Cervical cancer mortality rates in Latin America are three times higher than in North America, partly due to deficiencies in colposcopy training and a shortage of specialists. The innovative Intelligent Digital Education Tool for Colposcopy (iDECO), which integrates personalized analytics and advanced intelligent features such as identifying areas of weakness, generating tailored recommendations, and assigning learning objectives, has previously demonstrated effectiveness in Asian countries. This pilot study aimed to evaluate the viability, initial results, and participant perceptions of using the iDECO platform for colposcopy training among Mexican doctors as a model of international collaboration for improving colposcopy training in Latin America. An Intelligent Colposcopy Training was delivered via a blended approach, pairing synchronous expert-led virtual sessions with the iDECO platform's capacity for data-driven customization and automated learning adjustments. It was implemented as an international collaboration involving experts from China, Chile, and Mexico. Thirteen Mexican physicians completed a one-month course, that combined self-paced learning on the platform with interactive synchronous Q&A sessions led by Spanish-speaking specialists. Knowledge and diagnostic accuracy were assessed using pre- and post-tests, and feedback was collected via a satisfaction survey and voluntary interviews. The training resulted in a statistically significant improvement in participants' knowledge and diagnostic accuracy in a simulated environment. The proportion of correct diagnoses significantly increased from pre-test to post-test (47% vs. 80%, p < 0.001). Furthermore, participants reported high satisfaction and positive educational value, with 90% willing to recommend the training. The implementation of the iDECO-based colposcopy training demonstrates a promising model for addressing healthcare disparities in Latin America. This experience underscores the potential of advanced digital learning platforms and international collaborations to improve skills and facilitate knowledge transfer in global health, and it has led to the development of a Spanish version of the platform for broader use in the region.

Guided by the Andersen Behavioral Model of Health Service Utilization, this study examined the impact of a structured educational intervention to improve uptake of cervical cancer preventive services (CCPS) among female students at Kenyatta University, Kenya. The study implemented a cluster randomized controlled trial allocating two Kenyatta University campuses (Kitui - intervention; Mombasa - control) to study arms. A total of 243 female students aged ≥ 18 years were recruited (Intervention = 121; Control = 122). The intervention comprised six bi-weekly, face-to-face health education sessions delivered over 12 weeks, combining didactic content, demonstrations and facilitated peer discussions. Data were collected from 1st January 2025 to 31st March 2025; at baseline and at 12 weeks post-intervention using structured researcher-administered questionnaires and self-reports triangulated with university clinic records. Analyses included descriptive statistics, χ2 tests for differences in proportions, difference-in-differences (DiD) estimation of the intervention effect, and multivariable logistic regression. All analyses were adjusted for clustering effect. At endline, uptake in the intervention arm was 44.2% while the control arm remained essentially unchanged (8.0%); the DiD estimate was + 39.4% (p < 0.001). Multivariable logistic regression including an interaction term for time × treatment produced an adjusted odds ratio (aOR) for the intervention effect of 8.02 (95% CI: 2.01-12.65; p = 0.005). Awareness of service availability (aOR = 3.52) and community/peer support (aOR = 2.13) were independent predictors of CCPS uptake. A structured, repeated educational intervention programme delivered within the university context significantly increased uptake of CCPS. For sustained impact, such interventions should be linked to visible, accessible campus services and embedded in university health promotion structures.

The Translational Behavioral Oncology Postdoctoral Training Program at Moffitt Cancer Center, funded by the National Cancer Institute (T32CA090314), prepares postdoctoral fellows to excel in highly interdisciplinary and collaborative cancer research environments. This program leverages Moffitt's robust faculty expertise and institutional resources, and draws from various disciplines engaged in cancer research, including behavioral science, population science, health communication, nursing, and medicine. Over the past 20 years, this program has recruited a talented and diverse pool of postdoctoral trainees (n = 47) who have acquired the requisite knowledge, skills, and experience to become successful independent investigators in behavioral oncology. In this paper, the training components and outcomes over the past two decades are reported with a particular focus on trainee and mentor evaluations of core components from the 2019-2024 cycle. These findings provide insights for developing and optimizing postdoctoral training in cancer prevention and control, serving as a model for advancing the careers of the next generation of cancer researchers.

