623 Twitter conversations, with a mean of 101 per month (range 40-180). Five themes were identified. The first theme was experiences of scanxiety, identified in 60\% (2184/3623) of primary tweets, which captured the personal account of scanxiety by patients or their support person. Scanxiety was often described with negative adjectives or similes, despite being experienced differently by users. Scanxiety had psychological, physical, and functional impacts. Contributing factors to scanxiety included the presence and duration of uncertainty, which was exacerbated during the COVID-19 pandemic. The second theme (643/3623, 18\%) was the acknowledgment of scanxiety, where users summarized or labeled an experience as scanxiety without providing emotive clarification, and advocacy of scanxiety, where users raised awareness of scanxiety without describing personal experiences. The third theme was messages of support (427/3623, 12\%), where users expressed well wishes and encouraged positivity for people experiencing scanxiety. The fourth theme was strategies to reduce scanxiety (319/3623, 9\%), which included general and specific strategies for patients and strategies that required improvements in clinical practice by clinicians or health care systems. The final theme was research about scanxiety (50/3623, 1\%), which included tweets about the epidemiology, impact, and contributing factors of scanxiety as well as novel strategies to reduce scanxiety. Conclusions: Scanxiety was often a negative experience described by patients having cancer-related scans. Social media platforms like Twitter enable individuals to share their experiences and offer support while providing researchers with unique data to improve their understanding of a problem. Acknowledging scanxiety as a term and increasing awareness of scanxiety is an important first step in reducing scanxiety. Research is needed to guide evidence-based approaches to reduce scanxiety, though some low-cost, low-resource practical strategies identified in this study could be rapidly introduced into clinical care. ",
doi="10.2196/43609",
url="https://cancer.jmir.org/2023/1/e43609",
url="http://www.ncbi.nlm.nih.gov/pubmed/37074770"
}


@Article{info:doi/10.2196/37141,
author="Dolan, H. Elizabeth
and Goulding, James
and Tata, J. Laila
and Lang, R. Alexandra",
title="Using Shopping Data to Improve the Diagnosis of Ovarian Cancer: Computational Analysis of a Web-Based Survey",
journal="JMIR Cancer",
year="2023",
month="Mar",
day="31",
volume="9",
pages="e37141",
keywords="carcinoma",
keywords="ovarian epithelial",
keywords="ovarian neoplasms",
keywords="self-medication",
keywords="diagnostic errors",
keywords="symptom assessment",
keywords="machine learning",
keywords="nonprescription drugs",
keywords="over-the-counter",
keywords="pharmaceutical",
keywords="symptom",
keywords="ovary",
keywords="ovarian cancer",
keywords="oncology",
keywords="cancer",
abstract="Background: Shopping data can be analyzed using machine learning techniques to study population health. It is unknown if the use of such methods can successfully investigate prediagnosis purchases linked to self-medication of symptoms of ovarian cancer. Objective: The aims of this study were to gain new domain knowledge from women's experiences, understand how women's shopping behavior relates to their pathway to the diagnosis of ovarian cancer, and inform research on computational analysis of shopping data for population health. Methods: A web-based survey on individuals' shopping patterns prior to an ovarian cancer diagnosis was analyzed to identify key knowledge about health care purchases. Logistic regression and random forest models were employed to statistically examine how products linked to potential symptoms related to presentation to health care and timing of diagnosis. Results: Of the 101 women surveyed with ovarian cancer, 58.4\% (59/101) bought nonprescription health care products for up to more than a year prior to diagnosis, including pain relief and abdominal products. General practitioner advice was the primary reason for the purchases (23/59, 39\%), with 51\% (30/59) occurring due to a participant's doctor believing their health problems were due to a condition other than ovarian cancer. Associations were shown between purchases made because a participant's doctor believing their health problems were due to a condition other than ovarian cancer and the following variables: health problems for longer than a year prior to diagnosis (odds ratio [OR] 7.33, 95\% CI 1.58-33.97), buying health care products for more than 6 months to a year (OR 3.82, 95\% CI 1.04-13.98) or for more than a year (OR 7.64, 95\% CI 1.38-42.33), and the number of health care product types purchased (OR 1.54, 95\% CI 1.13-2.11). Purchasing patterns are shown to be potentially predictive of a participant's doctor thinking their health problems were due to some condition other than ovarian cancer, with nested cross-validation of random forest classification models achieving an overall in-sample accuracy score of 89.1\% and an out-of-sample score of 70.1\%. Conclusions: Women in the survey were 7 times more likely to have had a duration of more than a year of health problems prior to a diagnosis of ovarian cancer if they were self-medicating based on advice from a doctor rather than having made the decision to self-medicate independently. Predictive modelling indicates that women in such situations, who are self-medicating because their doctor believes their health problems may be due to a condition other than ovarian cancer, exhibit distinct shopping behaviors that may be identifiable within purchasing data. Through exploratory research combining women sharing their behaviors prior to diagnosis and computational analysis of these data, this study demonstrates that women's shopping data could potentially be useful for early ovarian cancer detection. ",
doi="10.2196/37141",
url="https://cancer.jmir.org/2023/1/e37141",
url="http://www.ncbi.nlm.nih.gov/pubmed/37000495"
}


@Article{info:doi/10.2196/44105,
author="Kang, Danbee
and Kim, Sooyeon
and Kim, Hyunsoo
and Lee, Mangyeong
and Kong, Sun-Young
and Chang, Jung Yoon
and Sim, Hoon Sung
and Kim, Yeon-Joo
and Cho, Juhee",
title="Surveillance of Symptom Burden Using the Patient-Reported Outcome Version of the Common Terminology Criteria for Adverse Events in Patients With Various Types of Cancers During Chemoradiation Therapy: Real-World Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Mar",
day="8",
volume="9",
pages="e44105",
keywords="surveillance",
keywords="patient-reported outcome",
keywords="symptoms",
keywords="cancer",
abstract="Background: Over 90\% of patients with cancer experience 1 or more symptoms caused directly by cancer or its treatment. These symptoms negatively impact on the completion of planned treatment as well as patients' health-related quality of life (HRQoL). It often results in serious complications and even life-threatening outcomes. Thus, it has been recommended that surveillance of symptom burden should be performed and managed during cancer treatment. However, differences in symptom profiles in various patients with cancer have not been fully elucidated for use in performing surveillance in the real world. Objective: This study aims to evaluate the burden of symptoms in patients with various types of cancers during chemotherapy or radiation therapy using the PRO-CTCAE (Patient-Reported Outcome Version of the Common Terminology Criteria for Adverse Events) and its impact on quality of life. Methods: We performed a cross-sectional study of patients undergoing outpatient-based chemotherapy, radiation therapy, or both at the National Cancer Center at Goyang or at the Samsung Medical Center in Seoul, Korea between December 2017 and January 2018. To evaluate cancer-specific symptom burden, we developed 10 subsets for using the PRO-CTCAE-Korean. To measure HRQoL, we used the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Participants answered questions prior to their clinic appointments on tablets. Multivariable linear regression was used to analyze symptoms based on cancer type and to evaluate the association between the PRO-CTCAE items and the EORTC QLQ-C30 summary score. Results: The mean age (SD) of the patients was 55.0 (11.9) years, and 39.94\% (540/1352) were male. Overall, symptoms in the gastrointestinal category were the most dominant in all cancers. Fatigue (1034/1352, 76.48\%), decreased appetite (884/1352, 65.38\%), and numbness and tingling (778/1352, 57.54\%) were the most frequently reported. Patients reported more local symptoms caused by a specific cancer. In terms of nonsite-specific symptoms, patients commonly reported concentration (587/1352, 43.42\%), anxiety (647/1352, 47.86\%), and general pain (605/1352, 44.75\%). More than 50\% of patients with colorectal (69/127, 54.3\%), gynecologic (63/112, 56.3\%), breast (252/411, 61.3\%), and lung cancers (121/234, 51.7\%) experienced decreased libido, whereas 67/112 (59.8\%) patients with gynecologic cancer and lymphoma/myeloma reported pain during sexual intercourse. Patients with breast, gastric, and liver cancers were more likely to have the hand-foot syndrome. Worsening PRO-CTCAE scores were associated with poor HRQoL (eg, fatigue: coefficient --8.15; 95\% CI --9.32 to --6.97), difficulty in achieving and maintaining erection (coefficient --8.07; 95\% CI --14.52 to --1.61), poor concentration (coefficient --7.54; 95\% CI --9.06 to --6.01), and dizziness (coefficient --7.24; 95\% CI --8.92 to --5.55). Conclusions: The frequency and severity of symptoms differed by cancer types. Higher symptom burden was associated with poor HRQoL, which suggests the importance of appropriate surveillance of PRO symptoms during cancer treatment. Considering patients had comprehensive symptoms, it is necessary to include a holistic approach in the symptom monitoring and management strategies based on comprehensive patient-reported outcome measurements. ",
doi="10.2196/44105",
url="https://publichealth.jmir.org/2023/1/e44105",
url="http://www.ncbi.nlm.nih.gov/pubmed/36884274"
}


@Article{info:doi/10.2196/43967,
author="Wu, Wenqiong
and Wang, Jing
and Liao, Xian-zhen
and Xu, Kekui
and Zou, Yanhua
and Shi, Zhaohui
and Hu, Yingyun
and Xiao, Haifan
and Li, Can
and Cao, Shiyu
and Wang, Shiyu
and Guo, Jia
and Luo, Zhicheng
and Liu, Mengjiao
and Xu, Mengyao
and Jin, Donghui
and Chen, Mengshi
and Fu, Zhongxi
and Yan, Shipeng",
title="Projection of Premature Cancer Mortality in Hunan, China, Through 2030: Modeling Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Mar",
day="6",
volume="9",
pages="e43967",
keywords="cancer",
keywords="forecasting",
keywords="premature mortality",
keywords="risk factors",
keywords="Sustainable Development Goals",
abstract="Background: The United Nations Sustainable Development Goals for 2030 include reducing premature mortality from noncommunicable diseases by one-third. Although previous modeling studies have predicted premature mortality from noncommunicable diseases, the predictions for cancer and its subcategories are less well understood in China. Objective: The aim of this study was to project premature cancer mortality of 10 leading cancers in Hunan Province, China, based on various scenarios of risk factor control so as to establish the priority for future interventions. Methods: We used data collected between 2009 and 2017 from the Hunan cancer registry annual report as empirical data for projections. The population-attributable fraction was used to disaggregate cancer deaths into parts attributable and unattributable to 10 risk factors: smoking, alcohol use, high BMI, diabetes, physical inactivity, low vegetable and fruit intake, high red meat intake, high salt intake, and high ambient fine particulate matter (PM2.5) levels. The unattributable deaths and the risk factors in the baseline scenario were projected using the proportional change model, assuming constant annual change rates through 2030. The comparative risk assessment theory was used in simulated scenarios to reflect how premature mortality would be affected if the targets for risk factor control were achieved by 2030. Results: The cancer burden in Hunan significantly increased during 2009-2017. If current trends for each risk factor continued to 2030, the total premature deaths from cancers in 2030 would increase to 97,787 in Hunan Province, and the premature mortality (9.74\%) would be 44.47\% higher than that in 2013 (6.74\%). In the combined scenario where all risk factor control targets were achieved, 14.41\% of premature cancer mortality among those aged 30-70 years would be avoided compared with the business-as-usual scenario in 2030. Reductions in the prevalence of diabetes, high BMI, ambient PM2.5 levels, and insufficient fruit intake played relatively important roles in decreasing cancer premature mortality. However, the one-third reduction goal would not be achieved for most cancers except gastric cancer. Conclusions: Existing targets on cancer-related risk factors may have important roles in cancer prevention and control. However, they are not sufficient to achieve the one-third reduction goal in premature cancer mortality in Hunan Province. More aggressive risk control targets should be adopted based on local conditions. ",
doi="10.2196/43967",
url="https://publichealth.jmir.org/2023/1/e43967",
url="http://www.ncbi.nlm.nih.gov/pubmed/36877566"
}


@Article{info:doi/10.2196/43651,
author="Luo, Ganfeng
and Zhang, Yanting
and Etxeberria, Jaione
and Arnold, Melina
and Cai, Xiuyu
and Hao, Yuantao
and Zou, Huachun",
title="Projections of Lung Cancer Incidence by 2035 in 40 Countries Worldwide: Population-Based Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Feb",
day="17",
volume="9",
pages="e43651",
keywords="lung cancer",
keywords="incidence",
keywords="projections",
keywords="temporal trends",
keywords="worldwide",
abstract="Background: The global burden of lung cancer (LC) is increasing. Quantitative projections of the future LC burden in different world regions could help optimize the allocation of resources and provide a benchmark for evaluating LC prevention and control interventions. Objective: We aimed to predict the future incidence of LC in 40 countries by 2035, with an emphasis on country- and sex-specific disparities. Methods: Data on LC incidence from 1978 to 2012 were extracted from 126 cancer registries of 40 countries in Cancer Incidence in Five Continents Volumes V-XI and used for the projection. Age-standardized incidence rates (ASRs) per 100,000 person-years and the number of incident cases were predicted through 2035, using the NORDPRED age-period-cohort model. Results: Global ASRs of the 40 studied countries were predicted to decrease by 23\% (8.2/35.8) among males, from 35.8 per 100,000 person-years in 2010 to 27.6 in 2035, and increase by 2\% (0.3/16.8) among females, from 16.8 in 2010 to 17.1 in 2035. The ASRs of LC among females are projected to continue increasing dramatically in most countries by 2035, with peaks after the 2020s in most European, Eastern Asian, and Oceanian countries, whereas the ASRs among males will continue to decline in almost all countries. The ASRs among females are predicted to almost reach those among males in Ireland, Norway, the United Kingdom, the Netherlands, Canada, the United States, and New Zealand in 2025 and in Slovenia in 2035 and even surpass those among males in Denmark in 2020 and in Brazil and Colombia in 2025. In 2035, the highest ASRs are projected to occur among males in Belarus (49.3) and among females in Denmark (36.8). The number of new cases in 40 countries is predicted to increase by 65.32\% (858,000/1,314,000), from 1.31 million in 2010 to 2.17 million in 2035. China will have the largest number of new cases. Conclusions: LC incidence is expected to continue to increase through 2035 in most countries, making LC a major public health challenge worldwide. The ongoing transition in the epidemiology of LC highlights the need for resource redistribution and improved LC control measures to reduce future LC burden worldwide. ",
doi="10.2196/43651",
url="https://publichealth.jmir.org/2023/1/e43651",
url="http://www.ncbi.nlm.nih.gov/pubmed/36800235"
}


