1
|
Islami F, Baeker Bispo J, Lee H, Wiese D, Yabroff KR, Bandi P, Sloan K, Patel AV, Daniels EC, Kamal AH, Guerra CE, Dahut WL, Jemal A. American Cancer Society's report on the status of cancer disparities in the United States, 2023. CA Cancer J Clin 2024; 74:136-166. [PMID: 37962495 DOI: 10.3322/caac.21812] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 11/15/2023] Open
Abstract
In 2021, the American Cancer Society published its first biennial report on the status of cancer disparities in the United States. In this second report, the authors provide updated data on racial, ethnic, socioeconomic (educational attainment as a marker), and geographic (metropolitan status) disparities in cancer occurrence and outcomes and contributing factors to these disparities in the country. The authors also review programs that have reduced cancer disparities and provide policy recommendations to further mitigate these inequalities. There are substantial variations in risk factors, stage at diagnosis, receipt of care, survival, and mortality for many cancers by race/ethnicity, educational attainment, and metropolitan status. During 2016 through 2020, Black and American Indian/Alaska Native people continued to bear a disproportionately higher burden of cancer deaths, both overall and from major cancers. By educational attainment, overall cancer mortality rates were about 1.6-2.8 times higher in individuals with ≤12 years of education than in those with ≥16 years of education among Black and White men and women. These disparities by educational attainment within each race were considerably larger than the Black-White disparities in overall cancer mortality within each educational attainment, ranging from 1.03 to 1.5 times higher among Black people, suggesting a major role for socioeconomic status disparities in racial disparities in cancer mortality given the disproportionally larger representation of Black people in lower socioeconomic status groups. Of note, the largest Black-White disparities in overall cancer mortality were among those who had ≥16 years of education. By area of residence, mortality from all cancer and from leading causes of cancer death were substantially higher in nonmetropolitan areas than in large metropolitan areas. For colorectal cancer, for example, mortality rates in nonmetropolitan areas versus large metropolitan areas were 23% higher among males and 21% higher among females. By age group, the racial and geographic disparities in cancer mortality were greater among individuals younger than 65 years than among those aged 65 years and older. Many of the observed racial, socioeconomic, and geographic disparities in cancer mortality align with disparities in exposure to risk factors and access to cancer prevention, early detection, and treatment, which are largely rooted in fundamental inequities in social determinants of health. Equitable policies at all levels of government, broad interdisciplinary engagement to address these inequities, and equitable implementation of evidence-based interventions, such as increasing health insurance coverage, are needed to reduce cancer disparities.
Collapse
Affiliation(s)
| | | | | | | | | | - Priti Bandi
- American Cancer Society, Atlanta, Georgia, USA
| | | | | | | | | | - Carmen E Guerra
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | |
Collapse
|
2
|
Hernandez M, Winicki N, Kadivar A, Alvarez S, Zhang Y, Maguire S, Thareja N, Onaitis M, Boys J, Thistlethwaite PA. Racial and ethnic variation in referral times for thoracic oncologic surgery in a major metropolitan area. J Thorac Cardiovasc Surg 2023; 165:482-494.e1. [PMID: 35863965 DOI: 10.1016/j.jtcvs.2022.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The study objective was to understand the impact of race/ethnicity on access to thoracic surgical care for patients undergoing lung resection for cancer. METHODS We performed a retrospective analysis on 206 consecutive patients who underwent lung resection for cancer (120 female, 86 male; median age 66 years), with respect to how race and ethnicity impact time to referral for thoracic surgery to a major healthcare center. Time between initial radiographic appearance of a lung nodule/mass 1 cm or greater to surgical referral and time from surgical referral to operation were evaluated for 121 White, 30 Asian, 26 Hispanic, 12 African American, and 17 mixed or other race patients. The impact of age, sex, median income of patient's household, national and state Area Deprivation Indices, insurance type, and distance between the patient's domicile and our hospital was evaluated. The influence of the referring physician's practice (hospital-based, hospital-affiliated, or private), internal or external referral, race/ethnicity, and level of specialization was also studied. RESULTS African American, Asian, Hispanic, and mixed/other race patients had significantly longer wait times between initial radiographic finding of a lung nodule/mass 1 cm or greater and surgical referral compared with White individuals (median days: African American, 78; Asian, 95; Hispanic, 92; mixed or other, 65; White, 35). Multiple linear regression analysis demonstrated that race/ethnicity was the only significant predictor of prolonged time to surgical referral when adjusted for age, sex, median household income level, national and state Area Deprivation Indices, insurance type, and distance between patient's home and our hospital. The referring physician's type of practice and internal versus external referral were not significant. However, the physician's race/ethnicity and level of specialization had an impact on referral times, with nonspecialists referring patients sooner to thoracic surgery compared with specialists who ordered more workup tests. For all patient races/ethnicities, there was no difference in time between surgical referral and day of operation. CONCLUSIONS Race and ethnicity have a major impact on the time from initial radiographic appearance of a lung nodule/mass 1 cm or greater to referral for surgical resection for cancer. This study suggests the need to develop strategies to reduce minority wait times and improve timely access to surgery for patients with thoracic malignancies. VIDEO ABSTRACT Discussion of how race and ethnicity impact referral time to thoracic surgery discussed by Dr Moises Hernandez.
Collapse
Affiliation(s)
- Moises Hernandez
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | - Nolan Winicki
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | - Armita Kadivar
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | - Sebastian Alvarez
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | - Yu Zhang
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | - Stephanie Maguire
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | - Nikita Thareja
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | - Mark Onaitis
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | - Joshua Boys
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, Calif
| | | |
Collapse
|
3
|
Walsh KM, Neff C, Bondy ML, Kruchko C, Huse JT, Amos CI, Barnholtz-Sloan JS, Ostrom QT. Influence of county-level geographic/ancestral origin on glioma incidence and outcomes in US Hispanics. Neuro Oncol 2022; 25:398-406. [PMID: 35868246 PMCID: PMC9925707 DOI: 10.1093/neuonc/noac175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Glioma incidence is 25% lower in Hispanics than White non-Hispanics. The US Hispanic population is diverse, and registry-based analyses may mask incidence differences associated with geographic/ancestral origins. METHODS County-level glioma incidence data in Hispanics were retrieved from the Central Brain Tumor Registry of the United States. American Community Survey data were used to determine the county-level proportion of the Hispanic population of Mexican/Central American and Caribbean origins. Age-adjusted incidence rate ratios and incidence rate ratios (IRRs) quantified the glioma incidence differences across groups. State-level estimates of admixture in Hispanics were obtained from published 23andMe data. RESULTS Compared to predominantly Caribbean-origin counties, predominantly Mexican/Central American-origin counties had lower age-adjusted risks of glioma (IRR = 0.83; P < 0.0001), glioblastoma (IRR = 0.86; P < 0.0001), diffuse/anaplastic astrocytoma (IRR = 0.78; P < 0.0001), oligodendroglioma (IRR = 0.82; P < 0.0001), ependymoma (IRR = 0.88; P = 0.012), and pilocytic astrocytoma (IRR = 0.76; P < 0.0001). Associations were consistent in children and adults and using more granular geographic regions. Despite having lower glioma incidence, Hispanic glioblastoma patients from predominantly Mexican/Central American-origin counties had poorer survival than Hispanics living in predominantly Caribbean-origin counties. Incidence and survival differences could be partially explained by state-level estimates of European admixture in Hispanics with European admixture associated with higher incidence and improved survival. CONCLUSIONS Glioma incidence and outcomes differ in association with the geographic origins of Hispanic communities, with counties of predominantly Mexican/Central American origin at significantly reduced risk and those of Caribbean origin at comparatively greater risk. Although typically classified as a single ethnic group, appreciating the cultural, socioeconomic, and genetic diversity of Hispanics can advance cancer disparities research.
Collapse
Affiliation(s)
- Kyle M Walsh
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA,The Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC,Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Corey Neff
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA,Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Melissa L Bondy
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Carol Kruchko
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA
| | - Jason T Huse
- Department of Translational Molecular Pathology and Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Christopher I Amos
- Department of Medicine, Section of Epidemiology and Population Sciences, and Institute for Clinical and Translational Research, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Jill S Barnholtz-Sloan
- Central Brain Tumor Registry of the United States, Hinsdale, Illinois, USA,Center for Biomedical Informatics & Information Technology and Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Quinn T Ostrom
- Corresponding Author: Quinn T. Ostrom, PhD, MPH, Department of Neurosurgery, Duke University School of Medicine, Box 3050, Durham, NC 27710 ()
| |
Collapse
|
4
|
Fernandez ML. Lifestyle Factors and Genetic Variants Associated to Health Disparities in the Hispanic Population. Nutrients 2021; 13:2189. [PMID: 34202120 PMCID: PMC8308310 DOI: 10.3390/nu13072189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022] Open
Abstract
Non-communicable diseases including type 2 diabetes mellitus, coronary heart disease, hepatic steatosis, and cancer are more prevalent in minority groups including Hispanics when compared to Non-Hispanic Whites, leading to the well-recognized terminology of health disparities. Although lifestyle factors including inadequate dietary habits, decreased physical activity, and more prominently, an unhealthy body weight, may be partly responsible for this disproportion in chronic diseases, genetic variations also make a substantial contribution to this problem. In this review, the well-recognized obesity problem in Hispanics that has been associated with chronic disease is examined as well as the influence of diet on promoting an inflammatory environment leading to increased cardiometabolic risk, insulin resistance, fatty liver disease, and cancer. In addition, some of the more studied genetic variations in Hispanics and their association with chronic disease is reviewed.
Collapse
Affiliation(s)
- Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA
| |
Collapse
|
5
|
Maki KG, Shete S, Volk RJ. Examining lung cancer screening utilization with public-use data: Opportunities and challenges. Prev Med 2021; 147:106503. [PMID: 33675881 DOI: 10.1016/j.ypmed.2021.106503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/23/2021] [Accepted: 02/27/2021] [Indexed: 11/29/2022]
Abstract
Lung cancer screening with low-dose computed tomography is recommended for high-risk smokers who meet specific eligibility criteria. Current guidelines suggest that eligible adults with a heavy smoking history will benefit from annual low dose computed tomography but due to several associated risks (e.g., false-positives, radiation exposure, overdiagnosis) a shared decision-making consultation is required by the Centers for Medicare & Medicaid Services, and endorsed by the United States Preventive Services Task Force. In order to examine potential for tracking LCS uptake, adherence, and patient-provider communication at a national level, we reviewed four regularly publicly available national surveys (National Health Interview Survey [NHIS], Behavioral Risk Factor Surveillance System [BRFSS], National Health and Nutrition Examination Survey [NHANES], and Health Information National Trends Survey [HINTS]) to assess available data; an overview of 37 publications using these sources is also provided. The results show that none of the surveys include items that fully assess current LCS guidelines. Implications for future research-including the potential to examine factors associated with LCS uptake and patient-provider communication-are addressed.