Firefighters face significant occupational exposure to carcinogenic substances, including those found in wildfire and structural fire smoke. Despite growing evidence linking firefighting to increased lung cancer risk, no occupationally tailored lung cancer screening guidelines exist. This study aims to assess firefighters' perspectives on lung health and screening to inform the development of targeted screening programs. A cross-sectional survey was conducted among 60 firefighters in the San Francisco Bay Area. Participants provided demographic and occupational exposure data, and attitudes toward lung cancer screening were assessed using a validated questionnaire. Logistic regression was used to analyze factors associated with favorable screening attitudes. The majority (95%) expressed willingness to undergo lung cancer screening, and 98% believed screening saves lives. Younger firefighters and those actively serving were more likely to favor screening (p = .031 and < 0.001, respectively). Greater exposure to wildland fires in the past year was associated with a 3.4 times increased likelihood of screening favorability (p = .036). In contrast, prior smokers were less favorable toward screening (p < .001). Firefighters demonstrate a high level of receptivity toward lung cancer screening, with younger and more recently exposed individuals showing greater engagement. These findings highlight the need for tailored lung health initiatives and targeted education, particularly for older and former smokers. Developing firefighter-specific screening protocols could enhance early detection and improve long-term health outcomes in this high-risk population.

Breast cancer (BC) is the most common cancer among women globally, including Ghana, where the disease is diagnosed at advanced stages. This study investigated the possible patient factors related to BC late-stage diagnosis at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. The study included 180 breast cancer patients receiving treatment at KATH, the main cancer hospital in central Ghana. Interviewer-administered questionnaires were used to collect information on patient socio-demographic characteristics, clinical history, and access to care. Clinical staging was retrieved from the patients' medical records. Multivariable logistic regression evaluated the predictors of stage at presentation. Out of the 180 patients interviewed, 145 patients had advanced breast cancer (Stages III and IV). Using traditional medicine was the only significant patient factor associated with late-stage breast cancer after adjusting for confounders (age at diagnosis, marital status, health insurance, and education) in the regression and sensitivity analyses, with OR 4.14 (1.30, 13.15) and OR 3.94 (2.02, 7.69), respectively. Breast cancer patients in Kumasi, Ghana, had higher odds of late-stage presentation if they used traditional medicine before seeking care at the cancer hospital. While Ghana has taken steps in educating traditional healers to refer patients early in the course of the disease, efforts are still needed for educating traditional healing providers and patients. The findings of our study may also apply to other low- and middle-income countries with traditional healing practices for cancer management.

This cross-sectional study evaluated the quality of information on radiotherapy-related oral mucositis (OM) available on the YouTube platform in Brazil. The first 200 videos retrieved using the keywords "boca ferida radioterapia" were analyzed, excluding those shorter than 1 min, longer than 15 min, or unrelated to the topic. Technical data was collected, and six variables were assessed: definitions of head and neck cancer, radiotherapy, and OM; along with OM frequency, symptoms, and prevention/treatment options. Videos were categorized as 'poor' (score 1-2 on ≥ 1 variable), 'average' (score 3 on all variables), or 'good' (score 4-5 on ≥ 1 variable with no scores 1 or 2). Of the 104 videos analyzed, 51.0% were produced by doctors and 85.6% were aimed at the lay public. Most videos lasted 1-9 min (87.5%), with 10,001-100,000 views (32.0%), ≤ 1,000 likes (54.4%), and ≤ 100 comments (66.3%). Overall, 10.6% (n = 11) were classified as 'poor' due to the presence of misinformation. An additional 32.7% (n = 34) were rated 'average' for failing to address any of the assessed variables. The majority, 56.7% (n = 59), were rated 'good' as they provided at least one accurate and comprehensive information and contained no misinformation. While few videos on radiotherapy-related OM in Brazil presented incorrect information, a significant number were incomplete. This highlights an opportunity to improve the content to provide the public with more comprehensive information.

