1
|
Guan A, Pruitt SL, Henry KA, Lin K, Meltzer D, Canchola AJ, Rathod AB, Hughes AE, Kroenke CH, Gomez SL, Hiatt RA, Stroup AM, Pinheiro PS, Boscoe FP, Zhu H, Shariff-Marco S. Asian American Enclaves and Healthcare Accessibility: An Ecologic Study Across Five States. Am J Prev Med 2023; 65:1015-1025. [PMID: 37429388 PMCID: PMC10921977 DOI: 10.1016/j.amepre.2023.07.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION Access to primary care has been a long-standing priority for improving population health. Asian Americans, who often settle in ethnic enclaves, have been found to underutilize health care. Understanding geographic primary care accessibility within Asian American enclaves can help to ensure the long-term health of this fast-growing population. METHODS U.S. Census data from five states (California, Florida, New Jersey, New York, and Texas) were used to develop and describe census-tract level measures of Asian American enclaves and social and built environment characteristics for years 2000 and 2010. The 2-step floating catchment area method was applied to National Provider Identifier data to develop a tract-level measure of geographic primary care accessibility. Analyses were conducted in 2022-2023, and associations between enclaves (versus nonenclaves) and geographic primary care accessibility were evaluated using multivariable Poisson regression with robust variance estimation, adjusting for potential area-level confounders. RESULTS Of 24,482 census tracts, 26.1% were classified as Asian American enclaves. Asian American enclaves were more likely to be metropolitan and have less poverty, lower crime, and lower proportions of uninsured individuals than nonenclaves. Asian American enclaves had higher primary care accessibility than nonenclaves (adjusted prevalence ratio=1.23, 95% CI=1.17, 1.29). CONCLUSIONS Asian American enclaves in five of the most diverse and populous states in the U.S. had fewer markers of disadvantage and greater geographic primary care accessibility. This study contributes to the growing body of research elucidating the constellation of social and built environment features within Asian American enclaves and provides evidence of health-promoting characteristics of these neighborhoods.
Collapse
Affiliation(s)
- Alice Guan
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Sandi L Pruitt
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kevin A Henry
- Department of Geography and Urban Studies, College of Liberal Arts, Temple University, Philadelphia, Pennsylvania; Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Katherine Lin
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California; Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California
| | - Dan Meltzer
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Alison J Canchola
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California; Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California
| | - Aniruddha B Rathod
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Amy E Hughes
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas; Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Candyce H Kroenke
- Kaiser Permanente Northern California Division of Research, Oakland, California
| | - Scarlett L Gomez
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California; Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Robert A Hiatt
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | | | - Paulo S Pinheiro
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida; Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
| | | | - Hong Zhu
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Salma Shariff-Marco
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California; Greater Bay Area Cancer Registry, University of California San Francisco, San Francisco, California; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California.
| |
Collapse
|
2
|
Iyer HS, Shi X, Satagopan JM, Cheng I, Roscoe C, McLaughlin RH, Stroup AM, Setoguchi S, Bandera EV, Hernandez BY, Doherty JA, Hsieh MC, Knowlton R, Qin B, Laden F, Rebbeck TR, Gomez SL. Advancing Social and Environmental Research in Cancer Registries Using Geomasking for Address-Level Data. Cancer Epidemiol Biomarkers Prev 2023; 32:1485-1489. [PMID: 37908192 DOI: 10.1158/1055-9965.epi-23-0790] [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] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 11/02/2023] Open
Abstract
Understanding the social and environmental causes of cancer in the United States, particularly in marginalized communities, is a major research priority. Population-based cancer registries are essential for advancing this research, given their nearly complete capture of incident cases within their catchment areas. Most registries limit the release of address-level geocodes linked to cancer outcomes to comply with state health departmental regulations. These policies ensure patient privacy, uphold data confidentiality, and enhance trust in research. However, these restrictions also limit the conduct of high-quality epidemiologic studies on social and environmental factors that may contribute to cancer burden. Geomasking refers to computational algorithms that distort locational data to attain a balance between effectively "masking" the original address location while faithfully maintaining the spatial structure in the data. We propose that the systematic deployment of scalable geomasking algorithms could accelerate research on social and environmental contributions across the cancer continuum by reducing measurement error bias while also protecting privacy. We encourage multidisciplinary teams of registry officials, geospatial analysts, cancer researchers, and others engaged in this form of research to evaluate and apply geomasking procedures based on feasibility of implementation, accuracy, and privacy protection to accelerate population-based research on social and environmental causes of cancer.
Collapse
Affiliation(s)
- Hari S Iyer
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Xun Shi
- Department of Geography, Dartmouth College, Hanover, New Hampshire
| | - Jaya M Satagopan
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
| | - Iona Cheng
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Charlotte Roscoe
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Robert H McLaughlin
- Cancer Registry of Greater California, Public Health Institute, Oakland, California
| | - Antoinette M Stroup
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
- New Jersey State Cancer Registry, Trenton, New Jersey
| | - Soko Setoguchi
- Rutgers University Institute for Health, Healthcare Policy, and Aging Research, the State University of New Jersey, New Brunswick, New Jersey
| | - Elisa V Bandera
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Brenda Y Hernandez
- Hawai'i Tumor Registry, University of Hawai'i Cancer Center, Honolulu, Hawaii
| | - Jennifer A Doherty
- Department of Population Science, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Mei-Chin Hsieh
- Louisiana Tumor Registry and Epidemiology Program, School of Public Health at Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Richard Knowlton
- Massachusetts Cancer Registry, Office of Data Management and Outcomes Assessment, Office of Population Health, Massachusetts Department of Public Health, Boston, Massachusetts
| | - Bo Qin
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Timothy R Rebbeck
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Scarlett L Gomez
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| |
Collapse
|
3
|
Kinney AY, Stroup AM, Scharf S, Libutti SK. Rutgers Cancer Institute of New Jersey's Community Outreach and Engagement Approach to Cancer Prevention. Cancer Prev Res (Phila) 2023; 16:595-600. [PMID: 37908146 PMCID: PMC10618643 DOI: 10.1158/1940-6207.capr-23-0293] [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: 07/18/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 11/02/2023]
Abstract
Rutgers Cancer Institute of New Jersey (New Brunswick, NJ) is committed to providing cancer prevention education, outreach, and clinical services in our catchment area (CA). Our approach to cancer prevention includes ongoing surveillance to better understand the CA cancer burden and opportunities for intervention, leveraging community partnerships, and vigorously engaging diverse communities to understand and address their needs. This approach considers individual, sociocultural, environmental, biologic, system, and policy-level factors with an equity lens. Rutgers Cancer Institute has had substantial impact on cancer prevention (risk reduction, screening, and early detection) over the past five years, including the development of a CA data dashboard advancing implementation of evidence-based cancer control actions by leveraging 357 healthcare and community partners (with 522 partner sites). Furthermore, we provided professional education (attendance 19,397), technical assistance to community organizations (1,875 support sessions), educational outreach for community members (87,000+ through direct education), facilitated access to preventive services (e.g., 60,000+ screenings resulting in the detection of >2,000 malignant and premalignant lesions), contributed to advances in health policy and population-level improvements in risk reduction behaviors, screening, and incidence. With longer-term data, we will assess the impact of our cancer prevention efforts on cancer incidence, downward shifts in stage at diagnosis, mortality, and disparities.
Collapse
Affiliation(s)
- Anita Y. Kinney
- Rutgers University School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Antoinette M. Stroup
- Rutgers University School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Sarah Scharf
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Steven K. Libutti
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
- Robert Wood Johnson Medical School, New Brunswick, New Jersey
| |
Collapse
|
4
|
McGee-Avila JK, Richmond J, Henry KA, Stroup AM, Tsui J. Disparities in geospatial patterns of cancer care within urban counties and structural inequities in access to oncology care. Health Serv Res 2023. [PMID: 37208901 DOI: 10.1111/1475-6773.14182] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVE To examine geospatial patterns of cancer care utilization across diverse populations in New Jersey-a state where most residents live in urban areas. DATA SOURCES/STUDY SETTING We used data from the New Jersey State Cancer Registry from 2012 to 2014. STUDY DESIGN We examined the location of cancer treatment among patients 20-65 years of age diagnosed with breast, colorectal, or invasive cervical cancer and investigated differences in geospatial patterns of care by individual and area-level (e.g., census tract-level) characteristics. DATA COLLECTION/EXTRACTION METHODS Multivariate generalized estimating equation models were used to determine factors associated with receiving cancer treatment within residential counties, residential hospital service areas, and in-state (versus out-of-state) care. PRINCIPAL FINDINGS We observed significant differences in geospatial patterns of cancer treatment by race/ethnicity, insurance type, and area-level factors. Even after adjusting for tumor characteristics, insurance type, and other demographic factors, non-Hispanic Black patients had a 5.6% higher likelihood of receiving care within their own residential county compared to non-Hispanic White patients (95% CI: 2.80-8.41). Patients insured with Medicaid and those without insurance had higher likelihoods of receiving care within their residential county compared to privately insured individuals. Patients living in census tracts with the highest quintile of social vulnerability were 4.6% more likely to receive treatment within their residential county (95% CI: 0.00-9.30) and were 2.7% less likely to seek out-of-state care (95% CI: -4.85 to -0.61). CONCLUSIONS Urban populations are not homogenous in their geospatial patterns of cancer care utilization, and individuals living in areas with greater social vulnerability may have limited opportunities to access care outside of their immediate residential county. Geographically tailored efforts, along with socioculturally tailored efforts, are needed to help improve equity in cancer care access.
Collapse
Affiliation(s)
| | - Jennifer Richmond
- Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kevin A Henry
- Department of Geography, Temple University, Philadelphia, Pennsylvania, USA
- Cancer Prevention and Control, Fox Chase Cancer Center, Temple University Health, Philadelphia, Pennsylvania, USA
| | - Antoinette M Stroup
- Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine at USC, University of Southern California, Los Angeles, California, USA
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
5
|
Fong AJ, Llanos AAM, Ashrafi A, Zeinomar N, Chokshi S, Bandera EV, Devine KA, Hudson SV, Qin B, O’Malley D, Paddock LE, Stroup AM, Evens AM, Manne SL. Sociodemographic and Health Correlates of Multiple Health Behavior Adherence among Cancer Survivors: A Latent Class Analysis. Nutrients 2023; 15:2354. [PMID: 37242237 PMCID: PMC10223681 DOI: 10.3390/nu15102354] [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: 03/20/2023] [Revised: 04/24/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
The study aimed to (a) assess current levels of adherence to the National Comprehensive Cancer Network's multiple health behavior guidelines and (b) identify characteristics of cancer survivors associated with different adherence levels. Cancer survivors (N = 661) were identified through the state registry and completed questionnaires. Latent class analysis (LCA) was used to identify patterns of adherence. Associations between predictors with the latent classes were reported as risk ratios. LCA identified three classes: lower- (39.6%), moderate- (52.0%), and high-risk lifestyle (8.3%). Participants in the lower-risk lifestyle class had the highest probability of meeting most of the multiple health behavior guidelines compared to participants in the high-risk lifestyle class. Characteristics associated with membership in the moderate-risk lifestyle class included self-identifying as a race other than Asian/Asian American, being never married, having some college education, and having been diagnosed with later stage colorectal or lung cancer. Those in the high-risk lifestyle class were more likely to be male, never married, have a high school diploma or less, diagnosed with colorectal or lung cancer, and diagnosed with pulmonary comorbidities. Study findings can be used to inform development of future interventions to promote multiple health behavior adherence among higher risk cancer survivors.
Collapse
Affiliation(s)
- Angela J. Fong
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Adana A. M. Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Adiba Ashrafi
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Nur Zeinomar
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Sagar Chokshi
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ 08901, USA
| | - Elisa V. Bandera
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Katie A. Devine
- Department of Pediatrics, Section of Pediatric Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Shawna V. Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Bo Qin
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Denalee O’Malley
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Lisa E. Paddock
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Antoinette M. Stroup
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Andrew M. Evens
- Department of Medicine, Division of Blood Disorders, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Sharon L. Manne
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| |
Collapse
|
6
|
Wiese D, Stroup AM, Islami F, Mattes M, Baylor E, Boscoe FP, Henry KA. Geographic Diffusion of Digital Mammography in the United States. Cancer 2023. [PMID: 36988982 DOI: 10.1002/cncr.34774] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Examining temporal and spatial diffusion of a new technology, such as digital mammography, can provide important insights into potential disparities associated with access to new medical technologies and how quickly these technologies are adopted. Although digital mammography is currently a standard technology in the United States for breast cancer screening, its adoption and geographic diffusion, as medical facilities transitioned from film to digital units, has not been explored well. METHODS This study evaluated the geographic diffusion of digital mammography facilities from 2001 to 2014 in the contiguous United States (excluding Alaska and Hawaii) and estimated the geographic accessibility to this new technology for women aged ≥45 years at the census tract level within a 20-minute drivetime by population density, rural/urban residence, and race/ethnicity. The number of mammography units by technology type (film or digital) and density per 10,000 women were also summarized. RESULTS The adoption of digital mammography advanced first in densely populated regions and last in remote rural areas. Overall, proportion of digital mammography units increased from 1.4% in 2001 to 94.6% in 2014, but since 2008, there was a decline in density of units from 2.31 per 10,000 women aged ≥45 years to 1.97 in 2014. In 2014, approximately 87% of women aged ≥45 years in the contiguous United States had accessibility to digital mammography, but this proportion was substantially lower for Native American women (67%) and rural residents (32%). CONCLUSION Understanding the diffusion of and accessibility to digital mammography may help predict future medical technology diffusion and assess its role in geographic differences in cancer diagnosis and treatment.
Collapse
Affiliation(s)
- Daniel Wiese
- Department of Surveillance and Health Equity Science, American Cancer Society, Kennesaw, Georgia, USA
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania, USA
| | - Antoinette M Stroup
- New Jersey State Cancer Registry, Trenton, New Jersey, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Farhad Islami
- Department of Surveillance and Health Equity Science, American Cancer Society, Kennesaw, Georgia, USA
| | - Molly Mattes
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania, USA
| | - Emma Baylor
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania, USA
| | - Francis P Boscoe
- Pumphandle, LLC, Camden, Maine, USA
- New York State Department of Health, Albany, New York, USA
| | - Kevin A Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania, USA
- Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| |
Collapse
|
7
|
Wiese D, Stroup AM, Shevchenko A, Hsu S, Henry KA. Disparities in Cutaneous T-Cell Lymphoma Incidence by Race/Ethnicity and Area-Based Socioeconomic Status. Int J Environ Res Public Health 2023; 20:3578. [PMID: 36834276 PMCID: PMC9960518 DOI: 10.3390/ijerph20043578] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 01/11/2023] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Cutaneous T-cell lymphoma (CTCL) is a rare type of extranodal non-Hodgkin lymphoma (NHL). This study uses population-based data from the New Jersey (NJ) State Cancer Registry to examine geographic variation in CTCL incidence and evaluates whether CTCL risk varies by race/ethnicity and census tract socioeconomic status (SES). The study included 1163 cases diagnosed in NJ between 2006 and 2014. Geographic variation and possible clustering of high CTCL rates were assessed using Bayesian geo-additive models. The associations between CTCL risk and race/ethnicity and census tract SES, measured as median household income, were examined using Poisson regression. CTCL incidence varied across NJ, but there were no statistically significant geographic clusters. After adjustment for age, sex, and race/ethnicity, the relative risk (RR) of CTCL was significantly higher (RR = 1.47, 95% confidence interval: 1.22-1.78) in the highest income quartile than in the lowest. The interactions between race/ethnicity and SES indicated that the income gradients by RR were evident in all groups. Compared to non-Hispanic White individuals in low-income tracts, CTCL risk was higher among non-Hispanic White individuals in high-income tracts and among non-Hispanic Black individuals in tracts of all income levels. Our findings suggest racial disparities and a strong socioeconomic gradient with higher CTCL risk among cases living in census tracts with higher income compared to those living in lower-income tracts.
