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Tran TXM, Kim S, Cha C, Park B. Temporal Trend in Uptake of the National General Health Checkups and Cancer Screening Program among Korean Women with Breast Cancer. Cancer Res Treat 2024; 56:522-530. [PMID: 37905311 PMCID: PMC11016641 DOI: 10.4143/crt.2023.729] [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: 06/07/2023] [Accepted: 10/28/2023] [Indexed: 11/02/2023] Open
Abstract
PURPOSE This study assessed the temporal trends of uptake of national general health and cancer screening among women with breast cancer in Korea between 2009 and 2016. MATERIALS AND METHODS We retrospectively analyzed the claims data from the Korean National Health Insurance Service database. Participants included 101,403 breast cancer patients diagnosed between 2009 and 2016. Information on participation in national screening programs, including breast cancer screening, general health, and gastric, colorectal, and cervical cancers, up to 2020 was collected. Screening participation rates within the first 2 and 5 years postdiagnosis were calculated by diagnosis year and fitted with joinpoint regression models to assess temporal trends. RESULTS Overall, the participation rate in breast cancer screening within 2 years postdiagnosis increased from 10.9% to 14.0% from 2009-2016, with an annual percentage change (APC) of 3.7% (p < 0.05). The participation rate in breast cancer screening was lower than that in general health checkup and screening for other cancers within 2 and 5 years postdiagnosis. A steady increase in screening trends was also observed for general health, gastric, colorectal, and cervical cancers, with APC of 5.3%, 5.7%, 6.9%, and 7.6% in the 2-year postdiagnosis rate, and APC of 3.6%, 3.7%, 3.7%, and 4.4% in 5-year postdiagnosis rate, respectively. The screening rate was highest among age groups 50-59 and 60-69 in 2009 and significant upward trends were observed in all age groups for general health checkup and gastric, colorectal, and cervical cancer screening. CONCLUSION Among female breast cancer survivors in Korea, the uptake rate of screenings for general health and various cancers, including breast, gastric, colorectal, and cervical cancers, has shown a gradual increase in recent years.
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Affiliation(s)
- Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Soyeoun Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Chihwan Cha
- Department of Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Korea
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Tsai MH, Moore JX, Odhiambo LA, Andrzejak SE, Tingen MS. Colorectal cancer screening utilization among breast, cervical, prostate, skin, and lung cancer survivors. J Cancer Surviv 2024; 18:541-552. [PMID: 36217067 PMCID: PMC9549837 DOI: 10.1007/s11764-022-01258-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/12/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE To examine whether sociodemographic characteristics, access to care, risk behavior factors, and chronic health conditions were associated with colorectal cancer (CRC) screening utilization among breast, cervical, prostate, skin, and lung cancer survivors. METHODS We analyzed the 2020 Behavioral Risk Factor Surveillance System (BRFSS) data on 9780 eligible cancer survivors. Descriptive statistics and multivariable logistic regression models were applied to assess the association between guideline-concordant CRC screening and the mentioned characteristics. RESULTS Overall, 81.9%, 65%, 88%,78.1%, and 80.1% of breast, cervical, prostate, skin, and lung cancer survivors received CRC screening, respectively (p-value < 0.001). In multivariable analysis, breast, cervical, and skin cancer survivors aged 60 years or older were associated with higher odds of receiving CRC screening. Respondents that had their recency of routine checkup two or more years before had lower odds of having CRC screening among cervical (OR = 0.06; 95% CI, 0.02-0.22), prostate (OR = 0.26; 95% CI, 0.14-0.49), and skin cancer (OR = 0.50; 95% CI, 0.36-0.70) survivors. The presence of chronic diseases was also associated with guideline-concordant CRC screening among breast, prostate, and skin cancer survivors. CONCLUSIONS Our findings provide important evidence on potential factors that are associated with guideline-concordant CRC screening utilization across different cancer survivors, which include older age, recency of routine checkup, and multiple chronic diseases. Moreover, variation in CRC screening utilization across cancer survivors may highlight missed opportunities for secondary cancer prevention. IMPLICATIONS FOR CANCER SURVIVORS Establishing clear CRC screening guidelines and including patient-provider communication on recommendation in cancer survivorship care may increase adherence to CRC screening.
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Affiliation(s)
- Meng-Han Tsai
- Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA.
- Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, USA.
| | - Justin X Moore
- Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
- Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Lorriane A Odhiambo
- Institute of Public and Preventive Health, Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - Sydney E Andrzejak
- Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
| | - Martha S Tingen
- Cancer Prevention, Control, and Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
- Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, 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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Ramapriyan R, Ramesh T, Yu H, Richardson LG, Nahed BV, Carter BS, Barker FG, Curry WT, Choi BD. County-level disparities in care for patients with glioblastoma. Neurosurg Focus 2023; 55:E12. [PMID: 37913538 PMCID: PMC10624113 DOI: 10.3171/2023.8.focus23454] [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: 07/01/2023] [Accepted: 08/25/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Racial and socioeconomic disparities in neuro-oncological care for patients with brain tumors remain underexplored. This study aimed to analyze county-level disparities in glioblastoma (GBM) care in the United States, focusing on access to surgery and the use of adjuvant temozolomide chemotherapy and radiation therapy. METHODS Using repeated cross-sectional data from the Surveillance, Epidemiology, and End Results 17 database; the Area Health Resources File; and the American Community Survey, from 2010 to 2019, the authors performed multivariate regression analyses to understand the associations between county-level racial and socioeconomic characteristics, as well as the rates of surgery performed, delays in surgery, and use of adjuvant chemotherapy and radiation therapy for newly diagnosed GBM. RESULTS In total, 29,609 GBM patients from 602 different US counties over a decade were included in this study. Counties with lower rates of surgery for GBM were associated with a higher percentage of Black residents (coefficient [CE] -0.001, 95% CI -0.002 to 0; p < 0.05) and being located in the Midwest (CE -0.132, 95% CI -0.195 to -0.069; p < 0.001) or West (CE -0.127, 95% CI -0.189 to -0.065; p < 0.001) relative to the Northeast. Counties with delayed surgical treatment were more likely to lack neurosurgeons (adjusted OR [aOR] 2.52, 95% CI 1.77-3.60; p < 0.001), have a higher percentage of Black residents (aOR 1.011, 95% CI 1.00-1.02; p < 0.05), and be located in the Midwest (aOR 3.042, 95% CI 1.12-8.24; p < 0.05) or West (aOR 3.175, 95% CI 1.12-8.97 p < 0.05). Counties with high rates of adjuvant radiation therapy were less likely to have higher percentages of Black residents (aOR 0.987, 95% CI 0.980-0.995; p < 0.01) and uninsured individuals (aOR 0.962, 95% CI 0.937-0.987; p < 0.01). CONCLUSIONS Counties without neurosurgeons and those with a higher percentage of Black patients have delays in surgical care and demonstrate lower overall rates of surgery and adjuvant therapy for GBM. This study underscores the need for targeted interventions and policies that address structural barriers in healthcare access, improve equitable distribution of the neurosurgery workforce, and ensure timely and comprehensive GBM care to all populations.
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Affiliation(s)
- Rishab Ramapriyan
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Tarun Ramesh
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
| | - Hao Yu
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
| | - Leland G. Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Brian V. Nahed
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Bob S. Carter
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Fred G. Barker
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - William T. Curry
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Bryan D. Choi
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts
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