Hispanic/Latino (H/L) patients with prostate cancer (PCa) are at an increased risk of developing side effects related to androgen deprivation therapy (ADT). While diet and exercise can reduce these toxicities, little is known about factors influencing their engagement in health-promoting behaviors. We developed a survey to examine sociodemographic characteristics, exercise/dietary habits, motivation for change, and barriers to participate in lifestyle interventions. We surveyed patients with PCa who self-identified as H/L ethnicity, treated at UCSD, and who were either previously or currently on ADT at the time of the survey. Questionnaires were administered in Spanish or English, either in person or by telephone, using interpreter services based on patient preference. Sixty one patients (median age 66 years) completed the survey with an 88% response rate. Most patients were of Mexican descent (85%), born outside the U.S. (72%), had public health insurance (51%), resided in disadvantaged neighborhoods (54%) based on the Area Deprivation Index (ADI), from H/L ethnic enclaves (64%), and were primarily Spanish speakers (51%), with 36% reporting limited English proficiency. About half (49%) reported household financial distress, yet 92% felt supported by their community or family during PCa diagnosis. At the time of the survey, 85% of patients were on ADT and 68% had distant metastasis. Most had a BMI >= 30 kg/m2 (52%), diabetes (51%), and 66% had a history of coronary artery disease (CAD) or a high-risk atherosclerotic cardiovascular disease (ASCVD) score of >= 20%. Most patients (51%) reported limited dietary monitoring and 71% reported less than 50 min/week of moderate-intensity exercise, with 41% not engaging in any moderate exercise. However, most (82%) showed interest in joining a community exercise program. Participation incentives included family involvement (73%), other H/L participants (77%), Spanish-speaking staff (86%), and a shorter driving distance. Neighborhood disadvantage (ADI quintile > 3) was linked to higher odds of CAD or high ASCVD risk (OR 5.4, p = 0.02), de novo metastatic PCa (OR >10, p < 0.01), lower clinical trial participation (OR 0.08, p < 0.01), self-reported physical inactivity (OR 4.6, p = 0.01), financial distress (OR 5, p < 0.01), and time toxicity (OR 4.6, p < 0.01). We report that H/L patients with PCa on ADT face substantial cardiometabolic risk factor burden and limited access to health-promoting activities due to socioeconomic and cultural barriers. Despite low physical activity, patients expressed motivation to improve health behaviors, when provided with incentives, underscoring the need for tailored interventions to mitigate ADT toxicity. These findings will inform the design of an interventional study that examines the impact of a combined group exercise and nutrition counseling intervention on physical fitness and cardiovascular health among H/L men with PCa on ADT. Sharon H. Choi, Frances Ramos, Bryanna Chavez, Kristine Ly, Samuel Pena, Yu-Wei Chen, J. Michael Randall, Tyler Stewart, Fred Millard, James Murphy, Noe Crespo, Soo Park, Brent Rose, Aditya Bagrodia, Elena Martinez, Rana R. McKay. Multilevel determinants of health behavior participation among Hispanic/Latino men with prostate cancer on androgen deprivation therapy: A cross-sectional survey [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A067.

The Simons Observatory (SO) is a cosmic microwave background experiment composed of three 0.42 m Small Aperture Telescopes (SATs) and one 6 m Large Aperture Telescope (LAT) in the Atacama Desert of Chile. The Large Aperture Telescope Receiver (LATR) was integrated into the LAT in August 2023; however, because mirrors were not yet installed, the LATR optical chain was capped at the 4K stage. In this dark configuration we are able to characterize many elements of the instrument without contributions from atmospheric noise. Here we show this noise is below the required upper limit and its features are well described with a simple noise model. Maps produced using this noise model have properties that are in good agreement with the white noise levels of our dark data. Additionally, we show that our nominal scan strategy has a minimal effect on the noise when compared to the noise when the telescope is stationary