Collapse
Affiliation(s)
- Daniel Wiese
- Department of Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA 30144, USA
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, USA
| | - Antoinette M. Stroup
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ 08608, USA
- Rutgers Cancer Institute of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Alina Shevchenko
- Department of Dermatology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Sylvia Hsu
- Department of Dermatology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Kevin A. Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, USA
- Division of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA 19115, USA
| |
Collapse
|
8
|
Villalona S, Villalona S, Reinoso D, Sukhdeo S, Stroup AM, Ferrante JM. Human Papillomavirus (HPV)-Associated Cancers Among Hispanic Males in the United States: Late-Stage Diagnosis by Country of Origin. Cancer Control 2023; 30:10732748231218088. [PMID: 38015627 PMCID: PMC10685781 DOI: 10.1177/10732748231218088] [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: 05/15/2023] [Revised: 10/09/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION The epidemiology of human papillomavirus (HPV)-associated cancers has changed since the development of the multivalent vaccine. This is evidenced by the decline in incidence of cervical cancers in the post-vaccine era. By contrast, studies have reported the rise in incidence of these cancers in males. Though little is known regarding HPV-associated cancers in males, Hispanic males have been largely excluded from research on these cancers. OBJECTIVE The purpose of this study was to examine the differences in late-stage diagnosis of HPV-associated cancers (oropharyngeal, anorectal, or penile) among subgroups of Hispanic males in the U.S. METHODS We performed a population-based retrospective cohort study using the 2005-2016 North American Association of Central Cancer Registries Cancer in North America Deluxe data file (n = 9242). Multivariable logistic regression modeling was used in studying late-stage diagnosis. RESULTS There were no differences in late-stage diagnosis of oropharyngeal cancer between Hispanic subgroups. Higher odds of late-stage penile cancers were observed among Mexican and Puerto Rican males relative to European Spanish males. Lower odds of late-stage anorectal cancers were observed among Central or South American and Puerto Rican males. Having Medicaid or no insurance were associated with late-stage diagnosis for all cancers. CONCLUSION Certain subgroups of Hispanic males have higher odds of late-stage HPV-associated cancer diagnosis based on country of origin and insurance status. These findings call for improved efforts to increase HPV vaccination, particularly among these subgroups of Hispanic males. Efforts to improve health care access and early detection from health care providers are also needed.
Collapse
Affiliation(s)
- Seiichi Villalona
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Daisy Reinoso
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Simone Sukhdeo
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Antoinette M. Stroup
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Jeanne M. Ferrante
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| |
Collapse
|
9
|
Plascak JJ, Beyer K, Xu X, Stroup AM, Jacob G, Llanos AAM. Association Between Residence in Historically Redlined Districts Indicative of Structural Racism and Racial and Ethnic Disparities in Breast Cancer Outcomes. JAMA Netw Open 2022; 5:e2220908. [PMID: 35802373 PMCID: PMC9270695 DOI: 10.1001/jamanetworkopen.2022.20908] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/20/2022] [Indexed: 11/20/2022] Open
Abstract
Importance Historical structural racism may be associated with racial, ethnic, and geographic disparities in breast cancer outcomes, but few studies have investigated these potential relationships. Objective To test associations among historical mortgage lending discrimination (using 1930s Home Owners' Loan Corporation [HOLC] redlining data), race and ethnicity, tumor clinicopathologic features, and survival among women recently diagnosed with breast cancer. Design, Setting, and Participants This cohort study used a population-based, state cancer registry to analyze breast tumor clinicopathology and breast cancer-specific death among women diagnosed from 2008 to 2017 and followed up through 2019. Participants included all primary, histologically confirmed, invasive breast cancer cases diagnosed among women aged at least 20 years and who resided in a HOLC-graded area of New Jersey. Those missing race and ethnicity data (n = 61) were excluded. Data were analyzed between June and December 2021. Exposures HOLC risk grades of A ("best"), B ("still desirable"), C ("definitely declining"), and D ("hazardous" [ie, redlined area]). Main Outcomes and Measures Late stage at diagnosis, high tumor grade, triple-negative subtype (lacking estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression), breast cancer-specific death. Results Among a total of 14 964 women with breast cancer, 2689 were Latina, 3506 were non-Latina Black, 7686 were non-Latina White, and 1083 were other races and ethnicities (non-Latina Asian/Pacific Islander/Native American/Alaska Native/Hawaiian or not otherwise specified); there were 1755 breast cancer-specific deaths. Median follow-up time was 5.3 years (95% CI, 5.2-5.3 years) and estimated 5-year breast cancer-specific survival was 88.0% (95% CI, 87.4%-88.6%). Estimated associations between HOLC grade and each breast cancer outcome varied by race and ethnicity; compared with residence in HOLC redlined areas, residence in HOLC areas graded "best" was associated with lower odds of late-stage diagnosis (odds ratio [OR], 0.34 [95% CI, 0.22-0.53]), lower odds of high tumor grade (OR, 0.72 [95% CI, 0.57-0.91]), lower odds of triple-negative subtype (OR, 0.67 [95% CI, 0.47-0.95]), and lower hazard of breast cancer-specific death (hazard ratio, 0.48 [95% CI, 0.35-0.65]), but only among non-Latina White women. There was no evidence supporting associations among non-Latina Black or Latina women. Conclusions and Relevance Compared with redlined areas, current residence in non-redlined areas was associated with more favorable breast cancer outcomes, but only among non-Latina White women. Future studies should examine additional factors to inform how historical structural racism could be associated with beneficial cancer outcomes among privileged racial and ethnic groups.
Collapse
Affiliation(s)
- Jesse J. Plascak
- Comprehensive Cancer Center, The Ohio State University, Columbus
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus
| | - Kirsten Beyer
- Institute for Health and Society, Division of Epidemiology, Medical College of Wisconsin, Milwaukee
| | - Xinyi Xu
- Department of Statistics, The Ohio State University, Columbus
| | - Antoinette M. Stroup
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
- Rutgers Cancer Institute of New Jersey, New Brunswick
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton
| | - Gabrielle Jacob
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
| | - Adana A. M. Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| |
Collapse
|
10
|
Llanos AAM, Li J, Tsui J, Gibbons J, Pawlish K, Nwodili F, Lynch S, Ragin C, Stroup AM. Variation in Cancer Incidence Rates Among Non-Hispanic Black Individuals Disaggregated by Nativity and Birthplace, 2005-2017: A Population-Based Cancer Registry Analysis. Front Oncol 2022; 12:857548. [PMID: 35463326 PMCID: PMC9024350 DOI: 10.3389/fonc.2022.857548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/16/2022] [Indexed: 01/25/2023] Open
Abstract
ObjectivesCompared to other racial and ethnic groups, little to no disaggregated cancer incidence data exist for subgroups of non-Hispanic Blacks (NHBs), despite heterogeneity in sociodemographic characteristics and cancer risk factors within this group. Our objective was to examine age-adjusted cancer incidence by nativity and birthplace among NHB cancer cases diagnosed in New Jersey.MethodsRace, ethnicity, and birthplace data from the New Jersey State Cancer Registry were used to classify NHB cancer cases diagnosed between 2005-2017. Thirteen waves of population estimates (by county, nativity, gender, age-group) were derived from the American Community Survey using Integrated Public-Use Microdata to approximate yearly demographics. Age-adjusted cancer incidence rates (overall and by site) by birthplace were generated using SEER*Stat 8.3.8. Bivariate associations were assessed using chi-square and Fisher’s exact tests. Trend analyses were performed using Joinpoint 4.7.ResultsBirthplace was available for 62.3% of the 71,019 NHB cancer cases. Immigrants represented 12.3%, with African-born, Haitian-born, Jamaican-born, ‘other-Caribbean-born’, and ‘other-non-American-born’ accounting for 18.5%, 17.7%, 16.5%, 10.6%, and 36.8%, respectively. Overall, age-adjusted cancer incidence rates were lower for NHB immigrants for all sites combined and for several of the top five cancers, relative to American-born NHBs. Age-adjusted cancer incidence was lower among immigrant than American-born males (271.6 vs. 406.8 per 100,000) and females (191.9 vs. 299.2 per 100,000). Age-adjusted cancer incidence was lower for Jamaican-born (114.6 per 100,000) and other-Caribbean-born females (128.8 per 100,000) than African-born (139.4 per 100,000) and Haitian-born females (149.9 per 100,000). No significant differences in age-adjusted cancer incidence were observed by birthplace among NHB males. Age-adjusted cancer incidence decreased for all sites combined from 2005-2017 among American-born males, immigrant males, and American-born females, while NHB immigrant female rates remained relatively stable.ConclusionsThere is variation in age-adjusted cancer incidence rates across NHB subgroups, highlighting the need for more complete birthplace information in population-based registries to facilitate generating disaggregated cancer surveillance statistics by birthplace. This study fills a knowledge gap of critical importance for understanding and ultimately addressing cancer inequities.
Collapse
Affiliation(s)
- Adana A. M. Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
- Cancer Population Science, Herbert Irving Comprehensive Cancer Center, New York, NY, United States
- *Correspondence: Adana A. M. Llanos,
| | - Jie Li
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, United States
| | - Jennifer Tsui
- Department of Population and Public Health, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Joseph Gibbons
- Department of Sociology, San Diego State University, San Diego, CA, United States
| | - Karen Pawlish
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, United States
| | - Fechi Nwodili
- Rutgers University School of Arts and Sciences, Douglass Residential College, New Brunswick, NJ, United States
| | - Shannon Lynch
- Cancer Prevention and Control Program, Fox Chase Cancer Center-Temple Health, Philadelphia, PA, United States
| | - Camille Ragin
- Cancer Prevention and Control Program, Fox Chase Cancer Center-Temple Health, Philadelphia, PA, United States
| | - Antoinette M. Stroup
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, United States
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States
- Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| |
Collapse
|
11
|
Wiese D, Lynch SM, Stroup AM, Maiti A, Harris G, Vucetic S, Henry KA. Examining socio-spatial mobility patterns among colon cancer patients after diagnosis. SSM Popul Health 2022; 17:101023. [PMID: 35097183 PMCID: PMC8783098 DOI: 10.1016/j.ssmph.2022.101023] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/08/2021] [Revised: 12/23/2021] [Accepted: 01/04/2022] [Indexed: 11/06/2022] Open
Abstract
Given the growing number of cancer survivors, it is important to better understand socio-spatial mobility patterns of cancer patients after diagnosis that could have public health implications regarding post-diagnostic access to care for treatment and follow-up surveillance. In this exploratory study, residential histories from LexisNexis were linked to New Jersey colon cancer cases diagnosed from 2006 to 2011 to examine differences in socio-spatial mobility patterns after diagnosis by stage at cancer diagnosis, sex, and race/ethnicity. For the colon cancer cases, we summarized and compared the number of residences and changes in the residential census tract and neighborhood poverty after the diagnosis. We found only minor changes in neighborhood poverty among the cases during the follow-up period after diagnosis. During the follow-up period of up to 10 years after diagnosis, 67% of the patients did not move to a different residential census tract, and 10.8% moved from New Jersey to another state. Cases that moved to a different census tract changed after diagnosis were generally less wealthy than non-movers, but the destination of relocation varied by race/ethnicity and socioeconomic status. We also found a significant association between residential mobility and stage at diagnosis, whereby patients diagnosed with colon cancer at an early stage were more likely to be movers. This study contributes to understanding of the socio-spatial mobility patterns in colon cancer patients and may help to inform cancer research by summarizing the extent to which colon cancer patients move after diagnosis. Post-diagnosis socio-spatial mobility is relatively low among colon cancer patients. Post-diagnosis, ∼67% of all colon cancer patients in NJ did not change residence. Movers spent more time living in high-poverty neighborhoods than non-movers. Approximately 10% of all patients left New Jersey for other states. Geographic destinations vary by race/ethnicity and socioeconomic status.
Collapse
|
12
|
Fong AJ, Evens AM, Bandera EV, Llanos AAM, Devine KA, Hudson SV, Qin B, Paddock LE, Stroup AM, Frederick S, Greco C, Manne SL. Survivorship transition care experiences and preparedness for survivorship among a diverse population of cancer survivors in New Jersey. Eur J Cancer Care (Engl) 2022; 31:e13553. [PMID: 35166393 DOI: 10.1111/ecc.13553] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/13/2021] [Accepted: 01/24/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aims were (1) to characterise preparedness for survivorship and (2) to evaluate sociodemographic, medical, survivorship care transition experiences (e.g., receiving a survivorship care plan), practical (e.g., cancer-related financial hardships and information needs) and psychological (e.g., fear of recurrence) factors with preparedness for survivorship. METHODS Three hundred and forty-six residents of Southern New Jersey who were diagnosed in 2015 or 2016 with bladder, breast, gynaecological, colorectal, lung, melanoma, prostate or thyroid cancer were identified and consented by the New Jersey State Cancer Registry. Participants completed a questionnaire assessing preparedness, provider care transition practices, financial hardships, information needs and fear of cancer recurrence. Correlations and multivariate analyses were conducted to identify factors associated with preparedness for survivorship. RESULTS Participants reported feeling somewhat prepared for survivorship. More than half reported not receiving a written survivorship care plan and many desired more information about follow-up tests, symptoms monitoring and maintaining good nutrition and health. Receipt of chemotherapy, limited transition care planning, limited discussion of medical and psychosocial effects, high information needs and financial hardship were predictors of low preparedness. CONCLUSION Identifying and addressing factors associated with survivorship preparedness at end of treatment and over cancer survivorship trajectory will foster higher quality survivorship experiences.
Collapse
Affiliation(s)
- Angela J Fong
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Andrew M Evens
- Blood Disorders Program, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Elisa V Bandera
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Katie A Devine
- Section of Pediatric Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Shawna V Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Bo Qin
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Lisa E Paddock
- Department of Epidemiology, Rutgers Cancer Institute of New Jersey, Rutgers Health, New Brunswick, New Jersey, USA
| | - Antoinette M Stroup
- Department of Epidemiology, Rutgers Cancer Institute of New Jersey, Rutgers Health, New Brunswick, New Jersey, USA
| | - Sara Frederick
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Carissa Greco
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Sharon L Manne
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| |
Collapse
|
13
|
Foran DJ, Durbin EB, Chen W, Sadimin E, Sharma A, Banerjee I, Kurc T, Li N, Stroup AM, Harris G, Gu A, Schymura M, Gupta R, Bremer E, Balsamo J, DiPrima T, Wang F, Abousamra S, Samaras D, Hands I, Ward K, Saltz JH. An Expandable Informatics Framework for Enhancing Central Cancer Registries with Digital Pathology Specimens, Computational Imaging Tools, and Advanced Mining Capabilities. J Pathol Inform 2022; 13:5. [PMID: 35136672 PMCID: PMC8794027 DOI: 10.4103/jpi.jpi_31_21] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Population-based state cancer registries are an authoritative source for cancer statistics in the United States. They routinely collect a variety of data, including patient demographics, primary tumor site, stage at diagnosis, first course of treatment, and survival, on every cancer case that is reported across all U.S. states and territories. The goal of our project is to enrich NCI's Surveillance, Epidemiology, and End Results (SEER) registry data with high-quality population-based biospecimen data in the form of digital pathology, machine-learning-based classifications, and quantitative histopathology imaging feature sets (referred to here as Pathomics features). MATERIALS AND METHODS As part of the project, the underlying informatics infrastructure was designed, tested, and implemented through close collaboration with several participating SEER registries to ensure consistency with registry processes, computational scalability, and ability to support creation of population cohorts that span multiple sites. Utilizing computational imaging algorithms and methods to both generate indices and search for matches makes it possible to reduce inter- and intra-observer inconsistencies and to improve the objectivity with which large image repositories are interrogated. RESULTS Our team has created and continues to expand a well-curated repository of high-quality digitized pathology images corresponding to subjects whose data are routinely collected by the collaborating registries. Our team has systematically deployed and tested key, visual analytic methods to facilitate automated creation of population cohorts for epidemiological studies and tools to support visualization of feature clusters and evaluation of whole-slide images. As part of these efforts, we are developing and optimizing advanced search and matching algorithms to facilitate automated, content-based retrieval of digitized specimens based on their underlying image features and staining characteristics. CONCLUSION To meet the challenges of this project, we established the analytic pipelines, methods, and workflows to support the expansion and management of a growing repository of high-quality digitized pathology and information-rich, population cohorts containing objective imaging and clinical attributes to facilitate studies that seek to discriminate among different subtypes of disease, stratify patient populations, and perform comparisons of tumor characteristics within and across patient cohorts. We have also successfully developed a suite of tools based on a deep-learning method to perform quantitative characterizations of tumor regions, assess infiltrating lymphocyte distributions, and generate objective nuclear feature measurements. As part of these efforts, our team has implemented reliable methods that enable investigators to systematically search through large repositories to automatically retrieve digitized pathology specimens and correlated clinical data based on their computational signatures.
