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Desjardins MR, Kanarek NF, Nelson WG, Bachman J, Curriero FC. Disparities in Cancer Stage Outcomes by Catchment Areas for a Comprehensive Cancer Center. JAMA Netw Open 2024; 7:e249474. [PMID: 38696166 PMCID: PMC11066700 DOI: 10.1001/jamanetworkopen.2024.9474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/04/2024] [Indexed: 05/05/2024] Open
Abstract
Importance The National Cancer Institute comprehensive cancer centers (CCCs) lack spatial and temporal evaluation of their self-designated catchment areas. Objective To identify disparities in cancer stage at diagnosis within and outside a CCC's catchment area across a 10-year period using spatial and statistical analyses. Design, Setting, and Participants This cross-sectional, population-based study conducted between 2010 and 2019 utilized cancer registry data for the Johns Hopkins Sidney Kimmel CCC (SKCCC). Eligible participants included patients with cancer in the contiguous US who received treatment for cancer, a diagnosis of cancer, or both at SKCCC. Patients were geocoded to zip code tabulation areas (ZCTAs). Individual-level variables included sociodemographic characteristics, smoking and alcohol use, treatment type, cancer site, and insurance type. Data analysis was performed between March and July 2023. Exposures Distance between SKCCC and ZCTAs were computed to generate a catchment area of the closest 75% of patients and outer zones in 5% increments for comparison. Main Outcomes and Measures The primary outcome was cancer stage at diagnosis, defined as early-stage, late-stage, or unknown stage. Multinomial logistic regression was used to determine associations of catchment area with stage at diagnosis. Results This study had a total of 94 007 participants (46 009 male [48.94%] and 47 998 female [51.06%]; 30 195 aged 22-45 years [32.12%]; 4209 Asian [4.48%]; 2408 Hispanic [2.56%]; 16 004 non-Hispanic Black [17.02%]; 69 052 non-Hispanic White [73.45%]; and 2334 with other or unknown race or ethnicity [2.48%]), including 47 245 patients (50.26%) who received a diagnosis of early-stage cancer, 19 491 (20.73%) who received a diagnosis of late-stage cancer , and 27 271 (29.01%) with unknown stage. Living outside the main catchment area was associated with higher odds of late-stage cancers for those who received only a diagnosis (odds ratio [OR], 1.50; 95% CI, 1.10-2.05) or only treatment (OR, 1.44; 95% CI, 1.28-1.61) at SKCCC. Non-Hispanic Black patients (OR, 1.16; 95% CI, 1.10-1.23) and those with Medicaid (OR, 1.65; 95% CI, 1.46-1.86) and no insurance at time of treatment (OR, 2.12; 95% CI, 1.79-2.51) also had higher odds of receiving a late-stage cancer diagnosis. Conclusions and Relevance In this cross-sectional study of CCC data from 2010 to 2019, patients residing outside the main catchment area, non-Hispanic Black patients, and patients with Medicaid or no insurance had higher odds of late-stage diagnoses. These findings suggest that disadvantaged populations and those living outside of the main catchment area of a CCC may face barriers to screening and treatment. Care-sharing agreements among CCCs could address these issues.
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Affiliation(s)
- Michael R. Desjardins
- Department of Epidemiology and Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Norma F. Kanarek
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - William G. Nelson
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jamie Bachman
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Frank C. Curriero
- Department of Epidemiology and Spatial Science for Public Health Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Huang HC, Guadamuz JS, Hoskins KF, Ko NY, Calip GS. Risk of contralateral breast cancer among Asian/Pacific Islander women in the United States. Breast Cancer Res Treat 2024; 203:533-542. [PMID: 37897647 DOI: 10.1007/s10549-023-07140-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/25/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE While breast cancer studies often aggregate Asian/Pacific Islander (API) women, as a single group or exclude them, this population is heterogeneous in terms of genetic background, environmental exposures, and health-related behaviors, potentially resulting in different cancer outcomes. Our purpose was to evaluate risks of contralateral breast cancer (CBC) among subgroups of API women with breast cancer. METHODS We conducted a retrospective cohort study of women ages 18 + years diagnosed with stage I-III breast cancer between 2000 and 2016 in the Surveillance, Epidemiology and End Results registries. API subgroups included Chinese, Japanese, Filipina, Native Hawaiian, Korean, Vietnamese, Indian/Pakistani, and other API women. Asynchronous CBC was defined as breast cancer diagnosed in the opposite breast 12 + months after first primary unilateral breast cancer. Multivariable-adjusted subdistribution hazard ratios (SHR) and 95% confidence intervals (CI) were estimated and stratified by API subgroups. RESULTS From a cohort of 44,362 API women with breast cancer, 25% were Filipina, 18% were Chinese, 14% were Japanese, and 8% were Indian/Pakistani. API women as an aggregate group had increased risk of CBC (SHR 1.15, 95% CI 1.08-1.22) compared to NHW women, among whom Chinese (SHR 1.23, 95% CI 1.08-1.40), Filipina (SHR 1.37, 95% CI 1.23-1.52), and Native Hawaiian (SHR 1.69, 95% CI 1.37-2.08) women had greater risks. CONCLUSION Aggregating or excluding API patients from breast cancer studies ignores their heterogeneous health outcomes. To advance cancer health equity among API women, future research should examine inequities within the API population to design interventions that can adequately address their unique differences.
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Affiliation(s)
- Hsiao-Ching Huang
- Department of Pharmacy Systems, Outcomes and Policy, University of Illinois Chicago, Chicago, IL, USA
| | - Jenny S Guadamuz
- School of Public Health, University of California, Berkeley, CA, USA
| | - Kent F Hoskins
- Division of Hematology and Oncology, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA
| | - Naomi Y Ko
- Section of Hematology/Oncology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Gregory S Calip
- Titus Family Department of Clinical Pharmacy, Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, 1985 Zonal Ave, Los Angeles, 90089, CA, USA.
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Morshed AKMH, Al Azad S, Mia MAR, Uddin MF, Ema TI, Yeasin RB, Srishti SA, Sarker P, Aurthi RY, Jamil F, Samia NSN, Biswas P, Sharmeen IA, Ahmed R, Siddiquy M, Nurunnahar. Oncoinformatic screening of the gene clusters involved in the HER2-positive breast cancer formation along with the in silico pharmacodynamic profiling of selective long-chain omega-3 fatty acids as the metastatic antagonists. Mol Divers 2023; 27:2651-2672. [PMID: 36445532 DOI: 10.1007/s11030-022-10573-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
The HER2-positive patients occupy ~ 30% of the total breast cancer patients globally where no prevalent drugs are available to mitigate the frequent metastasis clinically except lapatinib and neratinib. This scarcity reinforced researchers' quest for new medications where natural substances are significantly considered. Valuing the aforementioned issues, this research aimed to study the ERBB2-mediated string networks that work behind the HER2-positive breast cancer formation regarding co-expression, gene regulation, GAMA-receptor-signaling pathway, cellular polarization, and signal inhibition. Following the overexpression, promotor methylation, and survivability profiles of ERBB2, the super docking position of HER2 was identified using the quantum tunneling algorithm. Supramolecular docking was conducted to study the target specificity of EPA and DHA fatty acids followed by a comprehensive molecular dynamic simulation (100 ns) to reveal the RMSD, RMSF, Rg, SASA, H-bonds, and MM/GBSA values. Finally, potential drug targets for EPA and DHA in breast cancer were constructed to determine the drug-protein interactions (DPI) at metabolic stages. Considering the values resulting from the combinational models of the oncoinformatic, pharmacodynamic, and metabolic parameters, long-chain omega-3 fatty acids like EPA and DHA can be considered as potential-targeted therapeutics for HER2-positive breast cancer treatment.
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Affiliation(s)
- A K M Helal Morshed
- Pathology and Pathophysiology Major, Academy of Medical Science, Zhengzhou University, Zhengzhou, 450001, Henan Province, People's Republic of China
| | - Salauddin Al Azad
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Wuxi, 214122, Jiangsu Province, People's Republic of China.