@Article{info:doi/10.2196/41762,
author="Brewer, R. Hannah
and Hirst, Yasemin
and Chadeau-Hyam, Marc
and Johnson, Eric
and Sundar, Sudha
and Flanagan, M. James",
title="Association Between Purchase of Over-the-Counter Medications and Ovarian Cancer Diagnosis in the Cancer Loyalty Card Study (CLOCS): Observational Case-Control Study",
journal="JMIR Public Health Surveill",
year="2023",
month="Jan",
day="26",
volume="9",
pages="e41762",
keywords="ovarian cancer",
keywords="early diagnosis",
keywords="transactional data",
keywords="health informatics",
keywords="cancer risk",
keywords="medication",
keywords="self-medication",
keywords="self-care",
keywords="over-the-counter medication",
keywords="nonspecific symptoms",
keywords="pain medication",
keywords="indigestion medication",
abstract="Background: Over-the-counter (OTC) medications are frequently used to self-care for nonspecific ovarian cancer symptoms prior to diagnosis. Monitoring such purchases may provide an opportunity for earlier diagnosis. Objective: The aim of the Cancer Loyalty Card Study (CLOCS) was to investigate purchases of OTC pain and indigestion medications prior to ovarian cancer diagnosis in women with and without ovarian cancer in the United Kingdom using loyalty card data. Methods: An observational case-control study was performed comparing purchases of OTC pain and indigestion medications prior to diagnosis in women with (n=153) and without (n=120) ovarian cancer using loyalty card data from two UK-based high street retailers. Monthly purchases of pain and indigestion medications for cases and controls were compared using the Fisher exact test, conditional logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: Pain and indigestion medication purchases were increased among cases 8 months before diagnosis, with maximum discrimination between cases and controls 8 months before diagnosis (Fisher exact odds ratio [OR] 2.9, 95\% CI 2.1-4.1).  An increase in indigestion medication purchases was detected up to 9 months before diagnosis (adjusted conditional logistic regression OR 1.38, 95\% CI 1.04-1.83). The ROC analysis for indigestion medication purchases showed a maximum area under the curve (AUC) at 13 months before diagnosis (AUC=0.65, 95\% CI 0.57-0.73), which further improved when stratified to late-stage ovarian cancer (AUC=0.68, 95\% CI 0.59-0.78). Conclusions: There is a difference in purchases of pain and indigestion medications among women with and without ovarian cancer up to 8 months before diagnosis. Facilitating earlier presentation among those who self-care for symptoms using this novel data source could improve ovarian cancer patients' options for treatment and improve survival. Trial Registration: ClinicalTrials.gov NCT03994653; https://clinicaltrials.gov/ct2/show/NCT03994653 ",
doi="10.2196/41762",
url="https://publichealth.jmir.org/2023/1/e41762",
url="http://www.ncbi.nlm.nih.gov/pubmed/36701184"
}


@Article{info:doi/10.2196/40657,
author="Yuan, Ruixia
and Ren, Fang
and Xie, Yingying
and Li, Kaixiang
and Tong, Zhuang",
title="The Global, Regional, and National Burdens of Cervical Cancer Attributable to Smoking From 1990 to 2019: Population-Based Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Dec",
day="23",
volume="8",
number="12",
pages="e40657",
keywords="global burden of disease",
keywords="cervical cancer",
keywords="smoking women",
keywords="time trends",
abstract="Background: Cervical cancer is the fourth most common cause of cancer death in women worldwide. Smoking is one of the risk factors for cervical cancer. Understanding the global distribution of the disease burden of cervical cancer attributable to smoking and related changes is of clear significance for the prevention and control of cervical cancer in key populations and for tobacco control. As far as we know, research on the burden of cervical cancer attributable to smoking is lacking. Objective: We estimated the disease burden and mortality of cervical cancer attributable to smoking and related trends over time at the global, regional, and national levels. Methods: Data were obtained from the Global Burden of Disease study website. Age-standardized rates were used to facilitate comparisons of mortality and disability-adjusted life years (DALYs) at different levels. The estimated annual percentage change (EAPC) was used to assess trends in the age-standardized mortality rate (ASMR) and the age-standardized DALY rate (ASDR). A Pearson correlation analysis was used to evaluate correlations between the sociodemographic index and the age-standardized rates. Results: In 2019, there were 30,136.65 (95\% uncertainty interval [UI]: 14,945.09-49,639.87) cervical cancer--related deaths and 893,735.25 (95\% UI 469,201.51-1,440,050.85) cervical cancer--related DALYs attributable to smoking. From 1990 to 2019, the global burden of cervical cancer attributable to smoking showed a decreasing trend around the world; the EAPCs for ASMR and ASDR were --2.11 (95\% CI --2.16 to --2.06) and --2.22 (95\% CI --2.26 to --2.18), respectively. In terms of age characteristics, in 2019, an upward trend was observed for age in the mortality of cervical cancer attributable to smoking. Analysis of the trend in DALYs with age revealed an initially increasing and then decreasing trend. From 1990 to 2019, the burden of disease in different age groups showed a downward trend. Among 204 countries, 180 countries showed downward trends, 10 countries showed upward trends, and the burden was stable in 14 countries. The Pearson correlation analysis revealed a significant negative correlation between sociodemographic index and the age-standardized rates of cervical cancer attributable to smoking ($\rho$=--0.228, P<.001 for ASMR and $\rho$=--0.223, P<.001 for ASDR). Conclusions: An increase over time in the absolute number of cervical cancer deaths and DALYs attributable to smoking and a decrease over time in the ASMR and ASDR for cervical cancer attributable to smoking were observed in the overall population, and differences in these variables were also observed between countries and regions. More attention should be paid to cervical cancer prevention and screening in women who smoke, especially in low- and middle-income countries. ",
doi="10.2196/40657",
url="https://publichealth.jmir.org/2022/12/e40657",
url="http://www.ncbi.nlm.nih.gov/pubmed/36563035"
}


@Article{info:doi/10.2196/42245,
author="Basch, H. Corey
and Hillyer, C. Grace
and Yalamanchili, Bhavya
and Morris, Aldean",
title="How TikTok Is Being Used to Help Individuals Cope With Breast Cancer: Cross-sectional Content Analysis",
journal="JMIR Cancer",
year="2022",
month="Dec",
day="6",
volume="8",
number="4",
pages="e42245",
keywords="TikTok",
keywords="breast cancer",
keywords="social media",
keywords="short video apps",
keywords="social support",
keywords="content analysis",
keywords="video",
keywords="patient support",
keywords="medical information",
keywords="health information",
keywords="peer support",
keywords="online conversation",
keywords="online health information",
abstract="Background: Acknowledging the popularity of TikTok, how quickly medical information can spread, and how users seek support on social media, there is a clear lack of research on breast cancer conversations on TikTok. There is a paucity of information on how these videos can advocate for those impacted by breast cancer as a means to provide support and information as well as raise awareness. Objective: The purpose of this cross-sectional content analysis was to describe the content of videos from the hashtag \#breastcancer on TikTok. Content related to breast cancer support and coping, cancer education, and heightening the awareness of breast cancer early detection, prevention, and treatment was evaluated. Methods: This study included 100 of the most viewed TikTok videos related to breast cancer through June 30, 2022. Videos were excluded if they were not in the English language or relevant to the topic being studied. Content was deductively coded into categories related to video characteristics and content topics using a screener based on expert breast cancer information sheets. Univariable analyses were conducted to evaluate differences in video characteristics and content when stratified as advocating or not advocating for breast cancer (yes or no) support, education, and awareness. Results: The cumulative number of views of the videos included in this study was 369,504,590. The majority (n=81, 81\%) of videos were created by patients and loved ones of individuals with breast cancer, and the most commonly discussed topic was breast cancer support (n=88, 88\%), followed by coping with the myriad issues surrounding breast cancer (n=79, 79\%). Overall, <50\% of the videos addressed important issues such as body image (n=48, 48\%), surgery (n=46, 46\%), medication and therapy (n=41, 41\%), or the stigma associated with a breast cancer diagnosis (n=44, 44\%); however, in videos that were advocacy oriented, body image (40/62, 64\% vs 8/38, 21\%; P<.001), stigma associated with breast cancer (33/62, 53\% vs 11/38, 29\%; P=.02), and breast cancer surgery (36/62, 58\% vs 10/38, 26\%; P=.002) were discussed significantly more often than in videos that did not specifically advocate for breast cancer. Conclusions: The use of videos to display health journeys can facilitate engagement by patients, family members, and loved ones interested in information about challenging conditions. Collectively, these findings highlight the level of peer-to-peer involvement on TikTok and may provide insights for designing breast cancer educational campaigns. ",
doi="10.2196/42245",
url="https://cancer.jmir.org/2022/4/e42245",
url="http://www.ncbi.nlm.nih.gov/pubmed/36472899"
}


@Article{info:doi/10.2196/40386,
author="Wang, Jun
and Zhou, Juan
and Liu, Lei
and Wu, San-Gang",
title="Stage-Specific Survival in Breast Cancer in Chinese and White Women: Comparative Data Analysis",
journal="JMIR Public Health Surveill",
year="2022",
month="Nov",
day="15",
volume="8",
number="11",
pages="e40386",
keywords="breast cancer",
keywords="AJCC",
keywords="American Joint Committee on Cancer",
keywords="Chinese",
keywords="White American",
keywords="survival",
keywords="surveillance",
keywords="epidemiology",
keywords="staging",
keywords="pathological prognostic staging",
keywords="AJCC stage",
keywords="overall survival",
keywords="cancer-specific survival",
abstract="Background: Stage-specific survival, according to the eighth edition of the American Joint Committee on Cancer (AJCC) pathological prognostic staging (PPS) on breast cancer (BC), between Chinese and White American women remains unclear. Objective: This study aimed to assess stage-specific survival in BC between Chinese and White American women according to the eighth AJCC PPS. Methods: We included Chinese and White American women with BC diagnosed between 2010 and 2018 from the Surveillance, Epidemiology, and End Results database. A chi-square test, the Kaplan--Meier method, a receiver operating characteristic (ROC) curve, and multivariate Cox proportional hazards models were used for data analysis. Results: We included 376,818 individuals in this study: 369,522 White American and 7296 Chinese. Of them, 149,452 (39.7\%) migrated from the seventh AJCC anatomic staging (AS) to the eighth AJCC PPS, 22,516 (6.0\%) were upstaged, and 126,936 (33.7\%) were downstaged. With a median follow-up duration of 44 months, the 5-year overall survival and cancer-specific survival (CSS) for the entire group were 87.4\% and 95.9\%, respectively. The seventh AJCC AS (P<.001) and the eighth AJCC PPS (P<.001) could significantly predict the survival outcomes of BC, and multivariate analysis revealed that both staging systems were significant prognostic indicators of CSS. The ROC curve revealed that the PPS had a better discriminating ability than the AS (area under the curve [AUC] 0.769 vs 0.753, P<.001). Similar trends were observed after stratification by the 2 ethnic groups. The eighth AJCC PPS had better discriminating ability than the seventh AJCC AS among both White American (AUC 0.769 vs 0.753, P<.001) and Chinese patients (AUC 0.790 vs 0.776, P<.001). In the seventh AJCC AS, Chinese women had better CSS in stage IA (P=.02), stage IIA (P=.005), and stage IIIB (P=.04) disease than White American women, but no significant CSS was observed in stage IB, IIB, IIIA, and IIIC disease between the 2 ethnic groups. Regarding the eighth AJCC PPS, Chinese women had better CSS in stage IA (P=.002) and IIIA (P=.046) disease than White American women, and CSS was similar in Chinese and White American women in other substages. Conclusions: The eighth AJCC PPS has a similar discriminative ability between White American and Chinese individuals with BC compared with the seventh AJCC AS. Therefore, the eighth AJCC PPS is also applicable to Chinese individuals with BC. ",
doi="10.2196/40386",
url="https://publichealth.jmir.org/2022/11/e40386",
url="http://www.ncbi.nlm.nih.gov/pubmed/36378507"
}


@Article{info:doi/10.2196/36523,
author="Zeng, Qibing
and Yang, Jingyuan
and Wang, Ziyun
and Liu, Haiyan
and Wang, Junhua
and Yang, Tingting
and Hu, Jin
and Guan, Han
and Lu, Yun
and Liu, Huijuan
and Hong, Feng",
title="The Epidemiological Characteristics of Noncommunicable Diseases and Malignant Tumors in Guiyang, China: Cross-sectional Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Oct",
day="28",
volume="8",
number="10",
pages="e36523",
keywords="epidemiological characteristics",
keywords="noncommunicable diseases",
keywords="malignant tumors",
keywords="cross-sectional study",
keywords="Guiyang",
abstract="Background: Studies that address the changing characteristics of diseases are of great importance for preventing and controlling the occurrence and development of diseases and for improving health. However, studies of the epidemiological characteristics of noncommunicable diseases (NCDs) and malignant tumors (MTs) of the residents in Guiyang, China, are lacking. Objective: The aim of this study was to evaluate the prevalences of NCDs and MTs in residents of Guiyang, Guizhou Province, China, and analyze differences among ages, genders, and regions. Methods: A multistage stratified cluster sampling method was used. Based on the inclusion and exclusion criteria, 81,517 individuals were selected for the study. Of these, 77,381 (94.9\%) participants completed the study. Structured questionnaires were used to collect information on demographic characteristics, NCDs, and MTs. The chi-square test (with 95\% confidence intervals) was used to analyze differences in disease prevalence among genders, ages, and geographical regions. Results: The major chronic NCDs of Guiyang residents are obesity, hypertension, and diabetes. MTs in women are mostly breast cancer, cervical cancer, and endometrial cancer, whereas in men, MTs are mainly lung cancer, rectal cancer, and gastric cancer. The prevalences of hypertension and diabetes in women are higher than in men, but the prevalences of lung cancer and gastric cancer in men are higher than in women. The epidemiological characteristics of individuals in different life stages are dissimilar. In terms of regional distribution, the prevalences of the above diseases in the Baiyun and Yunyan districts of Guiyang are relatively high. Conclusions: Several NCDs (obesity, hypertension, and diabetes) and MTs (women: breast cancer, cervical cancer, and endometrial cancer; men: lung cancer, rectal cancer, and gastric cancer) should be the focus for the prevention and control of chronic diseases in the future. In particular, the Baiyun and Yunyan districts of Guiyang are the important regions to emphasize. ",
doi="10.2196/36523",
url="https://publichealth.jmir.org/2022/10/e36523",
url="http://www.ncbi.nlm.nih.gov/pubmed/36306160"
}