Collapse
Affiliation(s)
- David J. Foran
- Center for Biomedical Informatics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Pathology and Laboratory Medicine, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Eric B. Durbin
- Kentucky Cancer Registry, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
- Division of Biomedical Informatics, Department of Internal Medicine, College of Medicine, Lexington, KY, USA
| | - Wenjin Chen
- Center for Biomedical Informatics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Evita Sadimin
- Center for Biomedical Informatics, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Pathology and Laboratory Medicine, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Ashish Sharma
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
| | - Imon Banerjee
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
| | - Tahsin Kurc
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Nan Li
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
| | - Antoinette M. Stroup
- New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Gerald Harris
- New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Annie Gu
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
| | - Maria Schymura
- New York State Cancer Registry, New York State Department of Health, Albany, NY, USA
| | - Rajarsi Gupta
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Erich Bremer
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Joseph Balsamo
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Tammy DiPrima
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Feiqiao Wang
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| | - Shahira Abousamra
- Department of Computer Science, Stony Brook University, Stony Brook, NY, USA
| | - Dimitris Samaras
- Department of Computer Science, Stony Brook University, Stony Brook, NY, USA
| | - Isaac Hands
- Division of Biomedical Informatics, Department of Internal Medicine, College of Medicine, Lexington, KY, USA
| | - Kevin Ward
- Georgia State Cancer Registry, Georgia Department of Public Health, Atlanta, GA, USA
| | - Joel H. Saltz
- Department of Biomedical Informatics, Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
14
|
Stroup AM, Harris G, Wilson M, Black TM, Graber JM. New Jersey's Response to the Call for Firefighter Cancer Data: Creating a Retrospective Cohort to Study Cancer Mortality among New Jersey Firefighters through Data Linkages and an Honest Broker. J Registry Manag 2022; 49:39-40. [PMID: 37260627 PMCID: PMC10198388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
15
|
Hernandez BY, Zhu X, Risch HA, Lu L, Ma X, Irwin ML, Lim JK, Taddei TH, Pawlish KS, Stroup AM, Brown R, Wang Z, Wong LL, Yu H. Oral Cyanobacteria and Hepatocellular Carcinoma. Cancer Epidemiol Biomarkers Prev 2022; 31:221-229. [PMID: 34697061 PMCID: PMC8755591 DOI: 10.1158/1055-9965.epi-21-0804] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/22/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Gut microbial alterations have been linked to chronic liver disease and hepatocellular carcinoma (HCC). The role of the oral microbiome in liver cancer development has not been widely investigated. METHODS Bacterial 16S rRNA sequences were evaluated in oral samples from 90 HCC cases and 90 controls who were a part of a larger U.S. case-control study of HCC among patients diagnosed from 2011 to 2016. RESULTS The oral microbiome of HCC cases showed significantly reduced alpha diversity compared with controls (Shannon P = 0.002; Simpson P = 0.049), and beta diversity significantly differed (weighted Unifrac P = 0.004). The relative abundance of 30 taxa significantly varied including Cyanobacteria, which was enriched in cases compared with controls (P = 0.018). Cyanobacteria was positively associated with HCC [OR, 8.71; 95% confidence interval (CI), 1.22-62.00; P = 0.031] after adjustment for age, race, birthplace, education, smoking, alcohol, obesity, type 2 diabetes, Hepatitis C virus (HCV), Hepatitis B virus (HBV), fatty liver disease, aspirin use, other NSAID use, laboratory batch, and other significant taxa. When stratified by HCC risk factors, significant associations of Cyanobacteria with HCC were exclusively observed among individuals with negative histories of established risk factors as well as females and college graduates. Cyanobacterial genes positively associated with HCC were specific to taxa producing microcystin, the hepatotoxic tumor promotor, and other genes known to be upregulated with microcystin exposure. CONCLUSIONS Our study provides novel evidence that oral Cyanobacteria may be an independent risk factor for HCC. IMPACT These findings support future studies to further examine the causal relationship between oral Cyanobacteria and HCC risk.
Collapse
Affiliation(s)
- Brenda Y Hernandez
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii.
| | - Xuemei Zhu
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut
| | - Joseph K Lim
- Yale Liver Center and Section of Digestive Diseases, Department if Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Tamar H Taddei
- Yale Liver Center and Section of Digestive Diseases, Department if Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Karen S Pawlish
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Antoinette M Stroup
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, The State University of New Jersey, Piscataway, New Jersey
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Robert Brown
- Department of Medicine, Joan & Sanford I. Weill Medical College of Cornell University, New York, New York
- Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York
| | - Zhanwei Wang
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Linda L Wong
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii
- Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Herbert Yu
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, Hawaii
| |
Collapse
|
16
|
Plascak JJ, Rundle AG, Xu X, Mooney SJ, Schootman M, Lu B, Roy J, Stroup AM, Llanos AAM. Associations between neighborhood disinvestment and breast cancer outcomes within a populous state registry. Cancer 2021; 128:131-138. [PMID: 34495547 PMCID: PMC9070603 DOI: 10.1002/cncr.33900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/07/2021] [Accepted: 08/05/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Breast cancer (BrCa) outcomes vary by social environmental factors, but the role of built-environment factors is understudied. The authors investigated associations between environmental physical disorder-indicators of residential disrepair and disinvestment-and BrCa tumor prognostic factors (stage at diagnosis, tumor grade, triple-negative [negative for estrogen receptor, progesterone receptor, and HER2 receptor] BrCa) and survival within a large state cancer registry linkage. METHODS Data on sociodemographic, tumor, and vital status were derived from adult women who had invasive BrCa diagnosed from 2008 to 2017 ascertained from the New Jersey State Cancer Registry. Physical disorder was assessed through virtual neighborhood audits of 23,276 locations across New Jersey, and a personalized measure for the residential address of each woman with BrCa was estimated using universal kriging. Continuous covariates were z scored (mean ± standard deviation [SD], 0 ± 1) to reduce collinearity. Logistic regression models of tumor factors and accelerated failure time models of survival time to BrCa-specific death were built to investigate associations with physical disorder adjusted for covariates (with follow-up through 2019). RESULTS There were 3637 BrCa-specific deaths among 40,963 women with a median follow-up of 5.3 years. In adjusted models, a 1-SD increase in physical disorder was associated with higher odds of late-stage BrCa (odds ratio, 1.09; 95% confidence interval, 1.02-1.15). Physical disorder was not associated with tumor grade or triple-negative tumors. A 1-SD increase in physical disorder was associated with a 10.5% shorter survival time (95% confidence interval, 6.1%-14.6%) only among women who had early stage BrCa. CONCLUSIONS Physical disorder is associated with worse tumor prognostic factors and survival among women who have BrCa diagnosed at an early stage.
Collapse
Affiliation(s)
- Jesse J Plascak
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.,Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Xinyi Xu
- Department of Statistics, College of Arts and Sciences, Columbus, Ohio
| | - Stephen J Mooney
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Mario Schootman
- Department of Clinical Analytics, SSM Health, St Louis, Missouri
| | - Bo Lu
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.,Division of Biostatistics, College of Public Health, Columbus, Ohio
| | - Jason Roy
- Department of Biostatistics and Epidemiology, School of Public Health, Piscataway, New Jersey
| | - Antoinette M Stroup
- Department of Biostatistics and Epidemiology, School of Public Health, Piscataway, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, School of Public Health, Piscataway, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| |
Collapse
|
17
|
Henry KA, Wiese D, Maiti A, Harris G, Vucetic S, Stroup AM. Geographic clustering of cutaneous T-cell lymphoma in New Jersey: an exploratory analysis using residential histories. Cancer Causes Control 2021; 32:989-999. [PMID: 34117957 DOI: 10.1007/s10552-021-01452-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Cutaneous T-cell lymphoma (CTCL) is a rare type of non-Hodgkin lymphoma. Previous studies have reported geographic clustering of CTCL based on the residence at the time of diagnosis. We explore geographic clustering of CTCL using both the residence at the time of diagnosis and past residences using data from the New Jersey State Cancer Registry. METHODS CTCL cases (n = 1,163) diagnosed between 2006-2014 were matched to colon cancer controls (n = 17,049) on sex, age, race/ethnicity, and birth year. Jacquez's Q-Statistic was used to identify temporal clustering of cases compared to controls. Geographic clustering was assessed using the Bernoulli-based scan-statistic to compare cases to controls, and the Poisson-based scan-statisic to compare the observed number of cases to the number expected based on the general population. Significant clusters (p < 0.05) were mapped, and standard incidence ratios (SIR) reported. We adjusted for diagnosis year, sex, and age. RESULTS The Q-statistic identified significant temporal clustering of cases based on past residences in the study area from 1992 to 2002. A cluster was detected in 1992 in Bergen County in northern New Jersey based on the Bernoulli (1992 SIR 1.84) and Poisson (1992 SIR 1.86) scan-statistics. Using the Poisson scan-statistic with the diagnosis location, we found evidence of an elevated risk in this same area, but the results were not statistically significant. CONCLUSION There is evidence of geographic clustering of CTCL cases in New Jersey based on past residences. Additional studies are necessary to understand the possible reasons for the excess of CTCL cases living in this specific area some 8-14 years prior to diagnosis.
Collapse
Affiliation(s)
- Kevin A Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA, USA. .,Division of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA.
| | - Daniel Wiese
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA, USA
| | - Aniruddha Maiti
- Department of Computer and Information Sciences, Temple University, Philadelphia, PA, USA
| | - Gerald Harris
- Department of Health, New Jersey State Cancer Registry, Trenton, NJ, USA.,Rutgers Cancer Institute of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.,Department of Biostatitics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Slobodan Vucetic
- Department of Computer and Information Sciences, Temple University, Philadelphia, PA, USA
| | - Antoinette M Stroup
- Department of Health, New Jersey State Cancer Registry, Trenton, NJ, USA.,Rutgers Cancer Institute of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.,Department of Biostatitics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| |
Collapse
|
18
|
Acuna N, Plascak JJ, Tsui J, Stroup AM, Llanos AAM. Oncotype DX Test Receipt among Latina/Hispanic Women with Early Invasive Breast Cancer in New Jersey: A Registry-Based Study. Int J Environ Res Public Health 2021; 18:5116. [PMID: 34065945 PMCID: PMC8151910 DOI: 10.3390/ijerph18105116] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022]
Abstract
Oncotype DX® (ODX) is a valid test of breast cancer (BC) recurrence risk and chemotherapy benefit. The purpose of this study was to examine prevalence of and factors associated with receipt of ODX testing among eligible Latinas/Hispanics diagnosed with BC. Sociodemographic and tumor data of BC cases diagnosed between 2008 and 2017 among Latina/Hispanic women (n = 5777) were from the New Jersey State Cancer Registry (NJSCR). Eligibility for ODX testing were based on National Comprehensive Cancer Network guidelines. Multivariable logistic regression models of ODX receipt among eligible women were used to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI) by demographic and clinicopathologic factors. One-third of Latinas/Hispanics diagnosed with BC were eligible for ODX testing. Among the eligible, 60.9% received ODX testing. Older age (AOR 0.08, 95% CI: 0.04, 0.14), low area-level SES (AOR 0.58, 95% CI: 0.42, 0.52), and being uninsured (AOR 0.58, 95% CI: 0.39, 0.86) were associated with lower odds of ODX testing. While there was relatively high ODX testing among eligible Latina/Hispanic women with BC in New Jersey, our findings suggest that age, insurance status, and area-level SES contribute to unequal access to genetic testing in this group, which might impact BC outcomes.
Collapse
Affiliation(s)
- Nicholas Acuna
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (N.A.); (J.T.)
| | - Jesse J. Plascak
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Jennifer Tsui
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (N.A.); (J.T.)
| | - Antoinette M. Stroup
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA;
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ 08625, USA
| | - Adana A. M. Llanos
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA;
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| |
Collapse
|
19
|
Wiese D, Stroup AM, Maiti A, Harris G, Lynch SM, Vucetic S, Gutierrez-Velez VH, Henry KA. Measuring Neighborhood Landscapes: Associations between a Neighborhood's Landscape Characteristics and Colon Cancer Survival. Int J Environ Res Public Health 2021; 18:ijerph18094728. [PMID: 33946680 PMCID: PMC8124655 DOI: 10.3390/ijerph18094728] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/11/2022]
Abstract
Landscape characteristics have been shown to influence health outcomes, but few studies have examined their relationship with cancer survival. We used data from the National Land Cover Database to examine associations between regional-stage colon cancer survival and 27 different landscape metrics. The study population included all adult New Jersey residents diagnosed between 2006 and 2011. Cases were followed until 31 December 2016 (N = 3949). Patient data were derived from the New Jersey State Cancer Registry and were linked to LexisNexis to obtain residential histories. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI95) for the different landscape metrics. An increasing proportion of high-intensity developed lands with 80–100% impervious surfaces per cell/pixel was significantly associated with the risk of colon cancer death (HR = 1.006; CI95 = 1.002–1.01) after controlling for neighborhood poverty and other individual-level factors. In contrast, an increase in the aggregation and connectivity of vegetation-dominated low-intensity developed lands with 20–<40% impervious surfaces per cell/pixel was significantly associated with the decrease in risk of death from colon cancer (HR = 0.996; CI95 = 0.992–0.999). Reducing impervious surfaces in residential areas may increase the aesthetic value and provide conditions more advantageous to a healthy lifestyle, such as walking. Further research is needed to understand how these landscape characteristics impact survival.
Collapse
Affiliation(s)
- Daniel Wiese
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, USA; (V.H.G.-V.); (K.A.H.)
- Correspondence:
| | - Antoinette M. Stroup
- New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, NJ 08625, USA; (A.M.S.); (G.H.)
- Rutgers School of Public Health, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Aniruddha Maiti
- Department of Computer and Information Sciences, Temple University, Philadelphia, PA 19122, USA; (A.M.); (S.V.)
| | - Gerald Harris
- New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, NJ 08625, USA; (A.M.S.); (G.H.)
| | - Shannon M. Lynch
- Fox Chase Cancer Center, Division of Cancer Prevention and Control, Philadelphia, PA 19111, USA;
| | - Slobodan Vucetic
- Department of Computer and Information Sciences, Temple University, Philadelphia, PA 19122, USA; (A.M.); (S.V.)
| | - Victor H. Gutierrez-Velez
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, USA; (V.H.G.-V.); (K.A.H.)
| | - Kevin A. Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, USA; (V.H.G.-V.); (K.A.H.)
