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Headaches related to the use of personal protective equipment (PPE) could affect performance at work in healthcare personnel. Our aim was to describe the prevalence and risk factors for headaches related to PPE, in the personnel of a specialized coronavirus disease 2019 (COVID-19) tertiary hospital.In this cross-sectional survey study, we invited healthcare workers from COVID-19 referral center in Mexico (May 22-June 19, 2020) to answer a standardized structure questionnaire on characteristics of new-onset PPE-related headache or exacerbation of primary headache disorder. Participants were invited regardless of whether they had a current headache to avoid selection bias. This is the primary analysis of these data.Two hundred and sixty-eight subjects were analyzed, 181/268 (67.5%) women, 177/268 (66%) nurses, mean age 28 years. The prevalence of PPE-related headache was 210/268 (78.4%). Independent risk factors were occupation other than physician (OR 1.59, 95% CI 1.20-2.10), age 30 years (OR 2.54, 95% CI 1.25-5.14), and female sex (OR 3.58, 95% CI 1.86-6.87). In the 6-month follow-up, 13.1% of subjects evolve to chronic headache, with stress as predictive risk factor.The frequency of PPE-associated headache is high, and a subgroup could evolve to chronic headache. More studies are necessary to improve the knowledge about this condition.

e13518 Background: COVID-19 detection in a timely manner in patients (pts) undergoing anticancer treatment is essential. RT-PCR test for SARS-CoV2 is the diagnostic gold standard, however it is a potentially limited resource in our setting. As an alternative, clinicians have developed symptom-based questionnaires as a screening tool for the detection of COVID-19 to optimize resources. The predictive efficacy of these tools in pts with cancer and healthcare personnel (HCP) who treat them has not been evaluated. Our objective was to describe the findings of the follow-up through an online clinical tool in our cohort, and determine its predictive performance compared against the gold standard. Methods: Data was obtained from a follow-up cohort of HCP and pts attending the chemoradiotherapy unit of a tertiary hospital designated as a COVID-19 priority facility in Mexico City . The follow-up period was from June 12 to September 30, 2020, and consisted of a 10-item clinical questionnaire (CQ) on respiratory symptoms and contact with patients diagnosed with COVID-19, collected daily electronically or by telephone . In addition, RT-PCR for SARS-CoV2 was performed every two weeks. The CQ was considered as a positive screening test if in the period between the biweekly RT-PCRs the participants had reported symptoms or contact. Results: We included 130 asymptomatic participants. 44.6% (n = 58) were HCP and 55.3 % (n = 72) were pts. Within a median follow-up of 85 days (IQR 48-103) a total of 8970 CQ were completed, 48.3% (n = 4335) were answered by HCP and 51.6% (n = 4635) by pts. 4.03% (n = 175) of CQ returned positive in HCP and 0.77% (n = 36) in pts. 634 nasopharyngeal swabs for SARS-CoV-2 RT-PCR were performed, 13.5% (n = 18) of the participants tested positive for SARS-CoV2 infection. When we evaluate within the biweekly period, the CQ for symptoms or contact was found to be a positive screening test in 12% (n = 78). If we applied the standardized definition of COVID-19 suspicious case used at our center, the CQ was found to be positive just in 3.9% (n = 25). The CQ as a general screening tool gave a sensitivity (SN) of 33.3%, specificity (SP) of 88.3%, a positive predictive value (PPV) of 7.6% and a negative predictive value (NPV) of 97.8%. Using the standardized definition, CQ gave a SN of 38.8% and a SP of 97.07%, a PPV of 28% and a NPV of 98.1%. Conclusions: Screening based on self-reporting of symptoms and contact through a questionnaire demonstrated low sensivity but high specificity in our cohort. When we applied a standardized definition of COVID-19 suspicious case, the clinical performance improved. RT-PCR testing remains as the gold standard to detect COVID-19 and should be preferred in patients undergoing anticancer treatment. Nevertheless, clinical questionnaires are an accessible tool for follow-up.

