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Background: Disclosure of medical errors, in which a healthcare provider informs the patient/family of the error and takes responsibility, is an ethical imperative. Little is known about how medical error disclosure preferences or perceptions may vary for patients who are people of color, are older, or have lower educational attainment.Methods: We conducted a narrative review around medical errors and disclosure. We included studies in high-income countries that included a predominantly marginalized population, defined by any one of the following: older age adults (mean age > 65 years); low educational attainment (> 55% of participants with less than a high school education); and/or racial/ethnic minority (< 55% of participants identifying as non-Hispanic white for US studies). We reported results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: The literature search yielded 3,050 articles, and we included six studies for analysis. Four studies used hypothetical vignettes; one used focus groups, and one used a survey. Three studies met our marginalized population criteria based on education; three met our criteria based on race/ethnicity. No study met our inclusion criteria for age. All six articles examined patient preferences for disclosure, and two studies also examined patient perceptions of disclosure. Overall, participants preferred that medical errors be disclosed to them. Most of the studies lacked multiple regression analysis to investigate differences in disclosure preferences by race/ethnicity, age, and education.Conclusion: Participants from marginalized populations may have similar disclosure preferences to white and highly educated participants. Future studies should aim to examine differences in error disclosure preferences among patients who have experienced adverse events across race/ethnicity, educational attainment, and age.

Background Cancer is the leading cause of death among Asian Americans, who face barriers to cancer care. Cancer supportive care needs among Asian Americans remain understudied. Methods We recruited 47 Asian American adults with colorectal, liver, or lung cancer who spoke Chinese, English, or Vietnamese, and were starting or undergoing cancer treatment. We assessed cancer supportive care needs in four domains: cancer information, daily living, behavioral health, and language assistance. Hierarchical cluster analysis was used to identify clusters of participants based on their need profiles to further examine the association between need profiles and quality of life (QoL) assessed by the Functional Assessment of Cancer Therapy (FACT-G). Results Participants (mean age=57.6) included 72% males and 62% spoke English less than very well. Older participants (age >65) and those with annual income Conclusions Cancer supportive care needs among Asian American patients with colorectal, liver and lung cancer were associated with patient characteristics and QoL. Understanding cancer supportive care needs will inform future interventions to improve care and QoL for Asian American cancer patients.

Purpose Cancer is the leading cause of death for Asian Americans. However, few studies have documented supportive care needs from the perspective of Asian American cancer patients. This study describes the needs reported by Asian American patients with colorectal, liver, or lung cancer over a 6-month period during their treatment. Methods Participants were recruited through the Greater Bay Area Cancer Registry and from cancer care providers in San Francisco. Participants self-identified as Asian or Asian American; were age 21 or older; spoke English, Chinese, or Vietnamese; and had stage I–III colon, rectum, liver, or lung cancer. Participants were matched with a language concordant patient navigator who provided support during a 6-month period. Needs were assessed by surveys at baseline, 3, and 6 months. Results Among 24 participants, 58% were 65 years or older, 42% did not complete high school, and 75% had limited English proficiency (LEP). At baseline, the most prevalent needs were cancer information (79%), nutrition and physical activity (67%), language assistance (54%), and daily living (50%). At the 3- and 6-month follow-up surveys, there was a higher reported need for mental health resources and healthcare access among participants. Conclusion In this pilot study of Asian American cancer patients who predominantly had LEP, participants reported many needs, with cancer information and language assistance as the most prominent. The findings highlight the importance of culturally and linguistically appropriate patient navigators in addressing supportive care needs among cancer patients with LEP. Trial registration ClinicalTrials.gov identifier: NCT03867916.

Background The total impact of the current COVID-19 pandemic on cancer screenings and diagnostic procedures by race and ethnicity has not yet been fully characterized. Methods In this study, we compared the ethnic and racial differences in cancer screening for breast, colon, and prostate cancer and compared them to population-level SARS-CoV2 infection rates in the United States between January 2019 and January 2021. Results A significant reduction in all screening activities was observed between March and May of 2020, with the largest relative decline in April during the initial SARS-CoV2 surge. In that month, screening mammography declined by 80% overall, with the relative largest decline among Black individuals (90%). A higher proportion of Black individuals received diagnostic mammography in April 2020. However, between June 2020 and January 2021, there was a relative increase in diagnostic mammograms observed across all groups. There was also a relative reduction in colon cancer screening, with the largest decline in April 2020 among Black individuals (75%). The largest relative reduction in PSA screening was in Hispanic individuals (66%). During the examined study period, surgical resections for breast, colon, and prostate resections were reduced and remained lower than baseline through 2020. The reduction in breast, colon, and prostate cancer screening coincided with the first surge of the SARS-CoV2 infections, but not with the second. There was a small reduction in breast and colon cancer screening with the third surge. Conclusions Differential inequities in cancer screening and diagnoses were observed by race and ethnicity and corresponded primarily to the initial surge of SARS-CoV2.

