Todd Burus’s research while affiliated with University of Kentucky and other places

Background The University of Kentucky Markey Cancer Center developed the data gathering and visualization platform Cancer InFocus (CIF) as a solution for cancer center catchment area surveillance. CIF was released in June 2022 and made available for use to other institutions through a no‐cost licensing agreement. The purpose of this study was to evaluate the impact CIF has had on cancer centers since its release. Methods The authors adapted an existing management evaluation framework to assess the impact of CIF across three spheres—idea dissemination, product engagement, and adopter satisfaction. This assessment included an online survey administered between the dates of September 18, 2023 and June 22, 2024 among 28 individuals at 13 CIF adopting institutions. Results As of October 2024, the ideas and approaches of CIF had been disseminated with national audiences 13 times and featured in one peer‐reviewed publication. Thirty‐five institutions, including 26 National Cancer Institute–Designated Cancer Centers, had engaged in licensing CIF. In a user satisfaction survey among adopting institutions, a majority of individuals indicated they were gathering more data (91.7%) and requiring less effort to disseminate data (72.0%) using CIF than under their previous methods. Conclusions CIF has demonstrated a broad and positive impact on cancer center catchment area surveillance in the 2 years since its release. CIF represents a high value, low‐cost option for cancer centers wanting to build a cancer surveillance dashboard. The framework used for evaluating CIF's impact can be adapted to assess the impact of other open‐source software built and distributed by cancer centers.

This cross-sectional study analyzes whether different head and neck cancer mortality trends exist among the Appalachian population.

Decreases in lung cancer incidence in the United States (US) have paralleled decreasing smoking prevalence for several decades; however, recent data has revealed slower declines among females than males. Sex‐based differences in histologic lung cancer—and specifically adenocarcinoma—for all 50 US states and the District of Columbia have never been investigated. Using population‐based cancer registry data from the US Cancer Statistics, we examined age‐adjusted histologic lung cancer incidence rates and trends by sex and state of residence at diagnosis. We compared state‐level adenocarcinoma incidence to lung cancer screening (LCS) adherence and smoking prevalence estimates. Average annual percentage change (AAPC) and incidence rate ratios (IRR) were used to assess changes over time. Nationally, females experienced faster increases in adenocarcinoma incidence than males (1.75%/year vs. 0.35%/year), and slower decreases in incidence of squamous cell (−0.06%/year vs. −1.58%/year) and small cell carcinoma (−2.06%/year vs. −3.19%/year). Adenocarcinoma incidence increased significantly (AAPC>0) in 41 states among females compared to 10 among males. Significant adenocarcinoma increases in individuals under age 55 (IRR >1) occurred among females in six states (four in the southeastern US) and none among males. State‐level LCS adherence was significantly associated with adenocarcinoma incidence among females (r = 0.39; p<.01) but not males, though screening cannot account for increases among females under age 55. Our results highlight sex‐based differences in histologic lung cancer incidence trends, with specific concern for increases in adenocarcinoma in the southeastern US. Further research is needed into appropriate LCS eligibility criteria and the risk factors driving sex‐based disparities.

The National Cancer Institute's (NCI) Cancer Center Support Grant mandates that NCI-Designated Cancer Centers establish a Community Outreach and Engagement (COE) component to help direct efforts at reducing cancer burden within their catchment areas. Despite the critical role of COE offices, little is known about how they track and evaluate outreach activities and outcomes. We gathered information on current practices from representatives of 40 out of 65 COE offices using an online survey. While nearly all responding centers (97.5%) tracked COE activities, no consensus existed on resources used and satisfaction with current solutions was mixed (51.0% not satisfied). Respondents expressed need for a centralized, standardized, and comprehensive tracking solution to capture outreach events and external partnerships, automate report generation, and ensure alignment with COE aims. This study highlights challenges COE offices face with resource limitations and a heterogeneity of activities to track, and the need for a standard evaluation framework.

