Background: Patient information is a component of care following an urgent suspected cancer referral, but its ability to explain diagnostic uncertainty and support safe action while patients await investigation has not been systematically examined. We evaluated publicly retrievable referral resources used in England. Methods: We conducted a systematic environmental scan and directed content analysis of materials hosted or adopted by England's 20 NHS Cancer Alliances and NHS services. Standard, Easy Read, visual, and audiovisual variants were assessed using an 18-item Referral Uncertainty Communication Framework. Criteria were scored absent, incomplete, or explicit and actionable. PEMAT, readability, format comparisons, and prespecified sensitivity analyses were secondary. Results: Thirty-eight resource variants were included. Thirty-three (86.8
In Japan, the National Cancer Control Plan established cancer education as a foundational pillar; however, the effects of its implementation remain unclear. Therefore, this study aimed to describe cancer education outcomes and cancer perceptions among high school students in a nationwide survey. A cross-sectional survey was conducted among 11th-grade students in Japan. In total, 13,089 participants completed a 36-item questionnaire on cancer prevention, screening, treatment, survivorship, and literacy. We then analyzed sex differences and independent factors associated with accurate cancer risk perception. Only 32.7
Digital technologies have transformed healthcare, yet disparities persist, particularly among older adults and individuals with cancer. The digital divide encompasses not only access but also challenges in electronic communication and cognitive engagement, affecting health equity. This study examined the prevalence of three digital divide dimensions (Access, E-communication, and Cognitive Gaps) among U.S.adults with and without cancer and assessed their associations with sociodemographic factors, clinical characteristics, and self-rated health. Cross-sectional data from the 2022 Health Information National Trends Survey (HINTS 6; N = 5,808) were analyzed using survey-weighted methods. Generalized linear models examined sociodemographic and clinical predictors of digital gaps, and survey-weighted linear regression assessed associations with self-rated health. The E-communication Gap was most prevalent (36.2
Background/Purpose: Aquatic populations experience high cumulative ultraviolet radiation exposure and elevated skin cancer risk. Self-skin examination is widely promoted within cancer education strategies; however, its diagnostic accuracy in high-risk groups remains unclear. Method: Adults (≥ 18 years) participating in surfing or outdoor swimming (≥ 1 h/week) underwent full-body skin examination by an accredited skin cancer doctor. Prior to examination, participants identified any lesion(s) of concern, reflecting real-world self-detection. Suspicious lesions were biopsied or excised, with histopathology as the reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results: Among 191 participants (123 surfers, 68 swimmers), 50.8
Spanish is the second most commonly spoken language in the United States (US). The majority of Spanish speakers in the US identify as Hispanic/Latino individuals, a population for whom cancer is the leading cause of death. This descriptive study examined cancer information-seeking patterns among Spanish-speaking users of the National Cancer Institute’s Cancer Information Service (CIS), a free and publicly available cancer information resource. Between January 2019 and December 2025, the CIS received 19,280 Spanish-language inquiries from caregivers (33.4
Cancer referral thresholds are usually presented as products of guidelines, risk estimates and clinical findings. In practice, trainees also learn them through apprenticeship. A supervisor who refers early, watches cautiously, distrusts certain tests or worries about overinvestigation can shape a learner’s future decisions long after the placement ends. This article introduces threshold inheritance in the context of the largely unexamined transmission of cancer referral habits, risk tolerance and explanatory language from supervisor to trainee. The problem is not variation itself. Reasonable clinicians may reach different decisions when evidence is incomplete. The educational risk arises when variation remains tacit, authority substitutes for reasoning, and a local habit is absorbed as a universal standard. Cancer education should therefore make referral thresholds visible and discussable. Supervisors can compare decisions on the same borderline cases, identify which elements arise from evidence, experience, system pressure or patient context, and revisit outcomes without allowing diagnosis to retrospectively determine whether the original decision was sound. Learners should be assessed on calibrated reasoning, safety-netting and their ability to explain what would change the plan, rather than conformity with one trainer’s preference. Deliberate threshold calibration could help future clinicians develop an accountable referral practice that is neither inherited uncritically nor defended as instinct.