The Simons Observatory (SO) group of instruments are together pursuing a major step forward in the ground-based study of the Cosmic Microwave Background (CMB). With one 6 m large-aperture telescope and three 0.4 m small-aperture telescopes (SATs), SO will strive to recover faint CMB polarization signals at a wide range of angular scales and across six frequency bands inside of atmospheric transmission windows spanning the range 27 GHz to 280 GHz. The first instrument to record celestial light is the first of two mid-frequency SATs, SAT MF-1, with over 3,000 dichroic pixels sensitive to two frequency bands centered at 90 and 150 GHz. This instrument began observing in October 2023, and features a cryogenically-cooled polarization modulator consisting of a spinning half-wave plate, a set of three silicon lenses with metamaterial anti-reflection coating, and a focal plane of seven modules referred to as universal focal-plane modules (UFMs), each containing 1,720 AlMn transition-edge sensor (TES) bolometers coupled to a 100 mK bath. In this proceedings, we report on initial efforts to calibrate the TES bolometer response to electrical and optical signals and preliminary characterization of possible confounding signals like scan-synchronous pickup. We comment on how these elements pertain to the analysis of systematic errors relating to the ultimate goal of the SO SAT program: the further constraint of the tensor-to-scalar ratio, r, and the possibility of primordial gravitational waves generated in the early universe by a period of inflation.

The Simons Observatory is a ground-based telescope array located at an elevation of 5200 meters, in the Atacama Desert in Chile, designed to measure the temperature and polarization of the cosmic microwave background. It comprises four telescopes: three 0.42-meter small aperture telescopes (SATs), focused on searching for primordial gravitational waves, and one 6-meter large aperture telescope, focused on studying small-scale perturbations. Each of the SATs will field over 12,000 TES bolometers, with two SATs sensitive to both 90 and 150 GHz frequency bands (SAT-MF1, and SAT-MF2), while the third SAT is sensitive to 220 and 280 GHz frequency bands. Prior to its deployment in 2023, the optical properties of SAT-MF1 were characterized in the laboratory. We report here on measurements of beam maps acquired using a thermal source on SAT-MF1, along with measurements of near-field beam maps using a holographic method that enables characterization of both the amplitude and phase of the beam response, yielding an estimate of the far-field radiation pattern received by the telescope. We find that the near-field half-width-half-maximum (HWHM) requirements are met across the focal plane array for the 90 GHz frequency band, and through most of the focal plane array for the 150 GHz frequency band. Namely, the mean of the bandpass averaged HWHM of the edge-detector universal focal plane modules match the simulated HWHM to 10.4 %, with the discrepancy caused by fringing in the simulation. The measured radial profile of the beams matches simulations to within 2 dB from the beam center to at least the -10 dB level. Holography estimates of the far-field 90 GHz beams match the full-width-half-maximum from simulation within 1%, and the beam radial profiles deviate by less than 2 dB inside the central lobe. The success of the holography and thermal beam map experiments confirmed the optical performance were sufficient to meet the science requirements. SAT-MF1 was deployed to Chile in June, 2023. On-site observations are currently underway.

The Simons Observatory (SO) is a Cosmic Microwave Background experiment located in the Atacama Desert in Chile. SO consists of three small aperture telescopes (SATs) and one large aperture telescope (LAT) with a total of 60,000 detectors in six frequency bands.(1) As an observatory, SO encompasses hundreds of hardware components simultaneously running at different readout rates-all separate from its 60,000 detectors on-sky and their metadata. We provide an overview of commissioning SO's data acquisition software system for SAT-MF1, the first SAT deployed to the Atacama site. Additionally, we share insights from deploying data access software for all four telescopes, detailing how performance limitations affected data loading and quality investigations, which led to site-compatible software improvements.

For cosmic microwave background (CMB) polarization observations, calibration of detector polarization angles is essential. We have developed a fully remote controlled calibration system with a sparse wire grid that reflects linearly polarized light along the wire direction. The new feature is a remote-controlled system for regular calibration, which has not been possible in sparse wire grid calibrators in past experiments. The remote control can be achieved by two electric linear actuators that load or unload the sparse wire grid into a position centered on the optical axis of a telescope between the calibration time and CMB observation. Furthermore, the sparse wire grid can be rotated by using a motor. A rotary encoder and a gravity sensor are installed on the sparse wire grid to monitor the wire direction. They allow us to achieve detector polarization angle calibration with an expected systematic error of 0.08°. The calibration system will be installed in small-aperture telescopes at Simons Observatory.