| | - Md Abdur Rashid Mia
- Department of Pharmaceutical Technology, Faculty of Pharmacy, International Islamic University Malaysia, 25200, Pahang, Kuantan, Malaysia
| | - Mohammad Fahim Uddin
- College of Material Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, 310018, Zhejiang, People's Republic of China
| | - Tanzila Ismail Ema
- Department of Biochemistry and Microbiology, North South University, Dhaka, 1229, Bangladesh
| | - Rukaiya Binte Yeasin
- Department of Biochemistry and Microbiology, North South University, Dhaka, 1229, Bangladesh
| | | | - Pallab Sarker
- Department of Medicine, Sher-E-Bangla Medical College Hospital, South Alekanda, Barisal, 8200, Bangladesh
| | - Rubaita Younus Aurthi
- Department of Chemical Engineering, Bangladesh University of Engineering and Technology, Palashi, Dhaka, 1205, Bangladesh
| | - Farhan Jamil
- Department of Pharmacy, University of Asia Pacific, Farmgate, Dhaka, 1205, Bangladesh
| | | | - Partha Biswas
- Laboratory of Pharmaceutical Biotechnology and Bioinformatics, Department of Genetic Engineering and Biotechnology, Jashore University of Science and Technology, Jashore, 7408, Bangladesh
| | - Iffat Ara Sharmeen
- School of Data Sciences, Department of Mathematics & Natural Sciences, BRAC University, 66 Mohakhali, Dhaka, 1212, Bangladesh
| | - Rasel Ahmed
- School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, TS1 3BX, Tees Valley, UK
| | - Mahbuba Siddiquy
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, 214122, Jiangsu Province, People's Republic of China
| | - Nurunnahar
- Department of Mathematics, Mawlana Bhashani Science and Technology University, Santosh, Tangail, 1902, Bangladesh
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Im EO, Chee W, Paul S, Choi MY, Kim SY, Deatrick JA, Inouye J, Ma G, Meghani S, Nguyen GT, Schapira MM, Ulrich CM, Yeo S, Bao T, Shin D, Mao JJ. A randomized controlled trial testing a virtual program for Asian American women breast cancer survivors. Nat Commun 2023; 14:6475. [PMID: 37838727 PMCID: PMC10576740 DOI: 10.1038/s41467-023-42132-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/25/2023] [Indexed: 10/16/2023] Open
Abstract
A culturally tailored virtual program could meet the survivorship needs of Asian American women breast cancer survivors (AABC). This study aims to determine the efficacy of a culturally tailored virtual information and coaching/support program (TICAA) in improving AABC's survivorship experience. A randomized clinical trial (NCT02803593) was conducted from January 2017 to June 2020 among 199 AABC. The intervention group utilized TICAA and the American Cancer Society [ACS] website while the control group used only ACS website for 12 weeks. The outcomes were measured using the SCNS-34SF (needs; primary), the MSAS-SF (symptoms; secondary), and the FACT-B (quality of life; secondary). The data were analyzed using an intent-to-treat approach. The intervention group showed significant reductions in their needs from the baseline (T0) to post 4 weeks (T1) and to post 12 weeks (T2). Although the changes were not statistically significant, the intervention group had decreased symptoms from T0 to T2 while the control group had an increase in their symptoms. The intervention group had a significant increase in their quality of life from T0 to T2. A culturally tailored virtual program could therefore improve quality of life in AABC patients. Trial Registration: To Enhance Breast Cancer Survivorship of Asian Americans (TICAA), NCT02803593, https://clinicaltrials.gov/ct2/show/NCT02803593?titles=TICAA&draw=2&rank=1.
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Affiliation(s)
- Eun-Ok Im
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA.
| | - Wonshik Chee
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA
| | - Sudeshna Paul
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Mi-Young Choi
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
- Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Seo Yun Kim
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Janet A Deatrick
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Jillian Inouye
- University of Hawaii, 2528 McCarthy Mall, Webster Hall 402, Honolulu, HI, 96822, USA
| | - Grace Ma
- Temple University, 1801 N Broad St, Philadelphia, PA, 19122, USA
| | - Salimah Meghani
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Giang T Nguyen
- Harvard University Health Services, 75 Mt. Auburn Street, Cambridge, MA, 02138, USA
| | - Marilyn M Schapira
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Connie M Ulrich
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - SeonAe Yeo
- University of North Carolina, Carrington Hall, S Columbia St, Chapel Hill, NC, 27599, USA
| | - Ting Bao
- Memorial Sloan Kettering Cancer Center, 321 East 61st Street, Room 456, New York, NY, 10065, USA
| | - David Shin
- University of California, Los Angeles, 855 Tiverton Dr, Los Angeles, CA, 90024, USA
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, 321 East 61st Street, Room 456, New York, NY, 10065, USA
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Lim DW, Li WW, Giannakeas V, Cil TD, Narod SA. Survival of Filipino women with breast cancer in the United States. Cancer Med 2023; 12:19921-19934. [PMID: 37755311 PMCID: PMC10587940 DOI: 10.1002/cam4.6403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 07/18/2023] [Accepted: 07/23/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The survival of women with early-stage breast cancer varies by racial group. Filipino women with breast cancer are an understudied group and are often combined with other Asian groups. We compared clinical presentations and survival rates for Filipino and White women with breast cancer diagnosed in the United States. METHODS We conducted a retrospective cohort study of women with breast cancer diagnosed between 2004 and 2015 in the SEER18 registries database. We compared crude survival between Filipino and White women. We then calculated adjusted hazard ratios (HR) in a propensity-matched design using the Cox proportional hazards model. RESULTS There were 10,834 Filipino (2.5%) and 414,618 White women (97.5%) with Stage I-IV breast cancer in the SEER database. The mean age at diagnosis was 57.5 years for Filipino women and 60.8 years for White women (p < 0.0001). Filipino women had more high-grade and larger tumors than White women and were more likely to have node-positive disease. Among women with Stage I-IIIC breast cancer, the crude 10-year breast cancer-specific survival rate was 91.0% for Filipino and 88.9% for White women (HR 0.81, 95% CI 0.74-0.88, p < 0.01). In a propensity-matched analysis, the HR was 0.73 (95% CI 0.66-0.81). The survival advantage for Filipino women was present in subgroups defined by age of diagnosis, nodal status, estrogen receptor status, and HER2 receptor status. CONCLUSION In the United States, Filipino women often present with more advanced breast cancers than White women, but experience better breast cancer-specific survival.
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Affiliation(s)
- David W. Lim
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Women's College Research Institute, Women's College HospitalTorontoOntarioCanada
- Department of SurgeryWomen's College HospitalTorontoOntarioCanada
- Division of General Surgery, Department of SurgeryUniversity of TorontoTorontoOntarioCanada
| | - Winston W. Li
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Vasily Giannakeas
- Women's College Research Institute, Women's College HospitalTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Tulin D. Cil
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Department of SurgeryWomen's College HospitalTorontoOntarioCanada
- Division of General Surgery, Department of SurgeryUniversity of TorontoTorontoOntarioCanada
- Division of General SurgeryUniversity Health Network (Princess Margaret Cancer Centre)TorontoOntarioCanada
| | - Steven A. Narod
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Women's College Research Institute, Women's College HospitalTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Institute of Medical Science, University of TorontoTorontoOntarioCanada
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Hu WT, Bergren SM, Dychtwald DK, Ma Y, Dong X. Variations in racial and ethnic groups' trust in researchers associated with willingness to participate in research. Humanit Soc Sci Commun 2023; 10:466. [PMID: 38650745 PMCID: PMC11034911 DOI: 10.1057/s41599-023-01960-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 07/24/2023] [Indexed: 04/25/2024]
Abstract
Low enrollment in U.S. biomedical research by non-White adults has historically been attributed to mistrust, but few studies have simultaneously examined dimensions of trust in three or more racial/ethnic groups. Leveraging the racial/ethnic diversity of New Jersey, we prospectively recruited 293 adults (72% women, 38% older than 54 years of age) between October 2020 and February 2022 to complete two anonymous surveys in English or one of the common languages (e.g., Spanish, Mandarin Chinese). The first consisted of 12 Likert Scale questions related to trust in biomedical researchers (according to safety, equity, transparency), and the second assessed willingness to consider participation in eight common research activities (health-related survey, blood collection, genetic analysis, medication study, etc). Participants self-reported as Hispanic (n=102), Black (n=49), Chinese (n=48), other Asian (n=53), or White (n=41) race/ethnicity. Factor analysis showed three aspects related to trust in researchers: researchers as fiduciaries for research participants, racial/ethnic equity in research, and transparency. Importantly, we observed differences in the relationship between mistrust and willingness to participate. Whereas Chinese respondents' low trust in researchers mediated their low interest in research involving more than health-related surveys, Hispanic respondents' low trust in research equity did not deter high willingness to participate in research involving blood and genetic analysis. We caution that a generic association between trust and research participation should not be broadly assumed, and biomedical researchers should prospectively assess this relationship within each minoritized group to avoid hasty generalization.
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Affiliation(s)
- William T Hu
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | | | - Dana K Dychtwald
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | - Yiming Ma
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
| | - XinQi Dong
- Rutgers Institute for Health, Health Care Policy, and Aging Research, USA
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Peregrina HN, Maglalang DD, Hwang J, Yoo GJ. A qualitative exploration of the continuum of help-seeking among Asian American breast cancer survivors. Soc Work Health Care 2023; 62:345-358. [PMID: 37532433 PMCID: PMC10592301 DOI: 10.1080/00981389.2023.2244012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/29/2023] [Indexed: 08/04/2023]
Abstract
Breast cancer rates among Asian American women are increasing. Despite this, there are limited studies on help-seeking among this population. Through a qualitative exploration, this paper examines the help-seeking experiences of Asian American breast cancer survivors. Asian American women (n = 52) with early-stage breast cancer were interviewed. Findings illustrate a continuum of experiences including: keeping diagnosis personal and not asking for help, keeping diagnosis personal but asking for limited help, and sharing diagnosis and seeking support. Results indicate that seeking support is a complex process for Asian Americans with breast cancer, with implications for survivorship and quality of life.