- Fox Chase Cancer Center, Division of Cancer Prevention and Control, Philadelphia, PA 19111, USA;
| |
Collapse
|
20
|
Plascak JJ, Roy J, Stroup AM, Beyer K, Rundle AG, Mooney SJ, Jacob G, Llanos AAM. Historical Housing Discrimination, Indicators of Disinvestment, and Breast Cancer Outcomes Nearly a Century Later. Cancer Epidemiol Biomarkers Prev 2021. [DOI: 10.1158/1055-9965.epi-21-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose: We investigated associations between 1930's era records of mortgage lending discrimination (i.e., “redlining”), a present-day indicator of disinvestment (i.e., residential physical disorder), and tumor clinicopathologic features (stage, grade, subtype) and survival among women diagnosed with breast cancer in New Jersey. Methods: Historical, Home Owners' Loan Corporation (HOLC) data were recently geocoded from the University of Richmond's Digital Scholarship Lab. Risk grades of ‘A'/‘Best', ‘B'/‘Still Desirable', ‘C'/‘Definitely Declining', and ‘D'/‘Hazardous' – available for six metropolitan areas of New Jersey – were collapsed into C/D (‘redlined') and A/B (‘not redlined') for analyses. Sociodemographics (age, race, ethnicity, geocoded residential address, date of diagnosis), tumor features (stage at diagnosis, grade, subtype), and vital status (cause and date of death) were ascertained from the New Jersey State Cancer Registry for all primary, histologically-confirmed, invasive breast cancer cases diagnosed between 2008 and 2017, among female residents of a HOLC-graded area, who were ≥ 20 years at diagnosis (N = 11,980). Residential physical disorder was estimated based on residential address at diagnosis using spatial prediction models of virtually audited Google Street View scenes of 6,132 locations. Logistic regression models of tumor features and accelerated failure time models of survival time to BrCa-specific death (follow-up through 2019) were built to investigate associations with redlining and physical disorder, while controlling for covariates. Results: There were 1,215 BrCa-specific deaths, a median follow-up time of 5.1 years, and a 5-year survival of 89.6%. Living in a historically redlined neighborhood was associated with higher odds of late-stage and high-grade tumors. Living in a non-redlined neighborhood was associated with a 47.5% (95% CI: 20.1, 79.8) longer survival time in low physical disorder areas. This survival benefit decreased as physical disorder increased. Conclusions: Historical racial housing discrimination might interact with present-day measures of disinvestment to influence BrCa survival. Future studies should collect more comprehensive data including potential confounders and residential history.
Collapse
|
21
|
Pasalic D, Barocas DA, Huang LC, Zhao Z, Koyama T, Tang C, Conwill R, Goodman M, Hamilton AS, Wu XC, Paddock LE, Stroup AM, Cooperberg MR, Hashibe M, O'Neil BB, Kaplan SH, Greenfield S, Penson DF, Hoffman KE. Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer. Cancer 2021; 127:1912-1925. [PMID: 33595853 DOI: 10.1002/cncr.33388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/06/2020] [Revised: 10/14/2020] [Accepted: 11/30/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND To inform patients who are in the process of selecting prostate cancer treatment, the authors compared disease-specific function after external-beam radiotherapy (EBRT) alone versus EBRT plus a low-dose-rate (LDR) brachytherapy boost (EBRT-LDR). METHODS For this prospective study, men who had localized prostate cancer in 2011 and 2012 were enrolled. Assessments at baseline, 0.5, 1, 3, and 5 years included the patient-reported Expanded Prostate Index Composite, the 36-item Medical Outcomes Study Short-Form Health Survey, and treatment-related regret. Regression models were adjusted for baseline function and for patient and treatment characteristics. The minimum clinically important difference in scores on the Expanded Prostate Index Composite 26-item instrument was from 5 to 7 for urinary irritation and from 4 to 6 for bowel function. RESULTS Six-hundred ninety-five men met inclusion criteria and received either EBRT (n = 583) or EBRT-LDR (n = 112). Patients in the EBRT-LDR group were younger (median age, 66 years [interquartile range [IQR], 60-71 years] vs 69 years [IQR, 64-74 years]; P < .001), were less likely to receive pelvic radiotherapy (10% vs 18%; P = .040), and had higher baseline 36-item Medical Outcomes Study Short-Form Health Survey physical function scores (median score, 95 [IQR, 86-100] vs 90 [IQR, 70-100]; P < .001). Over a 3-year period, compared with EBRT, EBRT-LDR was associated with worse urinary irritative scores (adjusted mean difference at 3 years, -5.4; 95% CI, -9.3, -1.6) and bowel function scores (-4.1; 95% CI, -7.6, -0.5). The differences were no longer clinically meaningful at 5 years (difference in urinary irritative scores: -4.5; 95% CI, -8.4, -0.5; difference in bowel function scores: -2.1; 95% CI, -5.7, -1.4). However, men who received EBRT-LDR were more likely to report moderate or big problems with urinary function bother (adjusted odds ratio, 3.5; 95% CI, 1.5-8.2) and frequent urination (adjusted odds ratio, 2.6; 95% CI, 1.2-5.6) through 5 years. There were no differences in survival or treatment-related regret between treatment groups. CONCLUSIONS Compared with EBRT alone, EBRT-LDR was associated with clinically meaningful worse urinary irritative and bowel function over 3 years after treatment and more urinary bother at 5 years. LAY SUMMARY In men with prostate cancer who received external-beam radiation therapy (EBRT) with or without a brachytherapy boost (EBRT-LDR), EBRT-LDR was associated with clinically worse urinary irritation and bowel function through 3 years but resolved after 5 years. Men who received EBRT-LDR continued to report moderate-to-big problems with urinary function bother and frequent urination through 5 years. There was no difference in treatment-related regret or survival between patients who received EBRT and those who received EBRT-LDR. These intermediate-term estimates of function may facilitate counseling for men who are selecting treatment.
Collapse
Affiliation(s)
- Dario Pasalic
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Daniel A Barocas
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Li-Ching Huang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Zhiguo Zhao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tatsuki Koyama
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Chad Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ralph Conwill
- Patient Advocacy Program, Office of Patient and Community Education, Vanderbilt University Medical Center, Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Michael Goodman
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Ann S Hamilton
- Department of Preventative Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Xiao-Cheng Wu
- Department of Epidemiology, Louisiana State University New Orleans School of Public Health, New Orleans, Louisiana
| | - Lisa E Paddock
- Department of Epidemiology, Cancer Institute of New Jersey, Rutgers Health, New Brunswick, New Jersey
| | - Antoinette M Stroup
- Department of Epidemiology, Cancer Institute of New Jersey, Rutgers Health, New Brunswick, New Jersey
| | - Matthew R Cooperberg
- Department of Urology, University of California San Francisco, San Francisco, California
| | - Mia Hashibe
- Department of Family and Preventative Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Brock B O'Neil
- Department of Urology, University of Utah Health, Salt Lake City, Utah
| | - Sherrie H Kaplan
- Department of Medicine, University of California Irvine, Irvine, California
| | - Sheldon Greenfield
- Department of Medicine, University of California Irvine, Irvine, California
| | - David F Penson
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Karen E Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
22
|
Ahmed MF, Galfo A, Huggins W, Paddock LE, Stroup AM, Malhotra J. Challenges of Medical Record Abstraction in a Long-Term Follow-up Study. J Registry Manag 2021; 48:88-91. [PMID: 35413725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Medical records are a rich source of information and have tremendous value in epidemiological research. Nevertheless, the process of obtaining and abstracting medical records for a long-term follow-up study is complicated, time-consuming, and resource intensive. We identified the following major challenges during this process. First, widely varying infrastructure of electronic health record systems used by different organizations makes it difficult to ensure that all medical charts from all sources for a particular patient have been received. Second, extensive use of free text by health care providers requires a manual line-by-line search for relevant information, which may result in some missing data due to human error. Third, there are often discrepancies between patients' provided lists of health care providers and the registry data, which may affect the data-collection process. Fourth, providers have varied requirements for medical record release of their patients, which might entail multiple patient contacts. This, in turn, can frustrate patients and discourage them from participating in current or future research studies. Fifth, the use of inconsistent medical terminology by different providers complicates conversion of unstructured text into categorical data for analysis. We have the following recommendations for any future study with similar design to overcome the above challenges. First, the source of medical records best suited for the research objectives should be identified from the beginning. Second, the abstractors should be appropriately trained to accomplish research-specific tasks. Third, a quality data-tracking system for the abstracted elements should be employed to ensure data integrity. Fourth, the abstracted cases should be reviewed by one other abstractor. We also recommend a pilot study with a smaller number of patients to evaluate the required resources before any large-scale study.
Collapse
|
23
|
Qin B, Babel RA, Plascak JJ, Lin Y, Stroup AM, Goldman N, Ambrosone CB, Demissie K, Hong CC, Bandera EV, Llanos AAM. Neighborhood Social Environmental Factors and Breast Cancer Subtypes among Black Women. Cancer Epidemiol Biomarkers Prev 2020; 30:344-350. [PMID: 33234556 DOI: 10.1158/1055-9965.epi-20-1055] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 07/12/2020] [Revised: 08/31/2020] [Accepted: 11/19/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The disproportionate burden of more aggressive breast cancer subtypes among African American/Black women may stem from multilevel determinants. However, data are limited regarding the impacts of neighborhood social environmental characteristics among Black women. METHODS We evaluated the association between neighborhood-level socioeconomic status (nSES) and breast cancer subtypes in the Women's Circle of Health and Women's Circle of Health Follow-up Study, which included 1,220 Black women diagnosed from 2005 to 2017 with invasive breast cancer. nSES at diagnosis was measured using NCI's census tract-level SES index. We used multilevel multinomial logistic regression models to estimate the association of nSES with breast cancer subtypes [triple-negative breast cancer (TNBC), HER2-positive vs. luminal A], adjusting for individual-level SES, body mass index, and reproductive factors. We tested for interactions by neighborhood racial composition. RESULTS Compared with census tracts characterized as high nSES, the relative risk ratios (RRR) for TNBC were 1.81 [95% confidence interval (CI): 1.20-2.71] and 1.95 (95% CI: 1.27-2.99) for women residing in areas with intermediate and low nSES, respectively (P trend = 0.002). Neighborhood racial composition modified the association between nSES and TNBC; the highest relative risk of TNBC was among women residing in low nSES areas with low proportions of Black residents. CONCLUSIONS Black women residing in socioeconomically disadvantaged neighborhoods may have an increased risk of TNBC, particularly in areas with lower proportions of Black residents. IMPACT Places people live may influence breast tumor biology. A deeper understanding of multilevel pathways contributing to tumor biology is needed.
Collapse
Affiliation(s)
- Bo Qin
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
| | - Riddhi A Babel
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
| | - Jesse J Plascak
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
| | - Yong Lin
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
- Division of Biometrics, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Antoinette M Stroup
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Noreen Goldman
- Office of Population Research, Princeton University, Princeton, New Jersey
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Kitaw Demissie
- Department of Epidemiology and Biostatistics, SUNY Downstate Medical Center School of Public Health, Brooklyn, New York
| | - Chi-Chen Hong
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Adana A M Llanos
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
| |
Collapse
|
24
|
Almatkyzy G, Mojica CM, Stroup AM, Llanos AAM, O'Malley D, Xu B, Tsui J. Predictors of health-related quality of life among Hispanic and non-Hispanic White breast cancer survivors in New Jersey. J Psychosoc Oncol 2020; 39:595-612. [PMID: 33198603 DOI: 10.1080/07347332.2020.1844844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/23/2022]
Abstract
PURPOSE To examine predictors of health-related quality of life (HRQoL) in Hispanic and non-Hispanic White (NHW) breast cancer (BC) survivors. DESIGN Cross-sectional study using survey data. PARTICIPANTS Women diagnosed with BC at ages 21-79 years, between 2012-2014, recruited from the New Jersey State Cancer Registry. METHODS HRQoL was assessed using the Functional Assessment Cancer Therapy (FACT-G) instrument. Descriptive statistics compared Hispanics and NHWs, and multivariate regression analyses identified predictors of HRQoL. RESULTS HRQoL was significantly higher scores among NHW (85.7 ± 18.5) than Hispanics (79.4 ± 20.1) (p < 0.05). In multivariate analyses, comorbidities (β: -13.3, 95%CI: -20.6, -5.92), late-stage diagnosis (β: -5.67, 95%CI: -10.7, -0.62), lower income (β: -13.9, 95%CI: -19.8, -7.97) and younger age at diagnosis were associated with lower HRQoL. CONCLUSION Socio-demographic and clinic characteristics were significant predictors of HRQoL among diverse BC survivors. IMPLICATIONS FOR PSYCHOSOCIAL ONCOLOGY Supportive psychosocial care interventions tailored to the needs of young, low-income BC survivors with comorbidities are needed.
Collapse
Affiliation(s)
- Gulaiim Almatkyzy
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Cynthia M Mojica
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Antoinette M Stroup
- Division of Cancer Epidemiology, Rutgers School of Public Health, Cancer Prevention and Cancer Control, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Denalee O'Malley
- Department of Family Medicine and Community Health, Rutgers State University of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Baichen Xu
- Division of Population Science, Rutgers Cancer Institute of New, New Brunswick, New Jersey, USA
| | - Jennifer Tsui
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
25
|
McGee-Avila JK, Doose M, Nova J, Kumar R, Stroup AM, Tsui J. Patterns of HIV testing among women diagnosed with invasive cervical cancer in the New Jersey Medicaid Program. Cancer Causes Control 2020; 31:931-941. [PMID: 32803402 DOI: 10.1007/s10552-020-01333-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/04/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Practice-based guidelines recommend HIV testing during initial invasive cervical cancer (ICC) workup. Determinants of HIV testing during diagnosis of AIDS-defining cancers in vulnerable populations, where risk for HIV infection is higher, are under-explored. METHODS We examine factors associated with patterns of HIV testing among Medicaid enrollees diagnosed with ICC. Using linked data from the New Jersey State Cancer Registry and New Jersey Medicaid claims and enrollment files, we evaluated HIV testing among 242 ICC cases diagnosed from 2012 to 2014 in ages 21-64 at (a) any point during Medicaid enrollment (2011-2014) and (b) during cancer workup 6 months pre ICC diagnosis to 6 months post ICC diagnosis. Logistic regression models identified factors associated with HIV testing. RESULTS Overall, 13% of women had a claim for HIV testing during ICC workup. Two-thirds (68%) of women did not have a claim for HIV testing (non-receipt of HIV testing) while enrolled in Medicaid. Hispanic/NH-API/Other women had lower odds of non-receipt of HIV testing compared with NH-Whites (OR: 0.40; 95% CI: 0.17-0.94). Higher odds of non-receipt of HIV testing were observed among cases with no STI testing (OR: 4.92; 95% CI 2.27-10.67) and < 1 year of Medicaid enrollment (OR: 3.07; 95% CI 1.14- 8.26) after adjusting for other factors. CONCLUSIONS Few women had HIV testing claims during ICC workup. Opportunities for optimal ICC care are informed by knowledge of HIV status. Further research should explore if lack of HIV testing claims during ICC workup is an accurate indicator of ICC care, and if so, to assess testing barriers during workup.
Collapse
Affiliation(s)
- Jennifer K McGee-Avila
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA
- François-Xavier Bagnoud Center, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Michelle Doose
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Jose Nova
- Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Rizie Kumar
- Department of Sociology, University of Maryland, College Park, College Park, MD, USA
| | - Antoinette M Stroup
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
- Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, USA
| | - Jennifer Tsui
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
- Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
- Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
| |
Collapse
|
26
|
Wiese D, Stroup AM, Maiti A, Harris G, Lynch SM, Vucetic S, Henry KA. Residential Mobility and Geospatial Disparities in Colon Cancer Survival. Cancer Epidemiol Biomarkers Prev 2020; 29:2119-2125. [PMID: 32759382 DOI: 10.1158/1055-9965.epi-20-0772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/24/2020] [Accepted: 07/29/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Identifying geospatial cancer survival disparities is critical to focus interventions and prioritize efforts with limited resources. Incorporating residential mobility into spatial models may result in different geographic patterns of survival compared with the standard approach using a single location based on the patient's residence at the time of diagnosis. METHODS Data on 3,949 regional-stage colon cancer cases diagnosed from 2006 to 2011 and followed until December 31, 2016, were obtained from the New Jersey State Cancer Registry. Geographic disparity based on the spatial variance and effect sizes from a Bayesian spatial model using residence at diagnosis was compared with a time-varying spatial model using residential histories [adjusted for sex, gender, substage, race/ethnicity, and census tract (CT) poverty]. Geographic estimates of risk of colon cancer death were mapped. RESULTS Most patients (65%) remained at the same residence, 22% changed CT, and 12% moved out of state. The time-varying model produced a wider range of adjusted risk of colon cancer death (0.85-1.20 vs. 0.94-1.11) and resulted in greater geographic disparity statewide after adjustment (25.5% vs. 14.2%) compared with the model with only the residence at diagnosis. CONCLUSIONS Including residential mobility may allow for more precise estimates of spatial risk of death. Results based on the traditional approach using only residence at diagnosis were not substantially different for regional stage colon cancer in New Jersey. IMPACT Including residential histories opens up new avenues of inquiry to better understand the complex relationships between people and places, and the effect of residential mobility on cancer outcomes.See related commentary by Williams, p. 2107.
