Chemotherapy-associated steatosis is poorly understood in the context of colorectal cancer. In this study, Stage II–III colorectal cancer patients were retrospectively selected to evaluate the frequency of chemotherapy-associated steatosis and to determine whether patients on statins throughout adjuvant chemotherapy develop chemotherapy-associated steatosis at a lower frequency. Baseline and incident steatosis for up to one year from chemotherapy start date was assessed based on radiology. Of 269 patients, 76 (28.3%) had steatosis at baseline. Of the remaining 193 cases, patients receiving adjuvant chemotherapy (n = 135) had 1.57 (95% confidence interval [CI], 0.89 to 2.79) times the adjusted risk of developing steatosis compared to patients not receiving chemotherapy (n = 58). Among patients who underwent chemotherapy, those using statins for pre-existing hyperlipidemia (n = 37) had 0.71 (95% CI, 0.10 to 2.75) times the risk of developing steatosis compared to patients who were not prevalent users of statins (n = 98). Chemotherapeutic treatment of Stage II–III colorectal cancer appears to be consistent with a moderately increased risk of steatosis, although larger studies are necessary to assess the significance of this observation. Prospective trials should be considered to further explore the potential for protective use of statins in this curative patient population.

Endocrine therapy (ET) for hormone receptor-positive (HR+) breast cancer can contribute to gynecologic symptoms (GS) that impact vaginal health, sexual function, and quality of life (QoL). A cross-sectional study was conducted at St. Michael’s Hospital in Toronto, Canada between July 2017 and June 2018 to examine the occurrence and frequency of GS among HR+ breast cancer patients on ET, patient-provider communication, female sexual dysfunction (FSD), and QoL. A Treatment Experience questionnaire was developed for this study and the Female Sexual Function Index (FSFI) and Menopause-Specific Quality of Life questionnaire (MENQOL) were also administered. Of 151 patients surveyed, 77 (51.0%) were on tamoxifen and 74 (49.0%) on an aromatase inhibitor. Most patients (84.1%, 95% confidence interval [CI] 77.3% to 89.5%) experienced at least one GS “all the time” or “often”, or one or more infections, in the past year. Only 44 (31.9%) patients reported that their oncologist had ever previously asked them about experiencing GS. The prevalence of FSD was 61.2% (95% CI 46.2% to 74.8%) among 49 sexually active patients that completed the FSFI. Symptoms captured in the MENQOL’s vasomotor domain were deemed most bothersome. Side effect management and patient-provider communication should be prioritized to optimize GS, vaginal health, and sexual function of ET users.

e18618 Background: The coronavirus disease (COVID-19) pandemic has created unprecedented strain on healthcare systems across the world. COVID-19 has thought to have significant impacts on the oncology patient population and has affected their care. Additional research is needed to ascertain the impact of the COVID-19 pandemic at the patient level. We sought to evaluate whether the delivery of cancer care, quality of life (QoL) and treatment outcomes of oncology patients at Mount Sinai Hospital (MSH), Toronto, Canada was impacted by the COVID-19 pandemic. Methods: A 3-part longitudinal questionnaire study including 138 oncology patients receiving active treatment or in active follow-up at MSH was conducted between June 15, 2020 and August 25, 2021. The questionnaire consisted of the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer QoL Questionnaire Version 3) and satisfaction with virtual healthcare questionnaire. The questionnaire was completed at baseline (Jun 15-Sep 8, 2020), 1 month follow-up (Jul 15-Oct 8, 2020), and 12 months follow-up (Aug 4-Aug 25, 2021). Repeated measures analysis of variance tests were performed to evaluate EORTC QLQ-C30 subscale score changes and satisfaction with virtual care question scores over time. Results: Overall, the mean EORTC QLQ-C30 QoL scores were seen to improve in oncology patients from 65.1 (SD±22.3) at baseline to 69.1 (SD±16.9) at 12 months follow-up (p = 0.2). Within the EORTC QLQ-C30 functional scales, mean role functioning and mean social functioning scores were observed to increase over 12 months of follow-up, 66.4 to 79.2 (p < 0.05) and 67.7 to 76.4 (p = 0.17), respectively. Little change was observed within other EORTC QLQ-C30 functional scales and individual symptom scales during follow-up. Over 12 months of follow-up, mean agreement (0 = strongly disagree to 6 = strongly agree) to the questionnaire statement regarding avoiding going to the hospital during COVID-19 pandemic had declined, from 4.6 (SD±2.0) at baseline to 3.9 (SD±2.2) at 12 months follow-up (p = 0.09). Although not significant, virtual care satisfaction generally decreased over the follow-up time period. 97% of 48 patients who completed the survey at 12 months of follow-up reported feeling more safe coming into the hospital when considering the current increased vaccination rates in Ontario. Conclusions: As the COVID-19 pandemic has evolved, there has been increased knowledge of disease transmission, along with the introduction of health care measures such as vaccination and treatment. During this time, cancer outpatients at MSH became more comfortable as demonstrated by improvements in both QoL and virtual care scores. Prospective studies should still be considered to assess the efficacy of different methods of improving oncology patient care and QoL during the COVID-19 pandemic.