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Affiliation(s)
- Hillary Nicole Peregrina
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
| | | | - Jane Hwang
- Department of Asian American Studies, College of Ethnic Studies, San Francisco State University, San Francisco, CA, USA
| | - Grace J Yoo
- Department of Asian American Studies, College of Ethnic Studies, San Francisco State University, San Francisco, CA, USA
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Seo JY, Park SH, Choi SE, Lee M, Strauss SM. Development and Modification of a Culturally Tailored Education Program to Prevent Breast Cancer in Korean Immigrant Women in New York City. J Cancer Educ 2023; 38:913-923. [PMID: 35921065 PMCID: PMC9362115 DOI: 10.1007/s13187-022-02207-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 06/02/2023]
Abstract
Breast cancer (BC) is the most common cancer in Korean American (KA) women. In view of its high prevalence in these women, their low screening rates, and the cultural influence of BC risk factors in their lifestyles, we developed a community-based culturally tailored BC prevention program, the Korean Breast Cancer Risk Reduction Program (KBCRRP). Guided by the PRECEDE-PROCEDE and health belief models, the KBCRRP was developed to achieve four goals: (1) healthy weight, (2) physically active lifestyle, (3) healthy diet, and (4) BC screening and adherence. KBCRRP combines effective multicomponent strategies for BC screening and a group-based lifestyle intervention incorporating traditional Korean health beliefs and is tailored for BC risk reduction. In this paper, we provide an overview of the program, the process of program development, implementation, and evaluation, and modification during the COVID-19 pandemic. The initial program involved 8 weeks of in-person group education sessions led by interdisciplinary healthcare professionals and 16 weeks of follow-up involving smartphone applications, phone calls, and text messaging from trained lifestyle coaches. Participants received opportunities to obtain free mammography during the program. After feasibility testing, the program was modified by incorporating participants' feedback. During the COVID-19 pandemic, we provided the program using the Zoom video platform. Participants' recruitment and retention during the pandemic was successful, reflecting the fact that virtual delivery of group-based education was a feasible and acceptable alternative to in-person sessions. Collaboration with community organizations serving the target population is the key to developing and sustaining a successful community-based educational program.
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Affiliation(s)
- Jin Young Seo
- School of Nursing, Hunter College, the City University of New York, 425 E. 25th Street, New York, NY, 10010, USA.
| | - So-Hyun Park
- School of Nursing, Hunter College, the City University of New York, 425 E. 25th Street, New York, NY, 10010, USA
| | - Sung Eun Choi
- Department of Family, Nutrition, & Exercise Sciences, Queens College, the City University of New York, Flushing, NY, USA
| | - Minkyung Lee
- Medical Oncology Department, Santa Clara Valley Medical Center, San Jose, CA, USA
| | - Shiela M Strauss
- School of Nursing, Hunter College, the City University of New York, 425 E. 25th Street, New York, NY, 10010, USA
- Rory Meyers College of Nursing, NYU, New York, NY, USA
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John EM, Koo J, Ingles SA, Kurian AW, Hines LM. Changes in Breast Cancer Risk and Risk Factor Profiles among U.S.-Born and Immigrant Asian American Women Residing in the San Francisco Bay Area. Cancer Epidemiol Biomarkers Prev 2023; 32:666-677. [PMID: 36780232 PMCID: PMC10411517 DOI: 10.1158/1055-9965.epi-22-1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/20/2022] [Accepted: 02/09/2023] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Breast cancer incidence rates in women of Asian descent have been increasing in the United States and Asia. METHODS In a case-control study of Asian American women from the San Francisco Bay Area, we assessed associations with birthplace and migration-related characteristics and compared risk factors between Asian American and non-Hispanic White women by birthplace and birth cohort. RESULTS Birthplace and migration-related characteristics were associated with breast cancer risk only among women in the younger birth cohort (1951-1984) that comprised 355 cases diagnosed at age ≤55 years and 276 sister and population controls. Breast cancer risk was marginally increased among foreign-born women [OR = 1.40; 95% confidence interval (CI), 0.97-2.03] and two-fold among foreign-born Chinese women (OR = 2.16; 95% CI, 1.21-3.88). Two-fold increased risks were associated with migration at age ≥40 years and longer U.S. residence (≥30 years or ≥75% of life). The education level was high among both cases and controls. Differences in the prevalence of risk factors by birthplace and birth cohort suggest temporal changes in reproductive and lifestyle-related factors. The prevalence in risk factors was similar between foreign-born and U.S.-born women in the younger birth cohort, and did not fully explain the observed associations with birthplace and other migration characteristics. CONCLUSIONS In contrast to studies from earlier decades, younger foreign-born Asian American women had a higher risk of breast cancer than U.S.-born Asian American women. IMPACT It is important and urgent to understand what factors drive the increasing burden of breast cancer in women of Asian descent and implement effective prevention programs.
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Affiliation(s)
- Esther M John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
- Department of Medicine (Oncology), Stanford University School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Jocelyn Koo
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Sue A Ingles
- Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California, Los Angeles, California
| | - Allison W Kurian
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
- Department of Medicine (Oncology), Stanford University School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Lisa M Hines
- Department of Biology, University of Colorado at Colorado Springs, Colorado Springs, Colorado
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Choi E, Shin LJ, Chen L, Lu Q. Lived experiences of young adult Chinese American breast cancer survivors: A qualitative analysis of their strengths and challenges using expressive writing. Eur J Oncol Nurs 2023; 62:102253. [PMID: 36628853 DOI: 10.1016/j.ejon.2022.102253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/22/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Immigrant young adults of cancer survivors face unique challenges but their unmet needs are not well understood. The purpose of this study was to identify the challenges and strengths of immigrant young adult Chinese American breast cancer survivors. METHOD Descriptive phenomenology using a qualitative research approach was employed in this study. Expressive writing was used to explore the experiences of 15 young adult Chinese American immigrant breast cancer survivors. Thematic analysis was conducted to gain an understanding of the lived experiences of young adult Chinese American breast cancer survivors. RESULTS On average, participants had been diagnosed at 37 years (ranging from 32 to 39) and living in the USA for 12 years. Participants' writings revealed their challenges during and after treatment (major theme), including difficulty accepting having cancer at a young age, financial difficulties, self-blame, inadequate family support, uncertainty about their futures, and worries about their children and infertility (sub-themes). Participants' strengths and coping strategies (major theme) included physical recovery and positive self-perception, family as motivation for survival, and support from family and friends (sub-themes). Post-traumatic growth (major theme) included shifting life priorities and enjoying life and self-transcendence (i.e., forgiving and helping others) (sub-themes). CONCLUSIONS The overarching topic found across the major themes in the young adult Chinese American breast cancer survivors' essays was the importance of interpersonal relationships, especially with family and children. Healthcare providers should respond with culturally appropriate support, referrals, and resources based on these findings.
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Affiliation(s)
- Eunju Choi
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
| | - Lilian J Shin
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Lingjun Chen
- School of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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11
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Parida S, Siddharth S, Xia Y, Sharma D. Concomitant analyses of intratumoral microbiota and genomic features reveal distinct racial differences in breast cancer. NPJ Breast Cancer 2023; 9:4. [PMID: 36702853 PMCID: PMC9880005 DOI: 10.1038/s41523-023-00505-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/04/2023] [Indexed: 01/27/2023] Open
Abstract
Racial disparities are most accentuated among Black women as their lifetime risk of breast cancer incidence is lower than white and Asian women but their breast cancer related mortality is the highest among all races. Black women are more likely to develop triple-negative breast cancer at a younger age and harbor more aggressive tumors. In addition to tumor-centric alterations, tumor growth is also influenced by multiple other tumor microenvironment-related features, including resident immune cells and microbiota. Hence, in this study, we conduct concurrent genomic and metagenomic analyses, and uncover distinctive intratumoral microbial community compositions and tumor immune microenvironment-related traits in breast tumors from Asian, Black and white women. Interestingly, unique racially associated genomic nodes are found in the breast tumors from Asian, Black and white women. Examination of the cellular heterogeneity show differential enrichment of 11 out of 64 immune and stroma cell types in the breast tumors from different racial groups. In terms of microbial diversity, significant differences are revealed in alpha and beta-diversity measures. Intriguingly, potential race-specific microbial biomarkers of breast cancer are identified which significantly correlate with genes involved with tumor aggressiveness, angiogenesis, tumor cell migration and metastasis as well as oncogenic pathways-GLI and Notch. Investigating the metabolic features of intratumoral microbes, we find a significant differential enrichment of environmental information processing pathways, oncogenic pathways, and lipid metabolism pathways. Concomitantly investigating tumor-centric, tumor immune microenvironment-related and microbial alterations, our study provides a comprehensive understanding of racial disparities in breast cancer and warrants further exploration.
