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Choi J, Badowski G, Shvetsov YB, Dulana L, Teria R, Jin SB, Aguon C, Bordallo R, Leon Guerrero RT. Disparities in Colorectal Cancer Incidence among Asian and Pacific Islander Populations in Guam, Hawai'i, and the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:170. [PMID: 38397661 PMCID: PMC10888068 DOI: 10.3390/ijerph21020170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 02/25/2024]
Abstract
Colorectal cancer (CRC) ranks among the three most common cancers in Guam (GU), Hawai'i (HI), and the mainland United States (US). CRC prevalence in these areas is high among Filipinos, and indigenous CHamorus and Native Hawaiians; however, data on these populations are frequently aggregated in epidemiological studies, which can mask true CRC disparities. We examined CRC cumulative incidence rates (CIRs) among CHamorus in GU, Filipinos in GU, HI, and the US, and Native Hawaiians in HI and the US. CRC CIRs were calculated for two age groups (20-49 years; early onset, and 50-79 years; senior) and four time periods (2000-2004, 2005-2009, 2010-2014, and 2015-2019), stratified by ethnicity, sex, and location. Data analyzed included all invasive CRC cases reported to the Surveillance, Epidemiology, and End Results 9-Registry (n = 166,666), the Hawai'i Tumor Registry (n = 10,760), and the Guam Cancer Registry (n = 698) between 2000 and 2019. Senior CIRs were highest in HI and lowest in GU throughout all time periods, with a downward trend observed for senior CIRs in the US and HI, but not GU. This downward trend held true for all ethnic groups, except for CHamorus in GU, females in GU, and females of CHamoru ethnicity in GU. In contrast, early onset CIRs increased across all locations, sexes, and ethnic groups, except for Filipinos in HI and males of Filipino ethnicity in HI. Our findings provide crucial insights for future research and policy development aimed at reducing the burden of CRC among indigenous populations.
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Affiliation(s)
- JaeYong Choi
- College of Natural & Applied Sciences, University of Guam, 303 University Drive Mangilao, Mangilao 96923, Guam
| | - Grazyna Badowski
- College of Natural & Applied Sciences, University of Guam, 303 University Drive Mangilao, Mangilao 96923, Guam
| | - Yurii B. Shvetsov
- University of Hawaii Cancer Center, 701 Ilalo Street Honolulu, Honolulu, HI 96813, USA
| | - Louis Dulana
- Cancer Research Center, University of Guam, Dean Circle #7 UOG Station Mangilao, Mangilao 96923, Guam
| | - Rodney Teria
- Cancer Research Center, University of Guam, Dean Circle #7 UOG Station Mangilao, Mangilao 96923, Guam
| | - Su Bin Jin
- Cancer Research Center, University of Guam, Dean Circle #7 UOG Station Mangilao, Mangilao 96923, Guam
| | - Cabrini Aguon
- Cancer Research Center, University of Guam, Dean Circle #7 UOG Station Mangilao, Mangilao 96923, Guam
| | - Renata Bordallo
- Cancer Research Center, University of Guam, Dean Circle #7 UOG Station Mangilao, Mangilao 96923, Guam
| | - Rachael T. Leon Guerrero
- Cancer Research Center, University of Guam, Dean Circle #7 UOG Station Mangilao, Mangilao 96923, Guam
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Ansa BE, Alema-Mensah E, Sheats JQ, Mubasher M, Akintobi TH. Colorectal Cancer Knowledge and Screening Change in African Americans: Implementation Phase Results of the EPICS Cluster RCT. AJPM FOCUS 2023; 2:100121. [PMID: 37790949 PMCID: PMC10546549 DOI: 10.1016/j.focus.2023.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction African Americans are disproportionately affected by mortality risk for colorectal cancer. This study aimed to determine the most effective educational approach of 4 study arms that enhances the likelihood of pursuing subsequent colorectal cancer screening, and to identify the associated factors. Methods Age-eligible adults (N=2,877) were recruited to participate in a cluster randomized control dissemination and intervention implementation trial titled Educational Program to Increase Colorectal Cancer Screening. The project began in May 2012 and ended in March 2017 (the implementation phase lasted 36 months). Educational sessions were conducted through 16 community coalitions that were randomized into 1 of 4 conditions: website access (to facilitator training materials and toolkits) without technical assistance, website access with technical assistance, in-person training (provided by research staff and website access) without technical assistance, and in-person training with technical assistance. A follow-up to determine participant CRC screening was conducted 3 months later. Results Compared with the website access with technical assistance intervention group, 2 groups, in-person training with technical assistance and without technical assistance, indicated significantly higher odds for obtaining colorectal cancer screening (OR=1.31; 95% CI=1.04, 1.64; p=0.02 and OR=1.35; 95% CI=1.07, 1.71; p=0.01, respectively). Though sociodemographic factors were not significantly associated with pursuing subsequent colorectal cancer screening, the postintervention cancer knowledge increased significantly among the study participants. Conclusions The importance of in-person interactions, local coalitions, and community contexts may play a key role for successfully increasing colorectal cancer screening rates among African Americans as reflected through this study. The integration of telehealth and use of other virtual technologies to engage the public in research have increased since the COVID-19 pandemic and should be assessed to determine their impact on the degree to which in-person interventions are significantly more effective when compared with solely web-assisted ones. Trial registration The study is registered at www.clinicaltrials.gov NCT01805622.