@Article{info:doi/10.2196/35310,
author="Valvi, Nimish
and Patel, Hetvee
and Bakoyannis, Giorgos
and Haggstrom, A. David
and Mohanty, Sanjay
and Dixon, E. Brian",
title="COVID-19 Diagnosis and Risk of Death Among Adults With Cancer in Indiana: Retrospective Cohort Study",
journal="JMIR Cancer",
year="2022",
month="Oct",
day="6",
volume="8",
number="4",
pages="e35310",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="coronavirus",
keywords="cancer",
keywords="survival",
keywords="mortality",
keywords="death",
keywords="oncology",
keywords="cancer experience",
keywords="outcome",
keywords="electronic health record",
keywords="EHR",
keywords="patient with cancer",
keywords="cancer population",
keywords="Kaplan-Meier",
keywords="Cox proportional hazards model",
keywords="hazard ratio",
keywords="risk",
abstract="Background: Prior studies, generally conducted at single centers with small sample sizes, found that individuals with cancer experience more severe outcomes due to COVID-19, caused by SARS-CoV-2 infection. Although early examinations revealed greater risk of severe outcomes for patients with cancer, the magnitude of the increased risk remains unclear. Furthermore, prior studies were not typically performed using population-level data, especially those in the United States. Given robust prevention measures (eg, vaccines) are available for populations, examining the increased risk of patients with cancer due to SARS-CoV-2 infection using robust population-level analyses of electronic medical records is warranted. Objective: The aim of this paper is to evaluate the association between SARS-CoV-2 infection and all-cause mortality among recently diagnosed adults with cancer. Methods: We conducted a retrospective cohort study of newly diagnosed adults with cancer between January 1, 2019, and December 31, 2020, using electronic health records linked to a statewide SARS-CoV-2 testing database. The primary outcome was all-cause mortality. We used the Kaplan-Meier estimator to estimate survival during the COVID-19 period (January 15, 2020, to December 31, 2020). We further modeled SARS-CoV-2 infection as a time-dependent exposure (immortal time bias) in a multivariable Cox proportional hazards model adjusting for clinical and demographic variables to estimate the hazard ratios (HRs) among newly diagnosed adults with cancer. Sensitivity analyses were conducted using the above methods among individuals with cancer-staging information. Results: During the study period, 41,924 adults were identified with newly diagnosed cancer, of which 2894 (6.9\%) tested positive for SARS-CoV-2. The population consisted of White (n=32,867, 78.4\%), Black (n=2671, 6.4\%), Hispanic (n=832, 2.0\%), and other (n=5554, 13.2\%) racial backgrounds, with both male (n=21,354, 50.9\%) and female (n=20,570, 49.1\%) individuals. In the COVID-19 period analysis, after adjusting for age, sex, race or ethnicity, comorbidities, cancer type, and region, the risk of death increased by 91\% (adjusted HR 1.91; 95\% CI 1.76-2.09) compared to the pre--COVID-19 period (January 1, 2019, to January 14, 2020) after adjusting for other covariates. In the adjusted time-dependent analysis, SARS-CoV-2 infection was associated with an increase in all-cause mortality (adjusted HR 6.91; 95\% CI 6.06-7.89). Mortality increased 2.5 times among adults aged 65 years and older (adjusted HR 2.74; 95\% CI 2.26-3.31) compared to adults 18-44 years old, among male (adjusted HR 1.23; 95\% CI 1.14-1.32) compared to female individuals, and those with ?2 chronic conditions (adjusted HR 2.12; 95\% CI 1.94-2.31) compared to those with no comorbidities. Risk of mortality was 9\% higher in the rural population (adjusted HR 1.09; 95\% CI 1.01-1.18) compared to adult urban residents. Conclusions: The findings highlight increased risk of death is associated with SARS-CoV-2 infection among patients with a recent diagnosis of cancer. Elevated risk underscores the importance of adhering to social distancing, mask adherence, vaccination, and regular testing among the adult cancer population. ",
doi="10.2196/35310",
url="https://cancer.jmir.org/2022/4/e35310",
url="http://www.ncbi.nlm.nih.gov/pubmed/36201388"
}


@Article{info:doi/10.2196/37606,
author="Shuldiner, Jennifer
and Shah, Nida
and Reis, Catherine
and Chalmers, Ian
and Ivers, Noah
and Nathan, Paul",
title="Developing a Provincial Surveillance and Support System for Childhood Cancer Survivors: Multiphase User-Centered Design Study",
journal="JMIR Hum Factors",
year="2022",
month="Sep",
day="13",
volume="9",
number="3",
pages="e37606",
keywords="design",
keywords="cancer screening",
keywords="childhood cancer survivor",
keywords="late effects",
keywords="surveillance",
keywords="cancer",
keywords="cancer survivor",
keywords="morbidity",
keywords="mortality",
keywords="cancer treatment",
keywords="mammogram",
keywords="echocardiogram",
abstract="Background: Survivors of childhood cancer are at lifelong risk of morbidity (such as new cancers or heart failure) and premature mortality due to their cancer treatment. These are termed late effects. Therefore, they require lifelong, risk-tailored surveillance. However, most adult survivors of childhood cancer do not complete recommended surveillance tests such as mammograms or echocardiograms. Objective: In partnership with survivors, family physicians, and health system partners, we are designing a provincial support system for high-priority tests informed by principles of implementation science, behavioral science, and design thinking. Methods: Our multiphase process was structured as follows. Step 1 consisted of a qualitative study to explore intervention components essential to accessing surveillance tests. Step 2 comprised a workshop with childhood cancer survivors, family physicians, and health system stakeholders that used the Step 1 findings and ``personas'' (a series of fictional but data-informed characters) to develop and tailor the intervention for different survivor groups. Step 3 consisted of intervention prototype development, and Step 4 involved iterative user testing. Results: The qualitative study of 30 survivors and 7 family physicians found a high desire for information on surveillance for late effects. Respondents indicated that the intervention should help patients book appointments when they are due in addition to providing personalized information. Insights from the workshop included the importance of partnering with both family physicians and survivorship clinics and providing emotional support for survivors who may experience distress upon learning of their risk for late effects. In our user-testing process, prototypes went through iterations that incorporated feedback from users regarding acceptability, usability, and functionality. We sought to address the needs of survivors and physicians while balancing the capacity and infrastructure available for a lifelong intervention via our health system partners. Conclusions: In partnership with childhood cancer survivors, family physicians, and health system partners, we elucidated the barriers and enablers to accessing guideline-recommended surveillance tests and designed a multifaceted solution that will support survivors and their family physicians. The next step is to evaluate the intervention in a pragmatic randomized controlled trial. ",
doi="10.2196/37606",
url="https://humanfactors.jmir.org/2022/3/e37606",
url="http://www.ncbi.nlm.nih.gov/pubmed/36099013"
}


@Article{info:doi/10.2196/34589,
author="Donegan, Connor
and Hughes, E. Amy
and Lee, Craddock Simon J.",
title="Colorectal Cancer Incidence, Inequalities, and Prevention Priorities in Urban Texas: Surveillance Study With the ``surveil'' Software Package",
journal="JMIR Public Health Surveill",
year="2022",
month="Aug",
day="16",
volume="8",
number="8",
pages="e34589",
keywords="Bayesian analysis",
keywords="cancer prevention",
keywords="colorectal cancer",
keywords="health equity",
keywords="open source software",
keywords="public health monitoring",
keywords="time-series analysis",
abstract="Background: Monitoring disease incidence rates over time with population surveillance data is fundamental to public health research and practice. Bayesian disease monitoring methods provide advantages over conventional methods including greater flexibility in model specification and the ability to conduct formal inference on model-derived quantities of interest. However, software platforms for Bayesian inference are often inaccessible to nonspecialists. Objective: To increase the accessibility of Bayesian methods among health surveillance researchers, we introduce a Bayesian methodology and open source software package, surveil, for time-series modeling of disease incidence and mortality. Given case count and population-at-risk data, the software enables health researchers to draw inferences about underlying risk and derivative quantities including age-standardized rates, annual and cumulative percent change, and measures of inequality. Methods: We specify a Poisson likelihood for case counts and model trends in log-risk using the first-difference (random-walk) prior. Models in the surveil R package were built using the Stan modeling language. We demonstrate the methodology and software by analyzing age-standardized colorectal cancer (CRC) incidence rates by race and ethnicity for non-Latino Black (Black), non-Latino White (White), and Hispanic/Latino (of any race) adults aged 50-79 years in Texas's 4 largest metropolitan statistical areas between 1999 and 2018. Results: Our analysis revealed a cumulative decline of 31\% (95\% CI --37\% to --25\%) in CRC risk among Black adults, 17\% (95\% CI --23\% to --11\%) for Latino adults, and 35\% (95\% CI --38\% to --31\%) for White adults from 1999 to 2018. None of the 3 observed groups experienced significant incidence reduction in the final 4 years of the study (2015-2018). The Black-White rate difference (per 100,000) was 44 (95\% CI 30-57) in 1999 and 35 (95\% CI 28-43) in 2018. Cumulatively, the Black-White gap accounts for 3983 CRC cases (95\% CI 3746-4219) or 31\% (95\% CI 29\%-32\%) of total CRC incidence among Black adults in this period. Conclusions: Stalled progress on CRC prevention and excess CRC risk among Black residents warrant special attention as cancer prevention and control priorities in urban Texas. Our methodology and software can help the public and health agencies monitor health inequalities and evaluate progress toward disease prevention goals. Advantages of the methodology over current common practice include the following: (1) the absence of piecewise linearity constraints on the model space, and (2) formal inference can be undertaken on any model-derived quantities of interest using Bayesian methods. ",
doi="10.2196/34589",
url="https://publichealth.jmir.org/2022/8/e34589",
url="http://www.ncbi.nlm.nih.gov/pubmed/35972778"
}


@Article{info:doi/10.2196/34874,
author="Fu, Leiwen
and Tian, Tian
and Yao, Kai
and Chen, Xiang-Feng
and Luo, Ganfeng
and Gao, Yanxiao
and Lin, Yi-Fan
and Wang, Bingyi
and Sun, Yinghui
and Zheng, Weiran
and Li, Peiyang
and Zhan, Yuewei
and Fairley, K. Christopher
and Grulich, Andrew
and Zou, Huachun",
title="Global Pattern and Trends in Penile Cancer Incidence: Population-Based Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Jul",
day="6",
volume="8",
number="7",
pages="e34874",
keywords="global burden",
keywords="penile cancer",
keywords="incidence",
keywords="average annual percentage change",
keywords="epidemiology",
abstract="Background: Penile cancer is a relatively rare genital malignancy whose incidence and mortality are rising in many countries. Objective: This study aims to assess the recent incidence and mortality patterns and incidence trends of penile cancer. Methods: The age-standardized incidence and mortality rates (ASIR and ASMR, respectively) of penile cancer in 2020 were estimated from the Global Cancer Registries (GLOBOCAN) database. Incidence trends of penile cancer from 1973 to 2012 were assessed in 44 populations from 43 countries using the Cancer Incidence in Five Continents plus (CI5plus) and the Nordic Cancer Registries (NORDCAN) databases. Average annual percentage change was calculated to quantify trends in ASIR using joinpoint regression. Results: Globally, the estimated ASIR and ASMR of penile cancer were 0.80 (per 100,000) and 0.29 (per 100,000) in 2020, equating to 36,068 new cases and 13,211 deaths in 2020, respectively. There was no significant correlation between the ASIR (P=.05) or ASMR (P=.90) and Human Development Index. In addition, 15 countries saw increasing ASIR for penile cancer, 13 of which were from Europe (United Kingdom, Lithuania, Norway, Estonia, Finland, Sweden, Cyprus, Netherlands, Italy, Croatia, Slovakia, Russia, and the Czech), and 2 from Asia (China and Israel). Conclusions: Although the developing countries still bear the higher incidence and mortality of penile cancer, the incidence is on the rise in most European countries. To mitigate the disease burden resulting from penile cancer, measures to lower the risk for penile cancers, including improving penile hygiene and male human papillomavirus vaccination, may be warranted. ",
doi="10.2196/34874",
url="https://publichealth.jmir.org/2022/7/e34874",
url="http://www.ncbi.nlm.nih.gov/pubmed/35793140"
}