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Affiliation(s)
- Sheetal Parida
- Department of Oncology, Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Sumit Siddharth
- Department of Oncology, Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Yuqing Xia
- Department of Oncology, Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Dipali Sharma
- Department of Oncology, Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
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12
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Williams AD, Moo TA. The Impact of Socioeconomic Status and Social Determinants of Health on Disparities in Breast Cancer Incidence, Treatment, and Outcomes. Curr Breast Cancer Rep 2023. [DOI: 10.1007/s12609-023-00473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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13
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Cai S, Zheng J, Song H, Wu H, Cai W. Relationship between serum TGF- β 1, MMP-9 and IL-1β and pathological features and prognosis in breast cancer. Front Genet 2023; 13:1095338. [PMID: 36712861 PMCID: PMC9877302 DOI: 10.3389/fgene.2022.1095338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023] Open
Abstract
To investigate the levels of serum transforming growth factor-β 1 (TGF-β1), Matrix metalloproteinase-9 (MMP-9) and Interleukin-1 β (IL-1 β) in breast cancer (BC), and analyzing their relationship with pathological features and prognosis. Retrospective analysis of 86 subjects with BC (BC subgroup) and another 50 healthy subjects (control subgroup) during the same period were included. The clinical data were collected. In this research, in BC subgroup, The levels of serum TGF- β 1, MMP-9 and IL-1 β were significantly higher than those in control subgroup. The levels of TGF- β 1 and MMP-9 in serum of BC subjects was correlated with clinical stage, histological grade, lymph node metastasis and molecular classification, but not with age, tumor size and menopausal status. The level of serum IL-1 β was related to tumor size, clinical stage, histological grade and lymph node metastasis. Multivariate Logistic regression analysis showed that the high level of serum TGF- β1 and MMP-9 was independent risk factors for BC. High level of serum IL-1 β was not an independent risk factor for BC. The 3-year disease-free survival rate in high TGF- β1 subgroup and high MMP-9 subgroup was significantly lower than that in low TGF- β 1 subgroup and low MMP- 9 subgroup. To conclude, serum TGF- β 1, MMP-9 and IL-1β are highly expressed in BC, and the subjects with elevated serum levels of TGF- β 1 and MMP-9 suggests poor prognosis.
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Affiliation(s)
| | - Jianwei Zheng
- Department of General Surgery, Beijing Chaoyang Hospital Affiliated with Capital Medical University, Beijing, China
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14
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Gao Y, Heller SL. Health Disparity and Breast Cancer Outcomes in Asian Women. Radiographics 2022; 42:1912-1924. [PMID: 36053846 DOI: 10.1148/rg.220074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Health disparities in Asian women are complex and multifactorial. Screening attendance is low among Asian women, regardless of nativity or acculturation, and breast cancer detection has decreased by more than half in this population during the COVID-19 pandemic. The follow-up rate after abnormal screening results is similarly poor among Asian women compared with that among other groups, often resulting in a delay of cancer diagnosis. Yet the incidence of breast cancer in Asian women is increasing in the United States, with no such increase observed in other racial and ethnic groups in recent years. The age distribution of breast cancer in Asian women is distinct and peaks in younger women, underscoring the importance of early screening. The predilection for human epidermal growth factor receptor 2 (HER2)-enriched tumors may reflect the unique biologic characteristics of breast cancer among Asian subgroups, which are not well understood. Known biomarkers for breast cancer risk such as body mass index and mammographic density do not perform the same way in Asian women, as compared with other groups, owing to a lack of Asian population-specific data. Within that limitation, the association between body mass index and breast cancer is strongest in older Asian women, and the association between breast density and breast cancer is strongest in younger Asian women. There is an unmet need to improve breast cancer care in Asian women, a heterogeneous and growing population that is facing an increasing burden of breast cancer. An invited commentary by Leung is available online. ©RSNA, 2022.
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Affiliation(s)
- Yiming Gao
- From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016
| | - Samantha L Heller
- From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016
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15
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Fane L, Biswas T, Jindal C, Choi YM, Efird JT. Breast Cancer Disparities in Asian Women: The Need for Disaggregated Research. Int J Environ Res Public Health 2022; 19:9790. [PMID: 36011424 PMCID: PMC9408195 DOI: 10.3390/ijerph19169790] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/06/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
Asian (AZN) women are a heterogeneous group, comprising a wide array of cultural beliefs, languages, and healthcare needs. Yet, studies of breast cancer (BCa) risks and outcomes predominately consider AZNs in aggregate, assuming that the distinct ethnicities have similar disease profiles and homogeneous responses to treatment. This stereotypical portrayal of AZNs as a homogenous group tends to mask disparities. For example, healthcare-seeking behaviors and attitudes of medical providers toward AZN BCa patients frequently differ within this group and from other races. Misconceptions may arise that significantly influence the prevention, detection, treatment, and post-therapeutic care of AZN women. In addition to low BCa screening rates among AZN women, disparities also exist in various stages of BCa treatment-omission of radiation after breast-conserving surgery, less access to hypofractionation, underutilization of hormonal therapy, and higher-cost treatment owing to high HER2+ incidence. In this perspective, we highlight the need for disaggregated research of BCa among AZN women and advocate for comprehensive, culturally sensitive strategies to address health disparities in this priority population. Improving BCa literacy and awareness, access to care, and equitable recruitment into clinical trials are a few amelioratory goals to consider in the future.
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Affiliation(s)
- Lauren Fane
- MD University Program, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | - Tithi Biswas
- Department of Radiation Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Charulata Jindal
- Harvard Medical School, Harvard University, Boston, MA 02115, USA
| | | | - Jimmy T. Efird
- VA Cooperative Studies Program Coordinating Center, Boston, MA 02130, USA
- Department of Radiation Oncology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
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16
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Bevilacqua G. The Viral Origin of Human Breast Cancer: From the Mouse Mammary Tumor Virus (MMTV) to the Human Betaretrovirus (HBRV). Viruses 2022; 14:v14081704. [PMID: 36016325 PMCID: PMC9412291 DOI: 10.3390/v14081704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023] Open
Abstract
A Human Betaretrovirus (HBRV) has been identified in humans, dating as far back as about 4500 years ago, with a high probability of it being acquired by our species around 10,000 years ago, following a species jump from mice to humans. HBRV is the human homolog of the MMTV (mouse mammary tumor virus), which is the etiological agent of murine mammary tumors. The hypothesis of a HMTV (human mammary tumor virus) was proposed about 50 years ago, and has acquired a solid scientific basis during the last 30 years, with the demonstration of a robust link with breast cancer and with PBC, primary biliary cholangitis. This article summarizes most of what is known about MMTV/HMTV/HBRV since the discovery of MMTV at the beginning of last century, to make evident both the quantity and the quality of the research supporting the existence of HBRV and its pathogenic role. Here, it is sufficient to mention that scientific evidence includes that viral sequences have been identified in breast-cancer samples in a worldwide distribution, that the complete proviral genome has been cloned from breast cancer and patients with PBC, and that saliva contains HBRV, as a possible route of inter-human infection. Controversies that have arisen concerning results obtained from human tissues, many of them outdated by new scientific evidence, are critically discussed and confuted.
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17
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Taparra K, Dee EC, Dao D, Patel R, Santos P, Chino F. Disaggregation of Asian American and Pacific Islander Women With Stage 0-II Breast Cancer Unmasks Disparities in Survival and Surgery-to-Radiation Intervals: A National Cancer Database Analysis From 2004 to 2017. JCO Oncol Pract 2022; 18:e1255-e1264. [PMID: 35594493 PMCID: PMC9377694 DOI: 10.1200/op.22.00001] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/28/2022] [Accepted: 04/21/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Aggregation of Asian Americans (AAs) with Native Hawaiians and Other Pacific Islanders (NHPIs) masks significant health disparities. We evaluated overall survival (OS) and surgery-to-radiation intervals (STRIs) among AA and NHPI women with early-stage breast cancer. METHODS This National Cancer Database study included women with stage 0-II breast cancer diagnosed between 2004 and 2017. STRI was defined as days from surgery to radiation. Patients were stratified by adjuvant treatment. AAs were disaggregated into geographically relevant subpopulations: East, South, and Southeast Asians. Kaplan-Meier estimates and log-rank tests assessed survival. Cox proportional hazard and linear regression were adjusted for clinical and sociodemographic factors. RESULTS In total, 578,927 women were included (median age 61 years, median follow-up 65 months, and 10-year OS 83%). AA and NHPI 10-year OS was 91% overall; subpopulation 10-year OS was 92% for East Asian, 90% for South Asian, 90% for Southeast Asian, and 83% for NHPI. On multivariable analysis, compared with non-Hispanic White, NHPI women had worse survival (adjusted hazard ratio [aHR] = 1.38; 95% CI, 1.09 to 1.77); all AA subpopulations had improved survival: East Asian (aHR = 0.57; 95% CI, 0.48 to 0.69), South Asian (aHR = 0.66; 95% CI, 0.51 to 0.84), and Southeast Asian (aHR = 0.78; 95% CI, 0.65 to 0.94). The AA and NHPI median STRI for was 73 days overall; the disaggregated median STRI was 68 days for East Asian, 80 days for South Asian, 77 days for Southeast Asians, and 81 days for NHPI. On adjusted analysis, compared with non-Hispanic White, Southeast Asians and NHPI had longer STRI by 6.6 (95% CI, 4.3 to 8.9) and 10.0 (95% CI, 5.8 to 14) days, respectively. CONCLUSION Breast cancer disparities exist among disaggregated AA and NHPI subpopulations. Data disaggregation insights may lead to interventions to overcome these disparities, such as optimizing time-to-treatment for select populations.