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Affiliation(s)
- Benjamin E. Ansa
- Institute of Public and Preventive Health, Augusta University, Augusta Georgia
| | - Ernest Alema-Mensah
- Department of Community Health & Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia
| | - Joyce Q. Sheats
- Institute of Public and Preventive Health, Augusta University, Augusta Georgia
| | - Mohamed Mubasher
- Department of Community Health & Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia
| | - Tabia Henry Akintobi
- Department of Community Health & Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia
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Willingham ML, Sy A, Taafaki M, Bodnar R, Diaz TP, Somera LP, Porte CL, Ceria-Ulep CD, Pingul A, Bissell J, Cassel KD. Utilizing Filipino key informants to guide community outreach for cancer prevention in Hawai'i. Public Health Nurs 2023; 40:836-843. [PMID: 37530122 PMCID: PMC11115969 DOI: 10.1111/phn.13234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE/DESIGN The University of Hawai'i Cancer Center works with academic and community partners to examine health disparities and inequities that persist among Pacific Island Populations through the Pacific Island Partnership for Cancer Health Equity (PIPCHE). The Partnership's Community Outreach Core (COC) assists and promotes cancer research and helps to ensure the integration of historically excluded community perspectives by utilizing community-engaged and culturally-grounded approaches to reduce cancer burdens. However, cancer health disparities among Filipinos demonstrate a need for cancer-control initiatives within this community. SAMPLE/MEASUREMENTS COC staff conducted five semi-structured key informant interviews with Filipino nurse and healthcare leaders in Hawai'i to establishpartnerships with the community, as well as provide community-driven guidance for future cancer prevention and control efforts. RESULTS The informants provided recommendations for COC community engagement, relationship building, and future areas of directed cancer focus. The interviews also initiated relationship-building and community collaborations for directed cancer education and resources within Filipino communities. CONCLUSION The themes uncovered from the interviews provided guidance on how to begin addressing cancer concerns, and led to the informants' subsequent membership in our Outreach Advisory Council to engage in future collaboration with the Filipino community and a framework for future community-engaged cancer prevention efforts.
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Affiliation(s)
| | - Angela Sy
- John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, Hawai’i
| | - Munirih Taafaki
- John A. Burns School of Medicine, University of Hawai’i at Mānoa, Honolulu, Hawai’i
| | - Reyna Bodnar
- University of Hawai’i Cancer Center, Honolulu, Hawai’i
| | | | | | | | | | | | - Jeny Bissell
- State of Hawaiʻi Dept. of Health, Maui District Health Office, Maui, Hawai’i
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Oh KM, An K, Lee M, Shin C, Steves SL. Colorectal cancer screening disparities in Asian Americans: the influences of patient-provider communication and social media use. Cancer Causes Control 2023:10.1007/s10552-023-01720-z. [PMID: 37266764 PMCID: PMC10237058 DOI: 10.1007/s10552-023-01720-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE We examined the role of patient-provider communication (PPC) during in-person visits and via electronic communication and social media use on colorectal cancer (CRC) screening among Asian Americans (AAs) and Non-Hispanic Whites (NHWs) aged 50 and older. METHODS Health Information National Trends Survey 2017-2020 data were analyzed. RESULTS AAs tended to evaluate the quality of PPC during their in-person visits to a health care provider lower than NHWs. AAs' CRC screening rate was lower than the rate of NHWs (78.8% vs. 84.4%). After adjusting for sociodemographics, healthcare access, and health status, the quality of PPC was the only significant predictor associated with a lower probability of CRC screening among AAs (Adjusted OR 0.74; 95% CI 0.56, 0.96); while the Internet to communicate with a health care provider was the only significant predictor of CRC screening among NHWs (Adjusted OR 1.76; CI 1.11, 2.79). AAs were more likely to use YouTube to watch a health-related video than NHWs (43.5% vs, 24%). However, social media use was not associated with CRC screening in both AAs and NHWs. CONCLUSION Use of electronic communication technology may contribute to improve health information literacy and reduce the disparity. On-line communication may empower the culturally and linguistically diverse AAs by improving their confidence in communication with health care providers. Thus, communication technologies need to be strategically utilized and tailored to better meet the communication needs of racial/ethnic minorities. Online communication technologies may reduce the disparities in PPC related to cancer screening and cancer burden experienced by AAs.
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Affiliation(s)
- Kyeung Mi Oh
- School of Nursing, George Mason University, Fairfax, VA, USA.