Despite the proven safety and effectiveness of HPV vaccines, fewer than 50% of adolescents in the U.S. complete the full vaccine series. Initiating HPV vaccination at age nine improves completion rates, prompting exploration of vaccination in children younger than nine. However, perceptions among parents, children, and providers regarding early childhood HPV vaccination remain poorly understood. We conducted semi-structured interviews with a subset of participants in an open-label clinical trial evaluating the 2-dose 9-valent HPV vaccine in children aged 4-8 years old. Interviews included five parents, three parent-child dyads, and two healthcare providers. Parent and provider interviews lasted approximately 30 min; child interviews, 15 min. A cross-sectional survey was also administered to parents at trial enrollment. Data from 100 parent-child dyads were analyzed. The mean child age was 6 years; parents averaged 36 years. Most parents were female (83%); racially, 57% identified as African American, 15% Hispanic, 4% White, 2% Asian, and 22% Other. Parents perceived their children as vulnerable to serious illnesses, including HPV-related cancers, and viewed vaccination as beneficial. Trust in providers, providers' commitment to their children's well-being, positive research staff interactions played a key role in successful trial enrollment. Parents emphasized community protection and endorsed early vaccination. Providers highlighted cancer prevention in counseling and supported bundling HPV vaccination at four-year-old schedule to improve uptake and completion. HPV vaccination in children aged 4-8 was well accepted by parents, feasible for providers, and manageable for children. Trust, education, and strategic integration into routine care may facilitate broader acceptance of early HPV vaccination.

Clinician-educator (CE) faculty are essential to the education of trainees in cancer care, yet at research-intensive institutions advancement pathways for education-focused faculty are often unclear. Describe CE perceptions of advancement and recognition of educational work and identify priorities for a CE promotion pathway at a large cancer center. Anonymous faculty survey (January 2023) with analyses restricted to clinical faculty who self-identified as CEs or were unsure of their CE status. Descriptive statistics were reported; exploratory Kruskal-Wallis tests compared responses by rank and years in rank. One open-ended item on barriers underwent inductive content analysis by two coders. IRB approved (2022 - 1006). Of 208 respondents, 142 were clinical faculty; 103 (72.5%) identified as CEs or were unsure of their CE status. Nearly half perceived no clear advancement path (49/103, 47.6%), while 27/103 (26.2%) perceived a clear path. Most reported educational effort was undervalued relative to research for academic recognition (72/103, 69.9%) and promotion impact (67/103, 64.7%). A majority agreed that establishing a CE pathway would aid advancement (60/103, 57.9%). Highest-priority elements were transparent promotion criteria (64/103, 62.1%), protected time for education (64/103, 62.1%), and tools to document and quantify educational effort (60/103, 58.3%). CE faculty at a research-intensive center perceived unclear advancement and lower recognition of educational work. Institutions seeking to strengthen cancer education should implement transparent CE-specific criteria, allocate protected education time, and adopt systems that document educational contributions.

The purpose of this study was to describe evaluation outcomes, including reach, satisfaction with training, and strategies to increase uptake of implicit bias training across three cancer centers in Washington, DC. From October 25, 2022, to March 29, 2023, oncology clinicians and staff were asked to complete an implicit bias training and post-training survey. Strategies used to increase training reach included identifying and preparing champions, identifying facilitators and barriers, promoting adaptation, and mandating completion. We quantitatively assessed satisfaction with training and self-reported learning outcomes and qualitatively explored impact of the training and how implementation strategies affected uptake. We reviewed open-text responses for feedback and insights from learners. At the suggestion of our champions, we pivoted from a five-hour training to a one-hour training to adapt to clinical team availability. The most successful strategies for increasing training uptake included reducing training length and personalized follow-up from institutional champions. One hundred eight of the 163 (66%) invited learners completed the training. Over 94% of learners agreed or strongly agreed that they met the training's three learning objectives: describing implicit bias, providing examples of implicit bias in healthcare settings, and reflecting on one's own biases. Learners' open-ended responses described how training reaffirmed viewpoints for some learners while others became more aware of their biases. Implementing an implicit bias training across multiple care settings was successful in reaching our goal of 100 learners; however, reach varied by setting due to competing priorities and less champion influence at one institution.

Having an unsupportive culture has been identified as a reason that individuals leave the biomedical field. The purpose of this mixed methods convergent case study was to gain an understanding of how a supportive, mentoring-intensive, National Cancer Institute (NCI)-funded program affected the participating scholars' professional identity and sense of belonging while facilitating their career-advancing accomplishments. This Training Navigation Program at the Fred & Pamela Buffett Cancer Center (FPBCC) provided the group of scholars (which included predominantly predoctoral students but also postdoctoral fellows and early-stage faculty members, and two undergraduate associate members) with support for professional development activities and conference attendance along with networking opportunities and guidance in grant writing, bioinformatics, and appropriate usage of artificial intelligence in cancer research. The survey data and interview/focus group data on the first-year outcomes for the 39 predoctoral students in this Training Navigation Program were collected in parallel, and the results were combined to provide a deeper understanding of the participants' experiences. The results indicated that this program was successful in increasing the students' sense of belonging and professional identity, as well as their achievements in advancing their careers in cancer research.