@Article{info:doi/10.2196/35930,
author="Chauhan, Jyoti
and Aasaithambi, Sathyaraj
and M{\'a}rquez-Rodas, Iv{\'a}n
and Formisano, Luigi
and Papa, Sophie
and Meyer, Nicolas
and Forschner, Andrea
and Faust, Guy
and Lau, Mike
and Sagkriotis, Alexandros",
title="Understanding the Lived Experiences of Patients With Melanoma: Real-World Evidence Generated Through a European Social Media Listening Analysis",
journal="JMIR Cancer",
year="2022",
month="Jun",
day="13",
volume="8",
number="2",
pages="e35930",
keywords="melanoma",
keywords="social media",
keywords="social media listening",
keywords="real-world evidence",
keywords="patient journey",
keywords="cancer",
keywords="mortality rate",
keywords="health information",
abstract="Background: Cutaneous melanoma is an aggressive malignancy that is proposed to account for 90\% of skin cancer--related mortality. Individuals with melanoma experience both physical and psychological impacts associated with their diagnosis and treatment. Health-related information is being increasingly accessed and shared by stakeholders on social media platforms. Objective: This study aimed to assess how individuals living with melanoma across 14 European countries use social media to discuss their needs and provide their perceptions of the disease. Methods: Social media sources including Twitter, forums, and blogs were searched using predefined search strings of keywords relating to melanoma. Manual and automated relevancy approaches filtered the extracted data for content that provided patient-centric insights. This contextualized data was then mined for insightful concepts around the symptoms, diagnosis, treatment, impacts, and lived experiences of melanoma. Results: A total of 182,400 posts related to melanoma were identified between November 2018 and November 2020. Following exclusion of irrelevant posts and using random sampling methodology, 864 posts were identified as relevant to the study objectives. Of the social media channels included, Twitter was the most commonly used, followed by forums and blogs. Most posts originated from the United Kingdom (n=328, 38\%) and Spain (n=138, 16\%). Of the relevant posts, 62\% (n=536) were categorized as originating from individuals with melanoma. The most frequently discussed melanoma-related topics were treatment (436/792, 55\%), diagnosis and tests (261/792, 33\%), and remission (190/792, 24\%). The majority of treatment discussions were about surgery (292/436, 67\%), followed by immunotherapy (52/436, 12\%). In total, 255 posts discussed the impacts of melanoma, which included emotional burden (n=179, 70\%), physical impacts (n=61, 24\%), effects on social life (n=43, 17\%), and financial impacts (n=10, 4\%). Conclusions: Findings from this study highlight how melanoma stakeholders discuss key concepts associated with the condition on social media, adding to the conceptual model of the patient journey. This social media listening approach is a powerful tool for exploring melanoma stakeholder perspectives, providing insights that can be used to corroborate existing data and inform future studies. ",
doi="10.2196/35930",
url="https://cancer.jmir.org/2022/2/e35930",
url="http://www.ncbi.nlm.nih.gov/pubmed/35699985"
}


@Article{info:doi/10.2196/34073,
author="Faust, Guy
and Booth, Alison
and Merinopoulou, Evie
and Halhol, Sonia
and Tosar, Heena
and Nawaz, Amir
and Szlachetka, Magdalena
and Chiu, Gavin",
title="The Experiences of Patients With Adjuvant and Metastatic Melanoma Using Disease-Specific Social Media Communities in the Advent of Novel Therapies (Excite Project): Social Media Listening Study",
journal="JMIR Cancer",
year="2022",
month="May",
day="13",
volume="8",
number="2",
pages="e34073",
keywords="health-related social media",
keywords="patient-centric",
keywords="melanoma",
keywords="adjuvant",
keywords="metastatic",
keywords="immunotherapy",
keywords="targeted therapy",
keywords="natural language processing",
keywords="patient experience",
keywords="cancer",
keywords="cancer therapy",
keywords="patient perspective",
keywords="social media",
keywords="caregiver experience",
abstract="Background: Immunotherapy and targeted therapy treatments are novel treatments available for patients with metastatic and adjuvant melanoma. As recently approved treatments, information surrounding the patients' and caregivers' experience with these therapies, perceptions of treatments, and the effect the treatments have on their day-to-day life are lacking. Such insights would be valuable for any future decision-making with regard to treatment options. Objective: This study aims to use health-related social media data to understand the experience of patients with adjuvant and metastatic melanoma who are receiving either immunotherapy or targeted therapies. This study also included caregivers' perspectives. Methods: Publicly available social media forum posts by patients with self-reported adjuvant or metastatic melanoma (and their caregivers) between January 2014 to October 2019 were programmatically extracted, deidentified, cleaned, and analyzed using a combination of natural language processing and qualitative data analyses. This study identified spontaneously reported symptoms and their impacts, symptom duration, and the impact of treatment for both treatment groups. Results: Overall, 1037 users (9023 posts) and 114 users (442 posts) were included in the metastatic group and adjuvant group, respectively. The most identified symptoms in both groups were fatigue, pain, or exanthema (identified in 5\%-43\% of patients dependent on the treatment group). Symptom impacts reported by both groups were physical impacts, impacts on family, and impacts on work. Positive treatment impacts were reported in both groups and covered the areas of work, social and family life, and general health and quality of life. Conclusions: This study explored health-related social media to better understand the experience and perspectives of patients with melanoma receiving immunotherapy or targeted therapy treatments as well as the experience of their caregivers. This exploratory work uncovered the most discussed concerns among patients and caregivers on the forums including symptoms and their impacts, thus contributing to a deeper understanding of the patient/caregiver experience. ",
doi="10.2196/34073",
url="https://cancer.jmir.org/2022/2/e34073",
url="http://www.ncbi.nlm.nih.gov/pubmed/35559986"
}


@Article{info:doi/10.2196/33633,
author="Ye, Wenjing
and Lu, Weiwei
and Li, Xiaopan
and Chen, Yichen
and Wang, Lin
and Zeng, Guangwang
and Xu, Cheng
and Ji, Chen
and Cai, Yuyang
and Yang, Ling
and Luo, Zheng",
title="Long-term Changes in the Premature Death Rate in Lung Cancer in a Developed Region of China: Population-based Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Apr",
day="20",
volume="8",
number="4",
pages="e33633",
keywords="lung cancer",
keywords="mortality",
keywords="years of life lost",
keywords="trend analysis",
keywords="decomposition method",
abstract="Background: Lung cancer is a leading cause of death worldwide, and its incidence shows an upward trend. A study of the long-term changes in the premature death rate in lung cancer in a developed region of China has great exploratory significance to further clarify the effectiveness of intervention measures. Objective: This study examined long-term changes in premature lung cancer death rates in order to understand the changes in mortality and to design future prevention plans in Pudong New Area (PNA), Shanghai, China. Methods: Cancer death data were collected from the Mortality Registration System of PNA. We analyzed the crude mortality rate (CMR), age-standardized mortality rate by Segi's world standard population (ASMRW), and years of life lost (YLL) of patients with lung cancer from 1973 to 2019. Temporal trends in the CMR, ASMRW, and YLL rate were calculated by joinpoint regression expressed as an average annual percentage change (AAPC) with the corresponding 95\% CI. Results: All registered permanent residents in PNA (80,543,137 person-years) from 1973 to 2019 were enrolled in this study. There were 42,229 deaths from lung cancer. The CMR and ASMRW were 52.43/105 and 27.79/105 person-years, respectively. The YLL due to premature death from lung cancer was 481779.14 years, and the YLL rate was 598.16/105 person-years. The CMR and YLL rate showed significantly increasing trends in men, women, and the total population (P<.001). The CMR of the total population increased by 2.86\% (95\% CI 2.66-3.07, P<.001) per year during the study period. The YLL rate increased with an AAPC of 2.21\% (95\% CI 1.92-2.51, P<.001) per year. The contribution rates of increased CMR values caused by demographic factors were more evident than those caused by nondemographic factors. Conclusions: Lung cancer deaths showed an increasing trend in PNA from 1973 to 2019. Demographic factors, such as the aging population, contributed more to an increased CMR. Our research can help us understand the changes in lung cancer mortality and can be used for similar cities in designing future prevention plans. ",
doi="10.2196/33633",
url="https://publichealth.jmir.org/2022/4/e33633",
url="http://www.ncbi.nlm.nih.gov/pubmed/35442209"
}


@Article{info:doi/10.2196/33191,
author="Li, Yuanyuan
and Xu, Junfang
and Gu, Yuxuan
and Sun, Xueshan
and Dong, Hengjin
and Chen, Changgui",
title="The Disease and Economic Burdens of Esophageal Cancer in China from 2013 to 2030: Dynamic Cohort Modeling Study",
journal="JMIR Public Health Surveill",
year="2022",
month="Mar",
day="2",
volume="8",
number="3",
pages="e33191",
keywords="esophageal cancer",
keywords="disease burden",
keywords="disability-adjusted life year",
keywords="economic burden",
abstract="Background: Esophageal cancer (EC) is the sixth leading cause of tumor-related deaths worldwide. Estimates of the EC burden are necessary and could offer evidence-based suggestions for local cancer control. Objective: The aim of this study was to predict the disease burden of EC in China through the estimation of disability-adjusted life years (DALYs) and direct medical expenditure by sex from 2013 to 2030. Methods: A dynamic cohort Markov model was developed to simulate EC prevalence, DALYs, and direct medical expenditure by sex. Input data were collected from the China Statistical Yearbooks, Statistical Report of China Children's Development, World Population Prospects 2019, and published papers. The JoinPoint Regression Program was used to calculate the average annual percentage change (AAPC) of DALY rates, whereas the average annual growth rate (AAGR) was applied to analyze the changing direct medical expenditure trend over time. Results: From 2013 to 2030, the predicted EC prevalence is projected to increase from 61.0 to 64.5 per 100,000 people, with annual EC cases increasing by 11.5\% (from 835,600 to 931,800). The DALYs will increase by 21.3\% (from 30,034,000 to 36,444,000), and the years of life lost (YLL) will account for over 90\% of the DALYs. The DALY rates per 100,000 people will increase from 219.2 to 252.3; however, there was a difference between sexes, with an increase from 302.9 to 384.3 in males and a decline from 131.2 to 115.9 in females. The AAPC was 0.8\% (95\% CI 0.8\% to 0.9\%), 1.4\% (95\% CI 1.3\% to 1.5\%), and --0.7\% (95\% CI --0.8\% to --0.7\%) for both sexes, males, and females, respectively. The direct medical expenditure will increase by 128.7\% (from US \$33.4 to US \$76.4 billion), with an AAGR of 5.0\%. The direct medical expenditure is 2-3 times higher in males than in females. Conclusions: EC still causes severe disease and economic burdens. YLL are responsible for the majority of DALYs, which highlights an urgent need to establish a beneficial policy to reduce the EC burden. ",
doi="10.2196/33191",
url="https://publichealth.jmir.org/2022/3/e33191",
url="http://www.ncbi.nlm.nih.gov/pubmed/34963658"
}


@Article{info:doi/10.2196/19183,
author="Lei, Yuqi
and Xu, Songhua
and Zhou, Linyun",
title="User Behaviors and User-Generated Content in Chinese Online Health Communities: Comparative Study",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="15",
volume="23",
number="12",
pages="e19183",
keywords="online health community",
keywords="user behaviors",
keywords="user-generated content",
keywords="social network analysis",
keywords="weighted knowledge network",
abstract="Background: Online health communities (OHCs) have increasingly gained traction with patients, caregivers, and supporters globally. Chinese OHCs are no exception. However, user-generated content (UGC) and the associated user behaviors in Chinese OHCs are largely underexplored and rarely analyzed systematically, forfeiting valuable opportunities for optimizing treatment design and care delivery with insights gained from OHCs. Objective: This study aimed to reveal both the shared and distinct characteristics of 2 popular OHCs in China by systematically and comprehensively analyzing their UGC and the associated user behaviors. Methods: We concentrated on studying the lung cancer forum (LCF) and breast cancer forum (BCF) on Mijian, and the diabetes consultation forum (DCF) on Sweet Home, because of the importance of the 3 diseases among Chinese patients and their prevalence on Chinese OHCs in general. Our analysis explored the key user activities, small-world effect, and scale-free characteristics of each social network. We examined the UGC of these forums comprehensively and adopted the weighted knowledge network technique to discover salient topics and latent relations among these topics on each forum. Finally, we discussed the public health implications of our analysis findings. Results: Our analysis showed that the number of reads per thread on each forum followed gamma distribution (HL=0, HB=0, and HD=0); the number of replies on each forum followed exponential distribution (adjusted RL2=0.946, adjusted RB2=0.958, and adjusted RD2=0.971); and the number of threads a user is involved with (adjusted RL2=0.978, adjusted RB2=0.964, and adjusted RD2=0.970), the number of followers of a user (adjusted RL2=0.989, adjusted RB2=0.962, and adjusted RD2=0.990), and a user's degrees (adjusted RL2=0.997, adjusted RB2=0.994, and adjusted RD2=0.968) all followed power-law distribution. The study further revealed that users are generally more active during weekdays, as commonly witnessed in all 3 forums. In particular, the LCF and DCF exhibited high temporal similarity ($\rho$=0.927; P<.001) in terms of the relative thread posting frequencies during each hour of the day. Besides, the study showed that all 3 forums exhibited the small-world effect (mean $\sigma$L=517.15, mean $\sigma$B=275.23, and mean $\sigma$D=525.18) and scale-free characteristics, while the global clustering coefficients were lower than those of counterpart international OHCs. The study also discovered several hot topics commonly shared among the 3 disease forums, such as disease treatment, disease examination, and diagnosis. In particular, the study found that after the outbreak of COVID-19, users on the LCF and BCF were much more likely to bring up COVID-19--related issues while discussing their medical issues. Conclusions: UGC and related online user behaviors in Chinese OHCs can be leveraged as important sources of information to gain insights regarding individual and population health conditions. Effective and timely mining and utilization of such content can continuously provide valuable firsthand clues for enhancing the situational awareness of health providers and policymakers. ",
doi="10.2196/19183",
url="https://www.jmir.org/2021/12/e19183",
url="http://www.ncbi.nlm.nih.gov/pubmed/34914615"
}


@Article{info:doi/10.2196/31275,
author="Batta, Nisha
and Shangraw, Sarah
and Nicklawsky, Andrew
and Yamauchi, Takeshi
and Zhai, Zili
and Ravindran Menon, Dinoop
and Gao, Dexiang
and Dellavalle, P. Robert
and Fujita, Mayumi",
title="Global Melanoma Correlations With Obesity, Smoking, and Alcohol Consumption",
journal="JMIR Dermatol",
year="2021",
month="Dec",
day="13",
volume="4",
number="2",
pages="e31275",
keywords="melanoma incidence",
keywords="melanoma mortality",
keywords="non-UV risk factors",
keywords="obesity",
keywords="alcohol consumption",
keywords="smoking",
keywords="wine",
keywords="World Health Organization",
keywords="WHO",
keywords="Global Cancer Observatory",
keywords="GCO",
keywords="Global Health Observatory",
keywords="GHO",
keywords="aldehyde dehydrogenase 2",
keywords="ALDH2",
keywords="polymorphism",
doi="10.2196/31275",
url="https://derma.jmir.org/2021/2/e31275",
url="http://www.ncbi.nlm.nih.gov/pubmed/35990801"
}