| | - Kyungeh An
- Graduate School of Biomedical Sciences & School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Moonju Lee
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Chanam Shin
- College of Nursing, Texas Woman's University, Denton, TX, USA
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Mokhtari K, Peymani M, Rashidi M, Hushmandi K, Ghaedi K, Taheriazam A, Hashemi M. Colon cancer transcriptome. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2023; 180-181:49-82. [PMID: 37059270 DOI: 10.1016/j.pbiomolbio.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/16/2023]
Abstract
Over the last four decades, methodological innovations have continuously changed transcriptome profiling. It is now feasible to sequence and quantify the transcriptional outputs of individual cells or thousands of samples using RNA sequencing (RNA-seq). These transcriptomes serve as a connection between cellular behaviors and their underlying molecular mechanisms, such as mutations. This relationship, in the context of cancer, provides a chance to unravel tumor complexity and heterogeneity and uncover novel biomarkers or treatment options. Since colon cancer is one of the most frequent malignancies, its prognosis and diagnosis seem to be critical. The transcriptome technology is developing for an earlier and more accurate diagnosis of cancer which can provide better protectivity and prognostic utility to medical teams and patients. A transcriptome is a whole set of expressed coding and non-coding RNAs in an individual or cell population. The cancer transcriptome includes RNA-based changes. The combined genome and transcriptome of a patient may provide a comprehensive picture of their cancer, and this information is beginning to affect treatment decision-making in real-time. A full assessment of the transcriptome of colon (colorectal) cancer has been assessed in this review paper based on risk factors such as age, obesity, gender, alcohol use, race, and also different stages of cancer, as well as non-coding RNAs like circRNAs, miRNAs, lncRNAs, and siRNAs. Similarly, they have been examined independently in the transcriptome study of colon cancer.
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Affiliation(s)
- Khatere Mokhtari
- Department of Modern Biology, ACECR Institute of Higher Education (Isfahan Branch), Isfahan, Iran
| | - Maryam Peymani
- Department of Biology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran.
| | - Mohsen Rashidi
- Department Pharmacology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, 4815733971, Iran; The Health of Plant and Livestock Products Research Center, Mazandaran University of Medical Sciences, Sari, 4815733971, Iran
| | - Kiavash Hushmandi
- Department of Food Hygiene and Quality Control, Division of Epidemiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Kamran Ghaedi
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran.
| | - Afshin Taheriazam
- Farhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Department of Orthopedics, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mehrdad Hashemi
- Farhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
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Sekhon Inderjit Singh HK, Lal N, Majeed A, Pawa N. A systematic review of ethnic disparities in the uptake of colorectal cancer screening. Perspect Public Health 2022; 143:105-120. [PMID: 35506652 DOI: 10.1177/17579139221093153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Colorectal cancer (CRC) screening reduces mortality, but variation exists in uptake. Ethnicity is suggested to play a role; however, there is no high-level evidence to support this. We aim to clarify the impact of Ethnicity on CRC screening uptake and our barriers to its understanding. METHODS A systematic review to identify studies reporting on the participation of ethnic minorities in CRC screening worldwide was performed. MEDLINE, Embase, Scopus and Google Scholar databases up until 31 May 2019 were searched. Compliance with screening according to ethnic groups and screening modality was evaluated compared to the 'White' control group. RESULTS Twenty-two studies were included in the review reporting on 2,084,213 patients. Substantial variation in categorisation of ethnicities (40 sub-categories), screening modality studied and confounding factors accounted for was observed. 8/15 studies for 'Blacks', 10/13 for 'Hispanics', 2/2 for 'Asians' and 1/1 for 'South East Asians' suggest a less likely or significantly decreased compliance with screening for all screening modalities (p < .05) compared to 'Whites'. Interestingly 'Japanese', 'Vietnamese' and 'Filipino' groups consistently show no difference in the uptake of CRC screening compared to the 'White' majority. CONCLUSION This is the only systematic review on this topic. It highlights the inconsistency in screening uptake behaviour in different ethnic minority groups and identifies barriers like variation in ethnicity categorisation, screening modality and study design utilised to understanding the intricacies of this relationship. Further collaboration and action needs to be undertaken internationally to clarify and improve inequity in the uptake of screening.
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Affiliation(s)
- H K Sekhon Inderjit Singh
- Colorectal Surgical Department, West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Isleworth, UK
| | - N Lal
- Department of Surgery, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - A Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - N Pawa
- Consultant General and Colorectal Surgeon, Colorectal Surgical Department, West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Twickenham Road, Isleworth TW7 6AF, UK.,* HK Sekhon Inderjit Singh is now affiliated with Royal London Hospital, Barts Health NHS Trust. London, UK
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Long Non-coding RNA ZFPM2-AS1: A Novel Biomarker in the Pathogenesis of Human Cancers. Mol Biotechnol 2022; 64:725-742. [DOI: 10.1007/s12033-021-00443-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022]
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Oshiro CES, Frankland TB, Mor J, Wong CP, Martinez YT, Aruga CKK, Honda S. Lung Cancer Screening by Race and Ethnicity in an Integrated Health System in Hawaii. JAMA Netw Open 2022; 5:e2144381. [PMID: 35050353 PMCID: PMC8777569 DOI: 10.1001/jamanetworkopen.2021.44381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/28/2021] [Indexed: 11/14/2022] Open