As cancer incidence rises globally, there is a growing need for medical schools to engage students in oncology education and how social determinants of health (SDH) influence cancer risk, treatment, and outcomes. Integrating SDH into oncology curricula will prepare students to deliver equitable, patient-centered cancer care. At a U.S. medical school, a four-week pilot Oncology Summer Internship (OSI) was implemented in 2022 and 2023 for rising second-year medical students. In 2024, the OSI was revised to incorporate a stronger focus on SDH. This study used a mixed-methods approach to evaluate the impact of the SDH-focused OSI. Pre- and post-program survey data were collected from thirteen students, including five who participated in the SDH iteration of the internship. Participants rated understandings of oncology with a 5-point Likert scale. Students in the SDH internship were also asked to rate knowledge of SDH in cancer and describe socioeconomic challenges of cancer. Quantitative data was analyzed with Wilcoxon signed rank tests and qualitative data was coded and thematically analyzed. Quantitative analysis demonstrated increased understandings of the field of oncology, such as its training pathways (p = 0.001). Among participants of the SDH-focused program, responses related to SDH did not reveal any significant differences pre- and post-program. Upon qualitative analysis of descriptions of socioeconomic challenges, themes on the importance of SDH in cancer care and reference of SDH factors emerged. Responses revealed an increase in instances that participants mentioned a SDH (14 pre- vs. 22.5 post-survey). Overall, this pilot OSI enhanced students' understanding of oncology and offered deeper insight into the impact of SDH on cancer care.

Many hematology/oncology fellows who train at Comprehensive Cancer Centers (CCCs) seek academic careers. However, it is difficult to assess the impact of research conducted during fellowship, as it takes about three years for citation counts to stabilize. Altmetric Score (AS) is an alternative metric with an expedited time to maturity that quantifies article impact via online mentions. We aim to evaluate the academic productivity of these fellows using both traditional and alternative metrics. We compiled a list of heme/onc fellows who graduated In 2025 from each program website. We then performed a PubMed search for articles published by each fellow during their fellowship training. We acquired AS from the Altmetric API database. 545 fellows from 125 US-based programs published a total of 1430 papers (3.39 vs 1.71, p<0.001), with 483 as first author (1.25 vs 0.45, p<0.001), that accrued 7351 citations (19.75 vs 6.04, p<0.001) and an AS of 20614 (58.03 vs 13.80, p<0.001), with an average citation count of 2.74 (3.45 vs 1.89, p=0.002) and average AS of 6.70 (8.89 vs 4.10, p<0.001) for CCC-trained fellows compared to non-CCC-trained fellows. There was no significant difference in effect size between average citation count and average AS (95% confidence interval 0.631-0.951 vs 0.635-0.955). Fellows who trained at CCCs published significantly more total papers, first author papers, and accrued greater total and average citation counts and AS than those who did not. Furthermore, there was no significant difference between the novel, yet more practical, metric of AS and the widely-used citation count in this cohort. Future work can explore the potential for real-world use of AS as a quantifiable measure in academic hiring processes.

A well-trained workforce is essential to advance cancer research and improve patient outcomes. The National Cancer Institute T32 Institutional Research Training Grant programs are designed to cultivate the next generation of cancer researchers through interdisciplinary training. Despite widespread implementation, limited longitudinal evidence exists on the long-term impact of these programs. This study conducted a longitudinal bibliometric evaluation of two NCI-funded T32 programs at Case Western Reserve University School of Medicine from 2005 to 2024. Outcomes for T32 participants and matched controls were compared, assessing research productivity, scholarly impact, collaboration, innovation, and sustained funding. Data sources included publication records, citation metrics, patent applications, and federal research grant data. Analyses were performed at 5-, 7-, 10-, and 15-years post-training. T32 participants demonstrated higher research productivity and scholarly impact, particularly during early and mid-career stages. Significant advantages were observed in publication output, h-index, and field-weighted citation impact during the first 10 years post-training. T32 participants were more likely to secure federal funding and produce highly cited publications and patents, indicating stronger translational influence. However, group differences diminished by 15 years post-training. No significant differences were found in collaboration metrics between groups. NCI T32 training programs provide measurable early-career benefits in research productivity, scholarly impact, and innovation. These programs promote sustained engagement in cancer research and successful grant acquisition, supporting their role as engines for launching impactful scientific careers. Long-term outcome tracking is essential to optimize training program design and advance the cancer research workforce.

