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Japuntich SJ, Walaska K, Friedman EY, Balletto B, Cameron S, Tanzer JR, Fang P, Clark MA, Carey MP, Fava J, Busch AM, Breault C, Rosen R. Lung cancer screening provider recommendation and completion in black and White patients with a smoking history in two healthcare systems: a survey study. BMC PRIMARY CARE 2024; 25:202. [PMID: 38849725 PMCID: PMC11157907 DOI: 10.1186/s12875-024-02452-y] [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: 08/29/2023] [Accepted: 05/28/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Annual lung cancer screening (LCS) with low dose CT reduces lung cancer mortality. LCS is underutilized. Black people who smoke tobacco have high risk of lung cancer but are less likely to be screened than are White people. This study reports provider recommendation and patient completion of LCS and colorectal cancer screening (CRCS) among patients by race to assess for utilization of LCS. METHODS 3000 patients (oversampled for Black patients) across two healthcare systems (in Rhode Island and Minnesota) who had a chart documented age of 55 to 80 and a smoking history were invited to participate in a survey about cancer screening. Logistic regression analysis compared the rates of recommended and received cancer screenings. RESULTS 1177 participants responded (42% response rate; 45% White, 39% Black). 24% of respondents were eligible for LCS based on USPSTF2013 criteria. One-third of patients eligible for LCS reported that a doctor had recommended screening, compared to 90% of patients reporting a doctor recommended CRCS. Of those recommended screening, 88% reported completing LCS vs. 83% who reported completion of a sigmoidoscopy/colonoscopy. Black patients were equally likely to receive LCS recommendations but less likely to complete LCS when referred compared to White patients. There was no difference in completion of CRCS between Black and White patients. CONCLUSIONS Primary care providers rarely recommend lung cancer screening to patients with a smoking history. Systemic changes are needed to improve provider referral for LCS and to facilitate eligible Black people to complete LCS.
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Affiliation(s)
- Sandra J Japuntich
- Hennepin Healthcare, 730 South 8th St., Minneapolis, MN, 55415, USA.
- Hennepin Healthcare Research Institute, 701 Park Ave., PP7.700, Minneapolis, MN, 55415, USA.
- Department of Medicine, University of Minnesota Medical School, 401 East River Parkway, VCRC 1st Floor, Suite 131, Minneapolis, MN, 55455, USA.
| | - Kristen Walaska
- The Miriam Hospital, Coro Center West, 1 Hoppin St., Suite 309, Providence, RI, 02903, USA
| | - Elena Yuija Friedman
- Hennepin Healthcare Research Institute, 701 Park Ave., PP7.700, Minneapolis, MN, 55415, USA
| | - Brittany Balletto
- The Miriam Hospital, Coro Center West, 1 Hoppin St., Suite 309, Providence, RI, 02903, USA
| | - Sarah Cameron
- Hennepin Healthcare Research Institute, 701 Park Ave., PP7.700, Minneapolis, MN, 55415, USA
| | | | - Pearl Fang
- Hennepin Healthcare Research Institute, 701 Park Ave., PP7.700, Minneapolis, MN, 55415, USA
| | - Melissa A Clark
- Brown University School of Public Health, One Davol Square, 121 South Main St, Providence, RI, 02903, USA
| | - Michael P Carey
- Department of Psychiatry and Human Behavior, Brown University, 75 Waterman St, Providence, RI, 02912, USA
| | - Joseph Fava
- The Miriam Hospital, Coro Center West, 1 Hoppin St., Suite 309, Providence, RI, 02903, USA
| | - Andrew M Busch