Collapse
Affiliation(s)
- Kristin G Maki
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1444, Houston, TX 77030, USA.
| | - Sanjay Shete
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1411, Houston, TX 77030, USA; Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1411, Houston, TX 77030, USA.
| | - Robert J Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1444, Houston, TX 77030, USA.
| |
Collapse
|
6
|
McFarlane SJ, Morgan SE, Occa A, Peng W. An Evaluation of Clinical Trial Multimedia to Support Hispanic Cancer Patients' Informational and Decision-Making Needs. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:110-117. [PMID: 31444640 DOI: 10.1007/s13187-019-01606-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The inclusion of diverse populations in clinical trial research is a social justice imperative. Creating the communicative tools that can support cancer patients across varied cultural backgrounds in processing complex clinical trial information, to achieve informed consent, has been a challenge. This study sought to evaluate specific clinical trial multimedia-a website, four animations, and a decision aid-to meet the decision-making and informational needs of Hispanic patients. The multimedia content was positively evaluated by Hispanic cancer patients. However, the discussions also yielded important steps for culturally adapting these tools to account for particular informational needs and cultural values that would be important to incorporate into these, and future, clinical trial multimedia interventions that target Hispanic populations.
Collapse
Affiliation(s)
| | - Susan E Morgan
- School of Communication, University of Miami, Coral Gables, FL, USA
| | - Aurora Occa
- Department of Communication, University of Kentucky, Lexington, KY, USA
| | - Wei Peng
- School of Communication, University of Miami, Coral Gables, FL, USA
| |
Collapse
|
7
|
Cunningham-Erves J, Barajas C, Mayo-Gamble TL, McAfee CR, Hull PC, Sanderson M, Canedo J, Beard K, Wilkins CH. Formative research to design a culturally-appropriate cancer clinical trial education program to increase participation of African American and Latino communities. BMC Public Health 2020; 20:840. [PMID: 32493245 PMCID: PMC7268329 DOI: 10.1186/s12889-020-08939-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/17/2020] [Indexed: 01/24/2023] Open
Abstract
Background Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program. Methods We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An iterative-deductive approach was used to analyze focus group data. Qualitative data from advisory groups and community members were compiled and used to finalize the program. Results Focus group themes were: 1) Community Perspectives on Overall Presentation; 2) Community Opinions and Questions on the Content of the Presentation; 3) Culturally Specific Issues to Participation in Cancer Clinical Trials; 4) Barriers to Clinical Trial Participation; and 5) Perspectives of Community Health Educators. Feedback was documented during reviews by scientific experts and community members with suggestions to ensure cultural appropriateness using peripheral, evidential, linguistic, sociocultural strategies, and constituent-involving. The final program consisted of two versions (English and Spanish) of a culturally-appropriate slide presentation with speaker notes and videos representing community member and researcher testimonials. Conclusions Incorporating multiple community engagement approaches into formative research processes can facilitate the inclusion of multiple community perspectives and enhance the cultural-appropriateness of the programs designed to promote cancer clinical trial participation among African Americans and Latinos.
Collapse
Affiliation(s)
- Jennifer Cunningham-Erves
- Department of Internal Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Blvd, Nashville, TN, 37208, USA.
| | - Claudia Barajas
- Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Tilicia L Mayo-Gamble
- Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA, USA
| | - Caree R McAfee
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pamela C Hull
- Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maureen Sanderson
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA
| | - Juan Canedo
- Progreso Community Center, Nashville, TN, USA.,School of Graduate Research Studies, Meharry Medical College, Nashville, TN, USA
| | - Katina Beard
- Matthew Walker Community Health Center, Nashville, TN, USA
| | - Consuelo H Wilkins
- Department of Internal Medicine, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Blvd, Nashville, TN, 37208, USA.,Meharry Vanderbilt Alliance, Nashville, TN, USA.,VUMC Office of Health Equity, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
8
|
Kaul R, Purushothaman P, Uppal T, Verma SC. KSHV lytic proteins K-RTA and K8 bind to cellular and viral chromatin to modulate gene expression. PLoS One 2019; 14:e0215394. [PMID: 30998737 PMCID: PMC6472759 DOI: 10.1371/journal.pone.0215394] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
The oncogenic Kaposi's sarcoma-associated herpesvirus (KSHV) has two distinct life cycles with lifelong latent/non-productive and a sporadic lytic-reactivating/productive phases in the infected immune compromised human hosts. The virus reactivates from latency in response to various chemical or environmental stimuli, which triggers the lytic cascade and leads to the expression of immediate early gene, i.e. Replication and Transcription Activator (K-RTA). K-RTA, the latent-to-lytic switch protein, activates the expression of early (E) and late (L) lytic genes by transactivating multiple viral promoters. Expression of K-RTA is shown to be sufficient and essential to switch the latent virus to enter into the lytic phase of infection. Similarly, the virus-encoded bZIP family of protein, K8 also plays an important role in viral lytic DNA replication. Although, both K-RTA and K8 are found to be the ori-Lyt binding proteins and are required for lytic DNA replication, the detailed DNA-binding profile of these proteins in the KSHV and host genomes remains uncharacterized. In this study, using chromatin immunoprecipitation combined with high-throughput sequencing (ChIP-seq) assay, we performed a comprehensive analysis of K-RTA and K8 binding sites in the KSHV and human genomes in order to identify specific DNA binding sequences/motifs. We identified two novel K-RTA binding motifs, (i.e. AGAGAGAGGA/motif RB and AGAAAAATTC/motif RV) and one K8 binding motif (i.e. AAAATGAAAA/motif KB), respectively. The binding of K-RTA/K8 proteins with these motifs and resulting transcriptional modulation of downstream genes was further confirmed by DNA electrophoretic gel mobility shift assay (EMSA), reporter promoter assay, Chromatin Immunoprecipitation (ChIP) assay and mRNA quantitation assay. Our data conclusively shows that K-RTA/K8 proteins specifically bind to these motifs on the host/viral genomes to modulate transcription of host/viral genes during KSHV lytic reactivation.
Collapse
Affiliation(s)
- Rajeev Kaul
- Department of Microbiology, University of Delhi South Campus, New Delhi, India
| | - Pravinkumar Purushothaman
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, Nevada, United States of America
| | - Timsy Uppal
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, Nevada, United States of America
| | - Subhash C. Verma
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, Nevada, United States of America
| |
Collapse
|
9
|
Moore KJ, Sussman DA, Koru-Sengul T. Age-Specific Risk Factors for Advanced Stage Colorectal Cancer, 1981-2013. Prev Chronic Dis 2018; 15:E106. [PMID: 30148425 PMCID: PMC6110401 DOI: 10.5888/pcd15.170274] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Epidemiologic studies have identified an increase in colorectal cancer (CRC) among younger adults. By using a statewide population-based cancer registry, this study examines sociodemographic and clinical disparities in CRC and characterizes advanced stage CRC risk factors with specific attention to age-specific risk factors. METHODS Data from the Florida Cancer Data System from 1981 through 2013 were analyzed for adult CRC patients. Patients were divided into 2 age groups: younger than 50 years and 50 years or older. Stage of presentation was categorized as early (localized) or advanced (regional or distant). Multivariable logistic regression models adjusted for sociodemographic and clinical characteristics were fitted to identify risk factors for advanced stage CRC presentation. Adjusted odds ratios were calculated with 95% confidence intervals. RESULTS From 1981 through 2013, there were 182,095 Florida adults diagnosed with CRC. Those aged younger than 50 years were significantly more likely to have advanced stage CRC compared with those aged 50 or older. Among those younger than 50 years, current and former tobacco smokers and those of black or other race were significantly more likely to have advanced stage CRC. Among those aged 50 or older, Hispanics had significantly higher risk of advanced stage presentation compared with non-Hispanics, although this association was not significant in those younger than 50 years. CONCLUSION We identified significant age-specific risk factors for advanced stage CRC presentation. With CRC incidence on the rise among younger adults, it is important to identify and to target screening and interventions for groups at high risk for advanced stage CRC presentation.
Collapse
Affiliation(s)
- Kevin J Moore
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida
| | - Daniel A Sussman
- Department of Medicine, University of Miami School of Medicine, Miami, Florida.,Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida.,Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, Florida.,Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14 St, Locator code R669, Miami, FL 33136.
| |
Collapse
|
10
|
Martinez Tyson D, Medina-Ramirez P, Vázquez-Otero C, Gwede CK, Babilonia MB, McMillan SC. Initial evaluation of the validity and reliability of the culturally adapted Spanish CaSUN (S-CaSUN). J Cancer Surviv 2018; 12:509-518. [PMID: 29623531 DOI: 10.1007/s11764-018-0689-5] [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: 11/15/2017] [Accepted: 03/13/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE There is a dearth of knowledge and limited research on the needs of Hispanic male cancer survivors (HMCSs). There is a clear need for the development of culturally and linguistically adapted needs assessment tools that are valid and reliable for use among the growing HMCS population. Thus, the purpose of this paper is to describe the field testing and psychometric evaluation of the translated and culturally adapted Spanish Cancer Survivor Unmet Needs Measure (S-CaSUN). METHODS Hispanic male cancer survivors (n = 84) completed the Spanish CaSUN (S-CaSUN), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General Population (FACT-GP). Construct validity of the S-CaSUN was assessed by correlation analysis among aforesaid measures. A test-retest procedure with 2-week delay was used to examine reproducibility with a participant subsample (n = 50). Cronbach's alpha was computed to assess internal consistency of the S-CaSUN. RESULTS Construct validity of the S-CaSUN was estimated by moderate correlation with the HADS anxiety (r = 0.55, P < 0.001) and depression scales (r = 0.60, P < 0.001) and the FACT-GP (r = - 0.62, P < 0.001). The test-retest correlation coefficient for the S-CaSUN was 0.78. Cronbach's alpha was 0.96. Field testing yielded a mean S-CaSUN score of 38.3 (SD = 26.2); all needs and positive change items were endorsed. CONCLUSION Findings from field testing and preliminary psychometric evaluation of the S-CaSUN provide initial evidence of validity and reliability of the measure and highlight the importance of going beyond translation when adapting measures to take culture, literacy, and language into consideration. IMPLICATIONS FOR CANCER SURVIVORS Reliable, culturally, and linguistically valid instruments facilitate identification of unique unmet needs of Hispanic cancer survivors that, in turn, can be addressed with evidence-based interventions. As cancer centers continue to develop survivorship programs, the S-CaSUN may be useful for a growing group of cancer survivors.
