Statistical analysis of gynecological cancer

Background: Gynaecologic cancers constitute huge burden of morbidity and mortality all over the world. Statistics on gynaecologic malignancies is deficient. It is the leading cause of death and disability worldwide. In India breast cancer ranks number one followed by cervical cancer. The aim of our study was to establish pattern and incidence of gynaecological malignancy.Methods: This hospital based study was conducted in Sri Guru Ramdass Institute of medical sciences and research, Amritsar on 282 patients from March 2020 to December 2020. The demographic data of all cancer patients regarding age, clinical presentation, site, staging, histopathology and treatment given was collected and was analysed in tabulated form.Results: In our study, breast cancer was the commonest malignancy encountered in 46.09% followed by cervical cancer which constituted 32.26%.Ovarian cancer was diagnosed in 15.24%, endometrial cancer in 3.19%, vulval cancer in 2.12% and vaginal carcinomas in 1.06%.Conclusions: Gynaecological cancers are one of the leading causes of cancer related deaths in women worldwide, hence it is important to be aware of various types of malignancies. In our study, cases reported in advanced stages because of lack of education and COVID scenario as patients were reluctant to visit hospitals. So we must continue to provide our gynecologic oncology patient the highest quality of medical care at the same time assuring maximum safety for patients.

Urologic Oncology Patient Perspectives During COVID-19 Treatment Delays

Purpose The COVID-19 pandemic led to delays in urologic cancer treatment. We sought the patient perspective on these delays. Methods We conducted a mixed methods study with an explanatory-sequential design. Survey findings are presented here. Patients from a Midwestern Comprehensive Cancer Center and the Bladder Cancer Advocacy Network provided demographic and clinical data and responded to statements asking them to characterize their experience of treatment delay, patient-provider communication and coping strategies. We quantified patient distress with an ordinal scale (0-10), based on the National Comprehensive Cancer Network Distress Thermometer (NCCN-DT). Results Forty-four consenting patients responded to the survey. Most were older than 61 years (77%) and male (66%). Their diagnoses included bladder (45%), prostate (30%) and kidney (20%) cancers. Median time since diagnosis was 6 months, 95% had plans for surgical treatment. Dominant reactions to treatment delay included fear that cancer would progress (50%) and relief at avoiding COVID-19 exposure (43%). Most patients reported feeling that their providers acknowledged their emotions (70%), yet 52% did not receive follow up phone calls and only 55% felt continually supported by their providers. Patients’ median distress level was 5/10 with 68% of patients reaching a clinically significant level of distress (≥4). Thematically grouped suggestions for providers included better communication (18%), more personalized support (14%), and better patient education (11%). Conclusion During the COVID-19 pandemic, a high proportion of urologic cancer patients reached a clinically significant level of distress. While they felt concern from providers, they desired more engagement and personalized care.

Adolescent/Young Adult (AYA) Hematology/Oncology Patient and Parent Attitudes toward AYA COVID-19 Vaccination

Background: Adolescent/young adult (AYA) patients with hematologic and oncologic conditions are at increased risk for complications of COVID-19 and thus are important targets for vaccine outreach. AYA patients are transitioning from relying upon parental vaccine decision-making to independently making their own decisions. AYA with sickle cell disease (SCD) are of particular concern because a high proportion are African American and experience structural racism in addition to their illness. Further, AYA patients with chronic conditions may consider their past and present illness in their decision-making process. Methods: As part of a larger IRB-approved study, we recruited vaccine decision-makers for AYA patients aged 9-21 years attending SCD and oncology survivor clinics, including AYA patients 18-21 years old and parents of AYA patients 9-21 years old. After informed consent, participants completed a short demographic survey and a semi-structured interview regarding their vaccine decision-making process. Questions about the COVID-19 vaccine were incorporated given the ongoing pandemic. Results: Forty-nine parents and 21 AYA patients were recruited. The primary barriers reported regarding vaccination were concerns about its short-term side effects (57% AYAs; 37% parents) and potential to have unknown, long-term effects (10% AYAs; 14% parents). There were also concerns voiced about how rapidly the vaccine was developed (14% AYAs; 27% parents) and misconceptions about the vaccine (19% AYAs; 10% parents). Parents and AYA patients described the benefits of vaccination as lowering personal risk (62% AYAs; 35% parents) and several also mentioned the community benefits of preventing the spread of COVID-19 (19% AYAs; 8% parents) and a possible return to “normal” (14% AYAs; 10% parents). Potential Impact: The data from this study will further the understanding of how parents and young adults with chronic hematologic and oncologic conditions make decisions about COVID-19 vaccination, a vital tool for protecting medically and socially vulnerable populations during the COVID-19 pandemic.

INNV-34. NEURO NARRATIVES: AN AUTOETHNOGRAPHIC ACCOUNT OF EXPERIENCING RESILIENCE WITH A BRAIN TUMOR

The current research uses autoethnography as a method to share my experience as a brain tumor patient. In this piece, I reference poems from the day of my diagnosis through my surgery, recovery, and following treatment to demonstrate the thematic factors that allowed me to cope and experience positive emotions as an oncology patient. Results included the factors of trust in medical care, utilizing social support, finding meaning and purpose, and self-love and gratitude. The implications of these factors in relation to resilience structures and discourses to better serve other oncology and chronic illness patients are discussed.

Assessing oncology patient and provider telehealth experience.

284 Background: Due to COVID-19, telehealth volume at our comprehensive cancer center rose from less than 5% of exam visits to over 25% in April 2020. We sought to understand the experience of telehealth and compare it to in-person experiences for patients and providers (physicians, nurse practitioners, and physician assistants) to identify areas for improvement. Methods: A multidisciplinary team adapted our existing patient satisfaction survey to incorporate telehealth, defined as phone and video exam visits. A technology section was created to assess aspects unique to telehealth. Questions about the patient-provider experience were the same for telehealth and in-person visits. A provider experience survey was conducted during a two-week period in May and June 2020. The provider survey aligned questions with the patient survey to compare the perceptions of the provider-patient interaction. Results: Patient experience scores for in-person and telehealth visits were comparable, with a slightly higher mean score for in-person visits. The mean scores for patient perception of care given at our cancer center was 97.5 (n=11,969) and 96.9 (n=4670) and the likelihood to recommend was 97.8 (n=12,072) and 97.4 (n=4,398) for in-person and telehealth, respectively, between June and December 2020. Patient feedback prioritized addressing technical barriers. We implemented several interventions and increased the telehealth technology section mean scores from 93.2 (n=1,095) to 95.2 (n=700) between June and December 2020. When comparing the percent of respondents scoring good or very good, provider scores showed sizable gaps between in-person and telehealth experiences on all questions (see table). The question “degree to which the care team was well coordinated” had the largest difference between in-person and telehealth scores for both patients and providers. Several interventions to adapt staffing and workflows have been implemented to improve care telehealth coordination. Conclusions: While patients reported similar satisfaction between in-person and telehealth visits, increasing coordination remains vital to improving the experience for both patients and providers. Furthermore, understanding the gap in the provider experience between in-person and telehealth is critical for successful adoption of telehealth as a long-term strategy for healthcare delivery.[Table: see text]