10534 Background: With the growing indications for germline testing in prostate cancer (PCa), there is accumulating evidence that African American and Hispanic men with PCa are significantly under-tested compared to non-Hispanic white (NHW) men. Given this, little is known about the pathogenic germline variant landscape in Hispanic men with PCa. Methods: This was a retrospective cohort analysis of 17,256 men with PCa who underwent diagnostic germline testing through a commercial laboratory (Invitae) from 2015-2020. Self-identified Hispanic and NHW men were selected for comparative analysis. The primary endpoint was the rate of pathogenic/likely pathogenic (PLP) germline alterations in Hispanic men among 25 genes associated with PCa. Secondary endpoints included comparison of PLP rates in Hispanic vs NHW men, the rate of specific PLP alterations, and the rate of variants of uncertain significance (VUS). Fisher’s exact test was used to compare germline alteration rates for significance. Results: We identified 508 Hispanic and 12,542 NHW men with PCa who underwent testing during the study period. Median age at the time of testing was 69 vs 67 years in Hispanic vs NHW cohorts. A family history of PCa was reported in 21.1% (N=108) vs 27.3% (N=3428) in the Hispanic vs NHW cohorts, respectively (p=0.002). The PLP alteration rate was 7.1% in the Hispanic cohort and this rate was numerically lower but not significantly different when compared to the NHW cohort (9.7%) (p=0.058). A significantly higher rate of VUS was seen in the Hispanic cohort (Table). The four most frequently detected genes with PLP alterations in both cohorts were ATM, BRCA1, BRCA2, and CHEK2. Only the rate of CHEK2 alterations was significantly different between cohorts among all 25 genes analyzed (Table). Conclusions: In this analysis, the PLP alteration rate among Hispanic men was 7.1%, a much higher rate than has been previously reported, and the germline genomic landscape was similar to that of NHW men. The VUS rate was significantly higher among Hispanic men, a known consequence of under-testing among minority populations.These data support germline testing in Hispanic men with prostate cancer and emphasize the importance of improving testing rates.[Table: see text]

This conference presentation was prepared for the Millimeter, Submillimeter, and Far-Infrared Detectors and Instrumentation for Astronomy XI conference at SPIE Astronomical Telescopes + Instrumentation, 2022.

We present the design and measured performance of a new carbon fiber strut design that is used in a cryogenically cooled truss for the Simons Observatory Small Aperture Telescope (SAT). The truss consists of two aluminum 6061 rings separated by 24 struts. Each strut consists of a central carbon fiber tube fitted with two aluminum end caps. We tested the performance of the strut and truss by (i) cryogenically cycling and destructively pull-testing strut samples, (ii) non-destructively pull-testing the final truss, and (iii) measuring the thermal conductivity of the carbon fiber tubes. We found that the strut strength is limited by the mounting fasteners and the strut end caps, not the epoxy adhesive or the carbon fiber tube. This result is consistent with our numerical predictions. Our thermal measurements suggest that the conductive heat load through the struts (from 4 K to 1 K) will be less than 1 mW. This strut design may be a promising candidate for use in other cryogenic support structures.

150 Background: Little is known about the clinical course of patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) who harbor alterations in the homologous recombination repair (HRR) pathway. Here, we examine the outcomes of men with mHSPC with HRR alterations. Methods: Single center, retrospective analysis of men with mHSPC who underwent next generation sequencing from 2015-2020. The primary endpoint was to assess the time from diagnosis of mHSPC to onset of castrate resistance (mCRPC), as defined by PCWG3 criteria, in pts with HRR alterations vs wild type (WT). Both somatic and germline HRR alterations were permitted. Univariate and multivariate Cox regression were used to assess the effect of HRR alterations on time to mCRPC. Secondary endpoints included time to mCRPC stratified by HRR gene and time to treatment failure (TTF) in HRR altered vs WT pts, stratified by therapy. Results: We identified 151 men with mHSPC for the study. Median age was 66 years and 62% (n = 93) had de novo metastatic disease. 25% (n = 37) had HRR alterations detected and the most common alterations were in BRCA2 (n = 15), ATM (n = 10), CDK12 (n = 7). 78.4% (n = 29) of alterations were somatic and 13.5% (n = 5) of pts had co-alterations in 2 HRR genes. Time to mCRPC was significantly decreased in pts with HRR alterations vs WT (12.7 vs 16.1 mos, HR- 1.95, p- 0.02). In multivariate analysis, the effect of HRR alterations on time to mCRPC remained statistically significant when adjusting for age, mHSPC therapy, presence of visceral metastases, and PSA (adjusted HR- 1.69, p-0.02). Stratified by individual HRR gene, pts with BRCA2, CDK12, or co-occurring alterations had significantly decreased time to mCRPC compared to other HRR alterations (Table). In terms of mHSPC therapy, 45.7% were treated with ADT alone, 27.8% with an androgen receptor signaling inhibitor (ARSI), and 26.5% with docetaxel. TTF was inferior in HRR altered vs WT pts (10.8 vs 13.8 mos, p-0.004, HR- 1.84). Stratified by therapy, TTF was inferior in HRR altered vs WT pts treated with ADT alone (8.9 vs 13.3 mos, p- 0.019, HR-1.94) and there was no significant difference in TTF in HRR altered vs WT pts treated with either the addition of an ARSI or docetaxel. Conclusions: HRR alterations are associated with worsened outcomes in mHSPC patients. Given the established role of PARP inhibitors in mCRPC, these data highlight an opportunity to explore the use of PARP inhibitors in mHSPC to potentially improve outcomes. [Table: see text]