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Affiliation(s)
- Kekoa Taparra
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | | | - Dyda Dao
- Department of Surgery, Oregon Health and Science University, Portland, OR
| | - Rohan Patel
- Department of Internal Medicine, SUNY Downstate Medical Center, Brooklyn, NY
| | - Patricia Santos
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, NY
| | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering, New York, NY
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18
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Medina HN, Callahan KE, Koru-Sengul T, Maheshwari S, Liu Q, Goel N, Pinheiro PS. Elevated breast cancer mortality among highly educated Asian American women. PLoS One 2022; 17:e0268617. [PMID: 35584182 PMCID: PMC9116645 DOI: 10.1371/journal.pone.0268617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Postmenopausal breast cancer (PMBC) is the most commonly diagnosed and the second leading cause of cancer death among women in the US. Research examining the association between PMBC and education level has been inconsistent; no study in the US has examined how educational level impacts PMBC mortality in Asian American women, a largely immigrant population with above-average educational attainment. Methods California Vital Statistics data from 2012–2017 were analyzed to derive age-adjusted mortality rate ratios (MRRs) by education level (associates degree or above referred to as “higher education”, high school, less than high school) and race [Non-Hispanic White (NHW), Asian/Pacific Islander (Asian), and its two largest subpopulations: Chinese and Filipino] from negative binomial regression models. Results PMBC mortality for both NHWs and Asians was greater among women with higher education compared to those who did not complete high school: NHWs had 22% higher PMBC mortality (MRR 1.22; 95% CI: 1.14–1.31) and Asians had 2.6 times greater PMBC mortality (MRR 2.64; 95% CI: 2.32–3.00) than their counterparts who did not complete high school. Asians in the lowest education level had 70% lower mortality than NHWs (MRR 0.30; 95% CI: 0.27–0.34). This mortality advantage among Asians was greatly reduced to only 27% lower among the highest educated (MRR 0.73; 95% CI: 0.68–0.78). For higher educated Filipina women, no mortality advantage was evident compared to NHWs (MRR 0.96; 95% CI: 0.88–1.05). Conclusion PMBC mortality for higher educated Asian women is elevated in comparison to their counterparts with less education. Given that PMBC survival is greater among those with higher education, our findings strongly suggest an excess in the incidence of PMBC (more than double) among higher educated Asian women; this warrants more research into potentially modifiable causes of PMBC in this burgeoning population.
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Affiliation(s)
- Heidy N. Medina
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Karen E. Callahan
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Tulay Koru-Sengul
- Sylvester Comprehensive Cancer Center, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Sfurti Maheshwari
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Qinran Liu
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Neha Goel
- Division of Surgical Oncology, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Paulo S. Pinheiro
- Sylvester Comprehensive Cancer Center, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- * E-mail:
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Morey BN, Gee GC, Wang MC, von Ehrenstein OS, Shariff-Marco S, Canchola AJ, Yang J, Lee SSJ, Bautista R, Tseng W, Chang P, Gomez SL. Neighborhood Contexts and Breast Cancer Among Asian American Women. J Immigr Minor Health 2022; 24:445-454. [PMID: 33846877 PMCID: PMC8553603 DOI: 10.1007/s10903-021-01196-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study examines how neighborhood socioeconomic status (nSES) and ethnic composition are associated with breast cancer risk for Asian American women. METHODS We linked individual level data from a population-based case-control study of breast cancer among Asian American women with neighborhood level data in the Greater San Francisco Bay Area (cases: n = 118, controls: n = 390). Multivariable logistic regression models examined the association between nSES, ethnic composition, and odds of having breast cancer. RESULTS Asian American women living in neighborhoods with high nSES and high ethnic composition had the highest odds of breast cancer, compared to those living in neighborhoods with high nSES and low ethnic composition (OR = 0.34, 95% CI [0.16-0.75]) or in neighborhoods with low nSES and high ethnic composition (OR = 0.37, 95% CI [0.17-0.83]). DISCUSSION Neighborhood socioeconomic and ethnic contexts are associated with breast cancer for Asian American women. We discuss explanations and avenues for future research.
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Affiliation(s)
- Brittany N Morey
- Program of Public Health, Department of Health, Society, & Behavior, University of California Irvine, 653 E. Peltason Dr., Anteater Instruction and Research Building 2022, Irvine, CA, 92697-3957, USA.
| | - Gilbert C Gee
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - May C Wang
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - Ondine S von Ehrenstein
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
- Fielding School of Public Health, Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - Salma Shariff-Marco
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Alison J Canchola
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Juan Yang
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Sandra S-J Lee
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, 630 West 168th Street, PH 1525, New York, NY, 10032, USA
| | | | - Winston Tseng
- School of Public Health Division of Community Health Sciences, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720, USA
| | - Pancho Chang
- Council for the International Exchange of Scholars (CIES), Washington, DC, 20005, USA
| | - Scarlett Lin Gomez
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
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20
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Lawson JS, Glenn WK. Mouse Mammary Tumour Virus (MMTV) in Human Breast Cancer—The Value of Bradford Hill Criteria. Viruses 2022; 14:721. [PMID: 35458452 PMCID: PMC9028876 DOI: 10.3390/v14040721] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 01/27/2023] Open
Abstract
For many decades, the betaretrovirus, mouse mammary tumour virus (MMTV), has been a causal suspect for human breast cancer. In recent years, substantial new evidence has been developed. Based on this evidence, we hypothesise that MMTV has a causal role. We have used an extended version of the classic A. Bradford Hill causal criteria to assess the evidence. 1. Identification of MMTV in human breast cancers: The MMTV 9.9 kb genome in breast cancer cells has been identified. The MMTV genome in human breast cancer is up to 98% identical to MMTV in mice. 2. Epidemiology: The prevalence of MMTV positive human breast cancer is about 35 to 40% of breast cancers in Western countries and 15 to 20% in China and Japan. 3. Strength of the association between MMTV and human breast cancer: Consistency—MMTV env gene sequences are consistently five-fold higher in human breast cancer as compared to benign and normal breast controls. 4. Temporality (timing) of the association: MMTV has been identified in benign and normal breast tissues up to 10 years before the development of MMTV positive breast cancer in the same patient. 5. Exposure: Exposure of humans to MMTV leads to development of MMTV positive human breast cancer. 6. Experimental evidence: MMTVs can infect human breast cells in culture; MMTV proteins are capable of malignantly transforming normal human breast epithelial cells; MMTV is a likely cause of biliary cirrhosis, which suggests a link between MMTV and the disease in humans. 7. Coherence—analogy: The life cycle and biology of MMTV in humans is almost the same as in experimental and feral mice. 8. MMTV Transmission: MMTV has been identified in human sputum and human milk. Cereals contaminated with mouse fecal material may transmit MMTV. These are potential means of transmission. 9. Biological plausibility: Retroviruses are the established cause of human cancers. Human T cell leukaemia virus type I (HTLV-1) causes adult T cell leukaemia, and human immunodeficiency virus infection (HIV) is associated with lymphoma and Kaposi sarcoma. 10. Oncogenic mechanisms: MMTV oncogenesis in humans probably differs from mice and may involve the enzyme APOBEC3B. Conclusion: In our view, the evidence is compelling that MMTV has a probable causal role in a subset of approximately 40% of human breast cancers.
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Yu AYL, Thomas SM, DiLalla GD, Greenup RA, Hwang ES, Hyslop T, Menendez CS, Plichta JK, Tolnitch LA, Fayanju OM. Disease characteristics and mortality among Asian women with breast cancer. Cancer 2022; 128:1024-1037. [PMID: 34792814 PMCID: PMC8837687 DOI: 10.1002/cncr.34015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Asian women with breast cancer are often studied in aggregate, belying significant intragroup diversity. The authors sought to examine differences in breast cancer characteristics and outcomes among Asian women. METHODS Asian, non-Hispanic Black, Hispanic, and non-Hispanic White women aged 18 years and older who were diagnosed with breast cancer from 1990 to 2016 were identified in the Surveillance, Epidemiology, and End Results 18 database. Asian patients were subclassified as Chinese, Japanese, Korean, Filipino, Vietnamese, South Asian (Asian Indian or Pakistani), Southeast Asian (SEA, i.e., Cambodian, Laotian, Hmong, or Thai), or other Asian. Unadjusted overall survival (OS) and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Cox proportional hazards models were used to estimate adjusted OS and CSS. RESULTS In total, 910,415 women were included (Asian, n = 63,405; Black, n = 92,226; Hispanic, n = 84,451; White, n = 670,333). Asian women had higher rates of human epidermal growth factor receptor 2 (HER2)-positive disease compared with White women (18.7% vs 13.8%) and had the highest 10-year unadjusted OS and CSS among all racial/ethnic groups (all P < .001). SEA women had the highest rates of stage IV disease at presentation, whereas Japanese women had the lowest rates (5.9% vs 2.7%; P < .001). Japanese women had the highest 10-year unadjusted CSS (89.4%; 95% confidence interval, 88.7%-90.1%) of any distinct Asian group, whereas SEA women had the worst unadjusted CSS (78%; 95% confidence interval, 74.1%-81.3%; P < .001). After adjustment, SEA women had the worst OS of any Asian group and were the only Asian group without improved OS compared with White women (reference category; P = .08). CONCLUSIONS Breast cancer characteristics and outcomes vary significantly among Asian women. Future research should consider disaggregation by country or region of origin to identify subgroups that are at risk for worse outcomes than aggregated data may suggest. LAY SUMMARY Asian women with breast cancer are frequently studied as a single entity. However, Asian ethnic groups differ greatly by country of origin, genetic ancestry, disease frequency, socioeconomic status, patterns of immigration, as well as dietary and cultural practices. Women of different Asian ethnicities vary significantly with regard to cancer characteristics, such as mortality and tumor subtype. Future research should disaggregate these populations to better understand, treat, and counsel Asian patients with breast cancer.