- Hennepin Healthcare, 730 South 8th St., Minneapolis, MN, 55415, USA
- Hennepin Healthcare Research Institute, 701 Park Ave., PP7.700, Minneapolis, MN, 55415, USA
- Department of Medicine, University of Minnesota Medical School, 401 East River Parkway, VCRC 1st Floor, Suite 131, Minneapolis, MN, 55455, USA
| | - Christopher Breault
- The Miriam Hospital, Coro Center West, 1 Hoppin St., Suite 309, Providence, RI, 02903, USA
| | - Rochelle Rosen
- The Miriam Hospital, Coro Center West, 1 Hoppin St., Suite 309, Providence, RI, 02903, USA
- Brown University School of Public Health, One Davol Square, 121 South Main St, Providence, RI, 02903, USA
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Chen M, Hui S, Huang Y, Yu H, Yang H, Yang L, Tian L, Wang S. Knowledge, attitudes, and current practices toward lung cancer palliative care management in China: a national survey. Front Oncol 2024; 14:1382496. [PMID: 38812782 PMCID: PMC11133550 DOI: 10.3389/fonc.2024.1382496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/01/2024] [Indexed: 05/31/2024] Open
Abstract
Scope The present investigation seeks to illuminate the current state and disparities in the knowledge, attitudes, and practices (KAP) among healthcare professionals regarding the management of lung cancer palliative care (LCPC) in China, while simultaneously assessing the prevalence and context of patient-controlled analgesia (PCA) usage in the management of cancer-related pain. Methods A total of 2093 healthcare practitioners from 706 hospitals across China completed a structured questionnaire that probed various facets of LCPC management. The questionnaire consisted of seven thematic sections, incorporating chi-square tests and Fisher's exact probabilities to statistically assess the discrepancies in KAP among healthcare professionals across different hospital grades. Ordered data distributions among hospital grades were compared using non-parametric Kruskal-Wallis H and Mann-Whitney U tests. Multiple-choice items were subjected to multiple-response cross-tabulation analysis, while the Spearman rank-order correlation coefficient was employed to gauge potential associations among variables. Results Around 84.2% of the respondents perceived anti-tumor therapy to be of equal importance to palliative care. Statistically significant differences (χ² = 27.402, P = 0.002) in satisfaction levels were observed, with participants from Tertiary hospitals demonstrating higher satisfaction compared to those from Secondary and Primary hospitals. Pain emerged as the most prevalent symptom necessitating LCPC. Major impediments to LCPC adoption included patients' and families' concerns about the safety of long-term palliative care-related drug use. 31.1% of the respondents cited the most frequent rationale for PCA use as cases involving patients who required systemic administration of large opioid doses or exhibited intolerable adverse reactions to opioids. The principal deterrents against the use of PCA for cancer pain management were (1): apprehension about adverse drug reactions due to overdose (2), concern about the potential for opioid addiction, and (3) the anticipated increase in patients' economic burdens. Over the preceding 24-month period, 33.9% of the surveyed healthcare practitioners reported no engagement in either online or offline LCPC-related training initiatives. Conclusion This study emphasizes the pressing need for comprehensive training in LCPC among Chinese health personnels, particularly focusing on the effective management of cancer pain symptoms.