Abstract
Importance Racial and ethnic differences in lung cancer screening (LCS) completion and follow-up may be associated with lung cancer incidence and mortality rates among high-risk populations. Aggregation of Asian American, Native Hawaiian, and Pacific Islander racial and ethnic groups may mask the true underlying disparities in screening uptake and diagnostic follow-up, creating barriers for targeted, preventive health care. Objective To examine racial and ethnic differences in LCS completion and follow-up rates in a multiethnic population. Design, Setting, and Participants This population-based cohort study was conducted at a health maintenance organization in Hawaii. LCS program participants were identified using electronic medical records from January 1, 2015, to December 31, 2019. Study eligibility requirements included being aged 55 to 79 years, a 30 pack-year smoking history, a current smoker or having quit within the past 15 years, at least 5 years past any lung cancer diagnosis and treatment, and cancer free. Data analysis was performed from June 2019 to October 2020. Exposure Eligible for LCS. Main Outcomes and Measures Screening rates were analyzed by self-reported race and ethnicity and completion of a low-dose computed tomography (LDCT) test. Diagnostic follow-up results were based on the Lung Imaging Reporting and Data System (Lung-RADS) staging system. Results A total of 1030 eligible LCS program members had an order placed; their mean (SD) age was 65.5 (5.8) years, and 633 (61%) were men. The largest racial and ethnic groups were non-Hispanic White (381 participants [37.0%]), Native Hawaiian or part Native Hawaiian (186 participants [18.1%]), and Japanese (146 participants [14.2%]). Men and Filipino, Chinese, Japanese, and non-Hispanic White individuals had a higher proportion of screen orders for LDCT compared with women and individuals of the other racial and ethnic groups. The overall LCS completion rate was 81% (838 participants). There was a 14% to 15% screening completion rate gap among groups. Asian individuals had the highest screening completion rate (266 participants [86%]) followed by Native Hawaiian (149 participants [80%]) and non-Hispanic White individuals (305 participants [80%]), Pacific Islander (50 participants [79%]) individuals, and individuals of other racial and ethnic groups (68 participants [77%]). Within Asian subgroups, Korean (31 participants [94%]) and Japanese (129 participants [88%]) individuals had the highest completion rates followed by Chinese individuals (28 participants [82%]) and Filipino individuals (78 participants [79%]). Of the 54 participants with Lung-RADS stage 3 disease, 93% (50 participants) completed a 6-month surveillance LDCT test; of 37 individuals with Lung-RADS stage 4 disease, 35 (97%) were followed-up for additional procedures. Conclusions and Relevance This cohort study found racial and ethnic disparities in LCS completion rates after disaggregation of Native Hawaiian, Pacific Islander, and Asian individuals and their subgroups. These findings suggest that future research is needed to understand factors that may be associated with LCS completion and follow-up behaviors among these racial and ethnic groups.
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Affiliation(s)
- Caryn E. S. Oshiro
- Kaiser Permanente Hawaii, Center for Integrated Health Care Research Honolulu, Hawaii
| | - Timothy B. Frankland
- Kaiser Permanente Hawaii, Center for Integrated Health Care Research Honolulu, Hawaii
| | - Joanne Mor
- Kaiser Permanente Hawaii, Center for Integrated Health Care Research Honolulu, Hawaii
| | - Carmen P. Wong
- Kaiser Permanente Hawaii, Center for Integrated Health Care Research Honolulu, Hawaii
| | | | - Cheryl K. K. Aruga
- Kaiser Permanente Hawaii, Hawaii Permanente Medical Group Honolulu, Honolulu, Hawaii
| | - Stacey Honda
- Kaiser Permanente Hawaii, Center for Integrated Health Care Research Honolulu, Hawaii
- Kaiser Permanente Hawaii, Hawaii Permanente Medical Group Honolulu, Honolulu, Hawaii
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Khalil C, Chaplin A, Esmundo S, Crochetiere A, Almario CV. Filipinos' attitudes, barriers, and enablers on colorectal cancer screening: Insights from a qualitative research study. Cancer Treat Res Commun 2022; 33:100657. [PMID: 36410092 PMCID: PMC9945551 DOI: 10.1016/j.ctarc.2022.100657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Filipinos have lower colorectal cancer (CRC) screening rates and worse outcomes versus non-Hispanic Whites. As Filipinos are understudied on how they perceive CRC screening, we conducted focus groups examining their attitudes, enablers, and barriers to screening. METHODS In August and September 2021, we recruited Filipinos aged 40-75 years to participate in an online focus group. Filipinos who received care at an academic medical center or were members of Filipino community organizations in Los Angeles, CA, were sent emails inviting them to participate. We used a semi-structured interview guide for the focus groups and audio recordings were transcribed and analyzed using an inductive coding approach. Codes were generated from the qualitative data, sorted, classified into themes and subthemes, and illustrated with verbatim quotes. RESULTS We conducted four online focus groups with 16 Filipinos. As for enablers for CRC screening, participants mentioned the importance having a doctor's recommendation. Participants reported the following barriers: potential out-of-pocket costs (the Philippines healthcare system is largely cash-based); fatalistic beliefs; reactive approach to health; lack of awareness in the community on CRC screening. Suggested solutions for improving CRC screening uptake in the community included: providing information on screening benefits, what to expect from each test (e.g., steps involved, accuracy), and financial considerations; participation by Filipino celebrities and doctors in media campaigns. CONCLUSION Our study highlights Filipinos' perceptions on CRC screening. These data can support investigators, health systems, public health agencies, and community organizations in developing culturally tailored, sustainable interventions to address CRC screening disparities among Filipinos.