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Affiliation(s)
| | - Samantha M Thomas
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.,Duke Cancer Institute, Durham, North Carolina
| | - Gayle D DiLalla
- Duke Cancer Institute, Durham, North Carolina.,Division of Surgical Oncology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Rachel A Greenup
- Duke Cancer Institute, Durham, North Carolina.,Division of Surgical Oncology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - E Shelley Hwang
- Duke Cancer Institute, Durham, North Carolina.,Division of Surgical Oncology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Terry Hyslop
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.,Duke Cancer Institute, Durham, North Carolina
| | - Carolyn S Menendez
- Duke Cancer Institute, Durham, North Carolina.,Division of Surgical Oncology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Jennifer K Plichta
- Duke Cancer Institute, Durham, North Carolina.,Division of Surgical Oncology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Lisa A Tolnitch
- Duke Cancer Institute, Durham, North Carolina.,Division of Surgical Oncology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Oluwadamilola M Fayanju
- Duke Cancer Institute, Durham, North Carolina.,Division of Surgical Oncology, Department of Surgery, Duke University School of Medicine, Durham, North Carolina.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.,Department of Surgery, Durham Veterans Affairs Medical Center, Durham, North Carolina
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22
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Garbiec E, Cielecka-Piontek J, Kowalówka M, Hołubiec M, Zalewski P. Genistein-Opportunities Related to an Interesting Molecule of Natural Origin. Molecules 2022; 27:815. [PMID: 35164079 PMCID: PMC8840253 DOI: 10.3390/molecules27030815] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/19/2022] Open
Abstract
Nowadays, increasingly more attention is being paid to a holistic approach to health, in which diet contributes to disease prevention. There is growing interest in functional food that not only provides basic nutrition but has also been demonstrated to be an opportunity for the prevention of disorders. A promising functional food is soybean, which is the richest source of the isoflavone, genistein. Genistein may be useful in the prevention and treatment of such disorders as psoriasis, cataracts, cystic fibrosis, non-alcoholic fatty liver disease and type 2 diabetes. However, achievable concentrations of genistein in humans are low, and the use of soybean as a functional food is not devoid of concerns, which are related to genistein's potential side effects resulting from its estrogenic and goitrogenic effects.
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Affiliation(s)
- Ewa Garbiec
- Department of Pharmacognosy, Faculty of Pharmacy, Poznan University of Medical Sciences, 4 Święcickiego St., 60-780 Poznan, Poland; (E.G.); (P.Z.)
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Faculty of Pharmacy, Poznan University of Medical Sciences, 4 Święcickiego St., 60-780 Poznan, Poland; (E.G.); (P.Z.)
| | - Magdalena Kowalówka
- Department of Bromatology, Faculty of Pharmacy, Poznan University of Medical Sciences, 42 Marcelińska St., 60-354 Poznan, Poland;
| | - Magdalena Hołubiec
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland;
| | - Przemysław Zalewski
- Department of Pharmacognosy, Faculty of Pharmacy, Poznan University of Medical Sciences, 4 Święcickiego St., 60-780 Poznan, Poland; (E.G.); (P.Z.)
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23
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Almeida R, Fang CY, Byrne C, Tseng M. Mammographic Breast Density and Acculturation: Longitudinal Analysis in Chinese Immigrants. J Immigr Minor Health 2021; 23:1223-1231. [PMID: 33040215 PMCID: PMC8035345 DOI: 10.1007/s10903-020-01107-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 11/29/2022]
Abstract
Breast cancer is the most common cancer in women. Asian American women have experienced steadily increasing breast cancer incidence rates over the past several decades. The increased rate might be in part due to acculturation. We tested the hypothesis that higher level of acculturation was associated with higher mammographic breast density (MBD), an indicator of breast cancer risk, in a cohort of 425 premenopausal Chinese immigrant women in Philadelphia. Generalized estimating equations accounted for repeated observations and adjusted for age, type of mammographic image, body mass index, months of breastfeeding, number of live births, age at first birth, and menopausal stage (pre, early peri, late peri, post). Results indicated that acculturation level was not associated with any of the MBD measures. Findings were contrary to our hypothesis and previous, cross-sectional studies. In this study population, reproductive factors had a greater effect on MBD than acculturation-related behaviors in adulthood.
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Affiliation(s)
- Rebeca Almeida
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, CA, USA
| | | | - Celia Byrne
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Marilyn Tseng
- Department of Kinesiology and Public Health, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
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24
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Xie H, Li Y, Theodoropoulos N, Wang Q. Mammography Screening Disparities in Asian American Women: Findings From the California Health Interview Survey 2015-2016. Am J Health Promot 2021; 36:248-258. [PMID: 34814756 DOI: 10.1177/08901171211048136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To identify mammography screening prevalence and predictors in Asian American women, focusing on the potential disparities in race and its influence on screening behaviors. DESIGN A secondary analysis utilized the California Health Interview Survey (CHIS) 2015-2016. SETTING California, U.S. SAMPLE Cisgender women who were non-Hispanic (NH) White, Chinese, Filipino, Vietnamese, Japanese, Korean, or "other Asian", aged 40 or above (unweighted N=13 451). MEASURES Socioeconomics, chronic health conditions, and preventive care utilization were mesuared as potential risk factors, where up-to-date mammography screening as the outcome variable. ANALYSIS Multivariable adjusted logistic regressions were generalized to identify the up-to-date mammography screening behaviors in relation to potential factors, stratified by race and ethnicity. RESULTS The prevalence for up-to-date mammography screening in NH-White and Asian American women were 68.06% and 65.97%, respectively. In NH-White women, receiving an up-to-date mammogram was associated with age, birthplace, smoking status, diabetes, hypertension, health insurance coverage, and a preventive care visit in the past 12 months, whereas only age and a preventive care visit were significant predictors in Asian women. CONCLUSIONS The findings indicate that utilization disparities exist in mammogram in relation to socioeconomics, chronic health conditions, preventive care utilization, when comparing between race and ethnicity. Asian American women with borderline hypertension and no preventive care visits may require more public health outreach and cancer education.
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Affiliation(s)
- Hui Xie
- Joseph J. Zilber School of Public Health, 14751University of Wisconsin-Milwaukee Milwaukee, WI, USA
| | - Yannan Li
- Dapartment of Medicine, 5925Icahn School of Medicine at Mount Sinai Morningside and West, New York, NY, USA
| | - Nickolas Theodoropoulos
- Dapartment of Medicine, 5925Icahn School of Medicine at Mount Sinai Morningside and West, New York, NY, USA
| | - Qian Wang
- Division of Hematology and Medical Oncology, Department of Medicine, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
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25
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Bacong AM, Menjívar C. Recasting the Immigrant Health Paradox Through Intersections of Legal Status and Race. J Immigr Minor Health 2021; 23:1092-104. [PMID: 33656653 DOI: 10.1007/s10903-021-01162-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/23/2022]
Abstract
Immigrant health research has often noted an "immigrant health paradox", the observation that immigrants are "healthier" compared to their native-born peers of similar demographic and socioeconomic profile. This paradox disappears as immigrants stay longer in the host country. Multiple arguments, including migrant selectivity and cultural and behavioral factors have been proposed as reasons for the apparent paradox. Recently, the field has focused on immigrant legal status, especially its racialization. We review the literature on the immigrant health paradox, legal status, and racialized legal status to examine how this debate has taken a more structural approach. We find that immigrant health research has taken a needed intersectional approach, a productive development that examines how different markers of disadvantage work concurrently to shape immigrants' health. This approach, which factors in immigration enforcement practices, aligns with explanations for poor health outcomes among other racialized groups, and promises a fruitful avenue for future research.
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26
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Sharma M, Dai CL, Batra K, Chen CC, Pharr JR, Coughenour C, Awan A, Catalano H. Using the Multi-Theory Model (MTM) of Health Behavior Change to Explain the Correlates of Mammography Screening among Asian American Women. Pharmacy (Basel) 2021; 9:126. [PMID: 34287360 DOI: 10.3390/pharmacy9030126] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 12/22/2022] Open
Abstract
Globally, breast cancer is the most common malignancy affecting women. The incidence of breast cancer has been growing among Asian American women. Mammography is a screening procedure that provides early diagnosis for the timely treatment to reduce premature mortality due to breast cancer. However, there are no national data available that summarize the rates of mammography screening among Asian American women. Some small-scale studies have reported low rates of mammography uptake among Asian American women. This cross-sectional study utilized the fourth-generation, multi-theory model (MTM) of health behavior change to explain the correlates of mammography screening among Asian American women between the ages of 45–54 years. A 44-item instrument was evaluated for face, content, and construct validity (using structural equation modeling) and reliability (Cronbach’s alpha) and administered electronically to a nationally representative sample of Asian American women (n = 374). The study found that Asian American women who have had received mammograms in the past 12 months as per recommendations, all three constructs of MTM, namely, participatory dialogue (β = 0.156, p < 0.05), behavioral confidence (β = 0.236, p < 0.001), and changes in the physical environment (β = 0.426, p < 0.001) were statistically significant and crucial in their decision to initiate getting a mammogram, accounting for a substantial 49.9% of the variance in the decision to seek mammography. The study also found that the MTM constructs of emotional transformation (β = 0.437, p < 0.001) and practice for change (β = 0.303, p < 0.001) were significant for maintaining the repeated behavior of getting annual mammograms and were responsible for 53.9% of the variance. This evidence-based study validates the use of MTM in designing and evaluating mammography screening promotion programs among Asian American women aged 45–54 years.
