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Objectives Human papillomavirus (HPV)-associated cancers account for about 9% of the cancer mortality burden in the United States; however, survival differs among sociodemographic factors. We determine sociodemographic and clinical variables associated with HPV-associated cancer survival. Methods Data derived from the Surveillance, Epidemiology, and End Results 18 cancer registry were analyzed for a cohort of adult patients diagnosed with a first primary HPV-associated cancer (anal, cervical, oropharyngeal, penile, vaginal, and vulvar cancers), between 2007 and 2015. Multivariable Fine and Gray proportional hazards regression models stratified by anatomic site estimated the association of sociodemographic and clinical variables and cancer-specific survival. Results A total of 77 774 adults were included (11 216 anal, 27 098 cervical, 30 451 oropharyngeal, 2221 penile, 1176 vaginal, 5612 vulvar; average age = 57.2 years). The most common HPV-associated cancer was cervical carcinoma (58%) for females and oropharyngeal (81%) for male. Among patients diagnosed with anal/rectal squamous cell carcinoma (SCC), males had a higher risk of death than females. NonHispanic (NH) blacks had a higher risk of death from anal/rectal SCC, oropharyngeal SCC, and cervical carcinoma; and Hispanics had a higher risk of death from oropharyngeal SCC than NH whites. Marital status was associated with risk of death for all anatomic sites except vulvar. Compared to nonMedicaid insurance, patients with Medicaid and uninsured had higher risk of death from anal/rectal SCC, oropharyngeal SCC, and cervical carcinoma. Conclusions There exists gender (anal) and racial and insurance (anal, cervical, and oropharyngeal) disparities in relative survival. Concerted efforts are needed to increase and sustain progress made in HPV vaccine uptake among these specific patient subgroups, to reduce cancer incidence.

Objective To examine the association between adverse childhood events (ACEs) and cannabis use among adult cancer survivors in the United States. Methods We conducted a cross‐sectional study of cancer survivors ≥ 18 years old using 2020 Behavioral Risk Factor Surveillance System data. ACEs were categorized as 0, 1, 2–3, and ≥ 4. Weighted multivariable logistic regression estimated the odds of cannabis use by ACE category. Results Among 7896 cancer survivors, cannabis use prevalence was 6.0%. ACE distribution was 44.1% (0), 22.7% (1), 20.2% (2–3), and 13.0% (≥ 4). Cannabis use was more common among younger adults, Hispanics, never‐married individuals, smokers, and those reporting fair/poor health. Compared to those with 0 ACEs, cancer survivors with 2–3 ACEs (aOR: 2.56, 95% CI: 1.57–4.27) and ≥ 4 ACEs (aOR: 4.10, 95% CI: 2.54–6.64) had significantly higher odds of cannabis use. Conclusions Cancer survivors with a higher number of ACEs reported increased odds of cannabis use. These findings support further study of ACEs and substance use in cancer survivors and may inform trauma‐informed survivorship care.

Objective We examined the prevalence of psychological distress and its association with emergency room (ER) usage and all‐cause mortality among colorectal cancer (CRC) survivors. Methods We utilized data from the 2000–2018 National Health Interview Survey (NHIS) and the NHIS linked mortality files. The main exposure was psychological distress, assessed with the six‐item Kessler Psychological Distress Scale (K6) and classified as (no/low, moderate, severe). The outcomes were ER usage during the past 12 months and all‐cause mortality. Multivariable logistic and Cox proportional hazards models were used to examine the associations between psychological distress and ER usage and all‐cause mortality, respectively. Results A total of 3198 CRC survivors were included in the study, of whom 4.1% and 19.6% reported severe and moderate psychological distress, respectively. Approximately 30% of CRC survivors had ER use, and 41.5% of deaths occurred with a median follow‐up of 84 months. In the adjusted model, compared to CRC survivors with low/no psychological distress, those with severe (aOR = 1.83; 95% CI, 1.10–3.04) or moderate (aOR = 1.60; 95% CI, 1.21–2.10) psychological distress had higher odds of reporting ER use. However, there was no statistically significant association between psychological distress and all‐cause mortality. Conclusion CRC survivors with severe or moderate psychological distress have higher ER usage. This finding emphasizes the significance of timely identifying and addressing psychological distress to improve the quality of life and clinical outcomes of patients diagnosed with CRC. Integrating mental health support into routine cancer care may reduce distress levels, potentially leading to fewer ER usages among CRC survivors.