BackgroundThere is a need to assess neighborhood-level factors driving COVID-19 disparities across racial and ethnic groups.ObjectiveTo use census tract-level data to investigate neighborhood-level factors contributing to racial and ethnic group-specific COVID-19 caserates in California.DesignQuasi-Poisson generalized linear models were used to identify neighborhood-level factors associated with COVID-19 cases. In separate sequential models for Hispanic, Black, and Asian, we characterized the associations between neighborhood factors on neighborhood COVID-19 cases. Subanalyses were conducted on neighborhoods with majority Hispanic, Black, and Asian residents to identify factors that might be unique to these neighborhoods. Geographically weighted regression using a quasi-Poisson model was conducted to identify regional differences.Main measuresAll COVID-19 cases and tests reported through January 31, 2021, to the California Department of Public Health. Neighborhood-level data from census tracts were obtained from American Community Survey 5-year estimates (2015-2019), United States Census (2010), and United States Department of Housing and Urban Development.Key resultsThe neighborhood factors associated with COVID-19 case rate were racial and ethnic composition, age, limited English proficiency (LEP), income, household size, and population density. LEP had the largest influence on the positive association between proportion of Hispanic residents and COVID-19 cases (- 2.1% change). This was also true for proportion of Asian residents (- 1.8% change), but not for the proportion of Black residents (- 0.1% change). The influence of LEP was strongest in areas of the Bay Area, Los Angeles, and San Diego.ConclusionNeighborhood-level contextual drivers of COVID-19 burden differ across racial and ethnic groups.

Background: Cancer is the leading cause of death for Asian Americans. Patient navigation has shown benefits in enhancing cancer treatment outcomes and quality of life. Navigational needs in accessing cancer supportive care among Asian American cancer patients and how to address such needs, however, remain understudied. Asian Americans face unique language and cultural barriers in cancer care. We designed a culturally and linguistically-tailored pilot patient navigation intervention, Patient COUNTS, to better understand and address the needs of Asian American cancer patients. Objective: To examine cancer supportive care needs and resource use among patients, who participated in a pilot study that aimed to provide culturally and linguistically-tailored navigation for Asian American cancer patients. Methods: We recruited Asian American adults diagnosed with stage I-III colorectal, liver, or lung cancer from the Greater Bay Area Cancer Registry and San Francisco hospitals. Participants spoke English, Chinese, or Vietnamese and had not completed treatment. Participants were assigned a language-concordant patient navigator, who provided support for six months. This study describes participants' cancer supportive care needs and resource use from telephone and self-administered surveys collected at baseline, three, and six months. Participants included 24 Asian Americans with cancer who completed the baseline survey, with 18 (75%) who completed at least one of the follow-up surveys. Results: Of the study sample (n=24), 63% were men, 55% were 65 years or older, and 42% did not complete high school. A majority (75%) spoke limited English; participants' preferred language included Cantonese/Mandarin (61%), Vietnamese (26%) and English (13%). Most participants had stage I (54%) or III (42%) cancer of the lung (42%), colon (37%), or liver (21%). Across the three surveys, the most frequently reported types of needs by the 24 participants were: cancer information (83%), language translation (54%), basic resources such as financial, transportation, legal, housing, and food access resources (50%), access to healthcare (42%), and mental health (33%). Among the 18 participants who completed the three- or six-month surveys, 90% reported using one or more resources that navigators directed them to. Specifically, of the 18 patients, the most frequently used resources included healthcare (77%), basic needs (67%), language translation (56%), and mental health (28%). Conclusions: The Asian American cancer patients enrolled in Patient COUNTS, a pilot patient navigation program, had a variety of cancer supportive care needs. Findings provided preliminary support of Patient COUNTS as a promising approach to assess cancer supportive care needs and assist navigation of resources among Asian American cancer patients. These findings will inform future interventions to improve the care that Asian American cancer patients receive. Citation Format: Katarina Wang, Janice Tsoh, Carmen Ma, Ching Wong, Hoan Bui, Corina Liew, Junlin Chen, Salma Shariff-Marco, Janet N. Chu, Laura Allen, Mei-Chin Kuo, Debora L. Oh, Scarlett L Gomez, Tung T. Nguyen. Cancer supportive care needs and resource use among Asian American cancer patients: Preliminary findings from a pilot patient navigation intervention, “Patient COUNTS” [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-032.

8-Oxoguanine glycosylase (OGG1) is a base excision repair enzyme responsible for the recognition and removal of 8-oxoguanine, a commonly occurring oxidized DNA modification. OGG1 prevents the accumulation of mutations and regulates the transcription of various oxidative stress-response genes. In addition to targeting DNA, oxidative stress can affect proteins like OGG1 itself, specifically at cysteine residues. Previous work has shown that the function of OGG1 is sensitive to oxidants, with the cysteine residues of OGG1 being the most likely site of oxidation. Due to the integral role of OGG1 in maintaining cellular homeostasis under oxidative stress, it is important to understand the effect of oxidants on OGG1 and the role of cysteines in its structure and function. In this study, we investigate the role of the cysteine residues in the function of OGG1 by mutating and characterizing each cysteine residue. Our results indicate that the cysteines in OGG1 fall into four functional categories: those that are necessary for (1) glycosylase activity (C146 and C255), (2) lyase activity (C140S, C163, C241, and C253), and (3) structural stability (C253) and (4) those with no known function (C28 and C75). These results suggest that under conditions of oxidative stress, cysteine can be targeted for modifications, thus altering the response of OGG1 and affecting its downstream cellular functions.