Leveraging Patient Education to Amplify Colorectal Cancer Screening in the United States: Strategies and Implications.

Despite several available screening modalities, colorectal cancer (CRC) remains a leading cause of cancer deaths, especially among populations with lower screening rates. Barriers to screening include cost, access, awareness, and education disparities, with interventions such as patient education programs and mailed screening kits showing promise in increasing participation rates. The current review elucidates the correlation between patient awareness/knowledge and screening rates in the United States, highlighting the pivotal role of education in mitigating these deficiencies. Different educational models, including online resources, mailed information, community programs, direct provider-based interventions, and narratives, are explored in terms of their effectiveness and limitations. We also offer a blueprint for primary care providers (PCPs) that highlights the importance of tailored education, barrier identification, and utilization of available resources to enhance CRC screening uptake. Large-scale adoption of educational strategies has the potential to significantly increase CRC screening rates and consequently reduce mortality associated with this preventable malignancy.

Availability of primary care physicians and hepatocellular carcinoma-related mortality in the United States.

Hepatocellular carcinoma (HCC) is the fifth leading cause of cancer worldwide and majority cases are diagnosed at an intermediate or advanced stage. Per our analysis, greater availability of primary care physicians correlates with lower HCC-related mortality. Our results underscore the need for efforts to expand access to primary care among all populations, especially African Americans, to improve overall HCC-related outcomes.

Lost in translation: evaluating the readability of online patient information for neuroendocrine tumors.

INTRODUCTION: Recent data show that many patients with NETs do not receive sufficient education regarding their diagnosis and therefore tend to search for information or literature independently. We sought to assess the readability of OPI for neuroendocrine tumors and to analyze compliance to NIH guidelines for OPI (readability level 8th grade or below). METHODS: We performed a Google search to compile a list of the top ten OPI websites using the search term "neuroendocrine tumor". We calculated median readability scores for each website across the 9 scales as well as overall readability scores across all sites. RESULTS: A total of 10 websites were included for analysis. 6/10 (60%) of the websites belonged to academic institutions, while 2/10 (20%) were from non-profit organizations, and 1 each were a government website (10%) and patient advocacy organization (10%). The median (with interquartile range or IQR) readability score for all websites across the nine readability tests was 9.6 (IQR 8.8-11.2). CONCLUSION: Our findings underscore the need to develop online patient education material that is readable and therefore easily understandable for patients and caregivers dealing with this unique group of malignancies.

Outcome of Patients With Early-Stage Mismatch Repair Deficient Colorectal Cancer Receiving Neoadjuvant Immunotherapy: A Systematic Review.

PURPOSE: We conducted a systematic review to evaluate the outcome of patients with early-stage (stages I-III) mismatch repair deficient (dMMR) colorectal cancer (CRC) receiving neoadjuvant immunotherapy (NIT) with immune checkpoint inhibitor (ICI)-based regimens. METHODS: MEDLINE, Scopus, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched for publications reporting the outcome of patients with early-stage dMMR CRC receiving NIT. The primary outcome measures were the complete response (CR) rate (clinical CR [cCR] or pathologic CR [pCR]) and the incidence of grade 3 or higher toxicities. RESULTS: The search identified 37 publications that included 423 patients with colon (n = 326, 77%) and rectal (n = 97,23%) cancers aged 19-82 years; most patients had stage III CRC (88%). Approximately 67% of patients received monotherapy with anti-PD-1 agents; the rest received dual ICIs (ipilimumab plus nivolumab). The CR rate (pCR + cCR) in the overall population was 72% (305 of 423). The R0 resection and pCR rates were 99.3% and 70% among the patients undergoing surgery, respectively. Only four (0.9%) patients had primary resistance to NIT. After median follow-up periods ranging from 4 to 27 months, 3 (0.7%) patients progressed after an initial response. Grade 3 or higher toxicities were uncommon (6.3%), rarely delaying planned surgery. CONCLUSION: NIT in patients with early-stage dMMR CRC is associated with a high response rate, low primary resistance to immunotherapy and cancer recurrence rate, and an excellent safety profile. The findings of the present systematic review support further investigation of NIT in patients with early-stage dMMR CRC, with a particular emphasis on the organ-preserving potential of this strategy.