Adolescents are a key population in STI prevention, yet many lack foundational knowledge and access to reliable information. This study aimed to evaluate the impact of a targeted sexual health education lecture on knowledge about STIs and HPV vaccination as well as behavioral intentions in Bavaria, Germany. We conducted a prospective, anonymized survey with students from secondary schools across Bavaria. An online questionnaire was completed before (t = 1; n = 5,988) and after (t = 2; n = 4,739) a standardized, extracurricular sexual health lecture. Participants were aged 14–20 years (mean age 16.1), from diverse school types. Key outcomes included self-assessed knowledge, ability to explain specific STIs, awareness of the HPV vaccine, and willingness to receive the vaccination. Self-reported STI knowledge increased significantly: only 29.1
Early detection of childhood cancer is a key determinant of survival, as diagnostic delays result in advanced disease, higher treatment toxicity, and increased mortality. In low- and middle-income countries (LMICs), limited cancer education and awareness among primary care providers (PCPs) contribute to diagnosis delays, highlighting the need for educational interventions that support clinical decision-making. Mobile health (mHealth) tools offer a promising cancer education strategy; however, few are designed to address learning needs in local contexts. With support from the My Child Matters program and based on the Pan-American Health Organization (PAHO) Integrated Management of Childhood Illness-Cancer (IMCI-Cancer) "traffic-light" risk-stratification framework, we co-developed with PCPs S-IMCICA_V.2 (Sistema de Información para el Manejo Integral del Cáncer Infantil_Versión.2; Information System for Comprehensive Management of Childhood Cancer_Version.2), an mHealth educational and clinical decision support tool aimed at improving detection and referral of childhood cancer in Colombia. Applying user-centered design, we completed three phases: (1) app design and content development based on local educational needs, (2) participatory co-design sessions, and (3) iterative usability testing and prototype production. Seventy-nine stakeholders (37 PCPs, 8 nurses, 14 pediatric oncologists, 20 allied staff) participated. Rapid thematic analysis informed refinements in app content, usability, and functionality. The final high-fidelity prototype was perceived as intuitive and valuable for supporting cancer education and clinical reasoning, reinforcing knowledge and emphasizing timely referrals. Stakeholder input led to improvements in app personalization, navigation, clinical logic checks, educational content and referral guidance. Embedding educational content within mHealth clinical tools may enhance cancer knowledge retention and behavior change in clinical practice. Integrating S-IMCICA_V.2 into an e-learning curriculum and evaluating regional impact are underway.
Training in gynecologic oncology requires mastery of complex decision making and technically demanding procedures, yet opportunities for repetitive practice are often limited by case volume, patient-safety considerations, and unequal access to expert supervision. Artificial intelligence (AI) has therefore attracted attention as a potential adjunct to simulation-based and feedback-intensive surgical education. This qualitative study explored how educators and learners perceive the role of AI in gynecologic oncology training. Semi-structured interviews were conducted with five gynecologic oncology faculty members and ten postgraduate obstetrics and gynecology trainees at a university-affiliated teaching hospital. Interview data were analyzed using inductive thematic analysis. Three themes were identified: AI as a tool for expanding deliberate practice and structured feedback, barriers that limit acceptable adoption, and conditions required for responsible implementation. Participants described AI-enhanced simulation as valuable for risk-free rehearsal, exposure to uncommon cases, and more objective assessment, while also emphasizing concerns about realism, cost, access, and data governance. Both groups supported a hybrid educational model in which AI supplements rather than replaces human mentorship. These findings suggest that AI can strengthen gynecologic oncology education when it is integrated into competency-based curricula, accompanied by faculty oversight, and supported by appropriate ethical and infrastructural safeguards.