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Affiliation(s)
- Mengting Chen
- Department of Clinical Nutrition, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Suocheng Hui
- Department of Clinical Nutrition, The People’s Hospital of Chongqing Liang Jiang New Area, Chongqing, China
| | - Yalan Huang
- Outpatient Department, Yunnan Provincial Corps Hospital of Chinese People’s Armed Police Forces, Kunming, Yunnan, China
| | - Huiqing Yu
- Department of Clinical Nutrition, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
- Department of Geriatric Oncology and Department of Palliative Care, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Hong Yang
- Department of Geriatric Oncology and Department of Palliative Care, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Liejun Yang
- Department of Geriatric Oncology and Department of Palliative Care, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Ling Tian
- Department of Geriatric Oncology and Department of Palliative Care, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Sixiong Wang
- Department of Geriatric Oncology and Department of Palliative Care, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
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Harrington S, Kwatra N, Melvin P, Tartarilla AB, Whitley MY, Valencia VF, Ward VL. Sociodemographic factors and Child Opportunity Index disparities associated with missed care opportunities in pediatric patients with lymphoma and leukemia referred for FDG-PET/CT. Pediatr Radiol 2024; 54:1022-1032. [PMID: 38632134 DOI: 10.1007/s00247-024-05924-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Little data exists on the association of missed care opportunities (MCOs) in children referred for nuclear medicine/nuclear oncology imaging examinations and socioeconomic disparities. OBJECTIVE To determine the prevalence of MCOs in children with lymphoma/leukemia scheduled for fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and the impact of sociodemographic factors and Child Opportunity Index (COI). MATERIALS AND METHODS Retrospective analysis of MCOs in children with lymphoma/leukemia scheduled for FDG-PET/CT (2012 to 2022) was performed. In univariate analysis, patient, neighborhood, and appointment data were assessed across MCOs and completed appointments. Logistic regression evaluated independent effects of patient-, neighborhood-, and appointment-level factors with MCOs. Two-sided P-value < .05 was considered statistically significant. RESULTS In 643 FDG-PET/CT appointments (n = 293 patients; median age 15 years (IQR 11.0-17.0 years); 37.9% female), there were 20 MCOs (3.1%) involving 16 patients. Only 8.2% appointments involved Black/African American non-Hispanic/Latino patients, yet they made up a quarter of total MCOs. Patients living in neighborhoods with very low or low COI experienced significantly higher MCOs versus zip codes with very high COI (6.9% vs. 0.8%; P = 0.02). Logistic regression revealed significantly increased likelihood of MCOs for patients aged 18 to 21 [odds ratio (OR) 4.50; 95% CI 1.53-13.27; P = 0.007], Black/African American non-Hispanic/Latino (OR 3.20; 95% CI 1.08-9.49; P = 0.04), zip codes with very low or low COI (OR 9.60; 95% CI 1.24-74.30; P = 0.03), and unknown insurance status. CONCLUSION Children with lymphoma/leukemia, living in zip codes with very low or low COI, and who identified as Black/African American non-Hispanic/Latino experienced more MCOs. Our study supports the need to address intersecting sociodemographic, neighborhood, and health system factors that will improve equitable access to necessary healthcare imaging for children.
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Affiliation(s)
| | - Neha Kwatra
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Patrice Melvin
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
| | - Ashley B Tartarilla
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
| | - Melicia Y Whitley
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
| | | | - Valerie L Ward
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, USA
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
- Office of Health Equity and Inclusion, Boston Children's Hospital, Boston, MA, USA
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Abraham P, Haddad A, Bishay AE, Bishay S, Sonubi C, Jaramillo-Cardoso A, Sava M, Yee J, Flores EJ, Spalluto LB. Social Determinants of Health in Imaging-based Cancer Screening: A Case-based Primer with Strategies for Care Improvement. Radiographics 2023; 43:e230008. [PMID: 37824411 PMCID: PMC10612293 DOI: 10.1148/rg.230008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 10/14/2023]
Abstract