Importance US cancer diagnoses were substantially lower than expected during the COVID-19 pandemic in 2020. A national study on the extent to which rates recovered in 2021 has not yet been conducted. Objective To examine observed vs expected cancer rate trends for January 2020 to December 2021. Design, Setting, and Participants This cross-sectional, population-based study of cancer incidence trends used the Surveillance, Epidemiology, and End Results 22 (SEER-22) Registries Database, which covers 47.9% of the US population. Included individuals were those with an invasive cancer diagnosis reported to registries included in SEER-22 between January 1, 2000, and December 31, 2021. Exposures Age, sex, race and ethnicity, urbanicity, and stage at diagnosis. Main Outcomes and Measures Expected cancer incidence rates were measured for the COVID-19 pandemic years of 2020 and 2021 from prepandemic trends using ensemble forecasting methods. Relative difference between observed and expected cancer incidence rates and numbers of potentially missed cases were measured. Results The SEER-22 registries reported 1 578 697 cancer cases in 2020 and 2021, including 798 765 among male individuals (50.6%) and 909 654 among persons aged 65 years or older (57.6%). Observed all-sites cancer incidence rates were lower than expected by 9.4% in 2020 (95% prediction interval [PI], 8.5%-10.5%), lower than expected by 2.7% in 2021 (95% PI, 1.4%-3.9%), and lower than expected by 6.0% across both years combined (95% PI, 5.1%-7.1%), resulting in 149 577 potentially undiagnosed cancer cases (95% PI, 126 059-176 970). Of the 4 screening-detected cancers, only female breast cancer showed significant recovery in 2021, exceeding expected rates by 2.5% (95% PI, 0.1%-4.8%), while significant reductions remained for lung cancer (9.1% lower than expected; 95% PI, 6.4%-13.2%) and cervical cancer (4.5% lower than expected; 95% PI, 0.4%-8.0%), particularly for early stage at diagnosis. Rates of all-sites cancer incidence returned to prepandemic trends in 2021 among female individuals, persons aged younger than 65 years, and persons of non-Hispanic Asian and Pacific Islander race and ethnicity. Conclusions and Relevance This population-based cross-sectional study of US cancer incidence trends found that rates of diagnosis improved in 2021 but continued to be lower than expected, adding to the existing deficit of diagnosed cases from 2020. Particular attention should be directed at strategies to immediately increase cancer screenings to make up lost ground.

BACKGROUND Qualitative methods can provide a valuable complement to quantitative data in community health needs assessments to gain a deeper understanding of community perspectives on needs, inequities, and potential solutions. For needs assessments focusing on a large geographic area, it is challenging to collect qualitative data from a variety of different rural and urban contexts. In 2021, a steering committee of academic and community organizations in Kentucky (KY) was formed to drive a multi-method, statewide cancer needs assessment (CNA) to identify needs and future priorities for the state. OBJECTIVE This article reports on the virtual focus group component of the CNA. The objectives were to: 1) document existing community resources and perceived needs across the cancer care continuum and 2) explore the impacts of social determinants of health and the needs unique among populations that experience health disparities. METHODS We recruited adult KY residents who were not employed in health occupations to participate in 11 virtual 60-minute focus groups, with stratified sampling to include multiple target populations and geographic areas. We based our semi-structured discussion guide on the cancer care continuum domains and additionally focused on social determinants of health, health equity, and other factors affecting cancer diagnoses and outcomes. We conducted qualitative line-by-line analysis of the session recording transcripts to identify themes. RESULTS Participants (N=51) lived in 25 different counties, including 35% from rural communities, 14% from Appalachian KY, and 31% who self-identified as a racial or ethnic minority. We identified a variety of themes representing community-perceived needs and potential solutions across the cancer care continuum, including the need for the following: 1) novel approaches to make information accessible; 2) messaging that will not be interpreted as blaming or shaming; 3) messaging from individuals who engender trust; 4) screening efforts that reach individuals where they are; 5) ways to address practical barriers for screening and treatment, such as cost and transportation; and 6) ways to increase knowledge about insurance coverage for screening and treatment. We also found emergent themes across race, ethnicity, rural/urban residence, sexual orientation/gender identity, and age. Participants pointed to a need to promote positive, culturally sensitive communication between patients and providers and to create safe care spaces, which consider ways cultural and gender norms affect cancer care, to fight stigma and improve health equity. CONCLUSIONS The findings will inform future research and cancer control efforts to address KY's high cancer incidence and mortality rates. Virtual focus groups can be a valuable component of multi-method CNAs that cover a large geographic area and/or with diverse populations to capture community perceptions of cancer-related needs and solutions. Focusing on the cancer care continuum domains, social determinants of health, and unique needs of specific groups provides useful data for CNAs.