Background Filipinos have higher recurrence rates compared to other racial/ethnic groups, which might suggest a higher propensity for aggressive disease. The goal of this study was to perform a population‐based analysis of disease extent at diagnosis and survival outcomes in Filipino patients with well‐differentiated thyroid cancer relative to other racial/ethnic groups. Methods The study cohort comprised adult patients with well‐differentiated thyroid cancer diagnosed between 2004 and 2015, identified in the California Cancer Registry. Rates of extrathyroidal extension, nodal metastasis, and distant metastasis were compared between Filipinos, Non‐Filipino Asians, and Non‐Asians using multilevel logistic regression models. Survival outcomes were compared using Cox regression models, utilizing a sequential modeling approach. Results Filipino ethnicity was associated with extrathyroidal extension (OR 1.35, 95% CI 1.11–1.63) compared with non‐Asians and non‐Filipino Asians. Filipino ethnicity was also associated with nodal metastasis (OR 1.32, 95% CI 1.18–1.46), and with worse OS (Hazard Ratio [HR] 1.45, 95% CI 1.20–1.75) and DSS (HR 1.51, 95% CI 1.12–2.04). After adjusting for demographic and clinical factors, Filipino ethnicity was no longer associated with OS (HR 1.03, 95% CI 0.84–1.25) or DSS (HR 0.93, 95% CI 0.68–1.28). Conclusion Filipino patients with thyroid cancer are more likely to present with locoregionally advanced disease compared with non‐Filipino Asians and non‐Asians. Furthermore, Filipino patients have worse survival outcomes compared with non‐Filipino Asians and non‐Asians. However, this appears to be driven by the higher rates of locoregionally advanced disease in Filipino patients. Filipino patients with thyroid cancer are more likely to present with locoregionally advanced disease compared with non‐Filipino Asians and non‐Asians. This results in worse survival outcomes for Filipino patients.

One of the goals of the President’s Cancer Panel was to maximize access to human papillomavirus (HPV) vaccination through expansion of alternative settings for receiving the vaccine, such as in public health settings, schools, and pharmacies. In a cross-sectional analysis, we utilized the National Immunization Survey-Teen data from 2014 to 2020 (n = 74,645) to describe trends and factors associated with HPV vaccine uptake in private, public, and alternative settings. We calculated annual percent change (APC) between 2014 and 2020, estimating rate of HPV vaccine uptake across settings. Using multinomial logistic regression, we estimated the odds of receipt of HPV vaccine in public health settings and other alternative settings compared to private healthcare settings, adjusting for sociodemographic covariates. We found a 5 % annual increase in the use of private facilities between 2014–2018 (APC = 5.3; 95 % CI 3.4, 7.1), and almost 7 % between 2018–2020 (APC = 6.7; 95 % CI 1.4, 12.3). Adjusted multinomial logistic regression analyses found that odds of receiving vaccinations at a public facility vs. a private facility increased almost two times for adolescents living below poverty (aOR = 1.82, 95 % CI: 1.60, 2.08) compared to above poverty. Additionally, adolescents without physician recommendations had lower odds of receiving vaccines at public versus private facilities (aOR = 1.75, 95 % CI: 1.44, 2.12). Finally, odds of receiving HPV vaccines at public facilities vs. private facilities decreased by 33 % for White adolescents (aOR = 0.67, 95 % CI: 0.57, 0.78) versus Black adolescents. Sociodemographic factors such as race, and socioeconomic factors such as poverty level, and receipt of physician HPV recommendations are associated with receiving the vaccine at private settings vs. public health facilities and alternative settings. This information is important in strengthening alternative settings for HPV vaccine uptake to increase access to the vaccine among disadvantaged individuals.