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27
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Tsui J, Yang A, Anuforo B, Chou J, Brogden R, Xu B, Cantor JC, Wang S. Health Related Social Needs Among Chinese American Primary Care Patients During the COVID-19 Pandemic: Implications for Cancer Screening and Primary Care. Front Public Health 2021; 9:674035. [PMID: 34123992 PMCID: PMC8192797 DOI: 10.3389/fpubh.2021.674035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 04/23/2021] [Indexed: 12/28/2022] Open
Abstract
Research Objective: Initiatives to address social determinants of health (SDOH) and measure health-related social needs (HRSN) within clinic settings are increasing. However, few have focused on the specific needs of Asian Americans (AA). We examine the prevalence of HRSN during a period spanning the COVID-19 pandemic to inform strategies to improve cancer screening and primary care among AA patients. Methods: We implemented a self-administered HRSN screening tool in English and Chinese, traditional (T) or simplified (S) text, within a hospital-affiliated, outpatient primary care practice predominantly serving AA in New Jersey. HRSN items included food insecurity, transportation barriers, utility needs, interpersonal violence, housing instability, immigration history, and neighborhood perceptions on cohesion and trust. We conducted medical chart reviews for a subset of participants to explore the relationship between HRSN and history of cancer screening. Results: Among 236 participants, most were Asian (74%), non-US born (79%), and privately insured (57%). One-third responded in Chinese (37%). Half reported having ≥1 HRSN. Interpersonal violence was high across all participants. Transportation needs were highest among Chinese-T participants, while food insecurity and housing instability were higher among Chinese-S participants. Lower-income patients had higher odds of having ≥2 HRSN (OR:2.53, 95% CI: 1.12, 5.98). Older age and public insurance/uninsured were significantly associated with low neighborhood perceptions. Conclusions: We observed higher than anticipated reports of HRSN among primary care patients in a suburban, hospital-affiliated practice serving AA. Low neighborhood perceptions, particularly among Chinese-S participants, highlight the importance of addressing broader SDOH among insured, suburban AA patients. These study findings inform the need to augment HRSN identification to adequately address social needs that impact health outcomes and life course experiences for Asian patients. As HRSN measuring efforts continue, and COVID-19's impact on the health of minority communities emerge, it will be critical to develop community-specific referral pathways to connect AA to resources for HRSN and continue to address more upstream social determinants of health for those who are disproportionately impacted.
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Affiliation(s)
- Jennifer Tsui
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Annie Yang
- Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Bianca Anuforo
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Jolene Chou
- Rutgers Center for State Health Policy, Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, United States
| | - Ruth Brogden
- RWJBarnabas Health Medical Group, Center for Asian Health, Saint Barnabas Medical Center, Florham Park, NJ, United States
| | - Binghong Xu
- RWJBarnabas Health Medical Group, Center for Asian Health, Saint Barnabas Medical Center, Florham Park, NJ, United States
| | - Joel C. Cantor
- Rutgers Center for State Health Policy, Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, United States
- Rutgers Edward J. Bloustein School of Planning and Public Policy, New Brunswick, NJ, United States
| | - Su Wang
- RWJBarnabas Health Medical Group, Center for Asian Health, Saint Barnabas Medical Center, Florham Park, NJ, United States
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28
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Jang MK, Chung DW, Hamlish T, Rhee E, Mathew A, Li H, Doorenbos AZ. Factors Influencing Mammography Uptake Following a Screening Intervention among Asian American Women: A Systematic Review. J Immigr Minor Health 2021. [PMID: 33725222 DOI: 10.1007/s10903-021-01172-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 12/27/2022]
Abstract
Asian American women, both immigrant and US-born, are known to have low mammography screening rates. To reduce health disparities and address community health needs, we undertook a systematic review to identify factors that affect mammography uptake among Asian American women following a mammography screening intervention. Following the PRISMA guidelines, we searched four databases and selected 12 studies that met our inclusion criteria. We identified 22 relevant factors and developed a new conceptual model that comprehensively captures these sociodemographic; cultural; knowledge, attitude, and perception; health history; health care accessibility and availability; and intervention factors, including components and mode of intervention. This conceptual model can be used to guide development of interventions that effectively promote mammography screening. Future research should focus on the effect of acculturation on screening behaviors and the importance of culturally tailored intervention and information-sharing elements to improving mammography screening among Asian Americans.
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29
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Wang VA, Chu MT, Chie L, Gaston SA, Jackson CL, Newendorp N, Uretsky E, Dodson RE, Adamkiewicz G, James-Todd T. Acculturation and endocrine disrupting chemical-associated personal care product use among US-based foreign-born Chinese women of reproductive age. J Expo Sci Environ Epidemiol 2021; 31:224-232. [PMID: 33235331 PMCID: PMC7954893 DOI: 10.1038/s41370-020-00279-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/20/2020] [Accepted: 11/05/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Personal care products (PCPs) are an important source of endocrine disrupting chemicals (EDCs) linked to adverse reproductive health outcomes. OBJECTIVE We evaluated EDC-associated PCP use and acculturation among Asian women. METHODS Our study included 227 foreign-born Chinese women ages 18-45 seeking obstetrics-gynecology care at community health centers (Boston, MA). Acculturation was measured by English-language use, length of US residence, and age at US entry. Self-reported use of PCPs (crème rinse/conditioner, shampoo, perfume/cologne, bar soap/body wash, liquid hand soap, moisturizer/lotion, colored cosmetics, sunscreen, and nail polish) in the last 48 h was collected. Latent class analysis was used to identify usage patterns. We also conducted multivariable logistic to determine the cross-sectional associations of acculturation measures and the use of individual PCP types. RESULTS Those who used more PCP types, overall and by each type, tended to be more acculturated. Women who could speak English had 2.77 (95% CI: 1.10-7.76) times the odds of being high PCP users compared to their non-English speaking counterparts. English-language use was associated with higher odds of using perfume/cologne and nail polish. SIGNIFICANCE Our findings give insight about EDC-associated PCP use based on acculturation status, which can contribute to changes in immigrant health and health disparities.
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Affiliation(s)
- Veronica A Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - MyDzung T Chu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Lucy Chie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Symielle A Gaston
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
| | - Chandra L Jackson
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, 27709, USA
- Department of Health and Human Services, Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Nicole Newendorp
- Committee on Degrees in Social Studies, Harvard University, Cambridge, MA, 02138, USA
| | - Elanah Uretsky
- Department of Anthropology, Brandeis University, Waltham, MA, 02453, USA
| | | | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02114, USA.
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30
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Tuan AW, Davis Lynn BC, Chernyavskiy P, Yu M, Gomez SL, Gierach GL, Rosenberg PS. Breast Cancer Incidence Trends by Estrogen Receptor Status Among Asian American Ethnic Groups, 1990-2014. JNCI Cancer Spectr 2021; 4:pkaa005. [PMID: 33392441 DOI: 10.1093/jncics/pkaa005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 01/06/2020] [Accepted: 01/28/2020] [Indexed: 12/22/2022] Open
Abstract
Background Westernization and etiologic heterogeneity may play a role in the rising breast cancer incidence in Asian American (AA) women. We report breast cancer incidence in Asian-origin populations. Methods Using a specialized Surveillance, Epidemiology, and End Results-9 Plus API Database (1990-2014), we analyzed breast cancer incidence overall, by estrogen receptor (ER) status, and age group among non-Hispanic white (NHW) and AA women. We used age-period-cohort models to assess time trends and quantify heterogeneity by ER status, race and ethnicity, and age. Results Overall, breast cancer incidence increased for most AA ethnicities (Filipina: estimated annual percentage change [EAPC] = 0.96%/year, 95% confidence interval [CI] = 0.61% to 1.32%; South Asian: EAPC = 1.68%/year, 95% CI = 0.24% to 3.13%; Chinese: EAPC = 0.65%/year, 95% CI = 0.03% to 1.27%; Korean: EAPC = 2.55%/year, 95% CI = 0.13% to 5.02%; and Vietnamese women: EAPC = 0.88%/year, 95% CI = 0.37% to 1.38%); rates did not change for NHW (EAPC = -0.2%/year, 95% CI = -0.73% to 0.33%) or Japanese women (EAPC = 0.22%/year, 95% CI = -1.26% to 1.72%). For most AA ethnicities, ER-positive rates statistically significantly increased, whereas ER-negative rates statistically significantly decreased. Among older women, ER-positive rates were stable for NHW and Japanese women. ER-negative rates decreased fastest in NHW and Japanese women among both age groups. Conclusions Increasing ER-positive incidence is driving an increase overall for most AA women despite declining ER-negative incidence. The similar trends in NHW and Japanese women (vs other AA ethnic groups) highlight the need to better understand the influences of westernization and other etiologic factors on breast cancer incidence patterns in AA women. Heterogeneous trends among AA ethnicities underscore the importance of disaggregating AA data and studying how breast cancer differentially affects the growing populations of diverse AA ethnic groups.
