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OBJECTIVES: To explore the incidence of adverse childhood experiences (ACEs) in breast cancer survivors and potential associations with long-term treatment-related sequelae. SAMPLE & SETTING: English-speaking breast cancer survivors three or more years from diagnosis with complete treatment response (N = 120) were recruited prior to scheduled survivorship clinic visits. METHODS & VARIABLES: Participants in this crosssectional observational feasibility study rated anxiety, depression, fatigue, sleep disturbance, cognitive issues, resilience, and ACEs (experienced prior to age 18 years). Blood samples were analyzed for inflammatory and epigenetic biomarkers. RESULTS: ACEs assessment was feasible. Higher ACE scores correlated with greater fatigue, anxiety, and depression, and with lower cognitive function (p < 0.05). Resilience was positively associated with cognitive function and negatively associated with fatigue, anxiety, and depression. IMPLICATIONS FOR NURSING: There is evidence for the impact of ACEs on long-term treatment-related sequelae in women with breast cancer. Oncology nurses should consider incorporating ACEs assessment into the workflow for women receiving survivorship care. [ABSTRACT FROM AUTHOR]

Introduction: Patients without insurance often wait until their symptoms become severe before seeking treatment. While done to avoid the cost of preventative care, this decision leads to uninsured patients presenting with more advanced diseases. This trend can be clearly seen in cancer care. Research shows that uninsured adults are less likely to receive cancer screenings than their insured counterparts, more likely to be diagnosed with cancer at a later stage and have an increased risk for death for certain types of cancer., Hypothesis: We aim to calculate the overall uninsured rate for cancer patients across The University of Kansas Cancer Center's (KUCC) catchment area and estimate the uninsured rate for patients treated within a large health system in the state of Kansas., Methods: A literature review was conducted to collect the uninsured rates for Kansas and Missouri by age group. Three datasets were used to generate an overall uninsured rate for both states for the age groups of 0-19, 20-64, and 65 or older. The cancer incidence was derived using the 2020 estimated number of KUCC cases and the mean percentage of 2015-2019 cases for the corresponding age groups. The estimated uninsured and cancer incidence rates were then used to calculate the overall uninsured cancer rate., Results: The total number of estimated 2020 KUCC cases was 24,412, with 0.86%, 42.56%, and 56.58% being the percentage per the age groups 0-19, 20-64, and 65+. The estimated uninsured rate per age group was 5.33%, 13.49%, and 0.40%. Based on these results, there were an estimated number of 11 uninsured cancer patients in the MCA area between the ages of 0-19, 1,401 between the ages of 20-64, and 55 uninsured cancer patients over the age of 65. This yielded an overall uninsured cancer rate of 6.01%.