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Affiliation(s)
- Carine Khalil
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, United States of America
| | - Antwon Chaplin
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, United States of America
| | - Shenazar Esmundo
- Cancer Research Center for Health Equity, Cedars-Sinai Cancer, Los Angeles, CA, United States of America
| | - Austin Crochetiere
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - Christopher V. Almario
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, United States of America,Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America,Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America,Cancer Prevention & Control Program, Cedars-Sinai Cancer, Los Angeles, CA, United States of America,Division of Health Services Research, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America,Division of Informatics, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America,Corresponding author at: Cedars-Sinai Medical Center, Karsh Division of Gastroenterology and Hepatology, 116N. Robertson Boulevard, Suite 800, Los Angeles, California 90048, United States of America, (C.V. Almario)
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Bhimla A, Mann-Barnes T, Park H, Yeh MC, Do P, Aczon F, Ma GX. Effects of Neighborhood Ethnic Density and Psychosocial Factors on Colorectal Cancer Screening Behavior Among Asian American Adults, Greater Philadelphia and New Jersey, United States, 2014-2019. Prev Chronic Dis 2021; 18:E90. [PMID: 34591753 PMCID: PMC8522502 DOI: 10.5888/pcd18.210062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction We examined how neighborhood ethnic composition influences colorectal cancer (CRC) screening behavior in Asian American adults and explored whether associations between psychosocial predictors, including knowledge, self-efficacy, and barriers affecting CRC screening behavior, varied by level of neighborhood ethnic composition. Methods Filipino, Korean, and Vietnamese Americans (N = 1,158) aged 50 years or older were included in the study. Psychosocial factors associated with CRC screening, CRC screening behavior, and sociodemographic characteristics were extracted from participants’ data. Neighborhood ethnic composition was characterized as the census-tract–level percentage of Asian residents. Participants’ addresses were geocoded to the census tract level to determine whether they resided in an ethnically dense neighborhood. Multilevel logistic regression models were run with and without interaction terms. Results In mixed-effects logistic regression model 1, residing in an ethnically dense neighborhood was associated with lower odds of CRC screening (odds ratio [OR] = 0.65; 95% CI, 0.45–0.93; P = .02) after controlling for age, sex, education, ethnic group, and neighborhood socioeconomic status. Greater perceived barriers to CRC screening (OR = 0.62; 95% CI, 0.50–0.77; P < .001) resulted in significantly lower odds of obtaining a CRC screening, while higher self-efficacy (OR = 1.17, 95% CI, 1.11–1.23, P < .001) was associated with higher odds. In model 2, among those residing in a high ethnic density neighborhood, greater barriers to screening were associated with lower odds of having obtained a CRC screening (OR = 0.53; 95% CI, 0.30–0.96; P = .04). Conclusion We found that residing in an ethnically dense neighborhood indicated higher disparities in obtaining CRC screenings. Future studies should examine socioeconomic and cultural disparities, as well as disparities in the built environment, that are characteristic of ethnically dense neighborhoods and assess the impact of these disparities on CRC screening behaviors.
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Affiliation(s)
- Aisha Bhimla
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Tyrell Mann-Barnes
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Hemi Park
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Ming-Chin Yeh
- Nutrition Program, Hunter College, City University of New York, New York, New York
| | - Phuong Do
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Ferdinand Aczon
- Ilocano Cultural Association of Greater Philadelphia, Cherry Hill, New Jersey
| | - Grace X Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.,Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.,Lewis Katz School of Medicine, Temple University, Medical Education and Research Building, 3500 Broad St, Philadelphia, PA 19140.
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Li XP, Chen HM, Lei XH, Dou GS, Chen YC, Chen LP, Zhang Y, Zhao GM, Zhong W. Cost-effectiveness analysis of a community-based colorectal cancer screening program in Shanghai, China. J Dig Dis 2021; 22:452-462. [PMID: 34086400 DOI: 10.1111/1751-2980.13027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/17/2021] [Accepted: 06/03/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study investigated the cost-effectiveness of a community-based colorectal cancer-screening program (C-CRCSP) in Shanghai, China, among the residents in the urban, suburban and rural areas. METHODS A Markov model was constructed to evaluate the cost-effectiveness of a 25-year annual C-CRCSP including 100 000 populations. Cost-effectiveness was determined by the incremental cost-effectiveness ratio (ICER); referring to either life-years gained, or quality-adjusted life-years (QALYs) gained. The threshold was gross domestic product per capita. Univariate and multivariate sensitivity analyses were performed to investigate the influence of compliance, prevalence, technological performance, medical cost and annual cost discount rate (3.5%) on ICER. A probabilistic sensitivity analysis evaluated the probability of the cost-effectiveness of C-CRCSP at different maximum acceptable ceiling ratios. RESULTS Compared with no screening, the C-CRCSP resulted in total gains of 7840 QALYs and 2210 life-years (LY), at a total cost of CNY 58.54 million; that is, the ICER were CNY 7460/QALYs and CNY 26650/LY. Stratifying by residency, the cumulative gains in QALYs and LY were estimated to be the lowest in the urban populations compared with the rural and suburban populations. The cost for the urban population was 3-fold and 6-fold that of the suburban and rural populations. The ICER for QALYs ranged from 2180 (rural) to 16 840 (urban). CONCLUSION The cost-effectiveness of a C-CRCSP in Shanghai was most favorable for the rural population, while the urban population benefits less in terms of QALYs. ICER could be enhanced by measures that increase compliance.