Health disparities, preventable differences in the burden of disease and disease outcomes often experienced by socially disadvantaged populations, can be found in nearly all areas of radiology, including emergency radiology, neuroradiology, nuclear medicine, image-guided interventions, and imaging-based cancer screening. Disparities in imaging-based cancer screening are especially noteworthy given the far-reaching population health impact. The social determinants of health (SDoH) play an important role in disparities in cancer screening and outcomes. Through improved understanding of how SDoH can drive differences in health outcomes in radiology, radiologists can effectively provide patient-centered, high-quality, and equitable care. Radiologists and radiology practices can become active partners in efforts to assist patients along their imaging journey and overcome existing barriers to equitable cancer screening care for traditionally marginalized populations. As radiology exists at the intersection of diagnostic imaging, image-guided diagnostic intervention, and image-guided treatment, radiologists are uniquely positioned to design these strategies. Cost-effective and socially conscious strategies that address barriers to equitable care can improve both public health and equitable health outcomes. Potential strategies include championing supportive health policy, reducing out-of-pocket costs, increasing price transparency, improving education and outreach efforts, ensuring that appropriate language translation services are available, providing individualized assistance with appointment scheduling, and offering transportation assistance and childcare. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Peter Abraham
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Aida Haddad
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Anthony E. Bishay
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Steven Bishay
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Chiamaka Sonubi
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Adrian Jaramillo-Cardoso
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Melinda Sava
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Judy Yee
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Efren J. Flores
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
| | - Lucy B. Spalluto
- From the Department of Radiology, University of California San Diego,
200 W Arbor Dr, San Diego, CA 92103 (P.A., A.H.); Vanderbilt University School
of Medicine, Nashville, Tenn (A.E.B., S.B.); Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Ga (C.S.); Department of
Radiology, Vanderbilt University Medical Center, Nashville, Tenn (A.J.C.,
L.B.S.); Advanced Diagnostic Imaging, Nashville, Tenn (M.S.); Department of
Radiology, Albert Einstein College of Medicine, New York, NY (J.Y.); Department
of Radiology, Massachusetts General Hospital, Boston, Mass (E.J.F.);
Vanderbilt-Ingram Cancer Center, Nashville, Tenn (L.B.S.); and Veterans Health
Administration–Tennessee Valley Health Care System Geriatric Research,
Education and Clinical Center (GRECC), Nashville, Tenn (L.B.S.)
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Fu Y, Liu J, Chen Y, Liu Z, Xia H, Xu H. Gender disparities in lung cancer incidence in the United States during 2001-2019. Sci Rep 2023; 13:12581. [PMID: 37537259 PMCID: PMC10400573 DOI: 10.1038/s41598-023-39440-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023] Open
Abstract
Lung cancer ranks as one of the top malignancies and the leading cause of cancer death in both males and females in the US. Using a cancer database covering the entire population, this study was to determine the gender disparities in lung cancer incidence during 2001-2019. Cancer patients were obtained from the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology and End Results (SEER) database. The SEER*Stat software was applied to calculate the age-adjusted incidence rates (AAIR). Temporal changes in lung cancer incidence were analyzed by the Joinpoint software. A total of 4,086,432 patients (53.3% of males) were diagnosed with lung cancer. Among them, 52.1% were 70 years or older, 82.7% non-Hispanic white, 39.7% from the South, and 72.6% non-small cell lung cancer (NSCLC). The AAIR of lung cancer continuously reduced from 91.0 per 100000 to 59.2 in males during the study period, while it increased from 55.0 in 2001 to 56.8 in 2006 in females, then decreased to 48.1 in 2019. The female to male incidence rate ratio of lung cancer continuously increased from 2001 to 2019. Gender disparities were observed among age groups, races, and histological types. In those aged 0-54 years, females had higher overall incidence rates of lung cancer than males in recent years, which was observed in all races (except non-Hispanic black), all regions, and adenocarcinoma and small cell (but not squamous cell). Non-Hispanic black females aged 0-54 years had a faster decline rate than males since 2013. API females demonstrated an increased trend during the study period. Lung cancer incidence continues to decrease with gender disparities among age groups, races, regions, and histological types. Continuous anti-smoking programs plus reduction of related risk factors are necessary to lower lung cancer incidence further.
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Affiliation(s)
- Yu Fu
- Department of Physical Examination Center, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, China
| | - Jun Liu
- Department of Clinical Laboratory, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, 311202, China.