Collapse
Affiliation(s)
- Daniel Wiese
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.
| | - Antoinette M Stroup
- New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, New Jersey.,Rutgers Cancer Institute of New Jersey and Rutgers School of Public Health, Rutgers University, New Brunswick, New Jersey
| | - Aniruddha Maiti
- Department of Computer and Information Sciences, Temple University, Philadelphia, Pennsylvania
| | - Gerald Harris
- New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, New Jersey
| | - Shannon M Lynch
- Division of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Slobodan Vucetic
- Department of Computer and Information Sciences, Temple University, Philadelphia, Pennsylvania
| | - Kevin A Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.,Division of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| |
Collapse
|
27
|
Gallicchio L, Elena JW, Fagan S, Carter M, Hamilton AS, Hastert TA, Hunter LL, Li J, Lynch CF, Milam J, Millar MM, Modjeski D, Paddock LE, Reed AR, Moses LB, Stroup AM, Sweeney C, Trapido EJ, West MM, Wu XC, Helzlsouer KJ. Utilizing SEER Cancer Registries for Population-Based Cancer Survivor Epidemiologic Studies: A Feasibility Study. Cancer Epidemiol Biomarkers Prev 2020; 29:1699-1709. [PMID: 32651214 DOI: 10.1158/1055-9965.epi-20-0153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/24/2020] [Accepted: 06/09/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND While the primary role of central cancer registries in the United States is to provide vital information needed for cancer surveillance and control, these registries can also be leveraged for population-based epidemiologic studies of cancer survivors. This study was undertaken to assess the feasibility of using the NCI's Surveillance, Epidemiology, and End Results (SEER) Program registries to rapidly identify, recruit, and enroll individuals for survivor research studies and to assess their willingness to engage in a variety of research activities. METHODS In 2016 and 2017, six SEER registries recruited both recently diagnosed and longer-term survivors with early age-onset multiple myeloma or colorectal, breast, prostate, or ovarian cancer. Potential participants were asked to complete a survey, providing data on demographics, health, and their willingness to participate in various aspects of research studies. RESULTS Response rates across the registries ranged from 24.9% to 46.9%, with sample sizes of 115 to 239 enrolled by each registry over a 12- to 18-month period. Among the 992 total respondents, 90% answered that they would be willing to fill out a survey for a future research study, 91% reported that they would donate a biospecimen of some type, and approximately 82% reported that they would consent to have their medical records accessed for research. CONCLUSIONS This study demonstrated the feasibility of leveraging SEER registries to recruit a geographically and racially diverse group of cancer survivors. IMPACT Central cancer registries are a source of high-quality data that can be utilized to conduct population-based cancer survivor studies.
Collapse
Affiliation(s)
- Lisa Gallicchio
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
| | - Joanne W Elena
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Sarah Fagan
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Marjorie Carter
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Theresa A Hastert
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan
| | - Lisa L Hunter
- Iowa Cancer Registry, University of Iowa College of Public Health, Iowa City, Iowa
| | - Jie Li
- New Jersey State Cancer Registry, State of New Jersey, Department of Health, Trenton, New Jersey
| | - Charles F Lynch
- Iowa Cancer Registry, University of Iowa College of Public Health, Iowa City, Iowa.,Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa.,Cancer Epidemiology and Population Science Program, Holden Comprehensive Cancer Center, Iowa City, Iowa
| | - Joel Milam
- Department of Preventive Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Morgan M Millar
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Denise Modjeski
- Department of Preventive Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Lisa E Paddock
- New Jersey State Cancer Registry, State of New Jersey, Department of Health, Trenton, New Jersey.,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Amanda R Reed
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, Michigan
| | - Lisa B Moses
- Louisiana Tumor Registry, Louisiana State University School of Public Health, New Orleans, Louisiana
| | - Antoinette M Stroup
- New Jersey State Cancer Registry, State of New Jersey, Department of Health, Trenton, New Jersey.,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Carol Sweeney
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Edward J Trapido
- Louisiana Tumor Registry, Louisiana State University School of Public Health, New Orleans, Louisiana.,Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, Louisiana
| | - Michele M West
- Iowa Cancer Registry, University of Iowa College of Public Health, Iowa City, Iowa.,Cancer Epidemiology and Population Science Program, Holden Comprehensive Cancer Center, Iowa City, Iowa
| | - Xiao-Cheng Wu
- Louisiana Tumor Registry, Louisiana State University School of Public Health, New Orleans, Louisiana
| | - Kathy J Helzlsouer
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| |
Collapse
|
28
|
Plascak JJ, Rundle AG, Mooney SJ, Schootman M, Stroup AM, Llanos AA. Abstract D004: Beyond socioeconomic and racial composition: Association between neighborhood disorder and breast cancer survival. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp19-d004] [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: 11/16/2022] Open
Abstract
Abstract
Background: U.S. women who identify as Black/African American (AA) or reside in socioeconomically disadvantaged neighborhoods have greater breast cancer (BrCa) mortality compared to White women or women in more affluent neighborhoods. While biologic factors – physiologic stress, epigenetics, etc. – possibly involved in these pathways are under study, few social mechanisms have been investigated. We hypothesized that neighborhood disorder (i.e., physical deterioration, lack of social control) might be a social mechanism potentiating poorer BrCa survival. Methods: Sociodemographic (age, race, ethnicity, health insurance, residential address), tumor (subtype, grade, stage), and vital status data were collected on primary, histologically-confirmed, invasive BrCa cases diagnosed among females from 2008-2013, age 20-74 years, from the New Jersey State Cancer Registry (NJSCR). Neighborhood auditing of Google Street View (GSV) scenes was conducted at 29,017 locations across NJ and neighborhood disorder scores were created from nine characteristics observed: Physical disorder (garbage/litter, graffiti, boarded/burned buildings, dumpsters, building conditions, yard conditions) and aesthetic engagement (team sports equipment, yard decorations, yard seating). Physical disorder and aesthetic engagement values were assigned to each BrCa case’s residential address at diagnosis by extracting values predicted by stochastic spatial interpolation (Universal Kriging). Census-based factors were census tract socioeconomic status (Yost Index), AA segregation (Gini and Isolation indices) and % AA. Cox proportional hazard models estimated hazard ratios (HR) and 95% confidence intervals (CI) of BrCa-specific mortality by physical disorder and aesthetic engagement. Median BrCa diagnosis date was 01/24/2011, median GSV image date was 09/2013, and follow-up was through 12/31/2014. Results: Of 22,390 women, 70.0% were White, 12.7% were AA, 10.4% were Latina, and there were 2,040 BrCa deaths. Over two-thirds of AA and Latina women lived in high physical disorder areas compared to 43% of White women. In models adjusted for all factors listed above, hazard of BrCa mortality was 24% higher (CI: 6-45) in areas of the greatest physical disorder quartile compared to the lowest physical disorder quartile. Adjustment for physical disorder and aesthetic engagement alone reduced the non-Latino AA vs non-Latino White HR by 13% (HRCrude=2.01, HRAdj = 1.75). Conclusions: Inequities in BrCa survival might be partially attributable to characteristics of “place” – physical disorder and aesthetics – that are beyond socioeconomic and racial composition. Future studies should collect additional data to enable robust bias investigation.
Citation Format: Jesse J Plascak, Andrew G Rundle, Stephen J Mooney, Mario Schootman, Antoinette M Stroup, Adana A.M. Llanos. Beyond socioeconomic and racial composition: Association between neighborhood disorder and breast cancer survival [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D004.
Collapse
Affiliation(s)
- Jesse J Plascak
- 1Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA,
| | - Andrew G Rundle
- 2Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA,
| | - Stephen J Mooney
- 3Department of Epidemiology, University of Washington, Seattle, WA, USA,
| | - Mario Schootman
- 4Department of Clinical Analytics, SSM Health, St. Louis, MO, USA,
| | - Antoinette M Stroup
- 5New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, USA
| | - Adana A.M. Llanos
- 1Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA,
| |
Collapse
|
29
|
McGee-Avila JK, Doose M, Nova J, Kumar R, Stroup AM, Tsui J. Abstract B083: Patterns of HIV testing among New Jersey Medicaid enrollees diagnosed with invasive cervical cancer. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp18-b083] [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: 11/16/2022] Open
Abstract
Abstract
Purpose: HIV infection and cervical cancer disproportionately impact low-income and racial/ethnic minorities in urban areas. Few studies have examined factors associated with HIV testing during cancer diagnosis in vulnerable populations. Current National Comprehensive Cancer Network (NCCN) guidelines recommend an HIV test during initial invasive cervical cancer (ICC) workup. We examine factors associated with patterns of HIV testing among Medicaid enrollees diagnosed with ICC in New Jersey.
Methods: Using linked data from the New Jersey State Cancer Registry and New Jersey Medicaid claims and enrollment files, we examined patterns of HIV and other STI testing (chlamydia, gonorrhea and syphilis) among nonelderly (ages 21-64) ICC cases diagnosed between 2012 and 2014. We evaluated two HIV testing time periods: at any point during our study period (2011-2014; pre- or post-cancer diagnosis) and during the cancer workup (6 months pre/post ICC diagnosis). Bivariate and multivariable logistic regression models were used to identify sociodemographic, clinical tumor, and area-level factors associated with patterns of HIV testing.
Results: A total of 248 ICC Medicaid enrollees were included in the analytic sample, of whom 83 (33%) received an HIV test at any time. A little over a quarter (26.6%) received STI testing at any time, including 21% for chlamydia and gonorrhea testing. Of those who received any HIV testing, almost half (46%) received their HIV testing during the cancer workup. In the adjusted model, women who lacked any STI testing had higher odds of also not receiving an HIV test during initial cancer workup compared with at least one STI test pre/post cancer diagnosis (OR: 4.2; 95% CI: 1.98-8.98). Similarly, women enrolled for less than a full year prediagnosis also had higher odds of not receiving an HIV test compared to those with full-year enrollment (OR: 2.6; 95% CI: 1.02-6.94). The odds of nonreceipt of HIV testing during the cancer workup were lower among Hispanic/NH-API/Other women compared with White women (OR: 0.38; 95% CI: 0.16-0.88) and higher for those with no primary care visits post-diagnosis compared to ≥ 3 PCP visits (OR: 2.6; 95% CI: 1.07-6.53) Area-level factors (median household income and population density) were not associated with nonreceipt of HIV testing.
Conclusions: Although ICC is considered an AIDS-defining cancer, more than two-thirds of women diagnosed with ICC in our study population did not receive any HIV test during the study period. Strategies to address missed opportunities for HIV testing at ICC diagnosis for vulnerable populations warrant further exploration. Additional validation of claims and patterns of testing should also be explored.
Citation Format: Jennifer K. McGee-Avila, Michelle Doose, Jose Nova, Rizie Kumar, Antoinette M. Stroup, Jennifer Tsui. Patterns of HIV testing among New Jersey Medicaid enrollees diagnosed with invasive cervical cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B083.
Collapse
Affiliation(s)
- Jennifer K. McGee-Avila
- 1School of Nursing, François-Xavier Bagnoud Center, Rutgers, The State University of New Jersey, Newark, NJ, US,
| | - Michelle Doose
- 2School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ,
| | - Jose Nova
- 3Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ,
| | - Rizie Kumar
- 3Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ,
| | - Antoinette M. Stroup
- 4School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey; New Jersey State Cancer Registry, New Jersey Department of Health, New Brunswick, NJ,
| | - Jennifer Tsui
- 5School of Public Health, Cancer Institute of New Jersey, Center for State Health Policy, Rutgers, The State University of New Jersey, New Brunswick, NJ
| |
Collapse
|
30
|
Plascak JJ, Schootman M, Rundle AG, Xing C, Llanos AAM, Stroup AM, Mooney SJ. Spatial predictive properties of built environment characteristics assessed by drop-and-spin virtual neighborhood auditing. Int J Health Geogr 2020; 19:21. [PMID: 32471502 PMCID: PMC7257196 DOI: 10.1186/s12942-020-00213-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 05/19/2020] [Indexed: 02/03/2023] Open
Abstract
Background Virtual neighborhood audits have been used to visually assess characteristics of the built environment for health research. Few studies have investigated spatial predictive properties of audit item responses patterns, which are important for sampling efficiency and audit item selection. We investigated the spatial properties, with a focus on predictive accuracy, of 31 individual audit items related to built environment in a major Metropolitan region of the Northeast United States. Methods Approximately 8000 Google Street View (GSV) scenes were assessed using the CANVAS virtual audit tool. Eleven trained raters audited the 360° view of each GSV scene for 10 sidewalk-, 10 intersection-, and 11 neighborhood physical disorder-related characteristics. Nested semivariograms and regression Kriging were used to investigate the presence and influence of both large- and small-spatial scale relationships as well as the role of rater variability on audit item spatial properties (measurement error, spatial autocorrelation, prediction accuracy). Receiver Operator Curve (ROC) Area Under the Curve (AUC) based on cross-validated spatial models summarized overall predictive accuracy. Correlations between predicted audit item responses and select demographic, economic, and housing characteristics were investigated. Results Prediction accuracy was better within spatial models of all items accounting for both small-scale and large- spatial scale variation (vs large-scale only), and further improved with additional adjustment for rater in a majority of modeled items. Spatial predictive accuracy was considered ‘Excellent’ (0.8 ≤ ROC AUC < 0.9) for full models of all but four items. Predictive accuracy was highest and improved the most with rater adjustment for neighborhood physical disorder-related items. The largest gains in predictive accuracy comparing large- + small-scale to large-scale only models were among intersection- and sidewalk-items. Predicted responses to neighborhood physical disorder-related items correlated strongly with one another and were also strongly correlated with racial-ethnic composition, socioeconomic indicators, and residential mobility. Conclusions Audits of sidewalk and intersection characteristics exhibit pronounced variability, requiring more spatially dense samples than neighborhood physical disorder audits do for equivalent accuracy. Incorporating rater effects into spatial models improves predictive accuracy especially among neighborhood physical disorder-related items.
Collapse
Affiliation(s)
- Jesse J Plascak
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA. .,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
| | - Mario Schootman
- Department of Clinical Analytics, SSM Health, St. Louis, MO, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Cathleen Xing
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Antoinette M Stroup
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.,New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, NJ, USA
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| |
Collapse
|
31
|
Plascak JJ, Rundle AG, Babel RA, Llanos AAM, LaBelle CM, Stroup AM, Mooney SJ. Drop-And-Spin Virtual Neighborhood Auditing: Assessing Built Environment for Linkage to Health Studies. Am J Prev Med 2020; 58:152-160. [PMID: 31862100 PMCID: PMC6927542 DOI: 10.1016/j.amepre.2019.08.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Various built environment factors might influence certain health behaviors and outcomes. Reliable, resource-efficient methods that are feasible for assessing built environment characteristics across large geographies are needed for larger, more robust studies. This paper reports the item response prevalence, reliability, and rating time of a new virtual neighborhood audit protocol, drop-and-spin auditing, developed for assessment of walkability and physical disorder characteristics across large geographic areas. METHODS Drop-and-spin auditing, a method where a Google Street View scene was rated by spinning 360° around a point location, was developed using a modified version of the virtual audit tool Computer Assisted Neighborhood Visual Assessment System. Approximately 8,000 locations within Essex County, New Jersey were assessed by 11 trained auditors. Using a standardized protocol, 32 built environment items per a location within Google Street View were audited. Test-retest and inter-rater κ statistics were from a 5% subsample of locations. Data were collected in 2017-2018 and analyzed in 2018. RESULTS Roughly 70% of Google Street View scenes had sidewalks. Among those, two thirds were in good condition. At least 5 obvious items of garbage or litter were present in 41% of Google Street View scenes. Maximum test-retest reliability indicated substantial agreement (κ ≥0.61) for all items. Inter-rater reliability of each item, generally, was lower than test-retest reliability. The median time to rate each item was 7.3 seconds. CONCLUSIONS Compared with segment-based protocols, drop-and-spin virtual neighborhood auditing is quicker and similarly reliable for assessing built environment characteristics. Assessment of large geographies may be more feasible using drop-and-spin virtual auditing.