We quantify the calibration requirements for systematic uncertainties for next-generation ground-based observatories targeting the large-angle B-mode polarization of the Cosmic Microwave Background, with a focus on the Simons Observatory (SO). We explore uncertainties on gain calibration, bandpass center frequencies, and polarization angles, including the frequency variation of the latter across the bandpass. We find that gain calibration and bandpass center frequencies must be known to percent levels or less to avoid biases on the tensor-to-scalar ratio r on the order of Δ r∼10-3, in line with previous findings. Polarization angles must be calibrated to the level of a few tenths of a degree, while their frequency variation between the edges of the band must be known to O(10) degrees. Given the tightness of these calibration requirements, we explore the level to which residual uncertainties on these systematics would affect the final constraints on r if included in the data model and marginalized over. We find that the additional parameter freedom does not degrade the final constraints on r significantly, broadening the error bar by O(10%) at most. We validate these results by reanalyzing the latest publicly available data from the collaboration within an extended parameter space covering both cosmological, foreground and systematic parameters. Finally, our results are discussed in light of the instrument design and calibration studies carried out within SO.

The Simons Observatory (SO) Large Aperture Telescope Receiver (LATR) will be coupled to the Large Aperture Telescope located at an elevation of 5,200 m on Cerro Toco in Chile. The resulting instrument will produce arcminute-resolution millimeter-wave maps of half the sky with unprecedented precision. The LATR is the largest cryogenic millimeter-wave camera built to date with a diameter of 2.4 m and a length of 2.6 m. It cools 1200 kg of material to 4 K and 200 kg to 100 mk, the operating temperature of the bolometric detectors with bands centered around 27, 39, 93, 145, 225, and 280 GHz. Ultimately, the LATR will accommodate 13 40 cm diameter optics tubes, each with three detector wafers and a total of 62,000 detectors. The LATR design must simultaneously maintain the optical alignment of the system, control stray light, provide cryogenic isolation, limit thermal gradients, and minimize the time to cool the system from room temperature to 100 mK. The interplay between these competing factors poses unique challenges. We discuss the trade studies involved with the design, the final optimization, the construction, and ultimate performance of the system.

Ground-based observatories across a wide range of wavelengths implement cryogenic cooling techniques to increase the sensitivity of instruments and enable low temperature detector technologies. Commercial pulse tube cryocoolers (PTCs) are frequently used to provide 40 K and 4 K stages as thermal shells in scientific instruments. However, PTC operation is dependent on gravity, giving rise to changes in cooling capacity over the operational tilt range of pointed telescopes. We present a study of the performance of a two stage PTC with a cooling capacity of 1.8 W at 4.2 K and 50 W at 45 K (Cryomech PT420-RM) from 0 - 55 degrees away from vertical to probe capacity as a function of angle over a set of realistic thermal loading conditions. Our study provides a method to extract temperature estimates given predicted thermal loading conditions across the angular range sampled. We then discuss the design implications for current and future tilted cryogenic systems.

BackgroundRadiation recall pneumonitis (RRP) is a poorly understood clinical syndrome in which patients develop radiation pneumonitis triggered by a systemic agent, often years after the completion of radiation therapy. Immune checkpoint blockade agents have only recently been posited as a trigger for RRP. Here, we present three cases of immunotherapy-induced RRP.Case PresentationOur first patient was diagnosed with primary lung adenocarcinoma, and 4.5 years after completing radiation therapy developed symptomatic RRP immediately following a second dose of nivolumab-containing immunotherapy regimen. Our second patient was diagnosed with primary bladder cancer metastatic to the mediastinum, which was treated twice with radiation therapy. He developed RRP in the days following his second course of ipilimumab-pembrolizumab which was months after his second course of radiation that he received. Our final patient was diagnosed with metastatic small cell lung cancer and received local consolidative radiation therapy in addition to whole-brain radiation. He developed RRP on the 11th day after concluding his 4th cycle of nivolumab-ipilimumab, approximately 7 months after having had completed chest radiation therapy.ConclusionsImmunotherapy-induced RRP is a rare diagnosis which can present more focally than traditional immunotherapy pneumonitis and which must be clinically differentiated from other local processes such as pneumonia. Further research should explore the mechanisms underlying these radiation recall reactions as many patients receive radiation and immunotherapy during the course of their cancer treatment.