| | - Yan Chen
- Department of Gastroenterology, PLA Strategic Support Force Characteristic Medical Center, Beijing, China
| | - Zhuo Liu
- Department of Respiratory Therapy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, China
| | - Hongbo Xia
- Department of Respiratory Therapy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, China
| | - Haixia Xu
- Department of Respiratory Therapy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, China
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Behinaein P, Treffalls J, Hutchings H, Okereke IC. The Role of Sublobar Resection for the Surgical Treatment of Non-Small Cell Lung Cancer. Curr Oncol 2023; 30:7019-7030. [PMID: 37504369 PMCID: PMC10378348 DOI: 10.3390/curroncol30070509] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
Lung cancer is the most common cancer killer in the world. The standard of care for surgical treatment of non-small cell lung cancer has been lobectomy. Recent studies have identified that sublobar resection has non-inferior survival rates compared to lobectomy, however. Sublobar resection may increase the number of patients who can tolerate surgery and reduce postoperative pulmonary decline. Sublobar resection appears to have equivalent results to surgery in patients with small, peripheral tumors and no lymph node disease. As the utilization of segmentectomy increases, there may be some centers that perform this operation more than other centers. Care must be taken to ensure that all patients have access to this modality. Future investigations should focus on examining the outcomes from segmentectomy as it is applied more widely. When employed on a broad scale, morbidity and survival rates should be monitored. As segmentectomy is performed more frequently, patients may experience improved postoperative quality of life while maintaining the same oncologic benefit.
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Affiliation(s)
- Parnia Behinaein
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - John Treffalls
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Hollis Hutchings
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
| | - Ikenna C Okereke
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
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7
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Forman HP, Davis MA. Even in Radiology, Race Matters. Radiology 2023; 307:e223330. [PMID: 36809221 DOI: 10.1148/radiol.223330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- Howard P Forman
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, Tompkins East 2-204, New Haven, CT 06520 (H.P.F., M.A.D.); Yale School of Management, New Haven, Conn (H.P.F.); Yale School of Public Health, New Haven, Conn (H.P.F.); and Economics Department, Yale University, New Haven, Conn (H.P.F.)
| | - Melissa A Davis
- From the Department of Radiology and Biomedical Imaging, Yale School of Medicine, 333 Cedar St, Tompkins East 2-204, New Haven, CT 06520 (H.P.F., M.A.D.); Yale School of Management, New Haven, Conn (H.P.F.); Yale School of Public Health, New Haven, Conn (H.P.F.); and Economics Department, Yale University, New Haven, Conn (H.P.F.)
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8
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Ahadinezhad B, Maleki A, Amerzadeh M, Mohtashamzadeh B, Safdari M, Khosravizadeh O. Socioeconomic Inequalities in Cancer Incidence: A Comparative Investigation Based on Population of Iranian Provinces. CURRENT HEALTH SCIENCES JOURNAL 2023; 49:85-95. [PMID: 37780192 PMCID: PMC10541078 DOI: 10.12865/chsj.49.01.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/24/2022] [Indexed: 10/03/2023]
Abstract
Cancer is the second important cause of death worldwide. Cancer is one of the top health priorities in Iran. We aimed to study the socio-economic inequality of cancer incidence in Iran provinces. We conducted this cross-sectional study using provincial data. We obtained the required data from the statistical yearbook report, the Statistics Center Report and the National Cancer Registration Program Report of Iran's Ministry of Health and Medical Education (MoHME) for 2018. Socio-economic inequality of cancer incidence was analyzed by estimating the concentration index and extracting the concentration curve. Statistical analyzes were performed using STATA 14. Our findings revealed that cancer incidence was unequally distributed in terms of the socio-economic status in Iranian provinces. Cancer incidence is slightly concentrated in the provinces with higher than average literacy, per capita income and insurance coverage and household size below average. The concentration of cancer incidence has been to the detriment of the provinces that have a slightly better ranking in terms of the socio-economic index. The employment rate did not significantly affect cancer's distribution burden. We recommend policymakers facilitate early cancer detection by providing insurance coverage for screening services, payment exemptions, and public awareness.
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Affiliation(s)
- Bahman Ahadinezhad
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aisa Maleki
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Products Safety Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Mahdi Safdari
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Environmental Health Engineering, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Omid Khosravizadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Addressing Lung Cancer Screening Disparities: What Does It Mean to Be Centralized? Ann Am Thorac Soc 2022; 19:1457-1458. [PMID: 36048121 PMCID: PMC9447398 DOI: 10.1513/annalsats.202206-495ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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