Collapse
Affiliation(s)
- Dinorah Martinez Tyson
- Department of Community and Family Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA.
| | | | - Coralia Vázquez-Otero
- Department of Community and Family Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA
| | - Clement K Gwede
- Health Outcomes and Behavior, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Oncologic Sciences, Morsani College of Medicine, Tampa, FL, USA
| | | | | |
Collapse
|
11
|
Wasserman M, Bender D, Lee SYD. Use of Preventive Maternal and Child Health Services by Latina Women. Med Care Res Rev 2016; 64:4-45. [PMID: 17213456 DOI: 10.1177/1077558706296238] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Some health indicators for Latinos tend to be more positive than socioeconomic status would predict. Yet, Latina women and their young children use fewer preventive health services and have a higher incidence of preventable diseases than non-Hispanic whites. The Institute of Medicine recently called for intervention research among minority subgroups to end racial and ethnic disparities in health care. To help guide future intervention research, this article presents a critique and synthesis of the peer-reviewed literature on interventions that enroll Latina women into preventive reproductive health services (prenatal care, cervical cancer screening, and child immunizations). Results are presented according to three categories of interventions: improvements within formal health care settings, outreach through lay health advisors ( promotoras) and media, and interventions combining these approaches. An agenda for intervention research is proposed for preventive-care use by this population.
Collapse
|
12
|
Penedo FJ, Yanez B, Castañeda SF, Gallo L, Wortman K, Gouskova N, Simon M, Arguelles W, Llabre M, Sanchez-Johnsen L, Brintz C, Gonzalez P, Van Horn L, Rademaker AW, Ramirez AG. Self-Reported Cancer Prevalence among Hispanics in the US: Results from the Hispanic Community Health Study/Study of Latinos. PLoS One 2016; 11:e0146268. [PMID: 26808047 PMCID: PMC4726570 DOI: 10.1371/journal.pone.0146268] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/15/2015] [Indexed: 02/07/2023] Open
Abstract
Cancer has surpassed heart disease as the leading cause of death among Hispanics in the U.S., yet data on cancer prevalence and risk factors in Hispanics in regard to ancestry remain scarce. This study sought to describe (a) the prevalence of cancer among Hispanics from four major U.S. metropolitan areas, (b) cancer prevalence across Hispanic ancestry, and (c) identify correlates of self-reported cancer prevalence. Participants were 16,415 individuals from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), who self-identified as Cuban, Dominican, Mexican, Puerto Rican, Central or South American. All data were collected at a single time point during the HCHS/SOL baseline clinic visit. The overall self-reported prevalence rate of cancer for the population was 4%. The rates varied by Hispanic ancestry group, with individuals of Cuban and Puerto Rican ancestry reporting the highest cancer prevalence. For the entire population, older age (OR = 1.47, p < .001, 95% CI, 1.26-1.71) and having health insurance (OR = 1.93, p < .001, 95% CI, 1.42-2.62) were all significantly associated with greater prevalence, whereas male sex was associated with lower prevalence (OR = 0.56, p < .01, 95% CI, .40-.79). Associations between study covariates and cancer prevalence also varied by Hispanic ancestry. Findings underscore the importance of sociodemographic factors and health insurance in relation to cancer prevalence for Hispanics and highlight variations in cancer prevalence across Hispanic ancestry groups. Characterizing differences in cancer prevalence rates and their correlates is critical to the development and implementation of effective prevention strategies across distinct Hispanic ancestry groups.
Collapse
Affiliation(s)
- Frank J. Penedo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
- * E-mail:
| | - Betina Yanez
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Sheila F. Castañeda
- Institute For Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Linda Gallo
- Department of Psychology, San Diego State University, San Diego, CA, United States of America
| | - Katy Wortman
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Natalia Gouskova
- Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Melissa Simon
- Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - William Arguelles
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Maria Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Lisa Sanchez-Johnsen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Carrie Brintz
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Patricia Gonzalez
- Institute For Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Alfred W. Rademaker
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Amelie G. Ramirez
- Institute for Health Promotion, University of Texas Health Science Center, San Antonio, TX, United States of America
| |
Collapse
|
13
|
Patel MI, Wang A, Kapphahn K, Desai M, Chlebowski RT, Simon MS, Bird CE, Corbie-Smith G, Gomez SL, Adams-Campbell LL, Cote ML, Stefanick ML, Wakelee HA. Racial and Ethnic Variations in Lung Cancer Incidence and Mortality: Results From the Women's Health Initiative. J Clin Oncol 2015; 34:360-8. [PMID: 26700122 DOI: 10.1200/jco.2015.63.5789] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE This study aimed to evaluate racial/ethnic differences in lung cancer incidence and mortality in the Women's Health Initiative Study, a longitudinal prospective cohort evaluation of postmenopausal women recruited from 40 clinical centers. METHODS Lung cancer diagnoses were centrally adjudicated by pathology review. Baseline survey questionnaires collected sociodemographic and health information. Logistic regression models estimated incidence and mortality odds by race/ethnicity adjusted for age, education, calcium/vitamin D, body mass index, smoking (status, age at start, duration, and pack-years), alcohol, family history, oral contraceptive, hormones, physical activity, and diet. RESULTS The cohort included 129,951 women--108,487 (83%) non-Hispanic white (NHW); 10,892 (8%) non-Hispanic black (NHB); 4,882 (4%) Hispanic; 3,696 (3%) Asian/Pacific Islander (API); 534 (< 1%) American Indian/Alaskan Native; and 1,994 (1%) other. In unadjusted models, Hispanics had 66% lower odds of lung cancer compared with NHW (odds ratio [OR], 0.34; 95% CI, 0.2 to 0.5), followed by API (OR, 0.45; 95% CI, 0.27 to 0.75) and NHB (OR, 0.75; 95% CI, 0.59 to 0.95). In fully adjusted multivariable models, the decreased lung cancer risk for Hispanic compared with NHW women attenuated to the null (OR, 0.59; 95% CI, 0.35 to 0.99). In unadjusted models Hispanic and API women had decreased risk of death compared with NHW women (OR, 0.30 [95% CI, 0.15 to 0.62] and 0.34 [95% CI, 0.16 to 0.75, respectively); however, no racial/ethnic differences were found in risk of lung cancer death in fully adjusted models. CONCLUSION Differences in lung cancer incidence and mortality are associated with sociodemographic, clinical, and behavioral factors. These findings suggest modifiable exposures and behaviors may contribute to differences in incidence of and mortality by race/ethnicity for postmenopausal women. Interventions focused on these factors may reduce racial/ethnic differences in lung cancer incidence and mortality.
Collapse
Affiliation(s)
- Manali I Patel
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC.
| | - Ange Wang
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Kristopher Kapphahn
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Manisha Desai
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Rowan T Chlebowski
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Michael S Simon
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Chloe E Bird
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Giselle Corbie-Smith
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Scarlett Lin Gomez
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Lucile L Adams-Campbell
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Michele L Cote
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Marcia L Stefanick
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Heather A Wakelee
- Manali I. Patel, Ange Wang, Kristopher Kapphahn, Manisha Desai, Marcia L. Stefanick, and Heather A. Wakelee, Stanford University School of Medicine; Marcia L. Stefanick, Stanford Prevention Research Center; Heather A. Wakelee, Stanford Cancer Institute, Stanford; Rowan T. Chlebowski, Harbor-University of California, Los Angeles, Medical Center, Torrance; Chloe E. Bird, RAND Corporation, Santa Monica; Scarlett Lin Gomez, Cancer Prevention Institute of California, Fremont, CA; Michael S. Simon and Michele L. Cote, Karmanos Cancer Institute Detroit, MI; Giselle Corbie-Smith, University of North Carolina, Chapel Hill, NC; and Lucile L. Adams-Campbell, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| |
Collapse
|
14
|
Menzie NS, Simmons VN, Quinn GP, Diaz DB, Piñeiro B, Jimenez J, Castro E, Brandon TH. Acceptability and Cultural Appropriateness of Self-Help Booklets for Relapse Prevention in Puerto Rico. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:585-592. [PMID: 25219544 PMCID: PMC4384999 DOI: 10.1007/s13187-014-0729-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Cigarette smoking is associated with a range of cancers and is related to five of seven leading causes of death in Puerto Rico. Minimal self-help interventions have shown promising results in reaching participants and preventing relapse from smoking. Specifically, a collection of eight self-help booklets has demonstrated efficacy (Brandon et al., 2000; 2004). Those booklets have been transcreated into Spanish, with efforts to make them culturally appropriate across a range of Hispanic cultures. We conducted a pilot study in Ponce, Puerto Rico, to evaluate the Spanish version of our smoking relapse-prevention booklets. Qualitative, semi-structured interviews were conducted with 20 current and former smokers. Interviews were conducted to elicit feedback regarding the booklet's content, cultural appropriateness, dissemination, and perceived availability of smoking cessation resources in Puerto Rico. Interviews were audiotaped and transcribed verbatim. Transcripts were coded using content analysis, with a priori codes based on the interview guide. Emergent themes were examined. Overall, participants liked the booklets' content, perceived them to be culturally appropriate, easy to read and understand. Regarding dissemination, it was recommended that the booklets be disseminated by physicians and advertised through television. Most importantly, participants reported the best way to distribute and complement the booklets would be through support groups. Participants also reported having limited knowledge about resources provided in the community to aid smoking cessation. Overall, this pilot study was able to show the cultural acceptability of the booklets and highlights the need for the dissemination of these materials among current and former smokers in Puerto Rico.
Collapse
Affiliation(s)
- Nicole S Menzie
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 4115 E. Fowler Avenue, Tampa, FL, 33617, USA,
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Savas LS, Vernon SW, Atkinson JS, Fernández ME. Effect of acculturation and access to care on colorectal cancer screening in low-income Latinos. J Immigr Minor Health 2015; 17:696-703. [PMID: 25047403 PMCID: PMC4303535 DOI: 10.1007/s10903-014-0061-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Latinos have lower colorectal cancer screening (CRCS) and survival rates compared to other race/ethnic groups. This cross-sectional study examines relationships between acculturation, access to and utilization of healthcare services, and CRCS in low-income Latinos. Bilingual data collectors conducted structured interviews with 544 Latino men and women (>50 years) residing in the Texas-Mexico border area. Using a hierarchical logistic regression model, we examined the relationship between lifetime history of any CRCS test and indicators of acculturation, healthcare utilization and access to care, adjusting for socio-demographic characteristics. Survey results revealed a 34% prevalence of CRCS. Participants reporting a provider recommendation for screening, regular check-ups, higher acculturation level, and health insurance had significantly increased odds of CRCS. Findings indicate CRCS intervention research in Latinos should focus on (1) increasing physicians' recommendations for screening, (2) promoting regular check-ups, (3) and increasing CRC prevention efforts on less acculturated and uninsured groups.