You have accessJournal of UrologyProstate Cancer: Markers II (PD52)1 Apr 2020PD52-12 ANALYSIS OF THE PROGNOSTIC SIGNIFICANCE OF CIRCULATING TUMOR DNA (CTDNA) IN METASTATIC CASTRATE RESISTANT PROSTATE CANCER (MCRPC) Justin Shaya*, J. Michael Randall, Frederick Millard, Razelle Kurzrock, J. Kellogg Parsons, Pablo Tamayo, and Rana McKay Justin Shaya*Justin Shaya* More articles by this author , J. Michael RandallJ. Michael Randall More articles by this author , Frederick MillardFrederick Millard More articles by this author , Razelle KurzrockRazelle Kurzrock More articles by this author , J. Kellogg ParsonsJ. Kellogg Parsons More articles by this author , Pablo TamayoPablo Tamayo More articles by this author , and Rana McKayRana McKay More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000954.012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Given the technical limitations of obtaining tissue next-generation sequencing, there has been considerable interest in blood ctDNA to assess genomic alterations in mCRPC. We examined the genomic landscape and prognostic significance of ctDNA in mCRPC. METHODS: Single center retrospective analysis of mCRPC patients who underwent ctDNA genomic profiling using Guardant360. Overall survival (OS) and time to progression (TTP) were examined and stratified by the presence of tumor suppressor mutations (p53, PTEN, Rb), androgen receptor (AR) amplification or mutation, number of genomic alterations, and highest allelic fraction of detected mutations. RESULTS: At the time of ctDNA collection, all patients (n=46) had mCRPC with bone metastases present in 100% of patients and visceral metastases present in 17.3%. Median age at ctDNA collection was 71 years, median time from CRPC diagnosis to ctDNA was 13 months (range 0-45), and median follow-up time from CRPC diagnosis was 17.5 months (4-40). The most common alterations present were TP53 mutation (41.3%), AR amplification (30.4%), and CDK6 amplification (21.7%). Actionable mutations were detected in BRCA1 (4.3%), BRCA2 (4.3%), ATM (2.2%), and PMS2 (2.2%). The median number of genomic alterations was 2 (0-8) and the median ctDNA allelic fraction was 4.6% (0-86.9%). Median OS of the cohort was 36 months. The presence of a tumor suppressor mutation, > 2 genomic alterations, and >5% mutation allelic frequency was associated with inferior OS (Table 1). In terms of time to progression on 1st line abiraterone or enzalutamide, the presence of an AR amplification or mutation was associated with significantly worse TTP of 6.9 months vs 13.5 months (p-0.015). Lastly, median PSA of the cohort was 73.5 and PSA was weakly associated with both ctDNA allelic fraction (r2-0.064, p-0.01) and number of genomic alterations (r2-0.088, p<0.001) by Pearson correlation. CONCLUSIONS: ctDNA is frequently detected in mCRPC; and the type, number and frequency of alterations are potentially prognostic of OS in mCRPC. Ongoing studies are needed to assess concordance of ctDNA with tissue NGS and the predictability of ctDNA. Source of Funding: None. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1094-e1095 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Justin Shaya* More articles by this author J. Michael Randall More articles by this author Frederick Millard More articles by this author Razelle Kurzrock More articles by this author J. Kellogg Parsons More articles by this author Pablo Tamayo More articles by this author Rana McKay More articles by this author Expand All Advertisement PDF downloadLoading ...