@Article{info:doi/10.2196/29958,
author="Reuter, Katja
and Angyan, Praveen
and Le, NamQuyen
and Buchanan, A. Thomas",
title="Using Patient-Generated Health Data From Twitter to Identify, Engage, and Recruit Cancer Survivors in Clinical Trials in Los Angeles County: Evaluation of a Feasibility Study",
journal="JMIR Form Res",
year="2021",
month="Nov",
day="26",
volume="5",
number="11",
pages="e29958",
keywords="breast cancer",
keywords="cancer",
keywords="clinical research",
keywords="clinical trial",
keywords="colon cancer",
keywords="infoveillance",
keywords="kidney cancer",
keywords="lung cancer",
keywords="lymphoma",
keywords="patient engagement",
keywords="prostate cancer",
keywords="recruitment",
keywords="Twitter",
keywords="social media",
abstract="Background: Failure to find and attract clinical trial participants remains a persistent barrier to clinical research. Researchers increasingly complement recruitment methods with social media--based methods. We hypothesized that user-generated data from cancer survivors and their family members and friends on the social network Twitter could be used to identify, engage, and recruit cancer survivors for cancer trials. Objective: This pilot study aims to examine the feasibility of using user-reported health data from cancer survivors and family members and friends on Twitter in Los Angeles (LA) County to enhance clinical trial recruitment. We focus on 6 cancer conditions (breast cancer, colon cancer, kidney cancer, lymphoma, lung cancer, and prostate cancer). Methods: The social media intervention involved monitoring cancer-specific posts about the 6 cancer conditions by Twitter users in LA County to identify cancer survivors and their family members and friends and contacting eligible Twitter users with information about open cancer trials at the University of Southern California (USC) Norris Comprehensive Cancer Center. We reviewed both retrospective and prospective data published by Twitter users in LA County between July 28, 2017, and November 29, 2018. The study enrolled 124 open clinical trials at USC Norris. We used descriptive statistics to report the proportion of Twitter users who were identified, engaged, and enrolled. Results: We analyzed 107,424 Twitter posts in English by 25,032 unique Twitter users in LA County for the 6 cancer conditions. We identified and contacted 1.73\% (434/25,032) of eligible Twitter users (127/434, 29.3\% cancer survivors; 305/434, 70.3\% family members and friends; and 2/434, 0.5\% Twitter users were excluded). Of them, 51.4\% (223/434) were female and approximately one-third were male. About one-fifth were people of color, whereas most of them were White. Approximately one-fifth (85/434, 19.6\%) engaged with the outreach messages (cancer survivors: 33/85, 38\% and family members and friends: 52/85, 61\%). Of those who engaged with the messages, one-fourth were male, the majority were female, and approximately one-fifth were people of color, whereas the majority were White. Approximately 12\% (10/85) of the contacted users requested more information and 40\% (4/10) set up a prescreening. Two eligible candidates were transferred to USC Norris for further screening, but neither was enrolled. Conclusions: Our findings demonstrate the potential of identifying and engaging cancer survivors and their family members and friends on Twitter. Optimization of downstream recruitment efforts such as screening for digital populations on social media may be required. Future research could test the feasibility of the approach for other diseases, locations, languages, social media platforms, and types of research involvement (eg, survey research). Computer science methods could help to scale up the analysis of larger data sets to support more rigorous testing of the intervention. Trial Registration: ClinicalTrials.gov NCT03408561; https://clinicaltrials.gov/ct2/show/NCT03408561 ",
doi="10.2196/29958",
url="https://formative.jmir.org/2021/11/e29958",
url="http://www.ncbi.nlm.nih.gov/pubmed/34842538"
}


@Article{info:doi/10.2196/25976,
author="Yang, Shi-Ping
and Su, Hui-Luan
and Chen, Xiu-Bei
and Hua, Li
and Chen, Jian-Xian
and Hu, Min
and Lei, Jian
and Wu, San-Gang
and Zhou, Juan",
title="Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance, Epidemiology, and End Results Database",
journal="JMIR Public Health Surveill",
year="2021",
month="Nov",
day="17",
volume="7",
number="11",
pages="e25976",
keywords="ovarian epithelial carcinoma",
keywords="survivors",
keywords="histology",
keywords="survival rate",
keywords="survival",
keywords="ovarian",
keywords="cancer",
keywords="surveillance",
keywords="epidemiology",
keywords="women's health",
keywords="reproductive health",
keywords="Surveillance, Epidemiology, and End Results",
keywords="ovary",
keywords="oncology",
keywords="survivorship",
keywords="long-term outcome",
keywords="epithelial",
abstract="Background: Actual long-term survival rates for advanced epithelial ovarian cancer (EOC) are rarely reported. Objective: This study aimed to assess the role of histological subtypes in predicting the prognosis among long-term survivors (?5 years) of advanced EOC. Methods: We performed a retrospective analysis of data among patients with stage III-IV EOC diagnosed from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States. We used the chi-square test, Kaplan--Meier analysis, and multivariate Cox proportional hazards model for the analyses. Results: We included 8050 patients in this study, including 6929 (86.1\%), 743 (9.2\%), 237 (2.9\%), and 141 (1.8\%) patients with serous, endometrioid, clear cell, and mucinous tumors, respectively. With a median follow-up of 91 months, the most common cause of death was primary ovarian cancer (80.3\%), followed by other cancers (8.1\%), other causes of death (7.3\%), cardiac-related death (3.2\%), and nonmalignant pulmonary disease (3.2\%). Patients with the serous subtype were more likely to die from primary ovarian cancer, and patients with the mucinous subtype were more likely to die from other cancers and cardiac-related disease. Multivariate Cox analysis showed that patients with endometrioid (hazard ratio [HR] 0.534, P<.001), mucinous (HR 0.454, P<.001), and clear cell (HR 0.563, P<.001) subtypes showed better ovarian cancer-specific survival than those with the serous subtype. Similar results were found regarding overall survival. However, ovarian cancer--specific survival and overall survival were comparable among those with endometrioid, clear cell, and mucinous tumors. Conclusions: Ovarian cancer remains the primary cause of death in long-term ovarian cancer survivors. Moreover, the probability of death was significantly different among those with different histological subtypes. It is important for clinicians to individualize?the?surveillance?program for long-term ovarian cancer survivors. ",
doi="10.2196/25976",
url="https://publichealth.jmir.org/2021/11/e25976",
url="http://www.ncbi.nlm.nih.gov/pubmed/34787583"
}


@Article{info:doi/10.2196/32395,
author="Marron, Manuela
and Brackmann, Kim Lara
and Schwarz, Heike
and Hummel-Bartenschlager, Willempje
and Zahnreich, Sebastian
and Galetzka, Danuta
and Schmitt, Iris
and Grad, Christian
and Drees, Philipp
and Hopf, Johannes
and Mirsch, Johanna
and Scholz-Kreisel, Peter
and Kaatsch, Peter
and Poplawski, Alicia
and Hess, Moritz
and Binder, Harald
and Hankeln, Thomas
and Blettner, Maria
and Schmidberger, Heinz",
title="Identification of Genetic Predispositions Related to Ionizing Radiation in Primary Human Skin Fibroblasts From Survivors of Childhood and Second Primary Cancer as Well as Cancer-Free Controls: Protocol for the Nested Case-Control Study KiKme",
journal="JMIR Res Protoc",
year="2021",
month="Nov",
day="11",
volume="10",
number="11",
pages="e32395",
keywords="fibroblast",
keywords="irradiation",
keywords="childhood cancer",
keywords="neoplasm",
keywords="second primary neoplasm",
keywords="second cancer",
keywords="study design",
keywords="participation",
keywords="feasibility",
keywords="cell line",
abstract="Background: Therapy for a first primary neoplasm (FPN) in childhood with high doses of ionizing radiation is an established risk factor for second primary neoplasms (SPN). An association between exposure to low doses and childhood cancer is also suggested; however, results are inconsistent. As only subgroups of children with FPNs develop SPNs, an interaction between radiation, genetic, and other risk factors is presumed to influence cancer development. Objective: Therefore, the population-based, nested case-control study KiKme aims to identify differences in genetic predisposition and radiation response between childhood cancer survivors with and without SPNs as well as cancer-free controls. Methods: We conducted a population-based, nested case-control study KiKme. Besides questionnaire information, skin biopsies and saliva samples are available. By measuring individual reactions to different exposures to radiation (eg, 0.05 and 2 Gray) in normal somatic cells of the same person, our design enables us to create several exposure scenarios for the same person simultaneously and measure several different molecular markers (eg, DNA, messenger RNA, long noncoding RNA, copy number variation). Results: Since 2013, 101 of 247 invited SPN patients, 340 of 1729 invited FPN patients, and 150 of 246 invited cancer-free controls were recruited and matched by age and sex. Childhood cancer patients were additionally matched by tumor morphology, year of diagnosis, and age at diagnosis. Participants reported on lifestyle, socioeconomical, and anthropometric factors, as well as on medical radiation history, health, and family history of diseases (n=556). Primary human fibroblasts from skin biopsies of the participants were cultivated (n=499) and cryopreserved (n=3886). DNA was extracted from fibroblasts (n=488) and saliva (n=510). Conclusions: This molecular-epidemiological study is the first to combine observational epidemiological research with standardized experimental components in primary human skin fibroblasts to identify genetic predispositions related to ionizing radiation in childhood and SPNs. In the future, fibroblasts of the participants will be used for standardized irradiation experiments, which will inform analysis of the case-control study and vice versa. Differences between participants will be identified using several molecular markers. With its innovative combination of experimental and observational components, this new study will provide valuable data to forward research on radiation-related risk factors in childhood cancer and SPNs. International Registered Report Identifier (IRRID): DERR1-10.2196/32395 ",
doi="10.2196/32395",
url="https://www.researchprotocols.org/2021/11/e32395",
url="http://www.ncbi.nlm.nih.gov/pubmed/34762066"
}


@Article{info:doi/10.2196/30265,
author="Hathaway, A. Cassandra
and Chavez, N. Melody
and Kadono, Mika
and Ketcher, Dana
and Rollison, E. Dana
and Siegel, M. Erin
and Peoples, R. Anita
and Ulrich, M. Cornelia
and Penedo, J. Frank
and Tworoger, S. Shelley
and Gonzalez, D. Brian",
title="Improving Electronic Survey Response Rates Among Cancer Center Patients During the COVID-19 Pandemic: Mixed Methods Pilot Study",
journal="JMIR Cancer",
year="2021",
month="Aug",
day="6",
volume="7",
number="3",
pages="e30265",
keywords="response rates",
keywords="electronic survey",
keywords="cancer",
keywords="COVID-19",
keywords="pandemic",
keywords="surveillance",
keywords="cancer patients",
keywords="health promotion",
keywords="digital health",
keywords="patient experience",
keywords="health outcomes",
abstract="Background: Surveys play a vital role in cancer research. During the COVID-19 pandemic, the use of electronic surveys is crucial to improve understanding of the patient experience. However, response rates to electronic surveys are often lower compared with those of paper surveys. Objective: The aim of this study was to determine the best approach to improve response rates for an electronic survey administered to patients at a cancer center during the COVID-19 pandemic. Methods: We contacted 2750 patients seen at Moffitt Cancer Center in the prior 5 years via email to complete a survey regarding their experience during the COVID-19 pandemic, with patients randomly assigned to a series of variations of prenotifications (ie, postcard, letter) or incentives (ie, small gift, modest gift card). In total, eight combinations were evaluated. Qualitative interviews were conducted to understand the level of patient understanding and burden with the survey, and quantitative analysis was used to evaluate the response rates between conditions. Results: A total of 262 (9.5\%) patients completed the survey and 9 participated in a qualitative interview. Interviews revealed minimal barriers in understanding or burden, which resulted in minor survey design changes. Compared to sending an email only, sending a postcard or letter prior to the email improved response rates from 3.7\% to 9.8\%. Similarly, inclusion of an incentive significantly increased the response rate from 5.4\% to 16.7\%, especially among racial (3.0\% to 12.2\%) and ethnic (6.4\% to 21.0\%) minorities, as well as among patients with low socioeconomic status (3.1\% to 14.9\%). Conclusions: Strategies to promote effective response rates include prenotification postcards or letters as well as monetary incentives. This work can inform future survey development to increase response rates for electronic surveys, particularly among hard-to-reach populations. ",
doi="10.2196/30265",
url="https://cancer.jmir.org/2021/3/e30265",
url="http://www.ncbi.nlm.nih.gov/pubmed/34156965"
}


@Article{info:doi/10.2196/29723,
author="Fazel, S. Sajjad
and Quinn, K. Emma
and Ford-Sahibzada, A. Chelsea
and Szarka, Steven
and Peters, E. Cheryl",
title="Sunscreen Posts on Twitter in the United States and Canada, 2019: Content Analysis",
journal="JMIR Dermatol",
year="2021",
month="Jul",
day="19",
volume="4",
number="2",
pages="e29723",
keywords="sunscreen",
keywords="skin cancer",
keywords="Twitter",
keywords="misinformation",
keywords="prevention",
keywords="skin",
keywords="social media",
keywords="health promotion",
keywords="melanoma",
doi="10.2196/29723",
url="https://derma.jmir.org/2021/2/e29723",
url="http://www.ncbi.nlm.nih.gov/pubmed/37632814"
}