Nasopharyngeal carcinomas (NPC) are malignancies that have seen growing burdens with human papilloma virus (HPV) infection. This investigation aims to characterize social determinant factor of health (SDoH) differences across HPV-differentiated NPC across the USA. NPC-patients with confirmed-HPV status between 2010 and 2018 from the Surveillance-Epidemiology-End Results (SEER) database were analyzed by cox-proportional and logistic regressions of age, sex, race-ethnicity, census-level rurality-urbanicity, and census-level Yost-Socioeconomic Status (SES)-Index measures to assess mortality, staging, and delayed-treatment differences. Among 820-HPV( −) and 402-HPV(+) NPCs, both NPC-cohorts displayed reduced overall mortality risk with younger age (HR 0.56, 95% CI 0.38–0.81; HR 0.57, 0.45–0.73) and higher risk with male sex (HR 1.71, 95% CI 1.11–2.64; HR 1.42, 95% CI 1.07–1.87). For HPV(–) only, Hispanic (HR 0.51, 95% CI 0.32–0.82) and Asian ethnicities (HR 0.44, 95% CI 0.33–0.58) reduced overall mortality risk, while low Yost-SES-Index increased it (HR 1.44, 1.14–1.87). For HPV( −) only, delayed treatment occurred with lower Yost-SES-Index (OR 1.97, 95% CI 1.16–3.42). Using the Yost-SES-Index and other individual/census-level SDoH, multilevel SDoH-analyses of HPV-differentiated NPC-patients display vast prognostic and treatment differences based on HPV-status. These present specific targets to prospectively and strategically address drivers of disparity with limited public health resources.

Objective: Research outside the United States shows that certain subgroups of patients (eg, those who are older, male, of low socioeconomic status, and uninsured) are less likely than others to report receiving diabetes self-management education (DSME); however, less is known about DSME uptake in the United States. We examined sociodemographic, patient, and behavioral characteristics associated with DSME in a nationally representative sample. Methods: We analyzed data from the 2011-2013 Behavioral Risk Factor Surveillance System for 84 179 adults who self-identified receiving a diagnosis of diabetes. We constructed weighted, multivariate logistic regression models to examine the associations between DSME and sociodemographic characteristics (age, sex, race/ethnicity, marital status, education, and annual household income), patient characteristics (body mass index, having a regular provider, health insurance status, health status, and insulin use), and self-management behaviors (home foot examination, home blood glucose testing, and physical activity). Results: More than half (n = 45 557, 53.7% [weighted]) of respondents reported engaging in DSME. Compared with non-Hispanic white adults, non-Hispanic black adults were more likely to engage in DSME (adjusted odds ratio [aOR] = 1.17; 95% confidence interval [CI], 1.07-1.29). Respondents were less likely to engage in DSME if they were male (aOR = 0.85; 95% CI, 0.80-0.91) or Hispanic (aOR = 0.81; 95% CI, 0.71-0.92), were a high school graduate (but no college; aOR = 0.71; 95% CI, 0.66-0.78) or less than a high school graduate (aOR = 0.51; 95% CI, 0.45-0.59), had an annual household income of $15 000-$24 999 (aOR = 0.81; 95% CI, 0.73-0.89) or <$15 000 (aOR = 0.70; 95% CI, 0.62-0.78), or had no health insurance (aOR = 0.87; 95% CI, 0.76-0.98). DSME was significantly associated with all 3 self-management behaviors. Conclusions: Increasing public health interventions aimed at educating people with diabetes about self-management could improve outcomes.

Health-related social needs (HRSN) significantly influence healthcare utilization and outcomes. While prior studies have shown higher rates of hospital readmissions among individuals with HRSN, the impact of HRSN on hospital readmissions in persons living with HIV (PLWH) at population level, using ICD10 codes for HRSN in hospital discharge data, has not been fully explored. In this retrospective study using the 2016–2019 Florida and Maryland State Inpatient Database (SID), we examined the prevalence of HRSN among hospitalized PLWH using ICD-10 diagnosis codes including the domains of employment, family, housing, psychosocial, and education. In addition to descriptive analysis, we used multivariable logistic regression models to evaluate the association between hospital readmission and the presence of HRSN, controlling for potential confounders. In Florida, we identified 43,229 PLWH patients, of whom 9.6% (4,153) had HRSN. PLWH with HRSN had a significantly higher 90-day (40.6% vs. 23.1%) and one-year (73.6% vs. 41.3%) readmission rates compared with those without HRSN. Multivariable regression analysis showed that patients with HRSN had nearly three times the odds of 90-day readmission [adjusted odds ratio (aOR): 2.80 (95% confidence interval (CI): 2.61–3.01)] and four times the odds of one-year readmission [aOR: 3.93(95% CI: 3.62–4.27)]. In the Maryland SID, 12.5% (1,551) of the 12,396 PLWH had HRSN. PLWH with documented HRSN had a significantly higher 90-day (39.9% vs. 20.4%) and one-year (68.2% vs. 37.9%) readmission rates than those without HRSN. In multivariable regression analysis, HRSN were similarly associated with substantially higher odds of 90-day readmission [aOR: 2.70(95% CI: 2.38–3.05)] and one-year readmission [aOR: 3.60(95% CI: 3.15–4.12)]. In both states, there was a dose-response relationship between the number of HRSN and readmission rates. In conclusion, the prevalence of HRSN is associated with significantly higher rates of hospital readmissions among PLWH. Our findings highlight the importance of accounting for social factors when studying hospital readmissions and call for the development of interventions targeting HRSN to reduce readmissions in PLWH.