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Affiliation(s)
- Xiao Pan Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Office of Scientific Research and Information Management, Pudong Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Hui Min Chen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiao Hong Lei
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Guan Shen Dou
- Department of Health Economics, Key Laboratory For Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Yi Chen Chen
- Office of Scientific Research and Information Management, Pudong Center for Disease Control and Prevention, Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
| | - Li Ping Chen
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yao Zhang
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Gen Ming Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Wei Zhong
- Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, State Key Laboratory for Oncogenes and Related Genes, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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12
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Singh S, Sridhar P. A narrative review of sociodemographic risk and disparities in screening, diagnosis, treatment, and outcomes of the most common extrathoracic malignancies in the United States. J Thorac Dis 2021; 13:3827-3843. [PMID: 34277073 PMCID: PMC8264686 DOI: 10.21037/jtd-21-87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/20/2021] [Indexed: 11/06/2022]
Abstract
There is a well-established association between multiple sociodemographic risk factors and disparities in cancer care. These risk factors include minority race and ethnicity, low socioeconomic status (SES) including low income and education level, non-English primary language, immigrant status, and residential segregation, and distance to facilities that deliver cancer care. As cancer care advances, existing disparities in screening, treatment, and outcomes have become more evident. Lung cancer remains the most common and fatal malignancy in the United States, with breast, colorectal, and prostate cancer being the three most common and deadly extrathoracic malignancies. Achieving the best outcomes for patients with these malignancies relies on strong physician-patient relationships leading to robust screening, early diagnosis, and early referral to facilities that can deliver multidisciplinary care and multimodal therapy. It is likely that challenges experienced in developing patient trust and understanding, providing access to screening, and building referral pipelines for definitive therapy in lung cancer care to vulnerable populations are paralleled by those in extrathoracic malignancies. Likewise, progress made in delivering optimal care to all patients across sociodemographic and geographic barriers can serve as a roadmap. Therefore, we provide a narrative review of current disparities in screening, treatment, and outcomes for patients with breast, prostate, and colorectal malignancies.
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Affiliation(s)
- Sarah Singh
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Praveen Sridhar
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
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13
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Abstract
GOALS The goal of this study was to quantify the association between demographic factors and advanced colorectal cancer (CRC) in patients under age 50. BACKGROUND CRC incidence in the United States has declined in older individuals but increased in those under age 50 (early-onset). More than 60% of early-onset CRC patients present with advanced disease (stage III/IV), but predictors of stage in this population are poorly defined. STUDY We analyzed CRC cases diagnosed between age 20 and 49 in the United States Surveillance, Epidemiology, and End Results (SEER) 18 database during 2004 to 2015. Logistic regression models were fit to assess the impact of age, sex, race, ethnicity, marital status, and cancer site on the probability of advanced disease. RESULTS The analysis included 37,044 cases. On multivariable regression, age was inversely associated with advanced disease. Relative to 45 to 49-year-olds, 40 to 44-year-olds had 8% greater odds of having advanced CRC, and 20 to 24-year-olds had 53% greater odds. Asians, blacks, and Pacific Islanders had 10%, 12%, and 45% greater odds of advanced disease compared with whites. Compared with nonpartnered individuals, those with partners had 11% lower odds of advanced CRC. Both right-sided and left-sided colon cancer were more likely to be diagnosed at stage IV compared with rectal cancer. CONCLUSIONS Among individuals with early-onset CRC, younger age, Asian, black, or Pacific Islander race, and being nonpartnered were predictors of advanced disease at presentation. Colon cancer was more likely to be diagnosed at stage IV than rectal cancer. Patient characteristics associated with advanced CRC may indicate both differences in tumor biology and disparities in health care access.
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14
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Ayash C, Badreddine D, Gatarny R, Wu M, Alward Z, Roberts-Eversley N, Thompson H, Gany F. Associations with the Receipt of Colon Cancer Screening Among a Diverse Sample of Arab Americans in NYC. J Immigr Minor Health 2020; 22:503-511. [PMID: 31243689 PMCID: PMC7059222 DOI: 10.1007/s10903-019-00912-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Arab Americans (AA) face increased risk for colorectal cancer (CRC), the third leading cause of cancer-related death in the US, due to low utilization of preventative care and socioeconomic disparities. This study explores associations with the receipt of CRC screening among AA in New York City. A cross-sectional survey was conducted among 100 individuals attending religious and community organizations with interviewer-administered surveys in Arabic and English. Results from 100 participants showed they were more likely to complete CRC screening with a doctor recommendation (74%) and were more likely to get a recommendation with a high school education or higher (86%). Uninsured participants and those with public insurance were the least likely to complete screening. Those with a higher mean score in Spiritual Life/Faith (13.34 vs. 11.67) were less likely to complete screening. Findings suggest the need for culturally sensitive interventions to increase CRC screening rates among AA.
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Affiliation(s)
- Claudia Ayash
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA.
| | - Dalal Badreddine
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Redwane Gatarny
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Zeinab Alward
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Nicole Roberts-Eversley
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Haley Thompson
- Oncology Department, Wayne State University School of Medicine, Detroit, USA
- Community Outreach and Engagement at Karmanos Cancer Institute (KCI), KCI's Office of Cancer Health Equity and Community Engagement, Wayne State University School of Medicine, Detroit, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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15
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Gu M, Thapa S. Colorectal cancer in the United States and a review of its heterogeneity among Asian American subgroups. Asia Pac J Clin Oncol 2020; 16:193-200. [PMID: 32129941 DOI: 10.1111/ajco.13324] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 01/28/2020] [Indexed: 11/30/2022]
Abstract
Colorectal cancer is the third most common cancer in the United States. Established risk factors include older age, unhealthy lifestyle (high consumptions of red/preserved meat, low consumptions of fruit and vegetables, smoking, high alcohol consumption, and lack of physical activities), personal and family medical histories and low socioeconomic status (low insurance coverage, education and income). Asian American subgroups vary significantly in terms of culture, socioeconomic status, and health behaviors, yet most registries and researches aggregate all Asian Americans as one group. In this review, we summarized and compared colorectal cancer incidence among different Asian American subgroups, and to explore the reasons behind the heterogeneity. Based on limited literatures, we found that Japanese Americans have the highest colorectal cancer incidence among all Asian Americans. The incidence is decreasing among most Asian American subgroups except for Korean Americans. Such heterogeneity is influenced by lifestyle factors related to the country of origin and the United States, as well as colorectal cancer screening.