@Article{info:doi/10.2196/23990,
author="Krej{\v c}{\'i}, Denisa
and Karolyi, Mat?j
and Pehalov{\'a}, Lucie
and {\vS}{\v c}avnick{\'y}, Jakub
and Zapletalov{\'a}, Michaela
and Katinov{\'a}, Ivana
and {\vS}t?rba, Jaroslav
and Star{\'y}, Jan
and {\vS}najdrov{\'a}, Lenka
and Komenda, Martin
and Du{\vs}ek, Ladislav",
title="Development of the Czech Childhood Cancer Information System: Data Analysis and Interactive Visualization",
journal="JMIR Public Health Surveill",
year="2021",
month="Jun",
day="29",
volume="7",
number="6",
pages="e23990",
keywords="cancer epidemiology",
keywords="children",
keywords="data visualization",
keywords="software development",
abstract="Background: The knowledge of cancer burden in the population, its time trends, and the possibility of international comparison is an important starting point for cancer programs. A reliable interactive tool describing cancer epidemiology in children and adolescents has been nonexistent in the Czech Republic until recently. Objective: The goal of this study is to develop a new web portal entitled the Czech Childhood Cancer Information System (CCCIS), which would provide information on childhood cancer epidemiology in the Czech Republic. Methods: Data on childhood cancers have been obtained from the Czech National Cancer Registry. These data were validated using the clinical database of childhood cancer patients and subsequently combined with data from the National Register of Hospitalised Patients and with data from death certificates. These validated data were then used to determine the incidence and survival rates of childhood cancer patients aged 0 to 19 years who were diagnosed in the period 1994 to 2016 (N=9435). Data from death certificates were used to monitor long-term mortality trends. The technical solution is based on the robust PHP development Symfony framework, with the PostgreSQL system used to accommodate the data basis. Results: The web portal has been available for anyone since November 2019, providing basic information for experts (ie, analyses and publications) on individual diagnostic groups of childhood cancers. It involves an interactive tool for analytical reporting, which provides information on the following basic topics in the form of graphs or tables: incidence, mortality, and overall survival. Feedback was obtained and the accuracy of outputs published on the CCCIS portal was verified using the following methods: the validation of the theoretical background and the user testing. Conclusions: We developed software capable of processing data from multiple sources, which is freely available to all users and makes it possible to carry out automated analyses even for users without mathematical background; a simple selection of a topic to be analyzed is required from the user. ",
doi="10.2196/23990",
url="https://publichealth.jmir.org/2021/6/e23990",
url="http://www.ncbi.nlm.nih.gov/pubmed/34185010"
}


@Article{info:doi/10.2196/27052,
author="Naik, Hiten
and Johnson, Dimitri Maximilian Desmond
and Johnson, Roger Michael",
title="Internet Interest in Colon Cancer Following the Death of Chadwick Boseman: Infoveillance Study",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="15",
volume="23",
number="6",
pages="e27052",
keywords="colon cancer",
keywords="Google",
keywords="Wikipedia",
keywords="infodemiology",
abstract="Background: Compared with White Americans, Black Americans have higher colon cancer mortality rates but lower up-to-date screening rates. Chadwick Boseman was a prominent Black American actor who died of colon cancer on August 28, 2020. As announcements of celebrity diagnoses often result in increased awareness, Boseman's death may have resulted in greater interest in colon cancer on the internet, particularly among Black Americans. Objective: This study aims to quantify the impact of Chadwick Boseman's death on web-based search interest in colon cancer and determine whether there was an increase in interest in regions of the United States with a greater proportion of Black Americans. Methods: We conducted an infoveillance study using Google Trends (GT) and Wikipedia pageview analysis. Using an autoregressive integrated moving average algorithm, we forecasted the weekly relative search volume (RSV) for GT search topics and terms related to colon cancer that would have been expected had his death not occurred and compared it with observed RSV data. This analysis was also conducted for the number of page views on the Wikipedia page for colorectal cancer. We then delineated GT RSV data for the term colon cancer for states and metropolitan areas in the United States and determined how the RSV values for these regions correlated with the percentage of Black Americans in that region. Differences in these correlations before and after Boseman's death were compared to determine whether there was a shift in the racial demographics of the individuals conducting the searches. Results: The observed RSVs for the topics colorectal cancer and colon cancer screening increased by 598\% and 707\%, respectively, and were on average 121\% (95\% CI 72\%-193\%) and 256\% (95\% CI 35\%-814\%) greater than expected during the first 3 months following Boseman's death. Daily Wikipedia page view volume during the 2 months following Boseman's death was on average 1979\% (95\% CI 1375\%-2894\%) greater than expected, and it was estimated that this represented 547,354 (95\% CI 497,708-585,167) excess Wikipedia page views. Before Boseman's death, there were negative correlations between the percentage of Black Americans living in a state or metropolitan area and the RSV for colon cancer in that area (r=?0.18 and r=?0.05, respectively). However, in the 2 weeks following his death, there were positive correlations between the RSV for colon cancer and the percentage of Black Americans per state and per metropolitan area (r=0.73 and r=0.33, respectively). These changes persisted for 4 months and were all statistically significant (P<.001). Conclusions: There was a significant increase in web-based activity related to colon cancer following Chadwick Boseman's death, particularly in areas with a higher proportion of Black Americans. This reflects a heightened public awareness that can be leveraged to further educate the public. ",
doi="10.2196/27052",
url="https://www.jmir.org/2021/6/e27052",
url="http://www.ncbi.nlm.nih.gov/pubmed/34128824"
}


@Article{info:doi/10.2196/22160,
author="Safaeian, Fereshteh
and Ghaemimood, Shidrokh
and El-Khatib, Ziad
and Enayati, Sahba
and Mirkazemi, Roksana
and Reeder, Bruce",
title="Burden of Cervical Cancer in the Eastern Mediterranean Region During the Years 2000 and 2017: Retrospective Data Analysis of the Global Burden of Disease Study",
journal="JMIR Public Health Surveill",
year="2021",
month="May",
day="12",
volume="7",
number="5",
pages="e22160",
keywords="cervical cancer",
keywords="Eastern Mediterranean Region",
keywords="burden of disease",
keywords="cancer",
keywords="burden",
keywords="inequality",
keywords="mortality",
keywords="preventable disease",
abstract="Background: Cervical cancer is a growing health concern, especially in resource-limited settings. Objective: The objective of this study was to assess the burden of cervical cancer mortality and disability-adjusted life years (DALYs) in the Eastern Mediterranean Region (EMR) and globally between the years 2000 and 2017 by using a pooled data analysis approach. Methods: We used an ecological approach at the country level. This included extracting data from publicly available databases and linking them together in the following 3 steps: (1) extraction of data from the Global Burden of Disease (GBD) study in the years 2000 and 2017, (2) categorization of EMR countries according to the World Bank gross domestic product per capita, and (3) linking age-specific population data from the Population Statistics Division of the United Nations (20-29 years, 30-49 years, and >50 years) and GBD's data with gross national income per capita and globally extracted data, including cervical cancer mortality and DALY numbers and rates per country. The cervical cancer mortality rate was provided by the GBD study using the following formula: number of cervical cancer deaths {\texttimes} 100,000/female population in the respective age group. Results: The absolute number of deaths due to cervical cancer increased from the year 2000 (n=6326) to the year 2017 (n=8537) in the EMR; however, the mortality rate due to this disease decreased from the year 2000 (2.7 per 100,000) to the year 2017 (2.5 per 100,000). According to age-specific data, the age group ?50 years showed the highest mortality rate in both EMR countries and globally, and the age group of 20-29 years showed the lowest mortality rate both globally and in the EMR countries. Further, the rates of cervical cancer DALYs in the EMR were lower compared to the global rates (2.7 vs 6.8 in 2000 and 2.5 vs 6.8 in 2017 for mortality rate per 100,000; 95.8 vs 222.2 in 2000 and 86.3 vs 211.8 in 2017 for DALY rate per 100,000; respectively). However, the relative difference in the number of DALYs due to cervical cancer between the year 2000 and year 2017 in the EMR was higher than that reported globally (34.9 vs 24.0 for the number of deaths and 23.5 vs 18.1 for the number of DALYs, respectively). Conclusions: We found an increase in the burden of cervical cancer in the EMR as per the data on the absolute number of deaths and DALYs. Further, we found that the health care system has an increased number of cases to deal with, despite the decrease in the absolute number of deaths and DALYs. Cervical cancer is preventable if human papilloma vaccination is taken and early screening is performed. Therefore, we recommend identifying effective vaccination programs and interventions to reduce the burden of this disease. ",
doi="10.2196/22160",
url="https://publichealth.jmir.org/2021/5/e22160",
url="http://www.ncbi.nlm.nih.gov/pubmed/33978592"
}


@Article{info:doi/10.2196/21256,
author="Pluimakers, Vincent
and Fiocco, Marta
and van Atteveld, Jenneke
and Hobbelink, Monique
and Bresters, Dorine
and Van Dulmen-den Broeder, Eline
and Van der Heiden-van der Loo, Margriet
and Janssens, O. Geert
and Kremer, Leontien
and Loonen, Jacqueline
and Louwerens, Marloes
and Van der Pal, Helena
and Ronckers, C{\'e}cile
and Van Santen, Hanneke
and Versluys, Birgitta
and De Vries, Andrica
and Van den Heuvel-Eibrink, Marry
and Neggers, Sebastian",
title="Metabolic Syndrome Parameters, Determinants, and Biomarkers in Adult Survivors of Childhood Cancer: Protocol for the Dutch Childhood Cancer Survivor Study on Metabolic Syndrome (Dutch LATER METS)",
journal="JMIR Res Protoc",
year="2021",
month="Jan",
day="27",
volume="10",
number="1",
pages="e21256",
keywords="metabolic syndrome",
keywords="childhood cancer survivor",
keywords="Dutch Childhood Cancer Survivor Study",
keywords="methodology",
keywords="Dutch LATER METS",
abstract="Background: Potential late effects of treatment for childhood cancer include adiposity, insulin resistance, dyslipidemia, and hypertension. These risk factors cluster together as metabolic syndrome and increase the risk for development of diabetes mellitus and cardio- and cerebrovascular disease. Knowledge on risk factors, timely diagnosis, and preventive strategies is of importance to prevent cardio- and cerebrovascular complications and improve quality of life. Currently, no national cohort studies on the prevalence and determinants of metabolic syndrome in childhood cancer survivors, including biomarkers and genetic predisposition, are available. Objective: The objectives of the Dutch LATER METS study are to assess 1) the prevalence and risk factors of metabolic syndrome and its separate components, and 2) the potential diagnostic and predictive value of additional biomarkers for surveillance of metabolic syndrome in the national cohort of adult long-term survivors of childhood cancer. Methods: This is a cross-sectional study based on recruitment of all survivors treated in the Netherlands between 1963 and 2002. Metabolic syndrome will be classified according to the definitions of the third Adult Treatment Panel Report of the National Cholesterol Education Program as well as the Joint Interim Statement and compared to reference data. Dual-energy x-ray absorptiometry scans were performed to assess body composition in more detail. The effect of patient characteristics, previous treatment, and genetic variation on the risk of metabolic syndrome will be assessed. The diagnostic and predictive value of novel biomarkers will be tested. Results: Patient accrual started in 2016 and lasted until April 2020. A total of 2380 survivors from 7 pediatric oncology hospitals have participated. From July 2020, biomarker testing, single nucleotide polymorphism analysis, and data analysis will be performed. Conclusions: The Dutch LATER METS study will provide knowledge on clinical and genetic determinants of metabolic syndrome and the diagnostic value of biomarkers in childhood cancer survivors. The results of this study will be used to optimize surveillance guidelines for metabolic syndrome in survivors based on enhanced risk stratification and screening strategies. This will improve diagnosis of metabolic syndrome and prevent complications. International Registered Report Identifier (IRRID): DERR1-10.2196/21256 ",
doi="10.2196/21256",
url="https://www.researchprotocols.org/2021/1/e21256",
url="http://www.ncbi.nlm.nih.gov/pubmed/32750002"
}


@Article{info:doi/10.2196/18998,
author="Xu, Chenjie
and Cao, Zhi
and Yang, Hongxi
and Gao, Ying
and Sun, Li
and Hou, Yabing
and Cao, Xinxi
and Jia, Peng
and Wang, Yaogang",
title="Leveraging Internet Search Data to Improve the Prediction and Prevention of Noncommunicable Diseases: Retrospective Observational Study",
journal="J Med Internet Res",
year="2020",
month="Nov",
day="12",
volume="22",
number="11",
pages="e18998",
keywords="noncommunicable diseases",
keywords="internet searches",
keywords="Google Trends",
keywords="infodemiology",
keywords="infoveillance",
keywords="early warning model",
keywords="United States",
abstract="Background: As human society enters an era of vast and easily accessible social media, a growing number of people are exploiting the internet to search and exchange medical information. Because internet search data could reflect population interest in particular health topics, they provide a new way of understanding health concerns regarding noncommunicable diseases (NCDs) and the role they play in their prevention. Objective: We aimed to explore the association of internet search data for NCDs with published disease incidence and mortality rates in the United States and to grasp the health concerns toward NCDs. Methods: We tracked NCDs by examining the correlations among the incidence rates, mortality rates, and internet searches in the United States from 2004 to 2017, and we established forecast models based on the relationship between the disease rates and internet searches. Results: Incidence and mortality rates of 29 diseases in the United States were statistically significantly correlated with the relative search volumes (RSVs) of their search terms (P<.05). From the perspective of the goodness of fit of the multiple regression prediction models, the results were closest to 1 for diabetes mellitus, stroke, atrial fibrillation and flutter, Hodgkin lymphoma, and testicular cancer; the coefficients of determination of their linear regression models for predicting incidence were 80\%, 88\%, 96\%, 80\%, and 78\%, respectively. Meanwhile, the coefficient of determination of their linear regression models for predicting mortality was 82\%, 62\%, 94\%, 78\%, and 62\%, respectively. Conclusions: An advanced understanding of search behaviors could augment traditional epidemiologic surveillance and could be used as a reference to aid in disease prediction and prevention. ",
doi="10.2196/18998",
url="http://www.jmir.org/2020/11/e18998/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33180022"
}


