Background: Precision interventions using biological data may enhance smoking treatment, yet are understudied among smokers who are disproportionately burdened by smokingrelated disease. Methods: We surveyed smokers in the NCI-sponsored Southern Community Cohort Study, consisting primarily of African-American, low-income adults. Seven items assessed attitudes toward aspects of precision smoking treatment, from undergoing tests to acting on results. Items were dichotomized as favorable (5 ¼ strongly agree/4 ¼ agree) versus less favorable (1 ¼ strongly disagree/2 ¼ disagree/ 3 ¼ neutral); a summary score reflecting generalized attitudes was also computed. Multivariable logistic regression tested independent associations of motivation (precontemplation, contemplation, and preparation) and confidence in quitting (low, medium, and high) with generalized attitudes, controlling for sociodemographic factors and nicotine dependence. Results: More than 70% of respondents endorsed favorable generalized attitudes toward precision medicine, with individual item favorability ranging from 64% to 83%. Smokers holding favorable generalized attitudes reported higher income and education (P < 0.05). Predicted probabilities of favorable generalized attitudes ranged from 63% to 75% across motivation levels [contemplation vs. precontemplation: adjusted odds ratio (AOR) ¼ 2.10, 95% confidence interval (CI), 1.36-3.25, P ¼ 0.001; preparation vs. precontemplation:

Struma ovarii is a rare type of ovarian teratoma comprised of at least 50% thyroid tissue. While most are benign, 70% of malignant cases are diagnosed as papillary carcinoma. Management of patients with thyroid nodules following gynecologic surgery remains controversial and variable. Historically, the treatment of choice has been surgical removal to rule out ovarian carcinoma. Thyroid follow-up and further treatment options are guided by tumor characteristics. The patient in this case presented to the endocrine surgeon with multiple thyroid nodules, dysphagia and a history of struma ovarii that was surgically treated at an outside hospital. Fine needle aspiration demonstrated benign histology. However, due to compressive symptoms and uncertainty of other nodules, the patient underwent a total thyroidectomy. Due to limited published data and treatment guidelines regarding thyroid nodules in patients with a history of malignant struma ovarii, surgery was recommended to rule out papillary thyroid carcinoma and relieve the patient's dysphagia. More research focused on treatment and outcomes of struma ovarii patients with thyroid nodules is essential to establish treatment guidelines for these patients.

The opinions expressed by the authors are their own, and this material should not be interpreted as representing the official viewpoint of the U.S. Department of Health and Human Services, the National Institutes of Health or the National Cancer Institute. Nicole Senft Everson served as a lead role for conceptualization, formal analysis, writing-original draft, and writing-review & editing. William M. P. Klein contributed equally for writing-review & editing and served in a supporting role for conceptualization. Scott S. Lee contributed equally for methodology and served in a supporting role for writing-review & editing. Rebecca Selove and Maureen Sanderson contributed equally for funding acquisition and served in a supporting role for writing-review & editing. William J. Blot contributed equally for resources and served in a supporting role for supervision and writing-review & editing. Rachel F. Tyndale contributed equally for resources and served in a supporting role for and writing-review & editing. Stephen King contributed equally for project administration and served in a supporting role for writing-original draft and writing-review & editing. Karen Gilliam contributed equally for project administration and served in a supporting role for writing-review & editing. Suman Kundu served as a lead role for formal analysis and served in a supporting role for writing-original draft and writing-review & editing. Mark Steinwandel served in a supporting role for data curation and writing-review & editing. Sarah J. Sternlieb served in a supporting role for project administration and writing-review & editing.

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