e22521 Background: Cancer treatment during the COVID-19 pandemic represents a challenge. Increased hospital visits to receive treatment as well as interaction with healthcare personnel (HCP), represent a potential risk factor for acquiring COVID-19. Our objective was to analyze the SARS-CoV-2 infection rate in patients (pts) with cancer and HCP of a chemoradiotherapy unit localized in a center designated as a COVID-19 priority facility in Mexico City. Methods: We invited HCP and pts with solid tumors attending the chemoradiotherapy unit to participate in a prospective follow-up cohort to early detect asymptomatic COVID-19 infection. Only participants who gave informed consent were included. A RT-PCR test for SARS-COV-2 from nasopharyngeal swab samples was performed every 2 weeks, and daily electronic clinical questionnaires were sent. Recruitment started on June 12, 2020. Participants entered the study in different moments and they were followed until a positive test for COVID-19 was found, or pts finished treatment or, HCP changed work area or, withdrawal of inform consent, or follow up completion, which ever occurred first. The last day of follow up was September 30, 2020. The general infection rate during all the period of follow-up was calculated, as well as the infection rate per month. Results: We included 130 asymptomatic participants, 44.6% (n = 58) were HCP and 55.4% (n = 72) were cancer pts, 45.9% (n = 61) were men, and 54.1% (n = 72) were women. During a median follow-up of 85 days (IQR 48-103) we performed 634 nasopharyngeal swabs for SARS-CoV-2 RT-PCR, with a median number per participant of 5 (IQR 3-7). Within this period, 18 (13.5%) participants tested positive for SARS-CoV-2 infection. 12 were asymptomatic and 6 developed symptoms. None of them had a severe form of COVID-19 and we did not register any death associated to COVID-19. Table shows the infection rate per month. Conclusions: In our center, during the time period of follow up, the overall rate of COVID-19 infection was higher than that reported in a study from asymptomatic HCP and office workers in Mexico City (13.5 vs 8.4%). We also observed a monthly variation that was consistent with the months with the highest number of cases detected in Mexico City during the first wave. With careful implementation, it is feasible to continue to safely deliver systemic oncologic treatments during the COVID-19 pandemic.[Table: see text]

e18056 Background: Cancer awareness months (CAM) are a health promotion tool that pursues to increase the public knowledge of a specific type of cancer. Awareness campaigns have benefited from the ease of access to the internet and social media. Analysis of internet search data has been used as an indirect tool to determine the information-seeking patterns of people and may reflect the impact of a campaign. We aim to determine national cancer awareness months’ impact on people’s internet search habits focusing on malignancies that have a specific awareness month in Mexico: breast, colorectal and prostate. Methods: We used Google Trends (GT) to obtain search volume indexes (SVIs), a term designed by GT scaled from 0 to 100 based on total searches during a specified period, of malignancies with an awareness month in Mexico from January 2008 to December 2018. Terms were consulted in Spanish: "cáncer de mama" (breast cancer), "cáncer de colon + cáncer colorrectal" (colon + colorectal cancer), "cáncer de próstata" (prostate cancer). We compared mean SVIs from each cancer awareness month to mean SVIs from the rest of the year using two-tailed two-independent sample T-tests. For prostate and colorectal, SVI’s were compared from the year its CAM was nationally instituted. Results: For breast cancer, mean SVI from October, its awareness month was 54.18 vs 12.09 for the rest of the year (p < 0.001). For colorectal cancer, mean SVI from its awareness month March, was 65.0 vs 55.5 for the rest of the year (p = 0.34). For prostate cancer, mean SVI from November, Mexican prostate awareness month, was 72.0 vs 35.52 for the rest of the year (p = 0.44). Conclusions: Google’s search volume for breast cancer was significantly higher in its awareness month compared to the rest of the year, which proves the impact of its CAM on modifying online activity. For more recently instituted CAMs on prostate and colorectal cancer, search volume didn’t change significantly between their CAM and the rest of the year. There are perhaps lessons to be learned from the breast cancer awareness month campaign which might usefully be adapted for the highest incident malignancies in Mexico.

