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Introduction: While demographic risk factors of cancer‐related financial hardships have been studied, having minor children or being single have rarely been assessed in the context of healthcare‐related financial hardships. Methods: Using data from the 2015 to 2018 National Health Interview Survey, we assessed financial hardship (material and psychological hardship; behavioral coping due to costs: delaying/foregoing care, reducing prescription costs, or skipping specialists or follow‐up care) among adults aged 18–59 years with cancer (N = 2844) by minor child parenting status and family structure. In a secondary analysis, we compared this group with individuals without cancer. Using logistic regression models, we compared those with and without children aged <18 years, further distinguishing between those who were single versus one of two or more adults in the family. Results: Compared to individuals from families with two or more adults/without children, single adults with children more often reported cancer‐related financial hardships, for example material hardship (45.9% vs. 38.8%), and reducing prescription costs, (50.7% vs. 34.4%, adjusted OR 1.57, 95% CI 1.07–2.28). Single adults without minor children and those from families with two or more adults/with minor children also reported greater financial hardships on some dimensions. Associations were similar among those without cancer, but the overall magnitude of financial hardships was lower compared to those with cancer. Conclusions: Our findings suggest that having minor children, and being a single adult are risk factors for cancer‐related financial hardship. Financial vulnerability associated with family structure should be taken into consideration in healthcare, and especially cancer care. [ABSTRACT FROM AUTHOR]

Purpose: Melanoma incidence is higher in rural than in urban areas in the United States, possibly due to greater incidental sun exposures from rural outdoor‐focused lifestyles and occupational patterns. Our aim was to compare activities at the time of a sunburn between rural and urban residents. Methods: Utilizing the nationally representative 2019 cross‐sectional Health Information National Trends Survey (HINTS), we report odds ratios (OR) and confidence intervals (CI) from logistic regression models comparing self‐reported activities at most recent sunburn among rural versus urban adults. Findings: About one‐third of participants (37.2%) reported a sunburn in the past year, higher in urban (38.0%) than in rural populations (32.5%). At the time of most recent sunburn, swimming (36.6%) and working outside a home (29.4%) were the most commonly reported activities. Working on a job (30.4% vs 10.4%; OR: 3.30, 95% CI: 1.33, 8.20) or outside the house (38.7% vs 28.1%; OR: 1.86, 95% CI: 1.03, 3.33) were more common, while exercising or sunbathing were less common, among rural compared to urban participants. Conclusions: Incidental sun exposures during outdoor‐focused rural occupations and work outside the house may be critical skin cancer prevention targets in rural populations; outdoor exercise and sunbathing may be more important in urban populations; incidental exposures while swimming may be important in both populations. [ABSTRACT FROM AUTHOR]

Objective: To describe fear of cancer recurrence in a cohort of women with gynecologic cancers and to identify psychosocial predictors of elevated fear of recurrence. Methods: Survey data from an ongoing cohort study of gynecologic cancer survivors were used (n = 154). Relationships between fear of cancer recurrence measured by the 6‐item Cancer Worry Scale in the most recent survey and psychosocial factors (cancer‐related distress, depression, anxiety, hopelessness, and posttraumatic growth) assessed 6–18 months prior were examined using univariate and multivariate linear regression models, adjusting for age, cancer stage, cancer type, and time since diagnosis. Results: Most participants were ≥60 years old, diagnosed with early‐stage cancer, and 2–5 years post‐diagnosis. The mean score on the Cancer Worry Scale was 10.31 (SD = 3.01), and 46 individuals (30.0%) scored ≥12, indicating high fear of recurrence. In univariate analyses, greater distress (p = 0.007), anxiety (p = 0.006), hopelessness (p = 0.007), and posttraumatic growth (p = 0.0006) were significantly associated with higher scores on the Cancer Worry Scale. The associations of hopelessness and posttraumatic growth with higher Cancer Worry Scale scores remained significant after adjustment for covariates. Conclusions: Fear of recurrence is frequent among gynecologic cancer survivors. Women who reported more distress, hopelessness, anxiety and, surprisingly, more post‐traumatic growth reported more fear. These results contribute to our understanding of which cancer survivors are most at risk of elevated fear of recurrence and highlight the importance of continued focus on psychosocial well‐being among cancer survivors. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer screening is recommended for those with a cervix who are 21 to 65 years old, with specific timelines being dependent on individual risk. This study compared rates of ever undergoing Papanicolaou (Pap) testing at the intersection of self‐reported sexual minority (SM) status and race/ethnicity. Methods: Data from the National Health Interview Survey (2015 and 2018) were used to examine cervical cancer screening disparities. Natal females without a history of hysterectomy who were 21 to 65 years old and had reported their sexual orientation and Pap testing history were included. Demographic and health characteristics were summarized with descriptive statistics. To adjust for differences in confounding variables between groups, propensity score–based inverse probability of treatment weighting (IPTW) was performed. IPTW‐adjusted multivariable logistic regression models estimated odds of ever undergoing a Pap test by sexual orientation alone and with race/ethnicity (non‐Hispanic White, non‐Hispanic Black, and Hispanic). Results: SM persons (n = 877) had significantly reduced odds of ever undergoing Pap testing (odds ratio, 0.54; 95% confidence interval, 0.42‐0.70) in comparison with heterosexual persons (n = 17,760). When the intersection of sexual orientation and race/ethnicity was considered, non‐Hispanic White SM participants and Hispanic SM participants had reduced odds of ever undergoing Pap testing in comparison with non‐Hispanic White heterosexual participants. No significant differences were observed between non‐Hispanic White heterosexual participants and participants of non‐Hispanic Black SM or Hispanic heterosexual identities. Conclusions: SM participants were significantly less likely to have ever undergone a Pap test in comparison with heterosexual participants, with Hispanic SM participants having the lowest uptake. Future studies should further examine the roles of systemic discrimination and other key drivers of these disparities. In this study, sexual minority (SM) individuals were significantly less likely to have ever undergone Papanicolaou (Pap) testing, and this was consistent across most racial/ethnic identities. Hispanic SM participants had the lowest odds of ever undergoing Pap testing in comparison with non‐Hispanic White heterosexual participants. [ABSTRACT FROM AUTHOR]

