Anna Rasokat

Background Building on the German national Network Genomic Medicine (nNGM), which has improved access to molecular testing for lung cancer patients, the project DigiNet aims to enhance digital networking via a Network Data Platform (NDP) in order to optimize data exchange and personalized therapy management of non-small cell lung cancer (NSCLC). Methods To analyze facilitating and inhibiting factors from the perspective of healthcare providers (HCPs), qualitative interviews with respect to the implementation process were conducted. Qualitative content analysis in accordance with Kuckartz and Rädiker was undertaken, and the Consolidated Framework for Implementation Research (CFIR) was applied to guide the analysis. Results Overall, 40 HCPs contributed to 51 interviews, with 11 taking part twice. Facilitating factors included the establishment of DigiNet upon the preexisting infrastructure of nNGM and the systematic documentation of treatment data, thereby enabling a comprehensive review of the entire clinical pathway. Especially for peripheral locations, one benefit lies in the improved information flow and networking with nNGM centers. The most frequently reported barrier was the double documentation of patient data, as in-house and the NDP were used in parallel. There is a need for digital interfaces to enable transfer into existing software at each individual clinical site. Conclusions DigiNet highlights the potential of intensified digital networks to optimize precision oncology while underscoring the need to address regulatory and interoperability challenges to ensure integration into routine care.

Background/Objectives: Worldwide, men experience a higher incidence of pancreatic cancer (PC) than women. Methods: To increase understanding of the underlying reasons for this sex-related difference, we analysed general and sex-related risk factors for PC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (women/men No. = 293,682/136,728; 717/577 PC-cases). Results: Cox proportional hazards models showed a 1.31-fold higher risk of developing PC for men compared to women (HR, 95% CI 1.15–1.49) after adjustment for age, smoking history, BMI, diabetes, and alcohol consumption. Associations of PC with established risk factors did not differ between men and women, with the exception of a greater risk of PC among women with greater attained body height, meat consumption and cigarettes smoked (1.12 (1.05–1.19) per 5 cm, 1.18 (1.02–1.36) per 100 g/d, 1.42 (1.27–1.59) per 10/d; respectively). Among child-bearing women, long cumulative duration of breastfeeding was inversely associated with risk of PC (HR 0.74, 95% CI 0.61–0.89) for >5.7 months of breastfeeding (median) relative to ≤5.7 months and among HRT users, cumulative duration of HRT use was inversely associated with PC risk (HR 0.71, 95% CI 0.53–0.95, >2.4 versus ≤2.4 years). Further reproductive and hormonal factors, such as age at menarche, number of full-term pregnancies, age at menopause, or use of oral contraceptives, were not significantly associated with PC risk. Conclusions: Pooled analyses of large cohort studies are needed to confirm these results, and detailed data on the type and intensity of HRT are required to better evaluate its effect.