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Affiliation(s)
- Mofan Gu
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Susan Thapa
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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16
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Pokharel M, Elrick A, Canary HE, Clayton MF, Sukovic M, Champine M, Hong SJ, Kaphingst KA. Health communication roles in Latino, Pacific Islander, and Caucasian Families: A qualitative investigation. J Genet Couns 2019; 29:399-409. [PMID: 31605434 DOI: 10.1002/jgc4.1177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/28/2019] [Accepted: 09/16/2019] [Indexed: 11/06/2022]
Abstract
Family communication about health is critical for the dissemination of information that may improve health management of all family members. Communication about health issues, attitudes, and behaviors in families is associated with life expectancy as well as quality of life for family members. This study addresses family communication about health by examining individual roles for family health communication and factors related to these roles, among families of three different racial/ethnic groups: Caucasians, Latinos, and Pacific Islanders. Data were collected from 60 participants recruited as 30 family dyads, 10 from each group, through qualitative semistructured interviews. Interviews were conducted with each participant separately and then together in a dyadic interview. Two coders independently coded interview transcripts using NVivo 11. Results identified the family health communication roles of collector, disseminator, health educator, and researcher. We also identified several factors related to these roles using the lens of family systems theory-the presence of chronic conditions in the family, previous experience, medical education, and family hierarchy. Findings demonstrate many similarities and relatively few differences in the family health communication roles and the related factors among the families of different race/ethnicity. Conclusions highlight implications for future research and intervention development.
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Affiliation(s)
- Manusheela Pokharel
- Department of Communication Studies, Texas State University, San Marcos, Texas
| | - Ashley Elrick
- Department of Communication, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Heather E Canary
- School of Communication, San Diego State University, San Diego, California
| | - Margaret F Clayton
- Huntsman Cancer Institute, Salt Lake City, Utah.,College of Nursing, University of Utah, Salt Lake City, Utah
| | - Masha Sukovic
- Department of Communication, University of Utah, Salt Lake City, Utah
| | | | - Soo Jung Hong
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Kimberly A Kaphingst
- Department of Communication, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
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17
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Chi Y, Wang D, Wang J, Yu W, Yang J. Long Non-Coding RNA in the Pathogenesis of Cancers. Cells 2019; 8:cells8091015. [PMID: 31480503 PMCID: PMC6770362 DOI: 10.3390/cells8091015] [Citation(s) in RCA: 503] [Impact Index Per Article: 100.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/25/2019] [Accepted: 08/29/2019] [Indexed: 12/24/2022] Open
Abstract
The incidence and mortality rate of cancer has been quickly increasing in the past decades. At present, cancer has become the leading cause of death worldwide. Most of the cancers cannot be effectively diagnosed at the early stage. Although there are multiple therapeutic treatments, including surgery, radiotherapy, chemotherapy, and targeted drugs, their effectiveness is still limited. The overall survival rate of malignant cancers is still low. It is necessary to further study the mechanisms for malignant cancers, and explore new biomarkers and targets that are more sensitive and effective for early diagnosis, treatment, and prognosis of cancers than traditional biomarkers and methods. Long non-coding RNAs (lncRNAs) are a class of RNA transcripts with a length greater than 200 nucleotides. Generally, lncRNAs are not capable of encoding proteins or peptides. LncRNAs exert diverse biological functions by regulating gene expressions and functions at transcriptional, translational, and post-translational levels. In the past decade, it has been demonstrated that the dysregulated lncRNA profile is widely involved in the pathogenesis of many diseases, including cancer, metabolic disorders, and cardiovascular diseases. In particular, lncRNAs have been revealed to play an important role in tumor growth and metastasis. Many lncRNAs have been shown to be potential biomarkers and targets for the diagnosis and treatment of cancers. This review aims to briefly discuss the latest findings regarding the roles and mechanisms of some important lncRNAs in the pathogenesis of certain malignant cancers, including lung, breast, liver, and colorectal cancers, as well as hematological malignancies and neuroblastoma.
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Affiliation(s)
- Yujing Chi
- Department of Central Laboratory & Institute of Clinical Molecular Biology, Peking University People's Hospital, Beijing 100044, China
| | - Di Wang
- Department of Central Laboratory & Institute of Clinical Molecular Biology, Peking University People's Hospital, Beijing 100044, China
| | - Junpei Wang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
- Key Laboratory of Cardiovascular Science of the Ministry of Education, Center for Non-coding RNA Medicine, Beijing 100191, China
| | - Weidong Yu
- Department of Central Laboratory & Institute of Clinical Molecular Biology, Peking University People's Hospital, Beijing 100044, China
| | - Jichun Yang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China.