Use of direct‐to‐consumer genetic testing (DTC‐GT) is rapidly growing in the United States. Yet little is known about how specific populations like domestic and intercountry adoptees use DTC‐GT. Adoptees often have little to no biological family history, which may affect how they use DTC‐GT. This study aimed to examine adult adoptees' motivations to pursue DTC‐GT, experiences completing a test, and reasons for not completing one. An online survey consisting of 41 closed‐ended questions was distributed to domestic and intercountry adult adoptees in a snowball convenience method addressing seven areas: (a) demographics and adoption experience, (b) family health history, (c) familiarity with DTC‐GT, (d) actual DTC‐GT experience, (e) hypothetical DTC‐GT experience, (f) health results, and (g) satisfaction with DTC‐GT. Descriptive statistics were performed on participant demographics and adoption characteristics, and chi‐squared and Fisher's exact tests compared demographics and adoption characteristics by familiarity with DTC‐GT and completion of DTC‐GT. A total of 117 adoptees met criteria and completed the survey. Adoptees were motivated to use DTC‐GT to search for biological family (83.0%), verify race and ethnicity (72.3%), and find out where ancestors came from (66.0%). Most participants completed DTC‐GT (80.3%); completion was significantly associated with searching for biological relatives (p < 0.01) and with older age (p = 0.05). For those who received health information (59.6%), 44.4% of participants reported talking with a health provider. Adoptees are using DTC‐GT to search for biological relatives, confirm their ethnicity and ancestry, and gain information about their health. Genetic counselors and health professionals should be prepared to address DTC‐GT with adoptees as nearly half discussed their results with providers; findings from this study provide insight into how this unique population uses DTC‐GT, and the possibility of patient‐centered, tailored care for adopted patients who do not have family health history. [ABSTRACT FROM AUTHOR]

Cervical cancer is more common in the Somali immigrant population than the general population in the United States (US). There are low rates of cervical cancer screening among Somali women. This study compares cervical cancer screening test completion rates for a home human papilloma virus ( HPV) test and standard clinic Pap test. Sixty-three Somali immigrant women aged 30-70 years who had not undergone cervical cancer screening within the past 3 years were randomly assigned to a home HPV test group (intervention) or a clinic Pap test group (control). Test completion rates were measured at 3 months. Univariate and multivariate logistic regression models were used to explore factors associated with test completion (intention-to-treat analysis). Participants in the HPV test group were 14 times more likely to complete the test compared to those in the Pap test group ( P = 0.0002). Women who reported having friends/family members to talk about cancer screening were approximately three times more likely to complete any screening test than those who did not ( P = 0.127) and participants who reported residing in the US longer were more likely to complete a screening test ( P = 0.011). Future research should explore the potential of using the home-based HPV test kits as an initial approach to cervical cancer screening. Impact: The use of a self-sampling HPV kit has the potential to increase cervical cancer screening in under-served communities in the US. [ABSTRACT FROM AUTHOR]

Although ultraviolet radiation ( UV) exposure from indoor tanning has been linked to an increased risk of melanoma, the role of DNA repair genes in this process is unknown. We evaluated the association of 92 single nucleotide polymorphisms ( SNPs) in 20 DNA repair genes with the risk of melanoma and indoor tanning among 929 patients with melanoma and 817 controls from the Minnesota Skin Health Study. Significant associations with melanoma risk were identified for SNPs in ERCC4, ERCC6, RFC1, XPC, MGMT, and FBRSL1 genes; with a cutoff of P < 0.05. ERCC6 and FBRSL1 gene variants and haplotypes interacted with indoor tanning. However, none of the 92 SNPs tested met the correction criteria for multiple comparisons. This study, based on an a priori interest in investigating the role of DNA repair capacity using variants in base excision and nucleotide excision repair, identified several genes that may play a role in resolving UV-induced DNA damage. [ABSTRACT FROM AUTHOR]

The article presents information related to a study on chronic lymphocytic leukaemia (CLL) in patients undergoing reduced intensity conditioning (RIC) haematopoietic cell transplantation (HCT) from both matched related donors (MRD) and umbilical cord blood (UCB) donors. Under the study, 26 consecutive allogeneic transplants for CLL performed between 2000 and 2009 were analyzed.