@Article{info:doi/10.2196/20826,
author="Oliveira, R. Carlos
and Niccolai, Patrick
and Ortiz, Michelle Anette
and Sheth, S. Sangini
and Shapiro, D. Eugene
and Niccolai, M. Linda
and Brandt, A. Cynthia",
title="Natural Language Processing for Surveillance of Cervical and Anal Cancer and Precancer: Algorithm Development and Split-Validation Study",
journal="JMIR Med Inform",
year="2020",
month="Nov",
day="3",
volume="8",
number="11",
pages="e20826",
keywords="natural language processing",
keywords="automated data extraction",
keywords="human papillomavirus",
keywords="surveillance",
keywords="pathology reporting",
keywords="cervical cancer",
keywords="anal cancer",
keywords="precancer",
keywords="cancer",
keywords="HPV",
keywords="accuracy",
abstract="Background: Accurate identification of new diagnoses of human papillomavirus--associated cancers and precancers is an important step toward the development of strategies that optimize the use of human papillomavirus vaccines. The diagnosis of human papillomavirus cancers hinges on a histopathologic report, which is typically stored in electronic medical records as free-form, or unstructured, narrative text. Previous efforts to perform surveillance for human papillomavirus cancers have relied on the manual review of pathology reports to extract diagnostic information, a process that is both labor- and resource-intensive. Natural language processing can be used to automate the structuring and extraction of clinical data from unstructured narrative text in medical records and may provide a practical and effective method for identifying patients with  vaccine-preventable human papillomavirus disease for surveillance and research. Objective: This study's objective was to develop and assess the accuracy of a natural language processing algorithm for the identification of individuals with cancer or precancer of the cervix and anus. Methods: A pipeline-based natural language processing algorithm was developed, which incorporated machine learning and rule-based methods to extract diagnostic elements from the narrative pathology reports. To test the algorithm's classification accuracy, we used a split-validation study design. Full-length cervical and anal pathology reports were randomly selected from 4 clinical pathology laboratories. Two study team members, blinded to the classifications produced by the natural language processing algorithm, manually and independently reviewed all reports and classified them at the document level according to 2 domains (diagnosis and human papillomavirus testing results). Using the manual review as the gold standard, the algorithm's performance was evaluated using standard measurements of accuracy, recall, precision, and F-measure. Results: The natural language processing algorithm's performance was validated on 949 pathology reports. The algorithm demonstrated accurate identification of abnormal cytology, histology, and positive human papillomavirus tests with accuracies greater than 0.91. Precision was lowest for anal histology reports (0.87, 95\% CI 0.59-0.98) and highest for cervical cytology (0.98, 95\% CI 0.95-0.99). The natural language processing algorithm missed 2 out of the 15 abnormal anal histology reports, which led to a relatively low recall (0.68, 95\% CI 0.43-0.87). Conclusions: This study outlines the development and validation of a freely available and easily implementable natural language processing algorithm that can automate the extraction and classification of clinical data from cervical and anal cytology and histology. ",
doi="10.2196/20826",
url="https://medinform.jmir.org/2020/11/e20826",
url="http://www.ncbi.nlm.nih.gov/pubmed/32469840"
}


@Article{info:doi/10.2196/18556,
author="Rees-Punia, Erika
and Patel, V. Alpa
and Beckwitt, Asher
and Leach, R. Corinne
and Gapstur, M. Susan
and Smith, G. Tenbroeck",
title="Research Participants' Perspectives on Using an Electronic Portal for Engagement and Data Collection: Focus Group Results From a Large Epidemiologic Cohort",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="1",
volume="22",
number="10",
pages="e18556",
keywords="focus groups",
keywords="health information technology",
keywords="epidemiologic studies",
abstract="Background: Epidemiologic cohort studies have begun to leverage electronic research participant portals to facilitate data collection, integrate wearable technologies, lower costs, and engage participants. However, little is known about the acceptability of portal use by research participants. Objective: The aim of this study is to conduct focus groups among a sample of Cancer Prevention Study-3 (CPS-3) participants to better understand their preferences and concerns about research portals. Methods: CPS-3 participants were stratified based on sex, race and ethnicity, age, and cancer status, and randomly invited to participate. Focus groups used an exploratory case design with semistructured guides to prompt discussion. Using a constant comparison technique, transcripts were assigned codes to identify themes. Results: Participants (31/59, 52\% women; 52/59, 88\% White/non-Latinx) were favorably disposed toward using a research participant portal to take surveys, communicate with the study staff, and upload data. Most participants indicated that a portal would be beneficial and convenient but expressed concerns over data safety. Participants stressed the importance of an easy-to-use and trustworthy portal that is compatible with mobile devices. Conclusions: In addition to being beneficial to researchers, portals may also benefit participants as long as the portals are secure and simple. Participants believe that portals can provide convenient ways to report data and remain connected to the study. ",
doi="10.2196/18556",
url="https://www.jmir.org/2020/10/e18556",
url="http://www.ncbi.nlm.nih.gov/pubmed/33001033"
}


@Article{info:doi/10.2196/18143,
author="A'mar, Teresa
and Beatty, David J.
and Fedorenko, Catherine
and Markowitz, Daniel
and Corey, Thomas
and Lange, Jane
and Schwartz, M. Stephen
and Huang, Bin
and Chubak, Jessica
and Etzioni, Ruth",
title="Incorporating Breast Cancer Recurrence Events Into Population-Based Cancer Registries Using Medical Claims: Cohort Study",
journal="JMIR Cancer",
year="2020",
month="Aug",
day="17",
volume="6",
number="2",
pages="e18143",
keywords="cancer registries",
keywords="medical claims",
keywords="cancer recurrence event",
keywords="statistical learning",
keywords="breast cancer",
keywords="medical informatics",
keywords="data mining",
abstract="Background: There is a need for automated approaches to incorporate information on cancer recurrence events into population-based cancer registries. Objective: The aim of this study is to determine the accuracy of a novel data mining algorithm to extract information from linked registry and medical claims data on the occurrence and timing of second breast cancer events (SBCE). Methods: We used supervised data from 3092 stage I and II breast cancer cases (with 394 recurrences), diagnosed between 1993 and 2006 inclusive, of patients at Kaiser Permanente Washington and cases in the Puget Sound Cancer Surveillance System. Our goal was to classify each month after primary treatment as pre- versus post-SBCE. The prediction feature set for a given month consisted of registry variables on disease and patient characteristics related to the primary breast cancer event, as well as features based on monthly counts of diagnosis and procedure codes for the current, prior, and future months. A month was classified as post-SBCE if the predicted probability exceeded a probability threshold (PT); the predicted time of the SBCE was taken to be the month of maximum increase in the predicted probability between adjacent months. Results: The Kaplan-Meier net probability of SBCE was 0.25 at 14 years. The month-level receiver operating characteristic curve on test data (20\% of the data set) had an area under the curve of 0.986. The person-level predictions (at a monthly PT of 0.5) had a sensitivity of 0.89, a specificity of 0.98, a positive predictive value of 0.85, and a negative predictive value of 0.98. The corresponding median difference between the observed and predicted months of recurrence was 0 and the mean difference was 0.04 months. Conclusions: Data mining of medical claims holds promise for the streamlining of cancer registry operations to feasibly collect information about second breast cancer events. ",
doi="10.2196/18143",
url="http://cancer.jmir.org/2020/2/e18143/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32804084"
}


@Article{info:doi/10.2196/13979,
author="Alghamdi, Abdulrahman
and Abumelha, Khalid
and Allarakia, Jawad
and Al-Shehri, Ahmed",
title="Conversations and Misconceptions About Chemotherapy in Arabic Tweets: Content Analysis",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="29",
volume="22",
number="7",
pages="e13979",
keywords="internet",
keywords="chemotherapy",
keywords="cancer",
keywords="Twitter",
keywords="social media",
keywords="Arab world",
keywords="misconceptions",
keywords="infodemiology",
keywords="infoveillance",
abstract="Background: Although chemotherapy was first introduced for the treatment of cancer more than 60 years ago, the public understanding and acceptance of chemotherapy is still debatable. To the best of our knowledge, no study has assessed the conversations and misconceptions about chemotherapy as a treatment for cancer on social media platforms among the Arabic-speaking populations. Objective: The aim of this study was to assess the types of conversations and misconceptions that were shared on Twitter regarding chemotherapy as a treatment for cancer among the Arabic-speaking populations. Methods: All Arabic tweets containing any of the representative set of keywords related to chemotherapy and written between May 1, 2017 and October 31, 2017 were retrieved. A manual content analysis was performed to identify the categories of the users, general themes of the tweets, and the common misconceptions about chemotherapy. A chi-square test for independence with adjusted residuals was used to assess the significant associations between the categories of the users and the themes of the tweets. Results: A total of 402,157 tweets were retrieved, of which, we excluded 309,602 retweets and 62,651 irrelevant tweets. Therefore, 29,904 tweets were included in the final analysis. The majority of the tweets were posted by general users (25,774/29,904, 86.2\%), followed by the relatives and friends of patients with cancer (1913/29,904, 6.4\%). The tweets were classified into 9 themes; prayers and wishes for the well-being of patients undergoing chemotherapy was the most common theme (20,288/29,904, 67.8\%), followed by misconceptions about chemotherapy (2084/29,904, 7.0\%). There was a highly significant association between the category of the users and the themes of the tweets ($\chi$240= 16904.4, P<.001). Conclusions: Our findings support those of the previous infodemiology studies that Twitter is a valuable social media platform for assessing public conversations, discussions, and misconceptions about various health-related topics. The most prevalent theme of the tweets in our sample population was supportive messages for the patients undergoing chemotherapy, thereby suggesting that Twitter could play a role as a support mechanism for such patients. The second most prevalent theme of the tweets in our study was the various misconceptions about chemotherapy. The findings of our exploratory analysis can help physicians and health care organizations tailor educational efforts in the future to address different misconceptions about chemotherapy, thereby leading to increased public acceptance of chemotherapy as a suitable mode of treatment for cancer. ",
doi="10.2196/13979",
url="http://www.jmir.org/2020/7/e13979/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32723724"
}


@Article{info:doi/10.2196/14359,
author="Aqel, Ashraf
and Khader, Yousef
and Arqoub, Kamal
and Nimri, Omar",
title="Survival Rate of Gastric Cancer Patients in Jordan: Secondary Data Analysis",
journal="JMIR Public Health Surveill",
year="2020",
month="May",
day="4",
volume="6",
number="2",
pages="e14359",
keywords="gastric cancer",
keywords="survival rate",
keywords="Jordanian cancer cases",
abstract="Background: Gastric cancer accounts for 2.7\% of all newly diagnosed cancer cases in Jordan. Objective: The aim of this study was to calculate the survival rate and its determinants among Jordanian patients who were diagnosed with gastric cancer between 2010 and 2014. Methods: A descriptive study was conducted based on secondary analysis of data from the Jordan Cancer Registry during the period of 2010-2014. Only cancer-related deaths were recorded as ``death'' in the survival analysis. Results: A total of 1388 new cases of gastric cancer were recorded between 2010 and 2014. Of these, 872 (62.8\%) were Jordanians and 60.5\% were males. The mean age at diagnosis was 58.9 years and the median follow-up time was 1.6 years. The 5-year survival rate decreased significantly from 89\% in patients with well-differentiated cancer to 32\% in patients with poorly differentiated cancer (P=.005). The overall 5-year survival rate was 37.7\% and the median survival was 1.48 years (95\% CI 1.179-1.783). The 5-year survival rate decreased significantly with increasing age and with advanced stage of the disease: the 5-year survival rate was 75\% for localized-stage, 48\% for regional-stage, and 22.7\% for distant-metastasis disease (P=.005). Conclusions: This study showed that the overall 5-year survival rate among patients with gastric cancer in Jordan between 2010 and 2014 was 37.7\%, which is higher than the reported rates from different countries in the Eastern Mediterranean region such as Egypt. ",
doi="10.2196/14359",
url="https://publichealth.jmir.org/2020/2/e14359",
url="http://www.ncbi.nlm.nih.gov/pubmed/32364509"
}


@Article{info:doi/10.2196/12849,
author="Reeders, Jocelyn
and Ashoka Menon, Vivek
and Mani, Anita
and George, Mathew",
title="Clinical Profiles and Survival Outcomes of Patients With Well-Differentiated Neuroendocrine Tumors at a Health Network in New South Wales, Australia: Retrospective Study",
journal="JMIR Cancer",
year="2019",
month="Nov",
day="20",
volume="5",
number="2",
pages="e12849",
keywords="Australia",
keywords="neuroendocrine tumor",
keywords="New South Wales",
abstract="Background: Neuroendocrine tumors (NETs) are a heterogeneous group of malignancies with varying and often indolent clinicobiological characteristics according to their primary location. NETs can affect any organ and hence present with nonspecific symptoms that can lead to a delay in diagnosis. The incidence of NETs is increasing in Australia; data regarding characteristics of NETs were collected from the cancer registry of Hunter New England, Australia. Objective: This study aimed to explore the clinical profiles and treatment and survival outcomes of patients with well-differentiated NETs in an Australian population. Methods: We reviewed the data of all adult patients who received the diagnosis of NET between 2008 and 2013. The clinicopathological, treatment, and follow-up data were extracted from the local Cancer Clinical Registry. We also recorded the level of remoteness for each patient by matching the patient's residential postcode to the corresponding Australian Bureau of Statistics 2011 remoteness area category. Univariate analysis was used to find the factors associated with NET-related mortality. Survival analysis was computed. Results: Data from 96 patients were included in the study (men: 37/96, 38.5\%, and women: 59/96, 61.5\%). The median age at diagnosis was approximately 63 years. A higher proportion of patients lived in remote/rural areas (50/96, 52.1\%) compared with those living in city/metropolitan regions (46/96, 47.9\%). The most common primary tumor site was the gastroenteropancreatic tract, followed by the lung. The factors significantly associated with NET-related mortality were age, primary tumor site, surgical resection status, tumor grade, and clinical stage of the patient. At 5 years, the overall survival rate was found to be 62\%, and the disease-free survival rate was 56.5\%. Conclusions: Older age, advanced unresectable tumors, evidence of metastasis, and higher-grade tumors were associated with poorer outcomes. Lung tumors had a higher risk of NET-related mortality compared with other sites. ",
doi="10.2196/12849",
url="http://cancer.jmir.org/2019/2/e12849/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31746768"
}