Collapse
Affiliation(s)
- Lara S Savas
- Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas-Houston School of Public Health, 7000 Fannin, UCT Suite 2520, Houston, TX, 77030, USA,
| | | | | | | |
Collapse
|
16
|
Fernández ME, Savas LS, Wilson KM, Byrd TL, Atkinson J, Torres-Vigil I, Vernon SW. Colorectal cancer screening among Latinos in three communities on the Texas-Mexico border. HEALTH EDUCATION & BEHAVIOR 2015; 42:16-25. [PMID: 24786793 PMCID: PMC4214900 DOI: 10.1177/1090198114529592] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess colorectal cancer screening (CRCS) prevalence and psychosocial correlates of CRCS among Latinos in South Texas. METHOD Using multivariable analyses, we examined the association of perceived susceptibility, self-efficacy, pros and cons, subjective norms, knowledge and fatalism on CRCS among 544 Latinos (50 years and older). RESULTS In this socioeconomically disadvantaged population, 40% had never heard of any CRCS test, only 34% reported ever completing any type of CRCS, and only 25% were adherent to CRCS guidelines. Insurance status, gender, perceived cons, CRCS self-efficacy, and CRCS norms were significantly associated with CRCS. CONCLUSION CRCS interventions in this population should focus on improving access, increasing self-efficacy and perceived norms, and decreasing negative perceptions of CRCS.
Collapse
Affiliation(s)
| | - Lara S Savas
- University of Texas School of Public Health, Houston, TX, USA
| | | | - Theresa L Byrd
- Department of Family and Community Medicine, Texas Tech Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - John Atkinson
- University of Texas School of Public Health, Houston, TX, USA
| | - Isabel Torres-Vigil
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA Dorothy I. Height Center for Health Equity & Evaluation Research, University of Houston Graduate College of Social Work, Houston, TX, USA
| | - Sally W Vernon
- University of Texas School of Public Health, Houston, TX, USA
| |
Collapse
|
17
|
Schupp CW, Press DJ, Gomez SL. Immigration factors and prostate cancer survival among Hispanic men in California: does neighborhood matter? Cancer 2014; 120:1401-8. [PMID: 24477988 PMCID: PMC5739913 DOI: 10.1002/cncr.28587] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/20/2013] [Accepted: 12/23/2013] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hispanics are more likely than other racial/ethnic groups in the United States to be diagnosed with later stage of prostate cancer, yet they have lower prostate cancer mortality rates. The authors evaluated the impact of nativity and neighborhood-level Hispanic ethnic enclave on prostate cancer survival among Hispanics. METHODS A total of 35,427 Hispanic men diagnosed with invasive prostate cancer from 1995 through 2008 in the California Cancer Registry were studied; vital status data were available through 2010. Block group-level neighborhood measures were developed from US Census data. Stage-stratified Cox proportional hazards models were used to assess the effect of nativity and ethnic enclave on prostate cancer survival. RESULTS In models adjusted for neighborhood socioeconomic status and other individual factors, foreign-born Hispanics were found to have a significantly lower risk of prostate cancer survival (hazards ratio [HR], 0.81; 95% confidence interval [95% CI], 0.75-0.87). Living in an ethnic enclave appeared to modify this effect, with the survival advantage slightly more pronounced in the high ethnic enclave neighborhoods (HR, 0.78; 95% CI, 0.71-0.86) compared with low ethnic enclave neighborhoods (HR, 0.86; 95% CI, 0.76-0.98). CONCLUSIONS Despite lower socioeconomic status, Hispanic immigrants have better survival after prostate cancer than US-born Hispanics and this pattern was more striking among those living in ethnic enclaves. Identifying the modifiable individual and neighborhood-level factors that facilitate this survival advantage in Hispanic immigrants may help to inform specific interventions to improve survival among all patients.
Collapse
|
18
|
Luo Y, Sun Z, Li Y, Liu L, Cai X, Li Z. Caudatin inhibits human hepatoma cell growth and metastasis through modulation of the Wnt/β-catenin pathway. Oncol Rep 2013; 30:2923-8. [PMID: 24064800 DOI: 10.3892/or.2013.2749] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 08/27/2013] [Indexed: 11/06/2022] Open
Abstract
In the present study, we investigated the antitumor activity of caudatin in the human hepatoma cell line SMMC‑7721 by analysis of cell viability, cell cycle distribution, apoptosis and metastasis. The results showed that caudatin impaired the cell viability and inhibited the growth of SMMC-7721 cells in a time- and dose-dependent manner and resulted in cell cycle arrest in the G2 phase. In addition, SMMC-7721 cells, treated with caudatin exhibited typical characteristics of apoptosis. Furthermore, caudatin treatment resulted in a decrease in β-catenin and GSK3β in SMMC-7721 cells, with a concomitant reduction in metastatic capability and expression of Wnt signaling pathway targeted genes including cox-2, mmp-2 and mmp-9. Our findings revealed that caudatin inhibits human hepatoma cell growth and metastasis by targeting the GSK3β/β-catenin pathway and suppressing VEGF production.
Collapse
Affiliation(s)
- Yi Luo
- Institute of First Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210046, P.R. China
| | | | | | | | | | | |
Collapse
|
19
|
Wells KJ, McIntyre J, Gonzalez LE, Lee JH, Fisher KJ, Jacobsen PB, Meade C, Muñoz-Antonia T, Quinn GP. Feasibility trial of a Spanish-language multimedia educational intervention. Clin Trials 2013; 10:767-74. [PMID: 23935161 DOI: 10.1177/1740774513495984] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hispanic cancer patients are underrepresented in clinical trials; research suggests lack of knowledge and language barriers contribute to low accrual. Multimedia materials offer advantages to Hispanic populations because they have high acceptability, are easy to disseminate, and can be viewed with family. PURPOSE Hispanic cancer patients and caregivers participated in focus groups to aid in developing a Spanish-language multimedia intervention to educate Hispanic cancer patients about clinical trials. We explored the feasibility of delivering the intervention in medical oncology clinics. METHODS A total of 35 patients were randomized to either the multimedia intervention group (n = 18) or a control group (n = 17) who were asked to read the National Cancer Institute's Spanish-language clinical trials brochure. Self-reported data on knowledge about and attitudes toward clinical trials, self-efficacy for participating in a clinical trial, intention to participate in a clinical trial if asked, and receptivity to information about a clinical trial were collected at baseline and 10 days later. RESULTS Delivery of the multimedia presentation in oncology clinics was feasible. The intervention group had more knowledge about clinical trials at follow-up than the control group; scores for intention to participate in a clinical trial by participants in the intervention group increased from 3.8 to 4.0 of a possible 5, but declined in the control group from 4.5 to 4.1. No statistically significant difference was detected between groups in scores for attitudes or self-efficacy for making a decision to participate in a clinical trial. LIMITATIONS Our sample size was inadequate to identify differences between the informational methods. Although all patients were asked about their willingness to participate in a clinical trial, this decision was hypothetical. In addition, the study was conducted with a sample of Spanish-speaking Hispanic cancer patients at a comprehensive cancer center in Florida. Thus, the results may not generalize to other Hispanic populations. CONCLUSION In the pilot project, we demonstrated the feasibility of delivering multimedia information to patients in medical oncology clinics. Because delivery in a clinical setting was found to be feasible, a larger study should be conducted to evaluate the efficacy of the multimedia intervention with respect to promoting accrual of Hispanic patients to clinical trials.
Collapse
Affiliation(s)
- Kristen J Wells
- aDepartment of Psychology, San Diego State University, San Diego, CA, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Jafri NS, Gould M, El-Serag HB, Duan Z, Davila JA. Incidence and survival of colorectal cancer among Hispanics in the United States: a population-based study. Dig Dis Sci 2013; 58:2052-60. [PMID: 23086126 DOI: 10.1007/s10620-012-2454-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 10/04/2012] [Indexed: 12/09/2022]
Abstract
BACKGROUND Hispanics are the largest and fastest growing ethnic group in the United States (US). AIMS We evaluated the incidence and survival of colorectal cancer (CRC) among this population. METHODS Data from the surveillance, epidemiology, and end results program were used to calculate CRC age-adjusted and age-specific incidence rates in Hispanics during 1993-2007. Temporal trends in CRC incidence were examined using annual percent change (APC) and Poisson regression. The 1- and 5-year survival rates were calculated. RESULTS The annual age-adjusted incidence rates for CRC in Hispanics of all ages declined from 47.4 per 100,000 in 1993-1997 to 43.8 per 100,000 in 2003-2007, with an APC during 1993-2007 equal to -0.8/year. However, there was a 45 % increase in CRC incidence among Hispanic men and women aged 20-49 years that affected both the right and left colon. The proportions of CRC cases with regional (+37 %) and distant (+18 %) spread increased, now constituting 72 % of cases diagnosed at that age. The Poisson model confirmed the increasing CRC incidence in Hispanics aged 20-49 years during 1993-2007 while adjusting for sex and geographic region. The 1-year survival improved in younger Hispanics from approximately 86 % in 1993-1997 to 91 % in 2003-2007 with no significant improvement in 5-year survival. In Hispanics aged >50 years, no significant improvements in survival were observed. CONCLUSIONS The incidence of CRC in young Hispanic men and women has increased in the US. Most are diagnosed with regional or distant disease. No significant improvement in long-term survival was observed in young Hispanics with CRC.
Collapse
Affiliation(s)
- Nadim S Jafri
- Section of Gastroenterology, The Michael E DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA
| | | | | | | | | |
Collapse
|
21
|
Mario Uribe M, Clauio Heine T, Freddy Brito M, Diana Bravo L. Actualización en cáncer de vesícula biliar. REVISTA MÉDICA CLÍNICA LAS CONDES 2013. [DOI: 10.1016/s0716-8640(13)70202-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
22
|
Quinn GP, McIntyre J, Gonzalez LE, Antonia TM, Antolino P, Wells KJ. Improving awareness of cancer clinical trials among Hispanic patients and families: audience segmentation decisions for a media intervention. JOURNAL OF HEALTH COMMUNICATION 2013; 18:1131-1147. [PMID: 23639101 PMCID: PMC4818950 DOI: 10.1080/10810730.2013.768723] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Clinical trials hold great promise for cancer treatment; yet, Hispanic cancer patients have low rates of clinical trial participation. Lack of awareness and knowledge of clinical trials and language barriers may account for low participation rates. Patient education through audiovisual materials can improve knowledge of and attitudes toward clinical trials among Hispanic populations. In this study, 36 Hispanic cancer patients/survivors and caregivers in Florida and Puerto Rico participated in focus groups to aid in developing a Spanish-language DVD and booklet intervention designed to increase knowledge about clinical trials. Focus group results showed (a) low levels of knowledge about clinical trials, (b) uncertainty about why a physician would expect a patient to make a choice about treatment, and (c) desire for family participation in decision making. Respondents expressed various preferences for aspects of the DVD such as showing extended family in the DVD and physician explanations about key terms. On the basis of these preferences, the authors developed a creative brief for a DVD. The content of the DVD was reviewed by Hispanic community leaders and key stakeholders. A final DVD was created, in Spanish, using Hispanic patients and physicians, which contained the information deemed important from the focus groups and stakeholder interviews. The DVD is complete with companion booklet and currently undergoing a randomized control trial.