Background/Objectives: Head and neck cancer (HNC) represents the seventh most common cancer diagnosis globally, yet current treatments, including surgery, radiation, and immunotherapy, have shown limited improvement in outcomes. Drug repurposing offers a cost-effective strategy to identify new therapeutic options by leveraging existing medications with known safety profiles. Within this study, we developed the GARD pipeline (Genomic Alteration-based Repurposing for Drugs), designed to uncover repurposing candidates for HNC using genomic and network-based approaches. Methods: GARD integrates multi-omics data from The Cancer Genome Atlas (TCGA), including copy number variation (CNV) and somatic mutations (SOM). The cohort was stratified by human papillomavirus (HPV) status. Risk-associated genes were identified and then expanded via high-confidence protein–protein interaction (PPI) networks. Top candidate genes were filtered through comprehensive analysis of publicly available literature data in PubMed using LLMs to validate the relationship between the identified genes and HNC. The top risk genes and their network-expanded neighbors were mapped against DrugBank, and through statistical significance testing and literature validation, established significant drug–gene associations. Results: Significant genes associated with HNC, inferred by genomics alteration, were identified across HPV-positive and HPV-negative subgroups, such as PIK3CA, SOX2, TP53, EIF4G1, TLR7, CLDN1, PRKCI, and EPHA2. Further expansion through the PPI network identified other targetable genes such as EGFR, ERBB2, and the FGFRs. Literature-based validation efforts ensured confidence in the gene–disease association. Drug–gene mapping revealed candidates spanning those already in clinical trials for HNC (e.g., Afatinib, Cabozantinib, Dasatinib, Brigatinib, Lenvatinib, Capivasertib, and Erdafitinib) and emerging or repurposing candidates (Amuvatinib, XL765 (Voxtalisib), Golotimod, Artenimol, Quercetin, and Acetylsalicylic Acid), offering opportunities for precision repurposing. Conclusions: The GARD pipeline demonstrates a genomics-driven, network-informed framework for systematic drug repurposing in HNC. HPV stratification enhances precision, literature-based validation strengthens confidence, and integrated drug mapping enables refinement of existing therapies and discovery of novel candidates for personalized treatment strategies. Code Availability: The full implementation of the GARD pipeline, including preprocessing scripts, statistical analysis modules, and visualization tools, is publicly available on GitHub.

To examine predictors of information seeking behavior among individuals diagnosed with cancer versus those without. Cross-sectional data from the Health Information National Trends Survey 4 Cycles 1-3 (October 2011 to November 2013) were analyzed for 10,774 survey respondents aged ≥18 years. Binary logistic regression was used to examine the effect of socio-demographic and behavioral factors on health information seeking. Cancer diagnosis did not predict health information seeking. However, respondents diagnosed with cancer were more likely to seek health information from a healthcare practitioner. Compared to males, females were more likely to seek health information irrespective of cancer diagnosis. Regardless of cancer diagnosis, those without a regular healthcare provider were less likely to seek health information. Likelihood of seeking health information declined across education strata, and significantly worsened among respondents without high school diplomas irrespective of cancer diagnosis. Respondents sought health information irrespective of cancer diagnosis. However, the source of health information sought differed by cancer diagnosis. Gender, education, and having a regular healthcare provider were predictors of health information seeking. Future health communication interventions targeting cancer patients and the general public should consider these findings for tailored interventions to achieve optimal results.