PurposeIn the present work, we set out to comprehensively describe the unmet supportive care and information needs of lung cancer patients. MethodsThis cross-sectional study used the Supportive Care Needs Survey Short Form 34 (34 items) and an informational needs survey (8 items). Patients with primary lung cancer in any phase of survivorship were included. Demographic data and treatment details were collected from the medical charts of participants. The unmet needs were determined overall and by domain. Univariable and multivariable regression analyses were performed to determine factors associated with greater unmet needs. were recruited. The mean number of unmet needs was 8 (range: 0-34), and 69 patients (78%) reported at least 1 unmet need. The need proportions by domain were 52% health system and information, 66% psychological, 58% physical, 24% patient care, and 20% sexuality. The top 2 unmet needs were "fears of the cancer spreading" [n = 44 of 84 (52%)] and "lack of energy/tiredness" [n = 42 of 88 (48%)]. On multivariable analysis, more advanced disease and higher MD Anderson Symptom Inventory scores were associated with increased unmet needs. Patients reported that the most desired information needs were those for information on managing symptoms such as fatigue (78%), shortness of breath (77%), and cough (63%). ResultsConclusions Unmet supportive care needs are common in lung cancer patients, with some patients experiencing a very high number of unmet needs. Further work is needed to develop resources to address those needs.

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The patient journey with head and neck cancer (HNC) is particularly challenging given the physical and functional impact of the cancer and treatment. The ability to perform activities of daily living can be severely compromised and have a profound impact on psychosocial well-being. These complex and long-lasting effects can affect patient quality of life for months to years and the literature shows that information for HNC patients is often insufficient. This observational cross-sectional study utilized survey methodology to investigate the informational needs of HNC patients and the preferred modalities for delivery. This was done to inform the development of resources for HNC patients. Four hundred fifty surveys were analyzed. The median age was 61 years and 58% of the cohort was born in Canada. Most were Caucasian (72%), Chinese being the next largest ethnicity (12%). A third had less than high school education and most had cancer of the oral cavity (28%) and were in long-term follow-up (41%). Comparison of the percentage of items to which a patient responded "very important" across the six domains shows variation of importance by domain (overall mixed effects regression model p < 0.0001). Additionally, each domain was compared to the medical domain and all had significantly lower mean scores (all p < 0.0001) with the medical domain scoring highest (mean score 64.6). The top preferred education modalities were teaching with a healthcare professional and pamphlets. This study highlights the type of information that HNC patients want and the format they wish to receive it in. The design provides a comprehensive way to consult with patients toward building education that responds to their specific needs.

The human papillomavirus vaccine (Gardasil) is a significant advancement in women's health. We compared the reporting of fearinducing messages about human papillomavirus, cervical cancer, and the human papillomavirus vaccine in Canadian and U.S. national newspapers between January 2006 and December 2007. Significant differences between countries were found in the number of articles containing fear messages about human papillomavirus, cervical cancer, and the human papillomavirus vaccine. Educational level of readability was higher than recommended for the public, and the emotional tone of the articles became progressively negative over time. Our findings suggest that public discussion of some elements of the human papillomavirus vaccine message that could cause alarm or worry for women may need to be addressed within political and cultural contexts.

Background: Quitting smoking after a cancer diagnosis minimizes treatment-related effects, improves prognosis, and enhances quality of life. However, smoking cessation services are not routinely integrated into cancer care. The Princess Margaret Cancer Centre implemented a digitally based Smoking Cessation Program (SCP) in oncology, leveraging an e-referral system (CEASE), to screen all new ambulatory patients, provide tailored education and advice on quitting, and facilitate referrals. Methods: We adopted the Framework for Managing eHealth Change to guide implementation of the SCP by integrating six key elements: 1) Governance and leadership; 2) Stakeholder engagement; 3) Communication; 4) Work flow analysis and integration; 5) Monitoring and evaluation; and 6) Training and education.Results:  Incorporating elements of the Framework, we established a SCP with organizational and provincial accountability, through extensive stakeholder engagement and strategic partnerships. CEASE was integrated into existing electronic patient reported assessments. Clinic audits and staff engagement allowed for analysis of work flow, ongoing monitoring and evaluation aided in establishing a communication strategy and development of cancer-specific patient and healthcare provider education. From April 2016 to March 2018, 22,137 new patients were eligible for screening. Among those, 13,617 (62%) new patients were screened; 1,382 (10%) current smokers and 532 (4%) who recently quit within 6 months. Among those smokers or recently quit, all were advised to quit; 380 (20%) accepted referral to a smoking cessation counseling service.Conclusions: This paper provides a comprehensive practice blueprint to implement digitally based SCPs as a standard of care within comprehensive cancer centers with high patient volumes.