Collapse
Affiliation(s)
- Gwendolyn P Quinn
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
| | | | | | | | | | | |
Collapse
|
23
|
Iglesias-Rios L, Parascandola M. A historical review of R.J. Reynolds' strategies for marketing tobacco to Hispanics in the United States. Am J Public Health 2013; 103:e15-27. [PMID: 23488493 DOI: 10.2105/ajph.2013.301256] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds' marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February-July 2011 and April-August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities.
Collapse
Affiliation(s)
- Lisbeth Iglesias-Rios
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20892, USA.
| | | |
Collapse
|
24
|
Simone CB, Hampshire MK, Vachani C, Metz JM. The utilization of oncology web-based resources in Spanish-speaking Internet users. Am J Clin Oncol 2012; 35:520-6. [PMID: 21654312 PMCID: PMC3171691 DOI: 10.1097/coc.0b013e31821d4906] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES There currently are few web-based resources written in Spanish providing oncology-specific information. This study examines utilization of Spanish-language oncology web-based resources and evaluates oncology-related Internet browsing practices of Spanish-speaking patients. METHODS OncoLink (http://www.oncolink.org) is the oldest and among the largest Internet-based cancer information resources. In September 2005, OncoLink pioneered OncoLink en español (OEE) (http://es.oncolink.org), a Spanish translation of OncoLink. Internet utilization data on these sites for 2006 to 2007 were compared. RESULTS Visits to OncoLink rose from 4,440,843 in 2006 to 5,125,952 in 2007. OEE had 204,578 unique visitors and 240,442 visits in 2006, and 351,228 visitors and 412,153 visits in 2007. Although there was no time predilection for viewing OncoLink, less relative browsing on OEE was conducted during weekends and early morning hours. Although OncoLink readers searched for information on the most common cancers in the United States, OEE readers most often search for gastric, vaginal, osteosarcoma, leukemia, penile, cervical, and testicular malignancies. Average visit duration on OEE was shorter, and fewer readers surveyed OEE more than 15 minutes (4.5% vs. 14.9%, P < 0.001). CONCLUSIONS Spanish-speaking users of web-based oncology resources are increasingly using the Internet to supplement their cancer knowledge. Limited available resources written in Spanish contribute to disparities in information access and disease outcomes. Spanish-speaking oncology readers differ from English-speaking readers in day and time of Internet browsing, visit duration, Internet search patterns, and types of cancers searched. By acknowledging these differences, content of web-based oncology resources can be developed to best target the needs of Spanish-speaking viewers.
Collapse
Affiliation(s)
- Charles B Simone
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
| | | | | | | |
Collapse
|
25
|
Jonnalagadda S, Lin JJ, Nelson JE, Powell CA, Salazar-Schicchi J, Berman AR, Keller SM, Smith CB, Lurslurchachai L, Halm EA, Leventhal H, Wisnivesky JP. Racial and ethnic differences in beliefs about lung cancer care. Chest 2012; 142:1251-1258. [PMID: 22700777 PMCID: PMC3494476 DOI: 10.1378/chest.12-0330] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 05/05/2012] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Disparities in lung cancer treatment and palliative care are well documented. However,the mechanisms underlying these disparities are not fully understood. In this study, we evaluated racial and ethnic differences in beliefs and attitudes about lung cancer treatment and palliative care among patients receiving a new diagnosis of lung cancer. METHODS Patients were recruited from four medical centers in New York City and surveyed about their beliefs regarding lung cancer care, including disease-directed treatments, palliative and end-of-life care, and fatalistic and spiritual beliefs. We used univariate and multiple regression analyses to compare the distribution of beliefs among minority (black and Hispanic) and nonminority patients. RESULTS Of the 335 patients, 21% were black, 20% were Hispanic, and 59% were nonminority. Beliefs about chemotherapy and radiotherapy were similar across the three groups ( P > .05),whereas black patients were more likely to believe that surgery might cause lung cancer to spread( P =.008). Fatalistic beliefs potentially affecting cancer treatment were more common among both minority groups ( P ≤ .02). No signifi cant differences were found in attitudes toward clinician communication about cancer prognosis ( P > .05). However, both blacks and Hispanics were more likely to have misconceptions about advance directives and hospice care ( P ≤ .02). CONCLUSIONS Similarities and differences in beliefs about disease-directed treatment were observed between minority and nonminority patients with lung cancer. Minority patients hold more fatalistic views about the disease and misperceptions about advance care planning and hospice care. Further research is needed to assess the impact of these beliefs on decisions about lung cancer care and patient outcomes.
Collapse
Affiliation(s)
- Sirisha Jonnalagadda
- University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, NJ
| | - Jenny J Lin
- Division of General Internal Medicine, New York, NY
| | - Judith E Nelson
- Division of Pulmonary, Critical Care and Sleep Medicine, New York, NY; Hertzberg Palliative Care Institute, Brookdale Department of Geriatrics and Palliative Medicine, The Mount Sinai Hospital, New York, NY
| | - Charles A Powell
- Division of Pulmonary, Critical Care and Sleep Medicine, New York, NY
| | | | - Andrew R Berman
- Division of Pulmonary and Critical Care Medicine, University of Medicine and Dentistry of New Jersey, Newark, NJ
| | - Steven M Keller
- Department of Thoracic Surgery, Albert Einstein College of Medicine, Bronx, NY
| | - Cardinale B Smith
- Division of Hematology and Oncology, Mount Sinai School of Medicine, New York, NY; Hertzberg Palliative Care Institute, Brookdale Department of Geriatrics and Palliative Medicine, The Mount Sinai Hospital, New York, NY
| | | | - Ethan A Halm
- Department of Medicine, University of Texas Southwestern, Dallas, TX
| | | | - Juan P Wisnivesky
- Division of General Internal Medicine, New York, NY; Division of Pulmonary, Critical Care and Sleep Medicine, New York, NY.
| |
Collapse
|
26
|
Cokkinides VE, Bandi P, Siegel RL, Jemal A. Cancer-related risk factors and preventive measures in US Hispanics/Latinos. CA Cancer J Clin 2012; 62:353-63. [PMID: 22987448 DOI: 10.3322/caac.21155] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In this article, we provide prevalence data on major cancer-related risk factors, early detection testing, and vaccination among Hispanics using nationally representative surveys. Compared with non-Hispanic whites, Hispanic adults are less likely to be current smokers (13% vs 22%) or frequent alcohol drinkers, but they are more likely to be obese (32% vs 26%) and to have lower levels of mammography use within the past year (46% vs 51%), colorectal screening as per recommended intervals (47% vs 61%), and Papanicolaou (Pap) test use within the past 3 years (74% vs 79%). Within the Hispanic population, the prevalence of these risk factors and early detection methods substantially vary by country of origin. For example, Cuban men (20.7%) and Puerto Rican men (19%) had the highest levels of current smoking than any other Hispanic subgroups, while Mexican women had the lowest levels of mammogram use (44%) and Pap test use (71%). Hispanic migrants have a higher prevalence of hepatitis B virus and Helicobacter pylori, which cause liver and stomach cancer, respectively. Among Hispanic adolescents, tobacco use (eg, 20.8% use of any tobacco products), alcohol use (42.9%), and obesity (23.2%) remain highly prevalent risk factors. Although 56% of Hispanic adolescents initiate human papillomavirus vaccination, only 56% of them completed the 3-dose series. Differences in risk factors and early detection testing among Hispanic groups should be considered in clinical settings and for cancer control planning.
Collapse
|
27
|
Descriptive epidemiology of gastric adenocarcinoma in the state of Texas by ethnicity: Hispanic versus White non-Hispanic. Gastric Cancer 2012; 15:405-13. [PMID: 22252153 DOI: 10.1007/s10120-011-0127-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 12/03/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND We aimed to evaluate the clinicopathological and demographic characteristics of gastric adenocarcinoma in Hispanics and compare these trends with those found in non-Hispanic Whites in Texas. METHODS Records of patients with gastric adenocarcinoma found in the Texas Cancer Registry from 1995 to 2006 were reviewed. Four ethnic-geographic groups were formed: Hispanics residing in El Paso County (a county on the Texas-Mexico border), White non-Hispanics in El Paso County, Hispanics from the remaining counties of Texas combined, and White non-Hispanics from the remaining counties of Texas combined. Adjusted prevalence ratios (PRs) for the outcome of late stage at diagnosis were calculated. RESULTS Of 9949 patients, 561 patients were El Paso County residents, of whom 83% were Hispanics. Among the four ethnic-geographic groups, the age-adjusted incidence was the highest in Hispanics in El Paso County (15.5 cases/100000). Tumor pathobiology varied by ethnicity. White non-Hispanics were more likely than Hispanics to have a proximal tumor and less likely to have a poorly differentiated or undifferentiated tumor. In El Paso County, patients in each of the eight age groups under 75 years compared to patients aged ≥85 years were significantly more likely to be at late stage (adjusted PRs 1.44-1.71). CONCLUSION The incidence of gastric adenocarcinoma is higher in Hispanics than in Whites in both El Paso County and the remaining portion of Texas. Hispanics have a higher grade of gastric adenocarcinoma. The prevalence of late stage at the time of diagnosis is higher in younger patients than in older patients.
Collapse
|
28
|
Hernandez MN, Sussman DA, Lee DJ, Mackinnon JA, Fleming LE. Trends in colorectal cancer among hispanics by stage and subsite location: 1989-2006. Clin Transl Gastroenterol 2012; 3:e21. [PMID: 23238348 PMCID: PMC3464804 DOI: 10.1038/ctg.2012.15] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES: Hispanic colorectal cancer (CRC) rates historically have been lower than for non-Hispanic Whites in the United States and in Florida. The aim of this study is to understand CRC trends in Florida Hispanics and non-Hispanic Whites. METHODS: Using a cross-sectional study design, all invasive CRCs diagnosed among Florida residents between 1989 and 2006 were accessed from the Florida Cancer Data System (FCDS). These cases were analyzed by Hispanic and non-Hispanic White ethnic identification. The Hispanic Origin Identification Algorithm was applied to the FCDS data to identify Hispanic subjects. Primary cancer site and histology data were organized according to SEER (Surveillance Epidemiology and End Results) categories. Joinpoint regression was used to generate incidence trends by stage and subsite location. RESULTS: Rates of CRC incidence were higher for Florida Hispanics compared with non-Hispanic Whites since the mid 1990s. There was a consistent significant increase in the incidence of distant stage CRC in Hispanics (annual percent change (APC) of 1.26 and 0.90 in males and females), whereas rates in non-Hispanics decreased significantly during the same time period (APC −1.36 and −1.28, respectively). Similar trends were found in distant-stage right-sided CRC. Among right-sided CRCs, local stage incidence rate increased for both non-Hispanic Whites and Hispanics, whereas the incidence rate for regional stage decreased for both racial/ethnic groups. CONCLUSIONS: Trends for distant-stage CRC are increasing among Florida Hispanics. This is a particular public health concern given that CRC is a cancer for which screening modalities exist and could imply a concomitant increase in CRC-related mortality among Florida Hispanics. Lower rates of CRC screening in Hispanics are documented at the state level, relative to non-Hispanic Whites. Screening programs targeting the Florida Hispanic population are warranted.