This study aimed to investigate the publication rate of radiation oncology specialization theses in Türkiye and to identify the factors influencing this rate. This retrospective study examined radiation oncology specialization theses completed between 2003 and 2023 in Türkiye. The data were obtained from the Council of Higher Education Thesis Center, an official national database that archives all postgraduate and specialty theses completed in the country. Publication status was determined by searching the student's name, surname, and thesis title in PubMed, Google Scholar, Web of Science, and ULAKBİM TR Index. Journal indexing categories were defined as follows: SCI-E (Science Citation Index Expanded, indicating international journals indexed in Web of Science Core Collection), ESCI (Emerging Sources Citation Index, representing emerging international journals), and TR Index (Türkiye's National Academic Index for peer-reviewed journals). Among the 277 theses included, 52.3% were published. The mean time to publication was 4.79 ± 3.70 years. Of the 145 published theses, 58.6% were published in SCI-E indexed journals, 24.1% in the TR Index, 12.4% in ESCI, and 4.8% in other peer-reviewed journals. Theses authored by residents who pursued academic careers had a significantly higher publication rate. To our knowledge, this is the first study to examine the publication rate of radiation oncology theses. Our findings indicate that the publication rate in this field is comparatively higher than in other specialties, underscoring the contribution of radiation oncology residents to the scientific literature. These findings highlight the need to strengthen research training and mentorship during residency to support publication productivity.

To systematically evaluate the effectiveness of mindfulness-based nursing interventions (MBNIs) on psychological health outcomes-including depression, anxiety, and quality of life-as well as resilience and educational empowerment among women with gynecologic cancers. This systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. Randomized controlled trials (RCTs) investigating MBNIs among women with gynecologic cancers were systematically identified through PubMed, Scopus, Web of Science, Cochrane Library, Embase, and additional databases up to August 2025. Two reviewers independently extracted data and assessed methodological quality. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were performed by cancer type, and meta-regression analyses examined moderators such as mean age and marital status. Twelve RCTs including 1,228 participants (IG = 634; CG = 594) were eligible. Mindfulness-based interventions showed a tendency to reduce anxiety (SMD=-4.05; 95%CI - 9.19 to 1.09; I²=99.8%), depression (SMD=-2.68; 95%CI - 5.40 to 0.03; I²=99.4%), and fatigue (SMD=-3.38; 95% CI - 7.37 to 0.61; I²=99.2%), though effects were limited by high heterogeneity. Statistically significant improvements were observed in global health status (SMD = 2.62; 95%CI 0.27 to 4.97; I²=98.4%) and selected QOL domains, particularly role functioning (SMD = 0.29; 95%CI 0.13 to 0.44) and emotional functioning after bias correction (SMD = 2.89; 95%CI 0.22 to 5.57). Meta-regression showed that neither age nor marital status significantly moderated results. Mindfulness-based nursing interventions demonstrate potential not only for reducing psychological distress and improving quality of life among women with gynecologic cancers but also for serving as educational frameworks that strengthen self-regulation, resilience, and patient engagement in care. Integrating mindfulness-based education into oncology nursing practice may enhance both patient empowerment and professional development among healthcare providers. Further rigorous trials are warranted to validate these outcomes and define best practices for educational implementation.

Paraneoplastic neurological syndromes (PNS) represent a rare but clinically significant group of disorders that arise as indirect effects of cancer through immune-mediated mechanisms. They differ from direct tumor invasion, metastasis, or treatment-related toxicity, and often precede cancer diagnosis, making early recognition essential. This review outlines the distinctions between carcinoid syndrome, paraneoplastic endocrine/metabolic syndromes, and PNS, highlighting their clinical relevance in oncology education. We summarize current knowledge on the pathophysiology, clinical spectrum, diagnostic approaches, and management strategies for PNS. Emphasis is placed on their educational value as models for interdisciplinary learning, diagnostic reasoning, and integration of oncology with neurology. Improved awareness among medical trainees and oncologists can enhance early detection, appropriate management, and patient outcomes.

