Li, Jian

Abstract There is a large and increasing rate of incarcerated individuals that face a risk of cancer. Cancer is the leading cause of death among the incarcerated population, resulting in a significantly shortened survival rate amongst said population. Very few studies have been conducted to truly assess the knowledge gap between incarceration and cancer outcomes. But, from the few that have been done, like the population-based study done by UF Radiation Oncology assistant professor, Dr. Oladeru, it was discovered that a higher risk of cancer mortality was prevalent in those who were diagnosed with cancer during their time incarcerated as well as one year post release than the general population. My goal and intent with this literature review is to open the conversation about possible ways to bridge the knowledge gap between cancer health disparities amongst incarcerated patients and contribution factors. Citation Format: Tamia Isaacs, Oluwadamilola Oladeru, Jian Li, Yoshiko Iwai. Bridging the gap: A literature review of cancer mortality and incarcerated individuals [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C015.

PURPOSE The COVID-19 pandemic has profoundly affected cancer care worldwide, including radiation therapy (RT) for breast cancer (BC), because of risk-based resource allocation. We report the evolution of international breast RT practices during the beginning of the pandemic, focusing on differences in treatment recommendations between countries. MATERIALS AND METHODS Between July and November 2020, a 58-question survey was distributed to radiation oncologists (ROs) through international professional societies. Changes in RT decision making during the first surge of the pandemic were evaluated across six hypothetical scenarios, including the management of ductal carcinoma in situ (DCIS), early-stage, locally advanced, and metastatic BC. The significance of changes in responses before and during the pandemic was examined using chi-square and McNemar-Bowker tests. RESULTS One thousand one hundred three ROs from 54 countries completed the survey. Incomplete responses (254) were excluded from the analysis. Most respondents were from the United States (285), Japan (117), Italy (63), Canada (58), and Brazil (56). Twenty-one percent (230) of respondents reported treating at least one patient with BC who was COVID-19–positive. Approximately 60% of respondents reported no change in treatment recommendation during the pandemic, except for patients with metastatic disease, for which 57.7% (636/1,103; P < .0005) changed their palliative practice. Among respondents who noted a change in their recommendation during the first surge of the pandemic, omitting, delaying, and adopting short-course RT were the most frequent changes, with most transitioning to moderate hypofractionation for DCIS and early-stage BC. CONCLUSION Early in the COVID-19 pandemic, significant changes in global RT practice patterns for BC were introduced. The impact of published results from the FAST FORWARD trial supporting ultrahypofractionation likely confounded the interpretation of the pandemic's independent influence on RT delivery.