Collapse
Affiliation(s)
- M N Hernandez
- Florida Cancer Data System, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | | | | | | |
Collapse
|
29
|
Saeed AM, Toonkel R, Glassberg MK, Nguyen D, Hu JJ, Zimmers TA, Robbins DJ, Koniaris LG, Lally BE. The influence of Hispanic ethnicity on nonsmall cell lung cancer histology and patient survival: an analysis of the Survival, Epidemiology, and End Results database. Cancer 2012; 118:4495-501. [PMID: 22528551 DOI: 10.1002/cncr.26686] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 08/29/2011] [Accepted: 09/30/2011] [Indexed: 11/05/2022]
Abstract
BACKGROUND Most studies exploring ethnic/racial disparities in nonsmall cell lung cancer (NSCLC) compare black patients with whites. Currently, the effect of Hispanic ethnicity on the overall survival of NSCLC is poorly understood. Therefore, the authors carried out a large-scale, population-based analysis using the Surveillance, Epidemiology, and End Results (SEER) data base to determine the impact of Hispanic ethnicity the survival of patients with NSCLC. METHODS The authors identified 172,398 adult patients with pathologically confirmed NSCLC from the SEER data base who were diagnosed between 1988 and 2007. A multivariate Cox proportional hazards regression analysis was used to determine the impact of race/ethnicity on overall survival. Pair-wise comparisons were used to determine whether Hispanic ethnicity influenced NSCLC histology or stage at diagnosis. RESULTS Compared with non-Hispanic white patients, Hispanic white patients had a statistically significant better overall survival (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.83-0.87), and black patients had worse survival (HR, 1.091; 95% CI, 1.072-1.109). Within the bronchioalveolar carcinoma (BAC) subtype, Hispanic-white patients tend to be over represented (8.1% Hispanic whites vs 5.5% non-Hispanic whites vs 3.7% blacks; P < .001). CONCLUSIONS The current study demonstrated that Hispanic-white patients with NSCLC had a decreased risk for overall mortality compared with non-Hispanic whites and blacks. Moreover, Hispanic patients were over represented within the BAC histologic subtype. Thus, the overall survival advantage of Hispanic NSCLC patients may be because of their predilection toward developing certain histologic subtypes of NSCLC. Further studies are warranted to determine the etiologies of such predilections and may reveal certain genetic, environmental, and/or epigenetic factors associated with Hispanic ethnicity.
Collapse
Affiliation(s)
- Ali M Saeed
- Department of Radiation Oncology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Liang Y, Messer JC, Louden C, Jimenez-Rios MA, Thompson IM, Camarena-Reynoso HR. Prostate cancer risk prediction in a urology clinic in Mexico. Urol Oncol 2012; 31:1085-92. [PMID: 22306115 DOI: 10.1016/j.urolonc.2011.12.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 12/28/2011] [Accepted: 12/28/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES To evaluate factors affecting the risk of prostate cancer (CaP) and high-grade disease (HGCaP, Gleason score ≥ 7) in a Mexican referral population, with comparison to the Prostate Cancer Prevention Trial Prostate Cancer Risk Calculator (PCPTRC). METHODS AND MATERIALS From a retrospective study of 826 patients who underwent prostate biopsy between January 2005 and December 2009 at the Instituto Nacional de Cancerología, Mexico, logistic regression was used to assess the effects of age, prostate-specific antigen (PSA), digital rectal exam (DRE), first-degree family history of CaP, and history of a prior prostate biopsy on CaP and HGCaP, separately. Internal discrimination, goodness-of-fit, and clinical utility of the resulting models were assessed with comparison to the PCPTRC. RESULTS Rates of both CaP (73.2%) and HGCaP (33.3%) were high among referral patients in this Mexican urology clinic. The PCPTRC generally underestimated the risk of CaP but overestimated the risk of HGCaP. Four factors influencing CaP on biopsy were logPSA, DRE, family history and a prior biopsy history (all P < 0.001). The internal AUC of the logistic model was 0.823 compared with 0.785 of the PCPTRC for CaP (P < 0.001). The same 4 factors were significantly associated with HGCaP as well and the AUC was 0.779 compared with 0.766 of the PCPTRC for HGCaP (P = 0.13). CONCLUSIONS Lack of screening programs or regular urologic checkups in Mexico imply that men typically first reach specialized clinics with a high cancer risk. This renders diagnostic tools developed on comparatively healthy populations, such as the PCPTRC, of lesser utility. Continued efforts are needed to develop and externally validate new clinical diagnostic tools specific to high-risk referral populations incorporating new biomarkers and more clinical characteristics.
Collapse
Affiliation(s)
- Yuanyuan Liang
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, TX 78229, USA; Department of Urology, UTHSCSA, San Antonio, TX 78229, USA; School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Cancer Therapy and Research Center, UTHSCSA, San Antonio, TX 78229, USA.
| | | | | | | | | | | |
Collapse
|
31
|
Language use and adherence to multiple cancer preventive health behaviors among Hispanics. J Immigr Minor Health 2011; 13:849-59. [PMID: 21431332 DOI: 10.1007/s10903-011-9456-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Hispanics have lower cancer mortality rates than non-Hispanic Whites and Blacks, despite demographic profiles previously associated with higher cancer mortality. Differences in adherence to multiple cancer-preventive behaviors by acculturation may offer one explanation for this "Hispanic paradox," but the relationship is not well understood. We examined this relationship using the 2000 National Health Interview Survey, which provides cross-sectional data on a nationally representative sample of US Hispanics. Multinomial logistic regression models estimated relationships between language use (a measure of acculturation) and patterns of adherence, by gender, to multiple cancer-preventive health behaviors using adherence scores. Hispanics had greater odds of adherence to multiple behaviors compared to Non-Hispanics (OR = 2.76 [2.27, 3.36]). Hispanics with greater English language use had lower odds of adherence (OR = 0.45 [0.29, 0.69]). Women were more adherent than men (P < 0.01) and their language use was associated with patterns of behavioral adherence more so than among men. Differences by gender and language use were identified in patterns of adherence to behavioral recommendations among the Hispanic population. Greater English language use was negatively associated with tobacco, alcohol, fruit and vegetable recommendation adherence but not with exercise. Study findings support evidence behaviors occur in combination and contributes to understanding of the role of language use in patterns of behavioral adherence.
Collapse
|
32
|
Banegas MP, Gail MH, LaCroix A, Thompson B, Martinez ME, Wactawski-Wende J, John EM, Hubbell FA, Yasmeen S, Katki HA. Evaluating breast cancer risk projections for Hispanic women. Breast Cancer Res Treat 2011; 132:347-53. [PMID: 22147080 DOI: 10.1007/s10549-011-1900-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 11/23/2011] [Indexed: 10/14/2022]
Abstract
For Hispanic women, the Breast Cancer Risk Assessment Tool (BCRAT; "Gail Model") combines 1990-1996 breast cancer incidence for Hispanic women with relative risks for breast cancer risk factors from non-Hispanic white (NHW) women. BCRAT risk projections have never been comprehensively evaluated for Hispanic women. We compared the relative risks and calibration of BCRAT risk projections for 6,353 Hispanic to 128,976 NHW postmenopausal participants aged 50 and older in the Women's Health Initiative (WHI). Calibration was assessed by the ratio of the number of breast cancers observed with that expected by the BCRAT (O/E). We re-evaluated calibration for an updated BCRAT that combined BCRAT relative risks with 1993-2007 breast cancer incidence that is contemporaneous with the WHI. Cox regression was used to estimate relative risks. Discriminatory accuracy was assessed using the concordance statistic (AUC). In the WHI Main Study, the BCRAT underestimated the number of breast cancers by 18% in both Hispanics (O/E = 1.18, P = 0.06) and NHWs (O/E = 1.18, P < 0.001). Updating the BCRAT improved calibration for Hispanic women (O/E = 1.08, P = 0.4) and NHW women (O/E = 0.98, P = 0.2). For Hispanic women, relative risks for number of breast biopsies (1.71 vs. 1.27, P = 0.03) and age at first birth (0.97 vs. 1.24, P = 0.02) differed between the WHI and BCRAT. The AUC was higher for Hispanic women than NHW women (0.63 vs. 0.58, P = 0.03). Updating the BCRAT with contemporaneous breast cancer incidence rates improved calibration in the WHI. The modest discriminatory accuracy of the BCRAT for Hispanic women might improve by using risk factor relative risks specific to Hispanic women.
Collapse
Affiliation(s)
- Matthew P Banegas
- School of Public Health, Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Le MD, Henson D, Young H, Albores-Saavedra J. Is gallbladder cancer decreasing in view of increasing laparoscopic cholecystectomy? Ann Hepatol 2011. [PMID: 21677332 DOI: 10.1016/s1665-2681(19)31542-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Affiliation(s)
- My Di Le
- Department of Epidemiology and Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC, USA
| | | | | | | |
Collapse
|
34
|
Lopez-McKee G, Bader J. Validation of the English and Spanish Mammography Beliefs and Attitudes Questionnaire. ONLINE JOURNAL OF ISSUES IN NURSING 2011; 16:9. [PMID: 22088158 DOI: 10.3912/ojin.vol16no02ppt02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breast cancer is the leading cause of cancer deaths among Hispanic women in the United States. Unfortunately Hispanic women exhibit poor mammography screening participation, are diagnosed at later stages of the disease, and have lower survival rates than non-Hispanic white women. Several cultural and psycho-social factors have been found to influence mammography screening participation among Hispanic women. We will begin by presenting the theoretical framework that grounded this research program to develop an instrument to assess factors contributing to poor mammography participation among Hispanic women. We will also summarize the early stages in the development of the English and Spanish Mammography Beliefs and Attitudes Questionnaire (MBAQ and SMBAQ) for use with low-health-literacy Mexican-American women. Next we will describe the initial psychometric testing of the MBAQ/SMBAQ, after which we will present the psychometric testing of the SMBAQ with low-health-literacy women. This will be followed by a discussion of the modification of the MBAQ and SMBAQ subscales. We'll conclude with a discussion of the instruments and share our assessment regarding the limitations of this research program, where the program stands to date, and the implications for practice and future research.