Collapse
Affiliation(s)
- Jesse J Plascak
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Riddhi A Babel
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Celine M LaBelle
- Edward J. Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Antoinette M Stroup
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, Washington
| |
Collapse
|
32
|
Hill SM, Li J, Pawlish K, Paddock LE, Stroup AM. Unintended Consequences of Expanding Electronic Pathology Reporting: The Inverse Relationship Between Data Completeness and Data Quality. J Registry Manag 2020; 47:122-126. [PMID: 34128918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND In 2016, the New Jersey State Cancer Registry (NJSCR) began expanding electronic laboratory reporting. As a result, the number of electronic pathology reports (EPRs) submitted to NJSCR increased markedly from 2015 to 2017. EPRs are more likely to contain incomplete or missing race than North American Association of Central Cancer Registry (NAACCR) abstracts from hospitals and physician offices. NJSCR staff conduct follow-back for additional information for laboratory-only cases, but response rates are poor, the process is lengthy, and laboratory reports often do not include physician information. PURPOSE To assess the impact of increased EPR on the quality of race data. METHODS NJSCR data sets created 24 months after the end of the diagnosis year-with data that were more than 98% complete-were used to calculate the percent of EPR-only cases by primary site and the percent of cases with unknown race. We calculated the relative risk of unknown race by site, compared to all sites, and used Spearman's ρ to assess the correlation between EPR-only cases and unknown race. RESULTS While the percent of cases with unknown race was within the standards for NAACCR Gold Certification (3%), it varied by cancer site. Sites less likely to be reported by hospitals had higher rates of unknown race in the 24-month data set: prostate, leukemia, melanoma, bladder. After follow-back and death clearance activities, ≥36 months after the diagnosis year, the percent of cases with unknown race is reduced, although the impact varies by cancer site. CONCLUSION Race-specific incidence rates for certain cancer types may be artificially depressed in the 24-month data set due to the unavailability of race for the increasing number of laboratory-only cases. While follow-back activities help to improve the collection of race data over time, these new values are not available until a revised data set is released. The higher proportion of unknown or other race in the 24-month data set impacts the accuracy of reporting the burden and trends of cancer by race. In addition, cases with unknown race may be ineligible for inclusion in cancer surveillance research studies.
Collapse
|
33
|
Horn D, Roman K, Hanani E, Krol F, Hill SM, Stroup AM. Remote Auditing of Reporting Facilities by the Central Registry: Challenging but Rewarding. J Registry Manag 2020; 47:146-149. [PMID: 34128921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Discuss the experience of the New Jersey State Cancer Registry's (NJSCR's) transition to remote auditing of reporting facilities. METHODS We conducted remote audits from 2016-2019 for reporting years 2014-2017. Facilities were selected for audit if they (1) were <90% complete for the year; (2) had ≥10 electronic pathology records (HL7) without a corresponding hospital abstract; or (3) had not been audited in the past 5 years. HL7 records and disease index data were used to determine which cases were potentially unreported. Disease index data were linked to data from the NJSCR Surveillance, Epidemiology, and End Results Data Management System (SEER*DMS) via Match*Pro software. We describe the number of facilities audited and the number of unreported cases identified as a result of the audit process by reporting year and audit type. We also calculate the percent increase in cases reported by reporting year and describe salient challenges in the process. RESULTS During 4 years of data collection for the reporting years 2014-2017, 101 audits were completed and 10,546 cases were identified as unreported, representing a 7.1% increase in the number of reportable cases among those facilities audited. Challenges for the central registry involved organizing and reviewing large volumes of electronic data and Excel worksheets, and communications with facilities in the process of changing affiliations, personnel, or encryption policies. CONCLUSIONS The new process has improved the audit experience for central registry staff and increased the capture of cases being reported to NJSCR. Facilities also made improvements to casefinding, reporting, and communications to the NJSCR.
Collapse
|
34
|
Wiese D, Stroup AM, Crosbie A, Lynch SM, Henry KA. The Impact of Neighborhood Economic and Racial Inequalities on the Spatial Variation of Breast Cancer Survival in New Jersey. Cancer Epidemiol Biomarkers Prev 2019; 28:1958-1967. [PMID: 31649136 DOI: 10.1158/1055-9965.epi-19-0416] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/17/2019] [Accepted: 09/05/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Mapping breast cancer survival can help cancer control programs prioritize efforts with limited resources. We used Bayesian spatial models to identify whether breast cancer survival among patients in New Jersey (NJ) varies spatially after adjusting for key individual (age, stage at diagnosis, molecular subtype, race/ethnicity, marital status, and insurance) and neighborhood measures of poverty and economic inequality [index of concentration at the extremes (ICE)]. METHODS Survival time was calculated for all NJ women diagnosed with invasive breast cancer between 2010 and 2014 and followed to December 31, 2015 (N = 27,078). Nonlinear geoadditive Bayesian models were used to estimate spatial variation in hazard rates and identify geographic areas of higher risk of death from breast cancer. RESULTS Significant geographic differences in breast cancer survival were found in NJ. The geographic variation of hazard rates statewide ranged from 0.71 to 1.42 after adjustment for age and stage, and were attenuated after adjustment for additional individual-level factors (0.87-1.15) and neighborhood measures, including poverty (0.9-1.11) and ICE (0.92-1.09). Neighborhood measures were independently associated with breast cancer survival, but we detected slightly stronger associations between breast cancer survival, and the ICE compared to poverty. CONCLUSIONS The spatial models indicated breast cancer survival disparities are a result of combined individual-level and neighborhood socioeconomic factors. More research is needed to understand the moderating pathways in which neighborhood socioeconomic status influences breast cancer survival. IMPACT More effective health interventions aimed at improving breast cancer survival could be developed if geographic variation were examined more routinely in the context of neighborhood socioeconomic inequalities in addition to individual characteristics.
Collapse
Affiliation(s)
- Daniel Wiese
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.
| | - Antoinette M Stroup
- New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey Department of Health, Trenton, New Jersey.,Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey.,Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, Piscataway, New Jersey
| | - Amanda Crosbie
- New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey Department of Health, Trenton, New Jersey
| | | | - Kevin A Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.,Fox Chase Cancer Center, Philadelphia, Pennsylvania
| |
Collapse
|
35
|
Benard VB, Greek A, Jackson JE, Senkomago V, Hsieh MC, Crosbie A, Alverson G, Stroup AM, Richardson LC, Thomas CC. Overview of Centers for Disease Control and Prevention's Case Investigation of Cervical Cancer Study. J Womens Health (Larchmt) 2019; 28:890-896. [PMID: 31264934 DOI: 10.1089/jwh.2019.7849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/22/2022] Open
Abstract
Background: Despite advances in cervical cancer screening, a significant number of women in the United States have not received adequate screening. Studies have suggested that approximately half of the women who developed cervical cancer were not adequately screened. The Centers for Disease Control and Prevention (CDC) Case Investigation of Cervical Cancer (CICC) Study took a unique approach to reconstruct the time before a woman's cervical cancer diagnosis and understand the facilitators and barriers to screening and care. This article provides an overview of the study. Methods: This study included all cervical cancer survivors diagnosed with invasive cervical cancer aged 21 years and older in three U.S. states from 2014-2016. The study design consisted of three different data collection methods, including comprehensive registry data, a mailed survey, and medical chart abstraction. This overview compares the characteristics of cervical cancer survivors in the three states by study participation and eligibility status. Results: Registries identified 2,748 women diagnosed with invasive cervical cancer. Of these, 1,730 participants were eligible for participation, 28% (n = 481) enrolled in the study and 23% (n = 400) consented to the medical chart abstraction. Conclusion: The CICC Study is unique in that it addresses, with medical record verification, the medical history of woman 5 years before their cervical cancer diagnosis as well as provides information from the woman on her health care behaviors. This study provides data on a general population of cervical cancer survivors in three states that could be used to guide interventions to increase cervical cancer screening.
Collapse
Affiliation(s)
- Vicki B Benard
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Virginia Senkomago
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mei-Chin Hsieh
- 3Louisiana Tumor Registry and Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Amanda Crosbie
- 4New Jersey Department of Health, Cancer Epidemiology Services, Trenton, New Jersey
| | | | - Antoinette M Stroup
- 6Rutgers School of Public Health, Piscataway, New Jersey.,7Rutgers Cancer Institute of New Jersey (CINJ), New Brunswick, New Jersey
| | - Lisa C Richardson
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C Thomas
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
36
|
Plascak JJ, Llanos AAM, Chavali LB, Xing CY, Shah NN, Stroup AM, Plaha J, McCue EM, Rundle AG, Mooney SJ. Sidewalk Conditions in Northern New Jersey: Using Google Street View Imagery and Ordinary Kriging to Assess Infrastructure for Walking. Prev Chronic Dis 2019; 16:E60. [PMID: 31095921 PMCID: PMC6549436 DOI: 10.5888/pcd16.180480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jesse J Plascak
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, 683 Hoes Lane West, Room 209, Piscataway, NJ 08854. .,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Laxmi B Chavali
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Cathleen Y Xing
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Nimit N Shah
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Antoinette M Stroup
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,New Jersey State Cancer Registry, Trenton, New Jersey
| | - Jessica Plaha
- School of Arts and Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Emily M McCue
- School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, Washington
| |
Collapse
|
37
|
Millar MM, Kinney AY, Camp NJ, Cannon-Albright LA, Hashibe M, Penson DF, Kirchhoff AC, Neklason DW, Gilsenan AW, Dieck GS, Stroup AM, Edwards SL, Bateman C, Carter ME, Sweeney C. Predictors of Response Outcomes for Research Recruitment Through a Central Cancer Registry: Evidence From 17 Recruitment Efforts for Population-Based Studies. Am J Epidemiol 2019. [PMID: 30689685 DOI: 10.1093/aje/kwz011:10.1093/aje/kwz011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
When recruiting research participants through central cancer registries, high response fractions help ensure population-based representation. We conducted multivariable mixed-effects logistic regression to identify case and study characteristics associated with making contact with and obtaining cooperation of Utah cancer cases using data from 17 unique recruitment efforts undertaken by the Utah Cancer Registry (2007-2016) on behalf of the following studies: A Population-Based Childhood Cancer Survivors Cohort Study in Utah, Comparative Effectiveness Analysis of Surgery and Radiation for Prostate Cancer (CEASAR Study), Costs and Benefits of Follow-up Care for Adolescent and Young Adult Cancers, Study of Exome Sequencing for Head and Neck Cancer Susceptibility Genes, Genetic Epidemiology of Chronic Lymphocytic Leukemia, Impact of Remote Familial Colorectal Cancer Risk Assessment and Counseling (Family CARE Project), Massively Parallel Sequencing for Familial Colon Cancer Genes, Medullary Thyroid Carcinoma (MTC) Surveillance Study, Osteosarcoma Surveillance Study, Prostate Cancer Outcomes Study, Risk Education and Assessment for Cancer Heredity Project (REACH Project), Study of Shared Genomic Segment Analysis and Tumor Subtyping in High-Risk Breast-Cancer Gene Pedigrees, Study of Shared Genomic Segment Analysis for Localizing Multiple Myeloma Genes. Characteristics associated with lower odds of contact included Hispanic ethnicity (odds ratio (OR) = 0.34, 95% confidence interval (CI): 0.27, 0.41), nonwhite race (OR = 0.46, 95% CI: 0.35, 0.60), and younger age at contact. Years since diagnosis was inversely associated with making contact. Nonwhite race and age ≥60 years had lower odds of cooperation. Study features with lower odds of cooperation included longitudinal design (OR = 0.50, 95% CI: 0.41, 0.61) and study brochures (OR = 0.70, 95% CI: 0.54, 0.90). Increased odds of cooperation were associated with including a questionnaire (OR = 3.19, 95% CI: 1.54, 6.59), postage stamps (OR = 1.60, 95% CI: 1.21, 2.12), and incentives (OR = 1.62, 95% CI: 1.02, 2.57). Among cases not responding after the first contact, odds of eventual response were lower when >10 days elapsed before subsequent contact (OR = 0.71, 95% CI: 0.59, 0.85). Obtaining high response is challenging, but study features identified in this analysis support better results when recruiting through central cancer registries.
Collapse
Affiliation(s)
- Morgan M Millar
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Anita Y Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, Rutgers Health, Rutgers University, New Brunswick, New Jersey
| | - Nicola J Camp
- Division of Hematology and Hematological Malignancies, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Lisa A Cannon-Albright
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Mia Hashibe
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah.,Division of Public Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
| | - David F Penson
- Urologic Surgery, Department of Urology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee.,Center for Surgical Quality and Outcomes Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah.,Division of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Deborah W Neklason
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Alicia W Gilsenan
- Department of Epidemiology, RTI Health Solutions, RTI International, Research Triangle Park, North Carolina
| | - Gretchen S Dieck
- Safety, Epidemiology, and Risk Management, United BioSource Corporation, Blue Bell, Pennsylvania
| | - Antoinette M Stroup
- Rutgers Cancer Institute of New Jersey, Rutgers Health, Rutgers University, New Brunswick, New Jersey.,Division of Cancer Epidemiology, Rutgers School of Public Health, Rutgers University, New Brunswick, New Jersey.,New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Sandra L Edwards
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Carrie Bateman
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Marjorie E Carter
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Carol Sweeney
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| |
Collapse
|
38
|
Millar MM, Kinney AY, Camp NJ, Cannon-Albright LA, Hashibe M, Penson DF, Kirchhoff AC, Neklason DW, Gilsenan AW, Dieck GS, Stroup AM, Edwards SL, Bateman C, Carter ME, Sweeney C. Predictors of Response Outcomes for Research Recruitment Through a Central Cancer Registry: Evidence From 17 Recruitment Efforts for Population-Based Studies. Am J Epidemiol 2019; 188:928-939. [PMID: 30689685 DOI: 10.1093/aje/kwz011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/29/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 12/24/2022] Open
Abstract
When recruiting research participants through central cancer registries, high response fractions help ensure population-based representation. We conducted multivariable mixed-effects logistic regression to identify case and study characteristics associated with making contact with and obtaining cooperation of Utah cancer cases using data from 17 unique recruitment efforts undertaken by the Utah Cancer Registry (2007-2016) on behalf of the following studies: A Population-Based Childhood Cancer Survivors Cohort Study in Utah, Comparative Effectiveness Analysis of Surgery and Radiation for Prostate Cancer (CEASAR Study), Costs and Benefits of Follow-up Care for Adolescent and Young Adult Cancers, Study of Exome Sequencing for Head and Neck Cancer Susceptibility Genes, Genetic Epidemiology of Chronic Lymphocytic Leukemia, Impact of Remote Familial Colorectal Cancer Risk Assessment and Counseling (Family CARE Project), Massively Parallel Sequencing for Familial Colon Cancer Genes, Medullary Thyroid Carcinoma (MTC) Surveillance Study, Osteosarcoma Surveillance Study, Prostate Cancer Outcomes Study, Risk Education and Assessment for Cancer Heredity Project (REACH Project), Study of Shared Genomic Segment Analysis and Tumor Subtyping in High-Risk Breast-Cancer Gene Pedigrees, Study of Shared Genomic Segment Analysis for Localizing Multiple Myeloma Genes. Characteristics associated with lower odds of contact included Hispanic ethnicity (odds ratio (OR) = 0.34, 95% confidence interval (CI): 0.27, 0.41), nonwhite race (OR = 0.46, 95% CI: 0.35, 0.60), and younger age at contact. Years since diagnosis was inversely associated with making contact. Nonwhite race and age ≥60 years had lower odds of cooperation. Study features with lower odds of cooperation included longitudinal design (OR = 0.50, 95% CI: 0.41, 0.61) and study brochures (OR = 0.70, 95% CI: 0.54, 0.90). Increased odds of cooperation were associated with including a questionnaire (OR = 3.19, 95% CI: 1.54, 6.59), postage stamps (OR = 1.60, 95% CI: 1.21, 2.12), and incentives (OR = 1.62, 95% CI: 1.02, 2.57). Among cases not responding after the first contact, odds of eventual response were lower when >10 days elapsed before subsequent contact (OR = 0.71, 95% CI: 0.59, 0.85). Obtaining high response is challenging, but study features identified in this analysis support better results when recruiting through central cancer registries.
