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Patients with underlying comorbidities are particularly vulnerable to poor outcomes from SARS-CoV-2 infection. Despite the context-specific nature of vaccine hesitancy, there are currently no scales that incorporate disease or treatment-related hesitancy factors. We developed a six-item scale assessing disease-related COVID-19 vaccine attitudes and concerns (The Disease Influenced COVID-19 Vaccine Acceptance Scale-Six: DIVAS-6). A survey incorporating the DIVAS-6 was completed by 4683 participants with severe and/or chronic illness (3560 cancer; 842 diabetes; 281 multiple sclerosis (MS)). The survey included the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale, demographic, disease-related, and vaccination status questions. The six items loaded onto two factors (disease complacency and vaccine vulnerability) using exploratory factor analysis and exploratory structural equation modeling. The two factors were internally consistent. Measurement invariance analysis showed the two factors displayed psychometric equivalence across the patient groups. Each factor significantly correlated with the two Oxford COVID-19 Vaccine scales, showing convergent validity. The summary score showed acceptable ability to discriminate vaccination status across diseases, with the total sample providing good-to-excellent discriminative ability. The DIVAS-6 has two factors measuring COVID-19 vaccine attitudes and concerns relating to potential complications of SARS-CoV-2 infection due to underlying disease (disease complacency) and vaccine-related impact on disease progression and treatment (vaccine vulnerability). This is the first validated scale to measure disease-related COVID-19 vaccine concerns and has been validated in people with cancer, diabetes, and MS. It is quick to administer and should assist with guiding information delivery about COVID-19 vaccination in medically vulnerable populations. [ABSTRACT FROM AUTHOR]

Introduction: People with cancer are at higher risk of serious illness and death from COVID‐19 infection. We investigated COVID‐19 vaccine uptake among patients with solid organ and blood cancers and explored factors related to hesitancy. Methods: Cross‐sectional online survey of adults with a history of cancer at three health services across metropolitan and regional Victoria. Vaccine hesitancy was measured by the validated Oxford COVID‐19 vaccine hesitancy scale. Results: There were 1073 respondents: 56% female; median age 62 years (range 23 ‐ 91). Commonest tumor types included breast 29%, gastrointestinal 19%, hematological 15%, genitourinary 15%, and lung 8%. Thirty‐six percent had metastatic disease, and 54% were receiving active anticancer treatment. Eighty‐four percent of respondents indicated positive intent toward COVID‐19 vaccination, 10% were undecided, and 6% indicated negative attitudes. At least one vaccine dose had been received by 65% of respondents, leaving 35% unvaccinated. Fifty‐eight percent of unvaccinated patients answered that they would "definitely" or "probably" take a vaccine. Higher vaccine uptake was significantly associated with older age, male gender, English as first language, longer time since cancer diagnosis, and not being on current anticancer treatment. Concerns regarding vaccine side effects, particularly thrombosis, and the desire for clear medical advice were prominent among unvaccinated respondents. Conclusion: Despite being eligible for COVID‐19 vaccination since March 2021, a substantial minority of patients with cancer remained unvaccinated as of August 2021. Targeted communication and educational resources addressing vaccine safety in the context of cancer are key to promoting vaccine uptake in this vulnerable population. Practitioner Points: Though achieving higher vaccination rates than the general population, a significant proportion of cancer patients remain unvaccinated despite prioritization in the vaccine rollout program.Fifty‐eight percent of unvaccinated cancer patients indicate they are "definitely" or "probably" willing to be vaccinated.Vaccine safety in the context of cancer history and treatment and lack of clear medical advice were common concerns. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate gender differences in initial presentation, pathology, and outcomes with renal cell carcinoma (RCC). Materials and methods: The 1973–2004 Surveillance Epidemiology and End Results (SEER) 17-registries database was analyzed for renal tumors from 1988 to 2004 coded as primary site “kidney and renal pelvis.” After various exclusions, a final study group of 35,336 cases with complete data was obtained. Demographic variables analyzed included age, sex, and race. Tumor variables included size, stage at diagnosis, grade, and histology. Primary outcome variables included overall and cancer-specific survival. Results: Of the patients, 22,288 were male (63%). Females presented with smaller tumors (5.9 vs. 6.1cm, p <0.0001) of lower grade (p <0.0001). Males had a higher incidence of regional or metastatic spread of renal carcinoma (p <0.0001). Median overall survival from time of diagnosis was 130 mo for females versus 110 mo for males (p <0.0001). In comparisons of males and females, 5-yr cancer-specific survival was 78% versus 81%, and 5-yr overall survival was 65% versus 69% (p <0.0001). On multivariate analysis, cancer-specific survival was similar (HR, 1.00, p =0.960), whereas overall survival was significantly longer for females (HR, 0.92, p <0.0001). Older age at diagnosis, larger tumor size, higher grade, higher SEER historic stage, and sarcomatoid, collecting duct, or “other” histology were related to worse cancer-specific and overall survival. Conclusions: Men present with larger, higher stage, higher grade RCC than women. Overall survival is better in women, whereas cancer-specific survival is not significantly different. [Copyright &y& Elsevier]

Abstract: Objectives: To examine the racial differences in testicular cancer incidence, pathologic grade, stage, and survival with specific reference to Asian and white Americans and to evaluate the impact of disparities in stage at presentation, if present, on survival. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we extracted all testicular cancer cases among white and Asian-American males for the years 1973 to 2000. Baseline demographic data included age at diagnosis, year of diagnosis, stage at diagnosis, and histologic features. Survival was examined using the Kaplan-Meier method and Cox proportional hazards modeling. Results: The incidence of testicular cancer is lower among Asian Americans than among whites. However, Asian-American males presented with higher stage disease at diagnosis. Significant differences were noted in the histologic features between the two groups, with Asian Americans presenting with greater rates of seminoma. Asians also demonstrated survival differences, with poorer unadjusted survival compared with whites. However, when the variables of stage at diagnosis and histologic features were included in the analysis, the survival curves became similar. Conclusions: Asians appeared to present with higher stage disease than do whites. Observed differences in survival for the Asian group relative to whites appeared to be primarily a result of delayed presentation. Cultural perceptions of malignancy and the understanding of cancer screening may be important determinants of later presentation. Healthcare access and education issues, rather than inherent biologic differences, are more likely the primary underlying factors for the observed survival differences in Asian males. [Copyright &y& Elsevier]

Cancer, Adenocarcinoma, Pathology, molecular, Lung diseases Keywords: Cancer; Adenocarcinoma; Pathology; molecular; Lung diseases EN Cancer Adenocarcinoma Pathology molecular Lung diseases 118 118 1 03/12/21 20210215 NES 210215 A 58-year-old man presented with shortness of breath on exertion and cough. Computed tomography imaging (Figure, A and B) demonstrated innumerable miliary nodules throughout both lungs and two larger nodules in the right apex, initially raising the suspicion of tuberculosis. [Extracted from the article]