Children and adolescents with a history of childhood cancer may experience psychosocial, cognitive, and school-related difficulties, yet survivorship education and follow-up need to reflect heterogeneous needs rather than assume uniform impairment. This cross-sectional case-comparison study compared shared psychosocial and metacognitive outcomes in 61 participants with a history of childhood cancer and 57 age-aligned typically developing peers aged 8–17 years, and examined trauma-related symptoms and school-related burden within the cancer-history group. Shared Strengths and Difficulties Questionnaire outcomes and harmonized Metacognitions Questionnaire-derived outcomes were analyzed using Welch tests, Hedges’ g, and false-discovery-rate correction. Within the cancer-history group, correlations and theory-driven regression models examined metacognitive correlates of psychosocial, trauma-related, and school-impact outcomes. The analyses provided no evidence of statistically reliable between-group differences after correction, although the modest sample means that small group differences cannot be excluded. Within the cancer-history group, low cognitive confidence in memory was strongly associated with hyperactivity/inattention and total difficulties, and negative beliefs about worry were the clearest unique statistical correlate of trauma-related symptoms. School-related burden was common, with 60.7
Human papillomavirus (HPV) vaccination rates in Japan declined after the suspension of the government’s proactive recommendation in 2013. Vaccination behavior is influenced by knowledge as well as psychological and social factors. This study examined factors associated with HPV vaccination among Japanese women using the 7 C vaccination readiness model. A cross-sectional online survey was conducted among Japanese women aged 15–49 years in February 2025. Data on demographic characteristics, HPV vaccination status, self-reported knowledge of the HPV vaccine, and 7 C vaccination readiness were collected. Factors associated with HPV vaccination were analyzed using logistic regression, with separate analyses by student status (students vs. non-students). Among 1,200 participants, 339 (28.3
Early detection through mammographic screening plays a central role in improving breast cancer outcomes, with diagnostic accuracy relying heavily on radiologist performance. While experience and case volume are recognised contributors to accuracy, the specific effect of weekly mammogram reading hours (HPW) remains unclear. This study examined the relationship between HPW and diagnostic performance among BreastScreen (BS) radiologists, non-BreastScreen radiologists, and radiology registrars, and explored whether completing multiple BREAST training test sets enhanced diagnostic accuracy. This retrospective observer-performance study analysed digital mammography (DM) and digital breast tomosynthesis (DBT) readings from 871 test set completions by BreastScreen radiologists, non-BreastScreen radiologists and radiology registrars across 13 BREAST test sets completed between 2014–2024. Performance metrics included sensitivity, specificity, lesion sensitivity, ROC AUC, and JAFROC. Demographic and performance data of participants were collected through the BREAST platform. Statistical analyses were performed to assess associations between HPW and diagnostic performance, and to identify performance plateau thresholds across HPW categories. Performance of readers improved consistently with increasing HPW for all cohorts, with significant positive correlations observed for most performance metrics (p<0.05). JAFROC plateau values occurred at different thresholds: 20–30 HPW for BreastScreen radiologists, 10–20 HPW for non-BS radiologists, and 5–10 HPW for registrars. In DBT analyses, BreastScreen radiologists achieved significantly higher JAFROC scores than non-BreastScreen radiologists only within the lowest HPW category (p<0.05). Completing ten or more BREAST test sets was not associated with significant improvements in diagnostic performance. Increasing HPW was associated with improved diagnostic performance up to cohort-specific thresholds, beyond which additional reading yielded limited benefit. Establishing optimal HPW levels may help screening services maintain high diagnostic standards while minimising fatigue and supporting workforce sustainability.