@Article{info:doi/10.2196/13260,
author="Wang, Xiaofang
and Zhang, Yan
and Hao, Shiying
and Zheng, Le
and Liao, Jiayu
and Ye, Chengyin
and Xia, Minjie
and Wang, Oliver
and Liu, Modi
and Weng, Ho Ching
and Duong, Q. Son
and Jin, Bo
and Alfreds, T. Shaun
and Stearns, Frank
and Kanov, Laura
and Sylvester, G. Karl
and Widen, Eric
and McElhinney, B. Doff
and Ling, B. Xuefeng",
title="Prediction of the 1-Year Risk of Incident Lung Cancer: Prospective Study Using Electronic Health Records from the State of Maine",
journal="J Med Internet Res",
year="2019",
month="May",
day="16",
volume="21",
number="5",
pages="e13260",
keywords="lung cancer",
keywords="risk prediction model",
keywords="electronic health records",
keywords="prospective study",
abstract="Background: Lung cancer is the leading cause of cancer death worldwide. Early detection of individuals at risk of lung cancer is critical to reduce the mortality rate. Objective: The aim of this study was to develop and validate a prospective risk prediction model to identify patients at risk of new incident lung cancer within the next 1 year in the general population. Methods: Data from individual patient electronic health records (EHRs) were extracted from the Maine Health Information Exchange network. The study population consisted of patients with at least one EHR between April 1, 2016, and March 31, 2018, who had no history of lung cancer. A retrospective cohort (N=873,598) and a prospective cohort (N=836,659) were formed for model construction and validation. An Extreme Gradient Boosting (XGBoost) algorithm was adopted to build the model. It assigned a score to each individual to quantify the probability of a new incident lung cancer diagnosis from October 1, 2016, to September 31, 2017. The model was trained with the clinical profile in the retrospective cohort from the preceding 6 months and validated with the prospective cohort to predict the risk of incident lung cancer from April 1, 2017, to March 31, 2018. Results: The model had an area under the curve (AUC) of 0.881 (95\% CI 0.873-0.889) in the prospective cohort. Two thresholds of 0.0045 and 0.01 were applied to the predictive scores to stratify the population into low-, medium-, and high-risk categories. The incidence of lung cancer in the high-risk category (579/53,922, 1.07\%) was 7.7 times higher than that in the overall cohort (1167/836,659, 0.14\%). Age, a history of pulmonary diseases and other chronic diseases, medications for mental disorders, and social disparities were found to be associated with new incident lung cancer. Conclusions: We retrospectively developed and prospectively validated an accurate risk prediction model of new incident lung cancer occurring in the next 1 year. Through statistical learning from the statewide EHR data in the preceding 6 months, our model was able to identify statewide high-risk patients, which will benefit the population health through establishment of preventive interventions or more intensive surveillance. ",
doi="10.2196/13260",
url="http://www.jmir.org/2019/5/e13260/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31099339"
}


@Article{info:doi/10.2196/10677,
author="Xu, Chenjie
and Wang, Yi
and Yang, Hongxi
and Hou, Jie
and Sun, Li
and Zhang, Xinyu
and Cao, Xinxi
and Hou, Yabing
and Wang, Lan
and Cai, Qiliang
and Wang, Yaogang",
title="Association Between Cancer Incidence and Mortality in Web-Based Data in China: Infodemiology Study",
journal="J Med Internet Res",
year="2019",
month="Jan",
day="29",
volume="21",
number="1",
pages="e10677",
keywords="cancer",
keywords="incidence",
keywords="mortality",
keywords="web-based data",
keywords="internet searching",
abstract="Background: Cancer poses a serious threat to the health of Chinese people, resulting in a major challenge for public health work. Today, people can obtain relevant information from not only medical workers in hospitals, but also the internet in any place in real-time. Search behaviors can reflect a population's awareness of cancer from a completely new perspective, which could be driven by the underlying cancer epidemiology. However, such Web-retrieved data are not yet well validated or understood. Objective: This study aimed to explore whether a correlation exists between the incidence and mortality of cancers and normalized internet search volumes on the big data platform, Baidu. We also assessed whether the distribution of people who searched for specific types of cancer differed by gender. Finally, we determined whether there were regional disparities among people who searched the Web for cancer-related information. Methods: Standard Boolean operators were used to choose search terms for each type of cancer. Spearman's correlation analysis was used to explore correlations among monthly search index values for each cancer type and their monthly incidence and mortality rates. We conducted cointegration analysis between search index data and incidence rates to examine whether a stable equilibrium existed between them. We also conducted cointegration analysis between search index data and mortality data. Results: The monthly Baidu index was significantly correlated with cancer incidence rates for 26 of 28 cancers in China (lung cancer: r=.80, P<.001; liver cancer: r=.28, P=.016; stomach cancer: r=.50, P<.001; esophageal cancer: r=.50, P<.001; colorectal cancer: r=.81, P<.001; pancreatic cancer: r=.86, P<.001; breast cancer: r=.56, P<.001; brain and nervous system cancer: r=.63, P<.001; leukemia: r=.75, P<.001; Non-Hodgkin lymphoma: r=.88, P<.001; Hodgkin lymphoma: r=.91, P<.001; cervical cancer: r=.64, P<.001; prostate cancer: r=.67, P<.001; bladder cancer: r=.62, P<.001; gallbladder and biliary tract cancer: r=.88, P<.001; lip and oral cavity cancer: r=.88, P<.001; ovarian cancer: r=.58, P<.001; larynx cancer: r=.82, P<.001; kidney cancer: r=.73, P<.001; squamous cell carcinoma: r=.94, P<.001; multiple myeloma: r=.84, P<.001; thyroid cancer: r=.77, P<.001; malignant skin melanoma: r=.55, P<.001; mesothelioma: r=.79, P<.001; testicular cancer: r=.57, P<.001; basal cell carcinoma: r=.83, P<.001). The monthly Baidu index was significantly correlated with cancer mortality rates for 24 of 27 cancers. In terms of the whole population, the number of women who searched for cancer-related information has slowly risen over time. People aged 30-39 years were most likely to use search engines to retrieve cancer-related knowledge. East China had the highest Web search volumes for cancer. Conclusions: Search behaviors indeed reflect public awareness of cancer from a different angle. Research on internet search behaviors could present an innovative and timely way to monitor and estimate cancer incidence and mortality rates, especially for cancers not included in national registries. ",
doi="10.2196/10677",
url="https://www.jmir.org/2019/1/e10677/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30694203"
}


@Article{info:doi/10.2196/10447,
author="Flanagan, M. James
and Skrobanski, Hanna
and Shi, Xin
and Hirst, Yasemin",
title="Self-Care Behaviors of Ovarian Cancer Patients Before Their Diagnosis: Proof-of-Concept Study",
journal="JMIR Cancer",
year="2019",
month="Jan",
day="17",
volume="5",
number="1",
pages="e10447",
keywords="cancer",
keywords="early diagnosis",
keywords="proof of concept",
keywords="focus group",
keywords="acceptability",
keywords="data linkage",
keywords="cancer surveillance",
abstract="Background: Longer patient intervals can lead to more late-stage cancer diagnoses and higher mortality rates. Individuals may delay presenting to primary care with red flag symptoms and instead turn to the internet to seek information, purchase over-the-counter medication, and change their diet or exercise habits. With advancements in machine learning, there is the potential to explore this complex relationship between a patient's symptom appraisal and their first consultation at primary care through linkage of existing datasets (eg, health, commercial, and online). Objective: Here, we aimed to explore feasibility and acceptability of symptom appraisal using commercial- and health-data linkages for cancer symptom surveillance. Methods: A proof-of-concept study was developed to assess the general public's acceptability of commercial- and health-data linkages for cancer symptom surveillance using a qualitative focus group study. We also investigated self-care behaviors of ovarian cancer patients using high-street retailer data, pre- and postdiagnosis. Results: Using a high-street retailer's data, 1118 purchases---from April 2013 to July 2017---by 11 ovarian cancer patients and one healthy individual were analyzed. There was a unique presence of purchases for pain and indigestion medication prior to cancer diagnosis, which could signal disease in a larger sample. Qualitative findings suggest that the public are willing to consent to commercial- and health-data linkages as long as their data are safeguarded and users of this data are transparent about their purposes. Conclusions: Cancer symptom surveillance using commercial data is feasible and was found to be acceptable. To test efficacy of cancer surveillance using commercial data, larger studies are needed with links to individual electronic health records. ",
doi="10.2196/10447",
url="https://cancer.jmir.org/2019/1/e10447/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30664464"
}


@Article{info:doi/10.2196/publichealth.8163,
author="Ben Ramadan, Ahmed Awatef
and Jackson-Thompson, Jeannette
and Schmaltz, Lee Chester",
title="Improving Visualization of Female Breast Cancer Survival Estimates: Analysis Using Interactive Mapping Reports",
journal="JMIR Public Health Surveill",
year="2018",
month="May",
day="03",
volume="4",
number="2",
pages="e42",
keywords="survival",
keywords="female breast cancer",
keywords="Missouri",
keywords="cancer registry",
abstract="Background: The Missouri Cancer Registry collects population-based cancer incidence data on Missouri residents diagnosed with reportable malignant neoplasms. The Missouri Cancer Registry wanted to produce data that would be of interest to lawmakers as well as public health officials at the legislative district level on breast cancer, the most common non-skin cancer among females. Objective: The aim was to measure and interactively visualize survival data of female breast cancer cases in the Missouri Cancer Registry. Methods: Female breast cancer data were linked to Missouri death records and the Social Security Death Index. Unlinked female breast cancer cases were crossmatched to the National Death Index. Female breast cancer cases in subcounty senate districts were geocoded using TIGER/Line shapefiles to identify their district. A database was created and analyzed in SEER*Stat. Senatorial district maps were created using US Census Bureau's cartographic boundary files. The results were loaded with the cartographic data into InstantAtlas software to produce interactive mapping reports. Results: Female breast cancer survival profiles of 5-year cause-specific survival percentages and 95\% confidence intervals, displayed in tables and interactive maps, were created for all 34 senatorial districts. The maps visualized survival data by age, race, stage, and grade at diagnosis for the period from 2004 through 2010. Conclusions: Linking cancer registry data to the National Death Index database improved accuracy of female breast cancer survival data in Missouri and this could positively impact cancer research and policy. The created survival mapping report could be very informative and usable by public health professionals, policy makers, at-risk women, and the public. ",
doi="10.2196/publichealth.8163",
url="http://publichealth.jmir.org/2018/2/e42/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29724710"
}


@Article{info:doi/10.2196/cancer.7515,
author="Jabour, M. Abdulrahman
and Dixon, E. Brian
and Jones, F. Josette
and Haggstrom, A. David",
title="Toward Timely Data for Cancer Research: Assessment and Reengineering of the Cancer Reporting Process",
journal="JMIR Cancer",
year="2018",
month="Mar",
day="01",
volume="4",
number="1",
pages="e4",
keywords="neoplasms",
keywords="registries",
keywords="SEER program",
keywords="workflow",
keywords="computer simulation",
keywords="data collection",
keywords="epidemiological monitoring",
abstract="Background: Cancer registries systematically collect cancer-related data to support cancer surveillance activities. However, cancer data are often unavailable for months to years after diagnosis, limiting its utility. Objective: The objective of this study was to identify the barriers to rapid cancer reporting and identify ways to shorten the turnaround time. Methods: Certified cancer registrars reporting to the Indiana State Department of Health cancer registry participated in a semistructured interview. Registrars were asked to describe the reporting process, estimate the duration of each step, and identify any barriers that may impact the reporting speed. Qualitative data analysis was performed with the intent of generating recommendations for workflow redesign. The existing and redesigned workflows were simulated for comparison. Results: Barriers to rapid reporting included access to medical records from multiple facilities and the waiting period from diagnosis to treatment. The redesigned workflow focused on facilitating data sharing between registrars and applying a more efficient queuing technique while registrars await the delivery of treatment. The simulation results demonstrated that our recommendations to reduce the waiting period and share information could potentially improve the average reporting speed by 87 days. Conclusions: Knowing the time elapsing at each step within the reporting process helps in prioritizing the needs and estimating the impact of future interventions. Where some previous studies focused on automating some of the cancer reporting activities, we anticipate much shorter reporting by leveraging health information technologies to target this waiting period. ",
doi="10.2196/cancer.7515",
url="http://cancer.jmir.org/2018/1/e4/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29496653"
}


@Article{info:doi/10.2196/medinform.8175,
author="Chen, W. Henry
and Du, Jingcheng
and Song, Hsing-Yi
and Liu, Xiangyu
and Jiang, Guoqian
and Tao, Cui",
title="Representation of Time-Relevant Common Data Elements in the Cancer Data Standards Repository: Statistical Evaluation of an Ontological Approach",
journal="JMIR Med Inform",
year="2018",
month="Feb",
day="22",
volume="6",
number="1",
pages="e7",
keywords="common data elements",
keywords="database management systems",
keywords="database",
keywords="time",
keywords="biomedical ontology",
abstract="Background: Today, there is an increasing need to centralize and standardize electronic health data within clinical research as the volume of data continues to balloon. Domain-specific common data elements (CDEs) are emerging as a standard approach to clinical research data capturing and reporting. Recent efforts to standardize clinical study CDEs have been of great benefit in facilitating data integration and data sharing. The importance of the temporal dimension of clinical research studies has been well recognized; however, very few studies have focused on the formal representation of temporal constraints and temporal relationships within clinical research data in the biomedical research community. In particular, temporal information can be extremely powerful to enable high-quality cancer research. Objective: The objective of the study was to develop and evaluate an ontological approach to represent the temporal aspects of cancer study CDEs. Methods: We used CDEs recorded in the National Cancer Institute (NCI) Cancer Data Standards Repository (caDSR) and created a CDE parser to extract time-relevant CDEs from the caDSR. Using the Web Ontology Language (OWL)--based Time Event Ontology (TEO), we manually derived representative patterns to semantically model the temporal components of the CDEs using an observing set of randomly selected time-related CDEs (n=600) to create a set of TEO ontological representation patterns. In evaluating TEO's ability to represent the temporal components of the CDEs, this set of representation patterns was tested against two test sets of randomly selected time-related CDEs (n=425). Results: It was found that 94.2\% (801/850) of the CDEs in the test sets could be represented by the TEO representation patterns. Conclusions: In conclusion, TEO is a good ontological model for representing the temporal components of the CDEs recorded in caDSR. Our representative model can harness the Semantic Web reasoning and inferencing functionalities and present a means for temporal CDEs to be machine-readable, streamlining meaningful searches. ",
doi="10.2196/medinform.8175",
url="http://medinform.jmir.org/2018/1/e7/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29472179"
}