BACKGROUND:The addition of androgen deprivation therapy to radiation therapy (RT) improves survival in patients with intermediate- and high-risk prostate cancer (PCa), but it is not known whether combined androgen blockade (CAB) with a gonadotropin-releasing hormone agonist (GnRH-A) and a nonsteroidal antiandrogen improves survival over GnRH-A monotherapy. METHODS:This study evaluated patients with intermediate- and high-risk PCa diagnosed in 2001 through 2015 who underwent RT with either GnRH-A alone or CAB using the Veterans Affairs Informatics and Computing Infrastructure. Associations between CAB and prostate cancer-specific mortality (PCSM) and overall survival (OS) were determined using multivariable regression with Fine-Gray and multivariable Cox proportional hazards models, respectively. For a positive control, the effect of long-term versus short-term GnRH-A therapy was tested. RESULTS:The cohort included 8,423 men (GnRH-A, 4,529; CAB, 3,894) with a median follow-up of 5.9 years. There were 1,861 deaths, including 349 resulting from PCa. The unadjusted cumulative incidences of PCSM at 10 years were 5.9% and 6.9% for those receiving GnRH-A and CAB, respectively (P=.16). Compared with GnRH-A alone, CAB was not associated with a significant difference in covariate-adjusted PCSM (subdistribution hazard ratio [SHR], 1.05; 95% CI, 0.85-1.30) or OS (hazard ratio, 1.02; 95% CI, 0.93-1.12). For high-risk patients, long-term versus short-term GnRH-A therapy was associated with improved PCSM (SHR, 0.74; 95% CI, 0.57-0.95) and OS (SHR, 0.82; 95% CI, 0.73-0.93). CONCLUSIONS:In men receiving definitive RT for intermediate- or high-risk PCa, CAB was not associated with improved PCSM or OS compared with GnRH alone.

Renal cell carcinoma (RCC) is among the most prevalent malignancies in the USA. Most RCCs are sporadic, but hereditary syndromes associated with RCC account for 2–3 % of cases and include von Hippel-Lindau, hereditary leiomyomatosis, Birt-Hogg-Dube, tuberous sclerosis, hereditary papillary RCC, and familial renal carcinoma. In the past decade, our understanding of the genetic mutations associated with sporadic forms of RCC has increased considerably, with the most common mutations in clear cell RCC seen in the VHL, PBRM1, BAP1, and SETD2 genes. Among these, BAP1 mutations are associated with aggressive disease and decreased survival. Several targeted therapies for advanced RCC have been approved and include sunitinib, sorafenib, pazopanib, axitinib (tyrosine kinase inhibitors (TKIs) with anti-vascular endothelial growth factor (VEGFR) activity), everolimus, and temsirolimus (TKIs that inhibit mTORC1, the downstream part of the PI3K/AKT/mTOR pathway). High-dose interleukin 2 (IL-2) immunotherapy and the combination of bevacizumab plus interferon-α are also approved treatments. At present, there are no predictive genetic markers to direct therapy for RCC, perhaps because the vast majority of trials have been evaluated in unselected patient populations, with advanced metastatic disease. This review will focus on our current understanding of the molecular genetics of RCC, and how this may inform therapeutics.

OBJECTIVES:This study aims to validate the ability to perform depression screening with the patient health questionnaire (PHQ)-2 and PHQ-9 depression modules in a busy, outpatient practice, and to evaluate the prevalence of depression among lung cancer outpatients at our institution.METHODS:In 2010, 64 patients in a thoracic malignancy clinic completed the Patient Health Questionnaire-2. Patients endorsing either one or both items were then given the Patient Health Questionnaire-9, a nine-item depression assessment tool. Patients with mild or worse depression were offered a referral to a mental health care provider.RESULTS:Eighteen of 64 patients (28 %) endorsed one or both items on the PHQ-2. Thirteen of 18 patients with a positive PHQ-2 screen completed the PHQ-9, with mean score of 10.2 (SD 3.91), suggesting moderate depression. PHQ-9 item 4, evaluating fatigue, was positive in 12 patients, and PHQ-9 item 9, evaluating suicidal ideation, was never reported. Only 1 of 18 patients with a positive PHQ-2 screen was being followed by a psychiatrist, and no patient accepted a new referral to a mental health provider.CONCLUSIONS:The PHQ-2 and PHQ-9 modules are an effective means of depression screening in a busy, outpatient clinic. A high prevalence of depression was reported; yet, suicidal ideation was not reported. Depression severity ranged from mild to severe. The most endorsed PHQ-9 item was fatigue, although it is uncertain if this reflects a symptom of depression, a sequela of lung cancer itself, or both. The lung cancer patients in this sample who reported depression were unlikely to receive mental health services.