- Key Laboratory of Cardiovascular Science of the Ministry of Education, Center for Non-coding RNA Medicine, Beijing 100191, China.
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18
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Sy AU, Lim E, Ka'opua LS, Kataoka-Yahiro M, Kinoshita Y, Stewart SL. Colorectal cancer screening prevalence and predictors among Asian American subgroups using Medical Expenditure Panel Survey National Data. Cancer 2018; 124 Suppl 7:1543-1551. [PMID: 29578602 DOI: 10.1002/cncr.31098] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 10/10/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Asian American (AA) ethnic subgroups are diverse in socio-economic status, years in the United States, English proficiency, and cultures with different health seeking behaviors and health care access. Fifty-two percent of AAs age ≥50 years had colorectal cancer screening (CRCS) in 2013, compared with 61% of non-Hispanic whites. We hypothesized that CRCS prevalence among AA ethnicities is heterogeneous and that the reasons related to CRCS among AA subgroups are associated with demographic characteristics, acculturation, health care access, and health attitudes. METHODS Medical Expenditure Panel Survey data for 2009-2014 compared CRCS status among whites (n = 28,834), Asian Indians (n = 466), Chinese (n = 652), and Filipinos (n = 788). Multivariate logistic regression examined ethnic differences and correlates of CRCS accounting for complex sampling design. RESULTS Whites had the highest prevalence of screening (62.3%), followed by Filipinos (55.0%), Chinese (50.9%), and Asian Indians (48.6%). Older age, having health insurance, and having a usual care provider predicted CRCS across all ethnicities. Different demographic, health care access, and health attitude predictors within each ethnic group were related to CRCS. CONCLUSION This study contributes to the literature on influences of differential CRCS prevalence among AA subgroups. CRCS promotion should be tailored according to attitudes and structural barriers affecting screening behavior of specific ethnic subgroups to truly serve the health needs of the diverse AA population. Cancer 2018;124:1543-51. © 2018 American Cancer Society.
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Affiliation(s)
- Angela U Sy
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Eunjung Lim
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Lana Sue Ka'opua
- Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Merle Kataoka-Yahiro
- Department of Nursing, School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Yumiko Kinoshita
- Department of Health Sciences, Kyushu University, Fukuoka, Japan
| | - Susan L Stewart
- Division of Biostatistics, Department of Public Health Studies, University of California, Davis, California
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19
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Jih J, Nguyen MP, Ly I, Tsoh JY, Le GM, Woo K, Chan E, Gildengorin G, Stewart SL, Burke A, Pasick R, McPhee SJ, Nguyen TT. The Role of Physician Recommendation in Colorectal Cancer Screening Receipt Among Immigrant Chinese Americans. J Immigr Minor Health 2017; 20:1483-1489. [PMID: 29168060 DOI: 10.1007/s10903-017-0679-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Chinese Americans have low colorectal cancer (CRC) screening rates. It is unclear whether physicians should offer all CRC screening modalities (fecal occult blood test [FOBT], sigmoidoscopy, colonoscopy) to Chinese Americans to increase screening. Seven hundred and twenty-five Chinese Americans were asked in a survey if their physician had ever recommended CRC screening and to self-report receipt and type of CRC screening. Participants whose physician had recommended all CRC screening modalities were significantly more likely to report ever having screening (adjusted odds ratio 4.29, 95% CI 1.26-14.68) and being up-to-date (4.06, 95% CI 2.13-7.74) than those who reported that their physician only recommended FOBT. Participants who received a recommendation of only one type of screening did not report a significant difference in ever having or being up-to-date for screening. A potential strategy to increase CRC screening among Chinese Americans is for clinicians to recommend all available CRC screening modalities to each patient.
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Affiliation(s)
- Jane Jih
- Asian American Research Center on Health, San Francisco, CA, USA. .,Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA. .,Division of General Internal Medicine, University of California, San Francisco, 1545 Divisadero Street, P.O. Box 0320, San Francisco, CA, 94115, USA.
| | - Minh P Nguyen
- Asian American Research Center on Health, San Francisco, CA, USA
| | - Irene Ly
- Asian American Research Center on Health, San Francisco, CA, USA
| | - Janice Y Tsoh
- Asian American Research Center on Health, San Francisco, CA, USA.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Gem M Le
- Asian American Research Center on Health, San Francisco, CA, USA.,Division of General Internal Medicine, Zuckerberg San Francisco General Hospital/University of California, San Francisco, San Francisco, CA, USA
| | - Kent Woo
- NICOS Chinese Health Coalition, San Francisco, CA, USA
| | - Elaine Chan
- NICOS Chinese Health Coalition, San Francisco, CA, USA
| | - Ginny Gildengorin
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Susan L Stewart
- Division of Biostatistics, University of California, Davis, Davis, CA, USA
| | - Adam Burke
- Asian American Research Center on Health, San Francisco, CA, USA.,Department of Health Education, San Francisco State University, San Francisco, CA, USA
| | - Rena Pasick
- Asian American Research Center on Health, San Francisco, CA, USA.,Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Stephen J McPhee
- Asian American Research Center on Health, San Francisco, CA, USA.,Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Tung T Nguyen
- Asian American Research Center on Health, San Francisco, CA, USA.,Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
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