Collapse
Affiliation(s)
- Morgan M Millar
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Anita Y Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, New Jersey
- Rutgers Cancer Institute of New Jersey, Rutgers Health, Rutgers University, New Brunswick, New Jersey
| | - Nicola J Camp
- Division of Hematology and Hematological Malignancies, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Lisa A Cannon-Albright
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Mia Hashibe
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
- Division of Public Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
| | - David F Penson
- Urologic Surgery, Department of Urology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
- Center for Surgical Quality and Outcomes Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Deborah W Neklason
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Alicia W Gilsenan
- Department of Epidemiology, RTI Health Solutions, RTI International, Research Triangle Park, North Carolina
| | - Gretchen S Dieck
- Safety, Epidemiology, and Risk Management, United BioSource Corporation, Blue Bell, Pennsylvania
| | - Antoinette M Stroup
- Rutgers Cancer Institute of New Jersey, Rutgers Health, Rutgers University, New Brunswick, New Jersey
- Division of Cancer Epidemiology, Rutgers School of Public Health, Rutgers University, New Brunswick, New Jersey
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Sandra L Edwards
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Carrie Bateman
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Marjorie E Carter
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Carol Sweeney
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| |
Collapse
|
39
|
Tsui J, DeLia D, Stroup AM, Nova J, Kulkarni A, Ferrante JM, Cantor JC. Association of Medicaid enrollee characteristics and primary care utilization with cancer outcomes for the period spanning Medicaid expansion in New Jersey. Cancer 2018; 125:1330-1340. [DOI: 10.1002/cncr.31824] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/30/2018] [Accepted: 09/28/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Jennifer Tsui
- Cancer Institute of New Jersey Rutgers, the State University of New Jersey New Brunswick New Jersey
- School of Public Health Rutgers, the State University of New Jersey Piscataway New Jersey
| | - Derek DeLia
- MedStar Health Research Institute Hyattsville Maryland
| | - Antoinette M. Stroup
- Cancer Institute of New Jersey Rutgers, the State University of New Jersey New Brunswick New Jersey
- School of Public Health Rutgers, the State University of New Jersey Piscataway New Jersey
- New Jersey State Cancer Registry New Jersey Department of Health Trenton New Jersey
| | - Jose Nova
- Center for State Health Policy Rutgers, the State University of New Jersey New Brunswick New Jersey
| | - Aishwarya Kulkarni
- Cancer Institute of New Jersey Rutgers, the State University of New Jersey New Brunswick New Jersey
- New Jersey State Cancer Registry New Jersey Department of Health Trenton New Jersey
| | - Jeanne M. Ferrante
- Department of Family Medicine, Robert Wood Johnson Medical School Rutgers, the State University of New Jersey New Brunswick New Jersey
| | - Joel C. Cantor
- Center for State Health Policy Rutgers, the State University of New Jersey New Brunswick New Jersey
| |
Collapse
|
40
|
Llanos AAM, Tsui J, Rotter D, Toler L, Stroup AM. Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women. BMC Womens Health 2018; 18:162. [PMID: 30285820 PMCID: PMC6171187 DOI: 10.1186/s12905-018-0656-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/26/2018] [Indexed: 02/02/2023]
Abstract
Background Current cervical cancer screening guidelines recommend a Pap test every 3 years for women age 21–65 years, or for women 30–65 years who want to lengthen the screening interval, a combination of Pap test and high-risk human papilloma virus testing (co-testing) every 5 years. Little population-based data are available on human papilloma virus test utilization and human papilloma virus infection rates. The objective of this study was to examine the patient-level, cervical cancer screening, and area-level factors associated with human papilloma virus testing and infection among a diverse sample of uninsured and underinsured women enrolled in the New Jersey Cancer Early Education and Detection (NJCEED) Program. Methods We used data for a sample of 50,510 uninsured/underinsured women, age ≥ 29 years, who screened for cervical cancer through NJCEED between January 1, 2009 and December 31, 2015. Multivariable logistic regression models were used to estimate associations between ever having a human papilloma virus test or a positive test result, and individual- (age, race/ethnicity, birthplace) and area-level covariates (% below federal poverty level, % minority, % uninsured), and number of screening visits. Results Only 26.6% (13,440) of the sample had at least one human papilloma virus test. Among women who underwent testing, 13.3% (1792) tested positive for human papilloma virus. Most women who were positive for human papilloma virus (99.4%) had their first test as a co-test. Human papilloma virus test utilization and infection were significantly associated with age, race/ethnicity, birthplace (country), and residential area-level poverty. Rates of human papilloma virus testing and infection also differed significantly across counties in the state of New Jersey. Conclusions These findings suggest that despite access to no-cost cervical cancer screening for eligible women, human papilloma virus test utilization was relatively low among diverse, uninsured and underinsured women in New Jersey, and test utilization and infection were associated with individual-level and area-level factors.
Collapse
Affiliation(s)
- Adana A M Llanos
- Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Room 211, Piscataway, NJ, 08854, USA. .,Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
| | - Jennifer Tsui
- Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - David Rotter
- Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Lindsey Toler
- Department of Social and Behavioral Health Sciences, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Antoinette M Stroup
- Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Room 211, Piscataway, NJ, 08854, USA.,Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.,New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, USA
| |
Collapse
|
41
|
Lee DJ, Barocas DA, Zhao Z, Huang LC, Resnick MJ, Koyoma T, Conwill R, McCollum D, Cooperberg MR, Goodman M, Greenfield S, Hamilton AS, Hashibe M, Kaplan SH, Paddock LE, Stroup AM, Wu XC, Penson DF, Hoffman KE. Comparison of Patient-reported Outcomes After External Beam Radiation Therapy and Combined External Beam With Low-dose-rate Brachytherapy Boost in Men With Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2018; 102:116-126. [PMID: 30102188 DOI: 10.1016/j.ijrobp.2018.05.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 10/14/2022]
Abstract
PURPOSE To compare patient-reported disease-specific functional outcomes after external beam radiation therapy (EBRT) and EBRT combined with low-dose-rate brachytherapy prostate boost (EB-LDR) among men with localized prostate cancer. METHODS AND MATERIALS The prospective, population-based Comparative Effectiveness Analysis of Surgery and Radiation study enrolled men with localized prostate cancer in 2011 to 2012. The 26-item Expanded Prostate Cancer Index Composite measured patient-reported disease-specific function at baseline and at 6, 12, and 36 months. Higher domain scores indicate better function. Minimal clinically important difference was defined as 6 for urinary incontinence, 5 for urinary irritative function, 4 for bowel function, 12 for sexual function, and 4 for hormonal function. Multivariable linear and logistic regression models were fit to estimate the effect of treatment on patient-reported outcomes. RESULTS Five-hundred seventy-eight men received EBRT and 109 received EB-LDR. Median patient age was 69 years, and 70% had intermediate- or high-risk disease. Men in the EB-LDR group were younger (P < .001) and less likely to receive androgen deprivation therapy (P < .001). Baseline urinary, bowel, sexual, and hormonal function was similar between treatment groups (P > .05). On multivariable analyses, men receiving EB-LDR reported worse urinary irritative function at 6 months (adjusted mean difference [AMD] -14.4, P < .001), 12 months (AMD -12.9, P < .001), and 36 months (AMD -4.7, P = .034) than men receiving EBRT. At 12 months, men receiving EB-LDR reported worse bowel function (AMD -5.8, P = .002), but these differences were not seen at 36 months. There were no significant differences in sexual or hormone function between treatment groups. CONCLUSIONS Men treated with EB-LDR report worse bowel function at 1 year and worse urinary irritative function through 3 years compared with men treated with EBRT alone. These side effect profiles should be discussed with patients when considering EB-LDR versus EBRT treatment.
Collapse
Affiliation(s)
- Daniel J Lee
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Daniel A Barocas
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Zhiguo Zhao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Li-Ching Huang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew J Resnick
- Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tatsuki Koyoma
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ralph Conwill
- Prostate Cancer Patient Advocate, Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Dan McCollum
- Prostate Cancer Patient Advocate, Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Matthew R Cooperberg
- Department of Urology, University of California, San Francisco Medical Center, San Francisco, California
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Sheldon Greenfield
- Center for Health Policy Research and Department of Medicine, University of California, Irvine, Irvine, California
| | - Ann S Hamilton
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Mia Hashibe
- Department of Family and Preventative Medicine, University of Utah, Salt Lake City, Utah
| | - Sherrie H Kaplan
- Health Policy Research Institute, University of California, Irvine, Irvine, California
| | - Lisa E Paddock
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Antoinette M Stroup
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Xiao-Cheng Wu
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - David F Penson
- Tennessee Valley Veterans Administration Health System, Nashville, Tennessee
| | - Karen E Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
42
|
Crosbie AB, Roche LM, Johnson LM, Pawlish KS, Paddock LE, Stroup AM. Trends in colorectal cancer incidence among younger adults-Disparities by age, sex, race, ethnicity, and subsite. Cancer Med 2018; 7:4077-4086. [PMID: 29932308 PMCID: PMC6089150 DOI: 10.1002/cam4.1621] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 03/19/2018] [Revised: 05/14/2018] [Accepted: 05/31/2018] [Indexed: 01/06/2023] Open
Abstract
Millennials (ages 18-35) are now the largest living generation in the US, making it important to understand and characterize the rising trend of colorectal cancer incidence in this population, as well as other younger generations of Americans. Data from the New Jersey State Cancer Registry (n = 181 909) and Surveillance, Epidemiology, and End Results program (n = 448 714) were used to analyze invasive CRC incidence trends from 1979 to 2014. Age, sex, race, ethnicity, subsite, and stage differences between younger adults (20-49) and screening age adults (≥50) in New Jersey (NJ) were examined using chi-square; and, we compared secular trends in NJ to the United States (US). Whites, men, and the youngest adults (ages 20-39) are experiencing greater APCs in rectal cancer incidence. Rates among younger black adults, overall, were consistently higher in both NJ and the US over time. When compared to older adults, younger adults with CRC in NJ were more likely to be: diagnosed at the late stage, diagnosed with rectal cancer, male, non-white, and Hispanic. Invasive CRC incidence trends among younger adults were found to vary by age, sex, race, ethnicity, and subsite. Large, case-level, studies are needed to understand the role of genetics, human papillomavirus (HPV), and cultural and behavioral factors in the rise of CRC among younger adults. Provider and public education about CRC risk factors will also be important for preventing and reversing the increasing CRC trend in younger adults.
Collapse
Affiliation(s)
- Amanda B. Crosbie
- Cancer Epidemiology ServicesNew Jersey Department of HealthTrentonNJUSA
| | - Lisa M. Roche
- Cancer Epidemiology ServicesNew Jersey Department of HealthTrentonNJUSA
| | - Linda M. Johnson
- Cancer Epidemiology ServicesNew Jersey Department of HealthTrentonNJUSA
| | - Karen S. Pawlish
- Cancer Epidemiology ServicesNew Jersey Department of HealthTrentonNJUSA
| | - Lisa E. Paddock
- Cancer Epidemiology ServicesNew Jersey Department of HealthTrentonNJUSA
- Rutgers Cancer Institute of New JerseyNew BrunswickNJUSA
- Department of EpidemiologyRutgers School of Public HealthPiscatawayNJUSA
| | - Antoinette M. Stroup
- Cancer Epidemiology ServicesNew Jersey Department of HealthTrentonNJUSA
- Rutgers Cancer Institute of New JerseyNew BrunswickNJUSA
- Department of EpidemiologyRutgers School of Public HealthPiscatawayNJUSA
| |
Collapse
|
43
|
Lewis DR, Chen HS, Cockburn MG, Wu XC, Stroup AM, Midthune DN, Zou Z, Krapcho MF, Miller DG, Feuer EJ. Early estimates of cancer incidence for 2015: Expanding to include estimates for white and black races. Cancer 2018; 124:2192-2204. [PMID: 29509274 DOI: 10.1002/cncr.31315] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 11/22/2017] [Revised: 01/12/2018] [Accepted: 01/24/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND The National Cancer Institute's cancer incidence estimates through 2015 from the Surveillance, Epidemiology, and End Results (SEER) registries' November 2017 submission are released in April 2018. METHODS Early estimates (February 2017) of cancer incidence rates and trends from the SEER 18 registries for diagnoses in 2000 through 2015 were evaluated with a revised delay-adjustment model, which was used to adjust for the undercount of cases in the early release. For the first time, early estimates were produced for race (whites and blacks) along with estimates for new sites: the oral cavity and pharynx, leukemia, and myeloma. RESULTS Model validation comparing delay-adjusted rates and trends through 2014 and using 2016 submissions showed good agreement. Differences in trends through 2015 in comparison with those through 2014 were evident. The rate of female breast cancer rose significantly from 2004 to 2015 by 0.3% per year (annual percent change [APC] = 0.3%); the prior trend through 2014 (the same magnitude) was not yet significant. The female colon and rectum cancer trend for whites became flat after previously declining. Lung and bronchus cancer for whites showed a significant decline (APC for males = -2.3%, 2012-2015; APC for females = -0.7%, 2011-2015). Thyroid cancer for black females changed from a continuous rise to a flat final segment (APC = 1.6%, not significant, 2011-2015). Both kidney and renal pelvis cancer (APC = 1.5%, 2011-2015) and childhood cancers (APC = 0.5%, 2000-2015) for white males showed a significant rise in the final segments from previously flat trends. Kidney and renal pelvis cancer for black males showed a change from a significant rise to a flat trend. CONCLUSIONS The early release of SEER data continues to be useful as a preliminary estimate of the most current cancer incidence trends. Cancer 2018;124:2192-204. © 2018 American Cancer Society.