Collapse
|
35
|
Case studies in the co-production of populations and genetics: The making of ‘at risk populations’ in BRCA genetics. BIOSOCIETIES 2010. [DOI: 10.1057/biosoc.2010.27] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
36
|
Keegan THM, Quach T, Shema S, Glaser SL, Gomez SL. The influence of nativity and neighborhoods on breast cancer stage at diagnosis and survival among California Hispanic women. BMC Cancer 2010; 10:603. [PMID: 21050464 PMCID: PMC2988754 DOI: 10.1186/1471-2407-10-603] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 11/04/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the US, foreign-born Hispanics tend to live in socioeconomic conditions typically associated with later stage of breast cancer diagnosis, yet they have lower breast cancer mortality rates than their US-born counterparts. We evaluated the impact of nativity (US- versus foreign-born), neighborhood socioeconomic status (SES) and Hispanic enclave (neighborhoods with high proportions of Hispanics or Hispanic immigrants) on breast cancer stage at diagnosis and survival among Hispanics. METHODS We studied 37,695 Hispanic women diagnosed from 1988 to 2005 with invasive breast cancer from the California Cancer Registry. Nativity was based on registry data or, if missing, imputed from case Social Security number. Neighborhood variables were developed from Census data. Stage at diagnosis was analyzed with logistic regression, and survival, based on vital status determined through 2007, was analyzed with Cox proportional hazards regression. RESULTS Compared to US-born Hispanics, foreign-born Hispanics were more likely to be diagnosed at an advanced stage of breast cancer (adjusted odds ratio (OR) = 1.14, 95% confidence interval (CI): 1.09-1.20), but they had a somewhat lower risk of breast cancer specific death (adjusted hazard ratio (HR) = 0.94, 95% CI: 0.90-0.99). Living in low SES and high enclave neighborhoods was associated with advanced stage of diagnosis, while living in a lower SES neighborhood, but not Hispanic enclave, was associated with worse survival. CONCLUSION Identifying the modifiable factors that facilitate this survival advantage in Hispanic immigrants could help to inform specific interventions to improve survival in this growing population.
Collapse
|
37
|
Krankl JT, Shaykevich S, Lipsitz S, Lehmann LS. Patient predictors of colposcopy comprehension of consent among English- and Spanish-speaking women. Womens Health Issues 2010; 21:80-5. [PMID: 20833068 DOI: 10.1016/j.whi.2010.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 07/22/2010] [Accepted: 07/26/2010] [Indexed: 11/17/2022]
Abstract
PURPOSE patients with limited English proficiency may be at increased risk for diminished understanding of clinical procedures. This study sought to assess patient predictors of comprehension of colposcopy information during informed consent and to assess differences in understanding between English and Spanish speakers. METHODS between June and August 2007, English- and Spanish-speaking colposcopy patients at two Boston hospitals were surveyed to assess their understanding of the purpose, risks, benefits, alternatives, and nature of colposcopy. Patient demographic information was collected. FINDINGS there were 183 women who consented to participate in the study. We obtained complete data on 111 English speakers and 38 Spanish speakers. English speakers were more likely to have a higher education, greater household income, and private insurance. Subjects correctly answered an average of 7.91 ± 2.16 (72%) of 11 colposcopy survey questions. English speakers answered more questions correctly than Spanish speakers (8.50 ± 1.92 [77%] vs 6.21 ± 1.93 [56%]; p < .001). Using linear regression to adjust for confounding variables, we found that language was not significantly associated with greater understanding (p = .46). Rather, education was the most significant predictor of colposcopy knowledge (p < .001). CONCLUSION many colposcopy patients did not understand the procedure well enough to give informed consent. The observed differences in colposcopy comprehension based on language were a proxy for differences in education. Education, not language, predicted subjects' understanding of colposcopy. These results demonstrate the need for greater attention to patients' educational background to ensure adequate understanding of clinical information.
Collapse
|
38
|
Patricio Trincado M. Visión global de la medicina preventiva en chile. REVISTA MÉDICA CLÍNICA LAS CONDES 2010. [DOI: 10.1016/s0716-8640(10)70587-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
39
|
Keegan THM, John EM, Fish KM, Alfaro-Velcamp T, Clarke CA, Gomez SL. Breast cancer incidence patterns among California Hispanic women: differences by nativity and residence in an enclave. Cancer Epidemiol Biomarkers Prev 2010; 19:1208-18. [PMID: 20447917 DOI: 10.1158/1055-9965.epi-10-0021] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Breast cancer incidence is higher in U.S.-born Hispanic women than foreign-born Hispanics, but no studies have examined how these rates have changed over time. To better inform cancer control efforts, we examined incidence trends by nativity and incidence patterns by neighborhood socioeconomic status (SES) and Hispanic enclave (neighborhoods with high proportions of Hispanics or Hispanic immigrants). METHODS Information about all Hispanic women diagnosed with invasive breast cancer between 1988 and 2004 was obtained from the California Cancer Registry. Nativity was imputed from Social Security number for the 27% of cases with missing birthplace information. Neighborhood variables were developed from Census data. RESULTS From 1988 to 2004, incidence rates for U.S.-born Hispanics were parallel but lower than those of non-Hispanic whites, showing an annual 6% decline from 2002 to 2004. Foreign-born Hispanics had an annual 4% increase in incidence rates from 1995 to 1998 and a 1.4% decline thereafter. Rates were 38% higher for U.S.- than foreign-born Hispanics, with elevations more pronounced for localized than regional/distant disease, and for women>50 years of age. Residence in higher SES and lower Hispanic enclave neighborhoods were independently associated with higher incidence, with Hispanic enclave having a stronger association than SES. CONCLUSIONS Compared with foreign-born, U.S.-born Hispanic women in California had higher prevalence of breast cancer risk factors, suggesting that incidence patterns largely reflect these differences in risk factors. IMPACT Further research is needed to separate the effects of individual- and neighborhood-level factors that affect incidence in this large and growing population.
Collapse
Affiliation(s)
- Theresa H M Keegan
- Northern California Cancer Center, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA.
| | | | | | | | | | | |
Collapse
|
40
|
Bird Y, Moraros J, Banegas MP, King S, Prapasiri S, Thompson B. Breast cancer knowledge and early detection among Hispanic women with a family history of breast cancer along the U.S.-Mexico border. J Health Care Poor Underserved 2010; 21:475-88. [PMID: 20453351 DOI: 10.1353/hpu.0.0292] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Breast cancer is the leading cause of cancer-related death among U.S. Hispanic women. Hispanics are less likely than non-Hispanic White women to be diagnosed at an early stage and survive breast cancer. METHODS For this cross-sectional study, we assessed differences in breast cancer knowledge, attitudes, and screening practices between Hispanic women with (FH+) and without (FH-) a family history of breast cancer in three U.S.-Mexico border counties. RESULTS Among 137 Hispanic women age 40 and older, FH+ women had levels of knowledge and attitudes about breast cancer similar to those of FH- women. FH+ participants were more likely to have ever performed breast self-examinations, although levels of compliance with screening guidelines did not significantly differ between FH+ and FH- groups. CONCLUSION U.S. Hispanic women with a family history of breast cancer constitute an at-risk group for which adhering to preventive screening guidelines could substantially reduce breast cancer mortality.
Collapse
Affiliation(s)
- Yelena Bird
- Public Health Sciences and Cancer Biology Divisions, Fred Hutchinson Cancer Research Center (FHCRC), School of Public Health, University of Saskatchewan, Canada
| | | | | | | | | | | |
Collapse
|
41
|
Yeganeh N, Curtis D, Kuo A. Factors influencing HPV vaccination status in a Latino population; and parental attitudes towards vaccine mandates. Vaccine 2010; 28:4186-91. [PMID: 20417261 DOI: 10.1016/j.vaccine.2010.04.010] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 03/24/2010] [Accepted: 04/05/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Nava Yeganeh
- Mattel Children's Hospital UCLA, David Geffen School of Medicine, UCLA, United States.
| | | | | |
Collapse
|
42
|
A randomized controlled trial of a multilevel intervention to increase colorectal cancer screening among Latino immigrants in a primary care facility. J Gen Intern Med 2010; 25:564-7. [PMID: 20213208 PMCID: PMC2869418 DOI: 10.1007/s11606-010-1266-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 10/15/2009] [Accepted: 01/20/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Latino immigrants face a higher burden of colorectal cancer (CRC) and screening rates are low. OBJECTIVE To assess the effectiveness of a multilevel intervention in increasing the rate of CRC screening among Latino immigrants. DESIGN A randomized controlled trial, with randomization at the physician level. PARTICIPANTS Pairs of 65 primary care physicians and 65 Latino immigrant patients participated, 31 in the intervention and 34 in the control group. INTERVENTION CRC educational video in Spanish on a portable personal digital video display device accompanied by a brochure with key information for the patient, and a patient-delivered paper-based reminder for their physician. MEASUREMENTS Completed CRC screening, physician recommendation for CRC screening, and patient adherence to physician recommended CRC screening. RESULTS The overall rate of completed screening for CRC was 55% for the intervention and 18% for the control group (p = 0.002). Physicians recommended CRC screening for 61% of patients in the intervention group versus 41% in the control group (p = 0.08). Of those that received a recommendation, 90% in the intervention group adhered to it versus 26% in the control group (p = 0.007). CONCLUSIONS The intervention was successful in increasing rates of completed CRC screening primarily through increasing adherence after screening was recommended. Additional efforts should focus on developing new strategies to increase physician recommendation for CRC screening, while employing effective patient adherence interventions.
Collapse
|
43
|
Abstract
Gallbladder cancer is the most common biliary tract cancer. The highest incidence rates occur in Chile, which also has the highest mortality rates. This lethal gastrointestinal cancer has a predilection among adult women and older subjects of both sexes, and also among populations throughout central and Eastern Europe and certain racial groups, such as Native American Indians. Unfortunately, prospects are poor for preventing this form of cancer.