The oncology workforce faces a “human crisis” marked by a gap between technology and human connection. While standard training emphasizes technical scripts, this pilot study assesses the feasibility, safety, and acceptability of an integrated protocol developed by the Italian College of Medical Oncology Directors (CIPOMO). The intervention combines Medical Humanities (MH) and Compassion-Focused Therapy to enhance professional quality of life and relational competence. Forty oncologists, recruited via CIPOMO regional branches to ensure national representation, participated in a 6-day program. Primary outcomes focused on feasibility (retention rates) and acceptability (qualitative feedback). Secondary outcomes, assessed at T1, T2, and T3, included the relational competence gap and professional quality of life. The study demonstrated a 97.5
Scans constitute an important role in cancer management. "Scanxiety", or scan-associated anxiety, is commonly experienced by patients undergoing cancer-related scans. Although more patients are turning to the internet and social media platforms such as YouTube for health information, few studies have evaluated the scanxiety content presented in these online resources. This study aims to evaluate YouTube videos and webpages available to patients relating to scanxiety. YouTube was searched using pre-defined scanxiety search terms and a Google search analysis for the term scanxiety was carried out and results from the first two pages were collected in August 2024. YouTube videos and webpages were evaluated using the validated DISCERN quality criteria for consumer health information and the Agency for Healthcare Research and Quality Patient Education Materials Assessment Tool (PEMAT). To assess accessibility of reading content, the Flesch-Kincaid reading level was determined for each webpage. Three independent reviewers performed video and webpage analysis. There were 82 videos and 18 webpages included in the analysis. Videos had a mean independent-reviewer rated quality DISCERN score of 1.8 out of 5, which was between low and moderate quality. Websites showed a higher mean quality DISCERN score of 2.7 out of 5. Despite better quality of information, websites were written at a higher reading level than that of the general population, limiting accessibility. Both videos and webpages had low actionability as patient education materials. Efforts are needed to improve scanxiety-related patient education as the number of patients living with cancer and requiring cancer-related scans has significantly increased.
Background: Radiation oncology is central to multidisciplinary cancer care but remains poorly visible to students. Early educational exposure may improve awareness of the discipline and of the professional roles involved in radiotherapy. This study evaluated the short-term educational impact of a case-based school–work orientation program for high school students. Methods: Between December 2025 and March 2026, 80 high school students participated in the “Invisible Scalpel” program at Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome. The program included 18 h of classroom-based teaching and 12 h of supervised group activities focused on a simulated clinical case. Students explored the roles of radiation oncologists, radiotherapy technicians/radiation therapists, medical physicists, and biomedical engineers. Anonymous pre- and post-program questionnaires were completed by 60 students and analyzed descriptively. Likert scales (1–5) were used to evaluate attitudes towards the discipline. Results: Baseline knowledge of the purpose of radiotherapy was high, but awareness of professional roles, particularly medical physicists and biomedical engineers, was limited. After the program, all students correctly identified radiotherapy as a cancer treatment, 90
Inpatient malignant hematology rotations are essential for internal medicine residents to gain experience in hematology and oncology. The specialized nature of these rotations represents a challenge in education that is limited by time, complexity of material, and evolving clinical guidelines and recommendations. This study assesses the feasibility of a smartphone application (app) resource for IM residents to use during inpatient malignant hematology rotations. An app encompassing narrative text, figures, and links was created using free online technology. The app and follow-up survey were distributed to all IM residents rotating through the MedStar Georgetown University Hospital inpatient malignant hematology service (Bles2) from 2025-2026. Thirty-six IM residents completed the Bles2 rotation and were eligible to participate in this study, 108 secondary rotators were also included. 18 total survey responses were collected. Of the Bles2 rotators we had a response rate of 44.4% (16/36). Most residents (14/18, 77.8%) referenced the app between 1 and 4 times during their rotation. 17/18 (94.4%) felt that the app saved time looking up information related to a clinical question. On a 1-5 scale, average scores showed positive response to the app helping during the rotation (4.38), being easy to reference (4.61), being clinically relevant (4.66), helping with clinical decision making (4.29), and improving overall experience during the rotation (4.33). We illustrate that a smartphone app can be a novel and effective tool to distribute specialized, dynamically changing information to internal medicine residents rotating through an inpatient malignant hematology service.