Collapse
Affiliation(s)
- Denise Riedel Lewis
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Huann-Sheng Chen
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Myles G Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Xiao-Cheng Wu
- Louisiana Tumor Registry, Louisiana State University, New Orleans, Louisiana
| | - Antoinette M Stroup
- New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Douglas N Midthune
- Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Zhaohui Zou
- Information Management Systems Incorporated, Calverton, Maryland
| | - Martin F Krapcho
- Information Management Systems Incorporated, Calverton, Maryland
| | - Daniel G Miller
- Information Management Systems Incorporated, Calverton, Maryland
| | - Eric J Feuer
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| |
Collapse
|
44
|
Diamond J, Romero M, Seepersad R, Taylor G, Stabinsky H, Hill S, Stroup AM. CTR Exam Readiness Guide. J Registry Manag 2018; 45:80-81. [PMID: 31533134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
|
45
|
Benard VB, Watson M, Saraiya M, Harewood R, Townsend JS, Stroup AM, Weir HK, Allemani C. Cervical cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer 2017; 123 Suppl 24:5119-5137. [PMID: 29205300 DOI: 10.1002/cncr.30906] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/14/2017] [Accepted: 07/05/2017] [Indexed: 11/05/2022]
Abstract
BACKGROUND Overall, cervical cancer survival in the United States has been reported to be among the highest in the world, despite slight decreases over the last decade. Objective of the current study was to describe cervical cancer survival trends among US women and examine differences by race and stage. METHODS This study used data from the CONCORD-2 study to compare survival among women (aged 15-99 years) diagnosed in 37 states covering 80% of the US population. Survival was adjusted for background mortality (net survival) with state- and race-specific life tables and was age-standardized with the International Cancer Survival Standard weights. Five-year survival was compared by race (all races, blacks, and whites). Two time periods, 2001-2003 and 2004-2009, were considered because of changes in how the staging variable was collected. RESULTS From 2001 to 2009, 90,620 women were diagnosed with invasive cervical cancer. The proportion of cancers diagnosed at a regional or distant stage increased over time in most states. Overall, the 5-year survival was 63.5% in 2001-2003 and 62.8% in 2004-2009. The survival was lower for black women versus white women in both calendar periods and in most states; black women had a higher proportion of distant-stage cancers. CONCLUSIONS The stability of the overall survival over time and the persistent differences in survival between white and black women in all US states suggest that there is a need for targeted interventions and improved access to screening, timely treatment, and follow-up care, especially among black women. Cancer 2017;123:5119-37. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Collapse
Affiliation(s)
- Vicki B Benard
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meg Watson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mona Saraiya
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rhea Harewood
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Julie S Townsend
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Antoinette M Stroup
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Hannah K Weir
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
46
|
Steffen LE, Du R, Gammon A, Mandelblatt JS, Kohlmann WK, Lee JH, Buys SS, Stroup AM, Campo RA, Flores KG, Vicuña B, Schwartz MD, Kinney AY. Genetic Testing in a Population-Based Sample of Breast and Ovarian Cancer Survivors from the REACH Randomized Trial: Cost Barriers and Moderators of Counseling Mode. Cancer Epidemiol Biomarkers Prev 2017; 26:1772-1780. [PMID: 28971986 DOI: 10.1158/1055-9965.epi-17-0389] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/12/2017] [Accepted: 09/14/2017] [Indexed: 11/16/2022] Open
Abstract
Background: This study evaluates predictors of BRCA1/2 testing among breast and ovarian cancer survivors who received genetic counseling as part of a randomized trial and evaluates moderators of counseling mode on testing uptake.Methods: Predictors of BRCA1/2 testing within one year postcounseling were evaluated using multivariable logistic regression in a population-based sample of breast and ovarian cancer survivors at increased hereditary risk randomly assigned to in-person counseling (IPC; n = 379) versus telephone counseling (TC; n = 402). Variables that moderated the association between counseling mode and testing were identified by subgroup analysis.Results: Testing uptake was associated with higher perceived comparative mutation risk [OR = 1.32; 95% confidence interval (CI), 1.11-1.57] in the adjusted analysis. Those without cost barriers had higher testing uptake (OR = 18.73; 95% CI, 7.09-49.46). Psychologic distress and perceived comparative mutation risk moderated the effect of counseling and testing. Uptake between IPC versus TC did not differ at low levels of distress and risk, but differed at high distress (26.3% TC vs. 44.3% IPC) and high perceived comparative risk (33.9% TC vs. 50.5% IPC).Conclusions: Cost concerns are a strong determinant of testing. Differences in testing uptake by counseling mode may depend on precounseling distress and risk perceptions.Impact: Cost concerns may contribute to low testing in population-based samples of at-risk cancer survivors. Precounseling psychosocial characteristics should be considered when offering in-person versus telephone counseling. Cancer Epidemiol Biomarkers Prev; 26(12); 1772-80. ©2017 AACR.
Collapse
Affiliation(s)
- Laurie E Steffen
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ruofei Du
- University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico.,Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Amanda Gammon
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jeanne S Mandelblatt
- Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Wendy K Kohlmann
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Ji-Hyun Lee
- University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico.,Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Saundra S Buys
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Antoinette M Stroup
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.,Department of Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey
| | - Rebecca A Campo
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Kristina G Flores
- University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico
| | - Belinda Vicuña
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Marc D Schwartz
- Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC
| | - Anita Y Kinney
- University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico. .,Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| |
Collapse
|
47
|
Henry KA, Swiecki-Sikora AL, Stroup AM, Warner EL, Kepka D. Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States. BMC Public Health 2017; 18:19. [PMID: 28709420 PMCID: PMC5513319 DOI: 10.1186/s12889-017-4567-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 07/05/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study is the first to examine associations between several area-based socioeconomic factors and human papillomavirus (HPV) vaccine uptake among boys in the United States (U.S.). METHODS Data from the 2012-2013 National Immunization Survey-Teen restricted-use data were analyzed to examine associations of HPV vaccination initiation (receipt of ≥1 dose) and series completion (receipt of three doses) among boys aged 13-17 years (N = 19,518) with several individual-level and ZIP Code Tabulation Area (ZCTA) census measures. Multivariable logistic regression was used to estimate the odds of HPV vaccination initiation and series completion separately. RESULTS In 2012-2013 approximately 27.9% (95% CI 26.6%-29.2%) of boys initiated and 10.38% (95% CI 9.48%-11.29%) completed the HPV vaccine series. Area-based poverty was not statistically significantly associated with HPV vaccination initiation. It was, however, associated with series completion, with boys living in high-poverty areas (≥20% of residents living below poverty) having higher odds of completing the series (AOR 1.22, 95% CI 1.01-1.48) than boys in low-poverty areas (0-4.99%). Interactions between race/ethnicity and ZIP code-level poverty indicated that Hispanic boys living in high-poverty areas had a statistically significantly higher odds of HPV vaccine initiation (AOR 1.43, 95% CI 1.03-1.97) and series completion (AOR 1.56, 95% CI 1.05-2.32) than Hispanic boys in low-poverty areas. Non-Hispanic Black boys in high poverty areas had higher odds of initiation (AOR 2.23, 95% CI 1.33-3.75) and completion (AOR 2.61, 95% CI 1.06-6.44) than non-Hispanic Black boys in low-poverty areas. Rural/urban residence and population density were also significant factors, with boys from urban or densely populated areas having higher odds of initiation and completion compared to boys living in non-urban, less densely populated areas. CONCLUSION Higher HPV vaccination coverage in urban areas and among racial/ethnic minorities in areas with high poverty may be attributable to factors such as vaccine acceptance, health-care practices, and their access to HPV vaccines through the Vaccines for Children Program, which provides free vaccines to uninsured and under-insured children. Given the low HPV vaccination rates among boys in the U.S., these results provide important evidence to inform public health interventions to increase HPV vaccination.
Collapse
Affiliation(s)
- Kevin A Henry
- Department of Geography, Temple University, 115 W. Polett Walk, 308 Gladfelter Hall, Philadelphia, PA, 19122, USA. .,Fox Chase Cancer Center, Cancer Prevention and Control Program, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
| | - Allison L Swiecki-Sikora
- Temple University, Lewis Katz School of Medicine, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Antoinette M Stroup
- Department of Epidemiology, Division of Cancer Epidemiology, New Jersey State Cancer Registry, Rutgers University, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.,Cancer Institute of New Jersey, Rutgers University, Cancer Prevention and Control Program, 195 Little Albany Street, New Brunswick, NJ, 08903, USA
| | - Echo L Warner
- Huntsman Cancer Institute, University of Utah, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Deanna Kepka
- Huntsman Cancer Institute, University of Utah, Cancer Control and Population Sciences, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.,University of Utah College of Nursing, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| |
Collapse
|
48
|
Hoffman RM, Lo M, Clark JA, Albertsen PC, Barry MJ, Goodman M, Penson DF, Stanford JL, Stroup AM, Hamilton AS. Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study. J Clin Oncol 2017; 35:2306-2314. [PMID: 28493812 PMCID: PMC5501361 DOI: 10.1200/jco.2016.70.6317] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [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] [Indexed: 12/11/2022] Open
Abstract
Purpose To determine the demographic, clinical, decision-making, and quality-of-life factors that are associated with treatment decision regret among long-term survivors of localized prostate cancer. Patients and Methods We evaluated men who were age ≤ 75 years when diagnosed with localized prostate cancer between October 1994 and October 1995 in one of six SEER tumor registries and who completed a 15-year follow-up survey. The survey obtained demographic, socioeconomic, and clinical data and measured treatment decision regret, informed decision making, general- and disease-specific quality of life, health worry, prostate-specific antigen (PSA) concern, and outlook on life. We used multivariable logistic regression analyses to identify factors associated with regret. Results We surveyed 934 participants, 69.3% of known survivors. Among the cohort, 59.1% had low-risk tumor characteristics (PSA < 10 ng/mL and Gleason score < 7), and 89.2% underwent active treatment. Overall, 14.6% expressed treatment decision regret: 8.2% of those whose disease was managed conservatively, 15.0% of those who received surgery, and 16.6% of those who underwent radiotherapy. Factors associated with regret on multivariable analysis included reporting moderate or big sexual function bother (reported by 39.0%; OR, 2.77; 95% CI, 1.51 to 5.0), moderate or big bowel function bother (reported by 7.7%; OR, 2.32; 95% CI, 1.04 to 5.15), and PSA concern (mean score 52.8; OR, 1.01 per point change; 95% CI, 1.00 to 1.02). Increasing age at diagnosis and report of having made an informed treatment decision were inversely associated with regret. Conclusion Regret was a relatively infrequently reported outcome among long-term survivors of localized prostate cancer; however, our results suggest that better informing men about treatment options, in particular, conservative treatment, might help mitigate long-term regret. These findings are timely for men with low-risk cancers who are being encouraged to consider active surveillance.
Collapse
Affiliation(s)
- Richard M. Hoffman
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Mary Lo
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Jack A. Clark
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Peter C. Albertsen
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Michael J. Barry
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Michael Goodman
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - David F. Penson
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Janet L. Stanford
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Antoinette M. Stroup
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Ann S. Hamilton
- Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| |
Collapse
|
49
|
Barocas DA, Alvarez J, Resnick MJ, Koyama T, Hoffman KE, Tyson MD, Conwill R, McCollum D, Cooperberg MR, Goodman M, Greenfield S, Hamilton AS, Hashibe M, Kaplan SH, Paddock LE, Stroup AM, Wu XC, Penson DF. Association Between Radiation Therapy, Surgery, or Observation for Localized Prostate Cancer and Patient-Reported Outcomes After 3 Years. JAMA 2017; 317:1126-1140. [PMID: 28324093 PMCID: PMC5782813 DOI: 10.1001/jama.2017.1704] [Citation(s) in RCA: 228] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Importance Understanding the adverse effects of contemporary approaches to localized prostate cancer treatment could inform shared decision making. Objective To compare functional outcomes and adverse effects associated with radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance. Design, Setting, and Participants Prospective, population-based, cohort study involving 2550 men (≤80 years) diagnosed in 2011-2012 with clinical stage cT1-2, localized prostate cancer, with prostate-specific antigen levels less than 50 ng/mL, and enrolled within 6 months of diagnosis. Exposures Treatment with radical prostatectomy, EBRT, or active surveillance was ascertained within 1 year of diagnosis. Main Outcomes and Measures Patient-reported function on the 26-item Expanded Prostate Cancer Index Composite (EPIC) 36 months after enrollment. Higher domain scores (range, 0-100) indicate better function. Minimum clinically important difference was defined as 10 to 12 points for sexual function, 6 for urinary incontinence, 5 for urinary irritative symptoms, 5 for bowel function, and 4 for hormonal function. Results The cohort included 2550 men (mean age, 63.8 years; 74% white, 55% had intermediate- or high-risk disease), of whom 1523 (59.7%) underwent radical prostatectomy, 598 (23.5%) EBRT, and 429 (16.8%) active surveillance. Men in the EBRT group were older (mean age, 68.1 years vs 61.5 years, P < .001) and had worse baseline sexual function (mean score, 52.3 vs 65.2, P < .001) than men in the radical prostatectomy group. At 3 years, the adjusted mean sexual domain score for radical prostatectomy decreased more than for EBRT (mean difference, -11.9 points; 95% CI, -15.1 to -8.7). The decline in sexual domain scores between EBRT and active surveillance was not clinically significant (-4.3 points; 95% CI, -9.2 to 0.7). Radical prostatectomy was associated with worse urinary incontinence than EBRT (-18.0 points; 95% CI, -20.5 to -15.4) and active surveillance (-12.7 points; 95% CI, -16.0 to -9.3) but was associated with better urinary irritative symptoms than active surveillance (5.2 points; 95% CI, 3.2 to 7.2). No clinically significant differences for bowel or hormone function were noted beyond 12 months. No differences in health-related quality of life or disease-specific survival (3 deaths) were noted (99.7%-100%). Conclusions and Relevance In this cohort of men with localized prostate cancer, radical prostatectomy was associated with a greater decrease in sexual function and urinary incontinence than either EBRT or active surveillance after 3 years and was associated with fewer urinary irritative symptoms than active surveillance; however, no meaningful differences existed in either bowel or hormonal function beyond 12 months or in in other domains of health-related quality-of-life measures. These findings may facilitate counseling regarding the comparative harms of contemporary treatments for prostate cancer.
Collapse
Affiliation(s)
- Daniel A. Barocas
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - JoAnn Alvarez
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Matthew J. Resnick
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Tatsuki Koyama
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Karen E. Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark D. Tyson
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ralph Conwill
- Prostate Cancer Patient Advocate, Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Dan McCollum
- Prostate Cancer Patient Advocate, Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Matthew R. Cooperberg
- Department of Urology, University of California, San Francisco Medical Center, San Francisco, California
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Emory University, Atlanta, Georgia
| | - Sheldon Greenfield
- Center for Health Policy Research and Department of Medicine, University of California, Irvine, Irvine, California
| | - Ann S. Hamilton
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Mia Hashibe
- Department of Family and Preventative Medicine, University of Utah, Salt Lake City, Utah
| | - Sherrie H. Kaplan
- Health Policy Research Institute, University of California, Irvine, Irvine, California
| | - Lisa E. Paddock
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Antoinette M. Stroup
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
| | - Xiao-Cheng Wu
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - David F. Penson
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- Tennessee Valley Veterans Administration Health System, Nashville, TN
| |
Collapse
|
50
|
Lewis DR, Chen HS, Cockburn MG, Wu XC, Stroup AM, Midthune DN, Zou Z, Krapcho MF, Miller DG, Feuer EJ. Early estimates of SEER cancer incidence, 2014. Cancer 2017; 123:2524-2534. [PMID: 28195651 DOI: 10.1002/cncr.30630] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 12/14/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cancer incidence rates and trends for cases diagnosed through 2014 using data reported to the Surveillance, Epidemiology, and End Results (SEER) program in February 2016 and a validation of rates and trends for cases diagnosed through 2013 and submitted in February 2015 using the November 2015 submission are reported. New cancer sites include the pancreas, kidney and renal pelvis, corpus and uterus, and childhood cancer sites for ages birth to 19 years inclusive. METHODS A new reporting delay model is presented for these estimates for more consistent results with the model used for the usual November SEER submissions, adjusting for the large case undercount in the February submission. Joinpoint regression methodology was used to assess trends. Delay-adjusted rates and trends were checked for validity between the February 2016 and November 2016 submissions. RESULTS Validation revealed that the delay model provides similar estimates of eventual counts using either February or November submission data. Trends declined through 2014 for prostate and colon and rectum cancer for males and females, male and female lung cancer, and cervical cancer. Thyroid cancer and liver and intrahepatic bile duct cancer increased. Pancreas (male and female) and corpus and uterus cancer demonstrated a modest increase. Slight increases occurred for male kidney and renal pelvis, and for all childhood cancer sites for ages birth to 19 years. CONCLUSIONS Evaluating early cancer data submissions, adjusted for reporting delay, produces timely and valid incidence rates and trends. The results of the current study support using delay-adjusted February submission data for valid incidence rate and trend estimates over several data cycles. Cancer 2017;123:2524-34. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Denise Riedel Lewis
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Huann-Sheng Chen
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Myles G Cockburn
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Xiao-Cheng Wu
- Louisiana Tumor Registry, Louisiana State University, New Orleans, Louisiana
| | - Antoinette M Stroup
- New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Douglas N Midthune
- Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Zhaohui Zou
- Information Management Systems Incorporated, Calverton, Maryland
| | - Martin F Krapcho
- Information Management Systems Incorporated, Calverton, Maryland
| | - Daniel G Miller
- Information Management Systems Incorporated, Calverton, Maryland
| | - Eric J Feuer
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| |
Collapse
|