Collapse
|
44
|
Vadaparampil ST, Quinn GP, Small BJ, McIntyre J, Loi CA, Closser Z, Gwede CK. A pilot study of hereditary breast and ovarian knowledge among a multiethnic group of Hispanic women with a personal or family history of cancer. Genet Test Mol Biomarkers 2010; 14:99-106. [PMID: 19929403 DOI: 10.1089/gtmb.2009.0088] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To examine knowledge about hereditary breast and ovarian cancer (HBOC) among Mexican, Puerto Rican, and Cuban women. METHODS Women (age range, 18-65 years) with a personal or family history of breast or ovarian cancer were recruited to a mixed methods study using community-based approaches. Fifty-three women participated in the study: 16 Mexicans, 20 Puerto Ricans, and 17 Cubans. The majority of women (64.2%) were born outside the United States. All questions were interviewer administered in Spanish or English. HBOC knowledge was measured using an 11-item instrument developed by the National Center for Human Genome Research. We evaluated whether differences in knowledge varied as a function of Hispanic subethnicity, demographic characteristics, and medical and acculturation characteristics using a series of one-way analysis of variances. RESULTS The percentage of correct responses on the knowledge instrument ranged from 9.4% to 73.6% (median number of correct responses = 45%). Knowledge did not significantly differ by Hispanic subethnicity (p = 0.51). Exploratory analysis revealed lower knowledge in women with a personal history of cancer (p = 0.03). CONCLUSION Our study provides important information about characteristics associated with lower levels of knowledge and specific areas related to HBOC where additional education may be warranted in the Hispanic community.
Collapse
Affiliation(s)
- Susan T Vadaparampil
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, Florida 33612, USA.
| | | | | | | | | | | | | |
Collapse
|
45
|
Ortiz AP, Soto-Salgado M, Calo WA, Tortolero-Luna G, Pérez CM, Romero CJ, Pérez J, Figueroa-Vallés N, Suárez E. Incidence and mortality rates of selected infection-related cancers in Puerto Rico and in the United States. Infect Agent Cancer 2010; 5:10. [PMID: 20470399 PMCID: PMC2891681 DOI: 10.1186/1750-9378-5-10] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Accepted: 05/14/2010] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In 2002, 17.8% of the global cancer burden was attributable to infections. This study assessed the age-standardized incidence and mortality rates of stomach, liver, and cervical cancer in Puerto Rico (PR) for the period 1992-2003 and compared them to those of Hispanics (USH), non-Hispanic Whites (NHW), and non-Hispanic Blacks (NHB) in the United States (US). METHODS Age-standardized rates [ASR(World)] were calculated based on cancer incidence and mortality data from the PR Cancer Central Registry and SEER, using the direct method and the world population as the standard. Annual percent changes (APC) were calculated using the Poisson regression model from 1992-2003. RESULTS The incidence and mortality rates from stomach, liver and cervical cancer were lower in NHW than PR; with the exception of mortality from cervical cancer which was similar in both populations. Meanwhile, the incidence rates of stomach, liver and cervical cancers were similar between NHB and PR; except for NHB women who had a lower incidence rate of liver cancer than women in PR. NHB had a lower mortality from liver cancer than persons in PR, and similar mortality from stomach cancer. CONCLUSIONS The burden of liver, stomach, and cervical cancer in PR compares to that of USH and NHB and continues to be a public health priority. Public health efforts are necessary to further decrease the burden of cancers associated to infections in these groups, the largest minority population groups in the US. Future studies need to identify factors that may prevent infections with cancer-related agents in these populations. Strategies to increase the use of preventive strategies, such as vaccination and screening, among minority populations should also be developed.
Collapse
Affiliation(s)
- Ana P Ortiz
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Graduate School of Public Health, Department of Biostatistics and Epidemiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Marievelisse Soto-Salgado
- Medical Sciences Campus, Puerto Rico Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| | - William A Calo
- Medical Sciences Campus, Puerto Rico Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| | - Guillermo Tortolero-Luna
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Cynthia M Pérez
- Graduate School of Public Health, Department of Biostatistics and Epidemiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Carlos J Romero
- School of Medicine, Gastroenterology Research Unit, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Javier Pérez
- Puerto Rico Central Cancer Registry, San Juan, Puerto Rico
| | - Nayda Figueroa-Vallés
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Puerto Rico Central Cancer Registry, San Juan, Puerto Rico
| | - Erick Suárez
- Graduate School of Public Health, Department of Biostatistics and Epidemiology, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| |
Collapse
|
46
|
Varela A, Jandorf L, DuHamel K. Understanding factors related to Colorectal Cancer (CRC) screening among urban Hispanics: use of focus group methodology. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2010; 25:70-75. [PMID: 20082178 PMCID: PMC2848702 DOI: 10.1007/s13187-009-0015-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Colorectal cancer (CRC) is a major cause of cancer deaths among US Hispanics. Screening decreases mortality through early detection. To understand factors related to CRC screening among Hispanics, focus groups were conducted. Reasons for getting screened included peace of mind; influence from family and friends; and wanting to prevent CRC. Barriers included fear of finding cancer and fear of the examination. These results informed a survey to better understand CRC screening among Hispanics in a cross-sectional study. The information from both will direct the development of interventions to increase CRC screening among Hispanics.
Collapse
Affiliation(s)
- Alejandro Varela
- Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Lina Jandorf
- Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Katherine DuHamel
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan–Kettering Cancer Center, New York, NY 10022, USA
| |
Collapse
|
47
|
Ortiz AP, Pérez J, Otero-Domínguez Y, García-Rodríguez O, Garced-Tirado S, Escalera-Maldonado F, Gaud-Quintana S, Santiago-Rodríguez E, Svensson K, Vergara-Arroyo JL, Ortiz K, Torres M, Tortolero-Luna G, Figueroa-Vallés N. Endometrial cancer in Puerto Rico: incidence, mortality and survival (1992-2003). BMC Cancer 2010; 10:31. [PMID: 20128912 PMCID: PMC2833143 DOI: 10.1186/1471-2407-10-31] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 02/03/2010] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Endometrial cancer is the most common gynecologic malignancy in Puerto Rico and the United States (US). METHODS We compare the age-specific and age-adjusted incidence and mortality rates and the survival of endometrial cancer in Puerto Rico with that of non-Hispanic whites (NHW), non-Hispanic blacks (NHB) and Hispanics in the US. Data from the Puerto Rico Central Cancer Registry and the Surveillance, Epidemiology, and End Results program were analyzed from 1992-2003. RESULTS Age-standardized incidence rates of endometrial cancer increased significantly (p < 0.05) in Puerto Rico (APC = 2.8%) and among NHB (APC = 1.9%) and remained constant (p > 0.05) for NHW (APC = -0.1%) and Hispanics in the US (APC = 0.4%). Mortality trends remained constant in all racial/ethnic groups (p > 0.05). For 1999-2003, women in Puerto Rico had similar incidence of endometrial cancer as Hispanics (Standardized rate ratio [SRR] = 0.94, 95% CI = 0.87-1.01), although their risk was lower than that of NHW (SRR = 0.56, 95% CI = 0.53-0.59) and NHB (SRR = 0.91, 95% CI = 0.84-0.98). Meanwhile, women in Puerto Rico had 15% higher risk of death than Hispanic women (SRR = 1.15, 95% CI = 1.03-1.30) similar risk than NHW (SRR = 0.93, 95% CI = 0.83-1.03), and lower risk than NHB (SRR = 0.51, 95% CI = 0.46-0.57). Puerto Rico (63.1%) and NHB (56.8%) had a lower 5-year survival than NHW (78.4%) and Hispanics (79.5%). An age-adjusted Cox proportional hazards model showed that compared with women in Puerto Rico, Hispanic women in the United States had 37% lower mortality risk (HR = 0.63, 95% CI = 0.56-0.71) and NHW had 53% lower mortality risk (HR = 0.47, 95% CI = 0.43-0.52) after 5 years of diagnosis; NHB women had 22% higher mortality risk than women in Puerto Rico (HR = 1.22, 95% CI = 1.09-1.36). CONCLUSIONS The lower burden of endometrial cancer in Puerto Rico suggests the presence of protective factors or lower exposure to risk factors in this population, although increases in incidence suggest changes in the occurrence of lifestyles and environmental risk factors. Meanwhile, the lower five-year survival from endometrial cancer among Puerto Ricans suggests a health disparity for this group in areas such as quality of care and/or differences in terms of stage at diagnosis and associated comorbidities. Assessment of disease risk factors and characteristics, and access and response to treatment is required to further understand these results.
Collapse
Affiliation(s)
- Ana Patricia Ortiz
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Javier Pérez
- Puerto Rico Central Cancer Registry, Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Yomayra Otero-Domínguez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Omar García-Rodríguez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Sheyla Garced-Tirado
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Frances Escalera-Maldonado
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Sadja Gaud-Quintana
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Elvis Santiago-Rodríguez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Katherine Svensson
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - José L Vergara-Arroyo
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Karen Ortiz
- Puerto Rico Central Cancer Registry, Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Mariela Torres
- Puerto Rico Central Cancer Registry, Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Guillermo Tortolero-Luna
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Nayda Figueroa-Vallés
- Puerto Rico Central Cancer Registry, Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| |
Collapse
|
48
|
Ángeles-Llerenas A, Ortega-Olvera C, Pérez-Rodríguez E, Esparza-Cano JP, Lazcano-Ponce E, Romieu I, Torres-Mejía G. Moderate physical activity and breast cancer risk: the effect of menopausal status. Cancer Causes Control 2010; 21:577-86. [DOI: 10.1007/s10552-009-9487-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Accepted: 12/05/2009] [Indexed: 11/28/2022]
|
49
|
Wasserman MR, Bender DE, Lee SY, Morrissey JP, Mouw T, Norton EC. Social support among Latina immigrant women: bridge persons as mediators of cervical cancer screening. J Immigr Minor Health 2009; 8:67-84. [PMID: 19835001 DOI: 10.1007/s10903-006-6343-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
New Latina immigrants face numerous linguistic, cultural, logistical, and material barriers to cervical cancer screenings. Promotoras (lay health advisors) are a proven strategy to promote utilization of care. Since the mid-1990s, interventions in North Carolina have aimed to connect Latina immigrants to a broader range of bridge persons. This study assessed the effect of bridge persons on utilization of cervical cancer screening by Latina immigrants in North Carolina. Women were recruited in Spanish-language churches in four counties (N = 223). Logistic regression results show that persons known through advocacy organizations appeared to increase probability of recent Pap screening by an average of 10.4 percentage points (p < 0.05). Promotoras remain more effective, increasing probability of screening by 12.9 percentage points (p < 0.05) but few women (14%) knew one. No association was found with other bridge person profiles. Interventions are needed to better engage all bridge persons in linking immigrants to preventive health services.
Collapse
Affiliation(s)
- Melanie R Wasserman
- Center for Gerontology and Health Care Research, Brown University, Box G-S311, Providence, Rhode Island 02912, USA.
| | | | | | | | | | | |
Collapse
|
50
|
Consedine NS, Skamai A. Sociocultural considerations in aging men's health: implications and recommendations for the clinician. JOURNAL OF MEN'S HEALTH 2009. [DOI: 10.1016/j.jomh.2009.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|