e15158 Background: General population screening can reduce colorectal cancer (CRC) mortality. International guidelines recommend CRC screening for asymptomatic people over 50 years. There is no established national screening program in Mexico. Even in countries with low incidence of CRC such as Mexico, targeted screening of subjects at high risk could decrease resource utilization and cost. Our aim was to describe the distribution among an average-risk population based on risk for colorectal neoplasia (CRN). Methods: We performed a prospective assessment of the risk for CRN among asymptomatic people over 50 years at Instituto Nacional de Ciencias Médicas y Nutrición between 2017-2018. The inclusion was competitive consistent with our age-sex pyramid. We included workers, non-family attendants and patients (internal medicine consultation). Each subject answered a standardized questionnaire, which included information on their age, gender, family history of CRC, diabetes, body mass index (BMI), smoking status and drinking habits. In order to stratify the population according to their risk for CRN, we used the Asia-Pacific Colorectal Screening (APCS) score. Results: We included 256 subjects. Median age was 59 y/o (50-93), 52% were female. 5% had a first-degree relative with CRC. 44% were current or ex-smoker and 9% reported alcohol consumption. 21% had diabetes. The median BMI was 27.3 (17-51). According to the APCS score, 60% were assigned as average risk (AR) and 40% as high risk (HR) for CRN. We observed a higher proportion of HR compared to our previous retrospective data (Table). Conclusions: We prospectively confirmed that using basic clinical information (age, gender, smoking status, family history of CRC, BMI and diabetes), it is possible to identify a subset of asymptomatic subjects at high risk for CRN in whom screening strategies should be prioritized. In developing countries with limited resources, a focus on high risk groups could improve cost effectiveness of screening colonoscopy. Risk stratification based on APCS score. [Table: see text]

704 Background: Preoperative chemoradiotherapy (CRT) followed by total mesorectal excision (TME) and adjuvant chemotherapy (CT) is the standard of care for locally advanced rectal cancer (LARC). Total neoadjuvant therapy (TNT) consists of induction CT followed by CRT prior to surgery. This is an alternative strategy recommended in guidelines. Objective: To describe neoadjuvant strategies, oncologic outcomes and prognostic factors in a cohort of patients (pts) with LARC treated at a referral center in Mexico City. Methods: We retrospectively reviewed medical records from pts with LARC (T3-T4 or N+) treated with any neoadjuvant strategy at Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” from January 2010 to December 2015. Clinical and pathological information was registered. Survival was estimated by Kaplan-Meier method. Univariate analysis for prognostic factors was performed and survival was compared by the log rank test. Results: 43 pts were included. Median age was 62 y/o (19-83), 51% were female. Clinical stage (CS) II 9% and CS III 91%. 36 pts were T3-4 and N+(86%). Localization was lower third 30%, middle third 56% and upper third 12%. 63% were moderately differentiated adenocarcinoma. 84% had TNT: induction CT with FOLFOX-4 regimen for 3 months followed by CRT (50.4 Gy in 28 fractions concurrently with fluoropyrimidines) and TME. Surgery: ultra-low anterior resection (AR) 48%, low AR 28% and abdominoperineal resection 24%. One patient did not accept surgery. Of the 32 pts with ultra-low and low AR, 94% had protective ileostomy. The pathologic complete response (pCR) ypT0ypN0 rate was 45% (19/42). Median follow-up was 48 months. There were 8/42 recurrences (19%): local-only 2.3%, systemic only 12% and both 5%. None of the pts with pCR recurred. All pts with residual nodal disease recurred (5/5). The 5-year relapse-free survival rate was 73%. There were 6 deaths, one patient died without disease. The 5-year overall survival rate was 83%. Conclusions: In pts with LARC the TNT is associated with high rates of pCR and favorable oncological outcomes. pCR and residual nodal disease after neoadjuvant therapy were strongly associated with recurrence and survival.