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Background: During the COVID-19 pandemic, Twitter has been instrumental in accelerating knowledge dissemination and forging collaborations within the medical community and amongst patient advocates. Tweetchats within Twitter are scheduled conversations on a specific topic. In oncology, Tweetchats have been used by cancer advocates to spread awareness and for patient and caregiver education. A colorectal cancer (CRC) specific tweetchat did not previously exist. This describes the creation, and experiences with a CRC specific tweetchat. Method(s): The #CRCTrialsChat tweetchat was created by a patient advocate for colorectal cancer patients, caregivers and clinicians to meet and exchange clinical trial-related information. Two gastrointestinal (GI) medical oncologists and two radiation oncologists were enlisted as moderators. The topic for each session is chosen by the patient advocate, who creates an outline and divides the content, which is designed to last a one hour session. The idea is to create engaging, technical, but easy to understand content. Each moderator then works on the answers to their assigned section, which is edited to fit tweet character limit. Sessions may also have guest moderators with expertise on a specific topic. Through tweeting, moderators answer specific questions that come up during the session and later. Result(s): To date, we have had four sessions covering the following topics: Clinical trial basics, CRC Updates from ASCO22, ClinicalTrialFinders and BRAF-mutated tumors. The content created has been simple and engaging, the format has functioned smoothly, and the reach of #CRCTrialsChat has been steadily increasing. After the most recent session on BRAF in September 2022, the @CRCTrialsChat has 281 followers, 17K impressions and 14.6K profile visits, a reflection of its excellent content. From a clinician perspective, this is a great format to interact with colleagues, discuss enrolling trials and also become familiar with using Twitter. Conclusion(s): A CRC clinical trial focused tweetchat is an engaging way to deliver trial-related content to an audience of clinicians, patients and caregivers. The current format appears to be an effective way to create and disseminate information. Future sessions will focus on ctDNA, molecular markers such as KRAS and HER2, and rectal cancer trials. Our hope is that #CRCTrialsChat will stimulate continued patient and clinician engagement, increase awareness of clinical trials, enhance trial participation and initiate patient-centric research and collaborations.
RESUMO
Purpose/Background: Early onset CRC (EO CRC), patients <50yo, is increasing in incidence. Diagnosis is driven by symptoms as the patients are ineligible for screening. Where patients access the health system is unclear. Hypothesis/Aim: We hypothesize that non-white patients with EO CRC present at disproportionate rates to the Emergency Department (ED). Methods/Interventions: Our institutional tumor board registry was reviewed for patients who were presented from August 2020-August 2021. Clinical chart review for race, sex, age, hospital presentation, site of malignancy, and access to health system: primary care, emergency department, outside referral, were extracted. Access to the health system was determined by who ordered the diagnostic colonoscopy or imaging study. Results/Outcome(s): One-hundred ninety-seven patients with colon and rectal adenocarcinoma were discussed at tumor board between August 2020-August 2021 (Table 1). Fifty-seven were EO and 140/197 were age >50. The sex distribution was approximately equal across ages. Of those <50 the median age was 45, and non-white patients were disproportionally represented with 47% Hispanic, 17.5% Black, 10.5% Asian patients. Non-white EO patients were more likely to present through the ED (16/34) relative to white EO patients (1/13). Of all EO patients 17 presented through the Emergency Department, 24 through primary care providers, 11 were referred in from an outside facility, and 2 diagnosed internationally (Figure). Limitations: This is an exploratory, retrospective single institution review of patients discussed at multidisciplinary tumor board over a single year. The population includes a safety-net institution and may not reflect presentation patterns at other hospitals. The cohort size is underpowered for meaningful statistical comparison. The cohort was generated during the COVID-19 pandemic. Conclusions/Discussion: Patients with early onset colorectal cancer are referred for colonoscopic or imaging diagnostics through their primary care doctors, followed by the Emergency Department. Non-white patients, compared to other groups, access the healthcare system through the ED. However, whether this observation is due to the absence of a PCP access, due to restricted screening/diagnostic guidelines, or due to colonoscopic provider availability is unclear. Hispanic patients are disproportionately represented in our early onset cohort relative to the demographics of the hospital referral base. While the study is underpowered, it is provocative for requiring further investigation. Resources to heighten the suspicion for malignancy in patients presenting to our emergency departments and primary care offices, especially in young, non-white populations, may expedite access to diagnosis and definitive therapy for these patients. (Figure Presented).