No abstract

e13644 Background: In 2018, there were an estimated 4.8 million new cases of gastrointestinal (GI) cancers worldwide and 3.4 million related deaths. Iron deficiency (ID) is a frequent complication of GI malignancy that eventually manifests as iron deficiency anemia (IDA). Early recognition and treatment of ID/IDA in GI oncology patients is an important aspect of care. Traditional serum ferritin monitoring and oral iron supplementation hold limited diagnostic and therapeutic value in this population as it may be falsely elevated and confounded by poor absorption and blood loss, respectively. Therefore, we conducted a survey of Canadian physicians to assess disparities in IDA surveillance and management practices in GI cancer patients. Methods: From February 2020 to September 2021, a 20-question electronic survey was sent to Canadian medical oncologists (MO), surgical oncologists (SO), and gastroenterologists (GE). The survey collected information on four domains: demographics, screening practices, treatment practices, and knowledge of the latest guidelines of ID/IDA. Analysis was conducted using descriptive statistics. Results: A total of 108 (55 GE, 19 SO, and 34 MO) of the 872 (12.4%) invited physicians completed the survey. A greater proportion of GE (70.9% compared to 36.8% of SO, and 26.5% of MO) measured baseline iron parameters. Of these, a slight trend of iron parameters were being measured mainly at initial consult (61.5% of GE, 85.7% of SO, and 44.4% of MO), with little continuing surveillance throughout treatment course. Most physicians who measured iron parameters relied on ferritin mainly (82.1% of GE, 100% of SO), while MO were evenly distributed in their evaluation of ferritin (88.9%), serum iron (100%), total iron binding capacity (100%) and iron saturation (88.9%). The majority supplemented iron if ID/IDA was identified prior to systemic/surgical oncologic treatment (94.2% of GE, 85.7% SO, and 66.7% of MO). Of these, parenteral iron was the preferred modality for SO (85.7%), while oral iron was preferred among GE (82.8%) and MO (55.6%). The majority of physicians (81.3%) were not aware of the ASH/ASCO guidelines regarding the use of erythropoiesis stimulating agents in conjunction with parenteral iron supplementation for treatment anemia in this setting (92% of GE, 66.7% of SO, and 80.9% of MO). Conclusions: Results from this Canadian survey suggests a disparity in practice pattern for IDA management between different specialties caring for GI oncology patients. Moreover, there appears to be a gap in knowledge and thus a gap in care surrounding evidence-based IDA management principles which may be contributing to poor clinical outcomes. Focused knowledge translation and exchange efforts are required to improve treatment of ID/IDA in patients with GI cancer nationally.