Transurethral bladder tumor resection (TURBT) is the standard initial surgical procedure for non-muscle-invasive bladder cancer and a core competency for urologists. Online surgical preparation increasingly relies on YouTube, but the educational quality of TURBT videos has not been systematically assessed. We performed a systematic YouTube search (March 1, 2025) using "transurethral resection of bladder tumor," "bladder tumor removal," and "TURBT." Standard-format procedure videos 2-30 min were included; nonprocedural, promotional, and Shorts content were excluded. Video characteristics, technical details, and source (academic vs. individual urologist) were recorded; all videos were independently reviewed by 2 urologists. Educational quality was evaluated using the Global Quality Score (GQS; 1-5) and a 12-item TURBT Checklist Score (TURBT-CS) covering perioperative elements. Thirty-six videos met criteria (10 academic [27.8%]). Half were 1080p and half had audio narration, but subtitles were uncommon (13.9%). Academic videos achieved higher GQS and TURBT-CS (p = 0.001) and greater engagement (views, likes; VPI p = 0.034) yet lower image-quality scores (p = 0.003); audio narration was more frequent (p = 0.003); no significant differences were seen in duration, upload time, subtitles, visual aids, energy source, or resection technique (all p > 0.05). GQS and TURBT-CS correlated positively with engagement metrics (all p < 0.05); interobserver agreement was excellent (ICC 0.857 TURBT-CS; 0.853 GQS; both p < 0.001). Educational quality of YouTube TURBT videos is heterogeneous; academically sourced content is generally superior and more engaging, though technical image quality may lag. Standardized, validated checklists and increased academic oversight could enhance the educational utility of open-access surgical videos.

Introduction Cancer is becoming a leading cause of death in Latin America, yet oncology training for health professionals remains uneven. This review synthesizes evidence on oncology education for professionals, trainees, and community health workers (CHWs) in Latin American settings to identify gaps and opportunities for improvement. Methods We followed PRISMA 2020. The protocol was developed a priori and registered in PROSPERO (CRD420251108769) after initial screening. Searches covered PubMed, Scopus, Web of Science, LILACS, and SciELO. Eligible studies evaluated oncology education for professionals/trainees or CHWs and reported educational or implementation outcomes; patient-only education was excluded. Two reviewers conducted screening, extraction, and risk-of-bias appraisal using an adapted Newcastle-Ottawa Scale. Given heterogeneity, findings were narratively synthesized. Results Nine studies met inclusion criteria, spanning undergraduate, postgraduate/continuing, educator-training, and one secondary-level"pipeline" feasibility setting. Brazil was most represented, with additional work from Puerto Rico, multinational cohorts, and a U.S. border CHW-training context relevant to Latin American populations. Interventions included academic leagues, concept mapping, remote/online modules, train-the-trainer programs, and a regional nurse-educator hub. Several studies reported short-term improvements in knowledge or self-efficacy and high feasibility/acceptability. Most had moderate risk of bias due to non-randomized designs, self-reported outcomes, and short follow-up.Conclusions Published research on oncology education for health professionals in Latin America is limited and heterogeneous. Promising models show feasibility and short-term learning gains, but multicenter comparative evaluations with standardized outcomes, longer follow-up, and attention to implementation and educator capacity are needed to inform scalable, competency-based approaches across the region.

Precision oncology in non-small cell lung cancer (NSCLC) depends on biomarker testing and access to targeted therapies. However, disparities in testing and treatment highlight critical educational needs for patients, providers, and health systems. Using the NIH All of Us Research Program (2017-2022), we identified 287 patients with advanced NSCLC who received first-line carboplatin-based chemotherapy or targeted therapy. Social determinants of health (SDoH) including education, employment, retirement, and disability were evaluated as predictors of biomarker testing and targeted therapy receipt. Only 18% of patients had documented biomarker testing despite 45% minority representation in the All of Us cohort. Patients with any college education had significantly higher odds of receiving targeted therapy (OR 2.43, 95% CI 1.23-4.97), while retired patients were less likely to receive targeted therapy (OR 0.35, 95% CI 0.18-0.68). Disability was associated with increased biomarker testing (OR 2.82, 95% CI 1.19-6.51). Although TTD was longer for targeted therapies, incomplete biomarker documentation limited interpretation of outcomes. Findings underscore the need for enhanced cancer education strategies to improve biomarker literacy, guideline adherence, and equitable access to targeted therapy. Educational outreach should focus on retirees and patients with lower educational attainment, while provider training and system-level improvements are needed to strengthen precision oncology delivery.