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Affiliation(s)
- Alyssa W Tuan
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Brittny C Davis Lynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Pavel Chernyavskiy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA.,Department of Mathematics and Statistics, University of Wyoming, Laramie, WY, USA
| | - Mandi Yu
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Scarlett L Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Philip S Rosenberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
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31
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Zhang X, Li P, Guo P, Wang J, Liu N, Yang S, Yu L, Zhang X, Zhang W. Culturally Tailored Intervention to Promote Mammography Screening Practice Among Chinese American Women: a Systematic Review. J Cancer Educ 2020; 35:1052-1060. [PMID: 32140968 DOI: 10.1007/s13187-020-01730-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Our review aimed to assess the effectiveness of culturally tailored intervention in mammography practice for Chinese American women. We searched the entire paper published by the Cochrane Library, PubMed, and Web of Science from inception to 17 October 2019. Moreover, we manually checked reference lists of included studies to find other potentially eligible studies. It included clinical trials published in English that evaluated the effects of culturally tailored intervention on mammography practice for Chinese American women. Finally, we involved eight studies in our review. After the intervention, the mammography intention and breast cancer-related knowledge were significantly improved. However, there was no significant impact on mammography completion rate, perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, and Eastern cultural views of Chinese American women. The culturally tailored interventions could serve as promising approaches to improve mammography screening practice for Chinese American women, but further improvements are needed.
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Affiliation(s)
- Xuehui Zhang
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Ping Li
- The Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Pingping Guo
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Jie Wang
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Na Liu
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Shu Yang
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Lin Yu
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Xiumin Zhang
- School of Public Health, Jilin University, Changchun, 130021, Jilin Province, China.
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China.
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Mukand NH, Zolekar A, Ko NY, Calip GS. Risks of Second Primary Gynecologic Cancers following Ovarian Cancer Treatment in Asian Ethnic Subgroups in the United States, 2000-2016. Cancer Epidemiol Biomarkers Prev 2020; 29:2220-2229. [PMID: 32856609 PMCID: PMC10772992 DOI: 10.1158/1055-9965.epi-20-0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/03/2020] [Accepted: 08/04/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The differential occurrence of second primary cancers by race following ovarian cancer is poorly understood. Our objective was to determine the incidence of second primary gynecologic cancers (SPGC) following definitive therapy for ovarian cancer. Specifically, we aimed to determine differences in SPGC incidence by Asian ethnic subgroups. METHODS We identified 27,602 women ages 20 years and older and diagnosed with first primary epithelial ovarian cancer between 2000 and 2016 who received surgery and chemotherapy in 18 population-based Surveillance, Epidemiology and End Results Program registries. We compared the incidence of SPGC with expected incidence rates in the general population of women using estimated standardized incidence ratios (SIR) and 95% confidence intervals (CI). RESULTS The incidence of SPGC was lower among White women (SIR = 0.73; 95% CI, 0.59-0.89), and higher among Black (SIR = 1.80; 95% CI, 0.96-3.08) and Asian/Pacific Islander (API) women (SIR = 1.83; 95% CI, 1.07-2.93). Increased risk of vaginal cancers was observed among all women, although risk estimates were highest among API women (SIR = 26.76; 95% CI, 5.52-78.2) and were also significant for risk of uterine cancers (SIR = 2.53; 95% CI, 1.35-4.33). Among API women, only Filipinas had significantly increased incidence of SPGC overall including both uterine and vaginal cancers. CONCLUSIONS Risk of SPGC following treatment of ovarian cancer differs by race and ethnicity, with Filipina women having the highest rates of second gynecologic cancers among Asian women. IMPACT Ensuring access and adherence to surveillance may mitigate ethnic differences in the early detection and incidence of second gynecologic cancers.
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Affiliation(s)
- Nita H Mukand
- University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois
- University of Illinois Cancer Center, Chicago, Illinois
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ashwini Zolekar
- University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois
| | - Naomi Y Ko
- Section of Hematology Oncology, Boston University School of Medicine, Boston, Massachusetts
| | - Gregory S Calip
- University of Illinois at Chicago, College of Pharmacy, Chicago, Illinois.
- University of Illinois Cancer Center, Chicago, Illinois
- Flatiron Health, New York, New York
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Seo JY, Strauss SM. Association of Cancer History and Health Care Utilization Among Female Immigrants Using NHANES 2007-2016 Data. J Immigr Minor Health 2020; 22:1208-1216. [PMID: 32975742 DOI: 10.1007/s10903-020-01090-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite health disparities in preventive care among adult female immigrants, the extent to which their health service utilization is influenced by a cancer history remains largely unknown. METHODS Using Andersen's behavioral model, 2007-2016 National Health and Nutrition Examination Survey data were analyzed to examine the influence of a cancer history on health service utilization among adult immigrant women. Multivariate logistic regression models assessed factors related to past year health care utilization, operationalized as an outpatient doctor's visit and an inpatient overnight hospital stay. RESULTS Once other factors were considered, a past cancer history increased the likelihood of a past year inpatient overnight hospital stay, but was not associated with a past year outpatient doctor's visit. DISCUSSION An outpatient doctor's visit for adult female immigrant cancer survivors would provide an opportunity for essential preventive health services. They must be educated about the importance of ongoing outpatient care for cancer surveillance and health maintenance.
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Affiliation(s)
- Jin Young Seo
- Hunter-Bellevue School of Nursing, Hunter College, 425 East 25th Street, Rm.416W, New York, NY, 10010, USA.
| | - Shiela M Strauss
- Hunter-Bellevue School of Nursing, Hunter College, 425 East 25th Street, Rm.416W, New York, NY, 10010, USA
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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Abstract
Citizenship is considered an egalitarian legal identity but may function differently among minorities because of racial/ethnic stratification and historical context. Using Asians, I examine whether the association between citizenship and self-rated health differs by ethnicity. I examine the moderating effect of Asian ethnic group (Chinese, Filipino, Korean, Vietnamese, and Other Asian) on citizenship and self-rated health using the 2012-2016 California Health Interview Survey (n = 11,084). Models account for demographics, socioeconomic status, healthcare, and English proficiency. Adjusting for demographics, naturalized citizens and non-citizens were statistically significantly more likely to report fair/poor health compared to U.S.-born citizens. Naturalized and non-citizen Vietnamese reported statistically significantly poorer health to all U.S.-born groups. These trends largely disappear when controlling for all covariates. Citizenship status can be useful in considering structural barriers for immigrants. Future work should interrogate the non-citizen category and why trends are seen among Vietnamese, but not others.
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Affiliation(s)
- Adrian Matias Bacong
- Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South, 36-071 CHS, Box 951772, Los Angeles, CA, 90095-1772, USA.
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Gomez SL, Yao S, Kushi LH, Kurian AW. Is Breast Cancer in Asian and Asian American Women a Different Disease? J Natl Cancer Inst 2020; 111:1243-1244. [PMID: 31093671 DOI: 10.1093/jnci/djz091] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 05/06/2019] [Indexed: 12/28/2022] Open
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Acquati C, Miyawaki CE, Lu Q. Post-traumatic stress symptoms and social constraints in the communication with family caregivers among Chinese-speaking breast cancer survivors. Support Care Cancer 2020; 28:4115-22. [PMID: 31872294 DOI: 10.1007/s00520-019-05206-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 11/24/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The consequences of breast cancer on physical and psychological well-being have been extensively studied. One of the long-term effects of the disease is Post-Traumatic Stress Symptoms (PTSS). However, only a small number of studies examined PTSS among Chinese-speaking breast cancer survivors. This study investigated interpersonal and physical health predictors of PTSS and explored sociodemographic and clinical factors linked to PTSS in this group. We hypothesized that higher levels of social constraints and lower levels of social support, relationship closeness, and physical health would be associated with higher levels of PTSS. METHODS A sample of 96 Chinese-speaking breast cancer survivors completed measures of PTSS, social constraints, social support, closeness, health-related quality of life, and acculturation. Bivariate correlation examined association between variables of interest. Then, a hierarchical multiple regression analysis was conducted to examine predictors of PTSS. RESULTS Participants reported an average score of 14.7 (SD = 10.46, range 0-44) on the severity of PTSS, with 54.2% (N = 52) meeting the criteria for likelihood of PTSD. PTSS were positively associated with social constraints and negatively associated with social support, closeness, and physical health. More medication usage was linked to worse PTSS. Only social constraints in the ability to communicate cancer-related concerns to the caregiver predicted worse PTSS severity. CONCLUSIONS The study unveils the role of interpersonal factors in mental health outcomes of Chinese-speaking breast cancer survivors. Future research should be conducted on larger samples and culturally relevant psychosocial interventions should be developed.
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Coughlin SS. Social determinants of breast cancer risk, stage, and survival. Breast Cancer Res Treat 2019; 177:537-548. [DOI: 10.1007/s10549-019-05340-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 06/27/2019] [Indexed: 02/08/2023]
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