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Siegel DA, King JB, Lupo PJ, Durbin EB, Tai E, Mills K, Van Dyne E, Lunsford NB, Henley SJ, Wilson RJ. Counts, incidence rates, and trends of pediatric cancer in the United States, 2003-2019. J Natl Cancer Inst 2023; 115:1337-1354. [PMID: 37433078 PMCID: PMC11018256 DOI: 10.1093/jnci/djad115] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 03/22/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Cancer is a leading cause of death by disease among children and adolescents in the United States. This study updates cancer incidence rates and trends using the most recent and comprehensive US cancer registry data available. METHODS We used data from US Cancer Statistics to evaluate counts, age-adjusted incidence rates, and trends among children and adolescents younger than 20 years of age diagnosed with malignant tumors between 2003 and 2019. We calculated the average annual percent change (APC) and APC using joinpoint regression. Rates and trends were stratified by demographic and geographic characteristics and by cancer type. RESULTS With 248 749 cases reported between 2003 and 2019, the overall cancer incidence rate was 178.3 per 1 million; incidence rates were highest for leukemia (46.6), central nervous system neoplasms (30.8), and lymphoma (27.3). Rates were highest for males, children 0 to 4 years of age, Non-Hispanic White children and adolescents, those in the Northeast census region, the top 25% of counties by economic status, and metropolitan counties with a population of 1 million people or more. Although the overall incidence rate of pediatric cancer increased 0.5% per year on average between 2003 and 2019, the rate increased between 2003 and 2016 (APC = 1.1%), and then decreased between 2016 and 2019 (APC = -2.1%). Between 2003 and 2019, rates of leukemia, lymphoma, hepatic tumors, bone tumors, and thyroid carcinomas increased, while melanoma rates decreased. Rates of central nervous system neoplasms increased until 2017, and then decreased. Rates of other cancer types remained stable. CONCLUSIONS Incidence of pediatric cancer increased overall, although increases were limited to certain cancer types. These findings may guide future public health and research priorities.
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Affiliation(s)
- David A. Siegel
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica B. King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Philip J. Lupo
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Eric B. Durbin
- Kentucky Cancer Registry, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Eric Tai
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kathi Mills
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elizabeth Van Dyne
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Natasha Buchanan Lunsford
- Office of the Director, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Reda J. Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Arrazola RA, Griffin T, Lunsford NB, Kittner D, Bammeke P, Courtney-Long EA, Armour BS. US Cigarette Smoking Disparities by Race and Ethnicity - Keep Going and Going! Prev Chronic Dis 2023; 20:E45. [PMID: 37262328 DOI: 10.5888/pcd20.220375] [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: 06/03/2023] Open
Abstract
INTRODUCTION Although current cigarette smoking among US adults decreased from 42.4% in 1965 to 12.5% in 2020, prevalence is higher among certain racial and ethnic groups, including non-Hispanic American Indian and Alaska Native (AIAN) adults. METHODS We examined trends in current cigarette smoking prevalence, population estimates, and relative disparity among US adults (aged ≥18 y) between 2011 and 2020 by using data from the National Health Interview Survey. SAS-callable SUDAAN was used to obtain prevalence and population estimates, and relative disparity was calculated on the basis of findings in the literature. Trends were significant at P < .05. RESULTS From 2011 to 2020, linear decreases in prevalence and population estimates were observed for non-Hispanic White (20.6% to 13.3%; 32.1 million to 20.7 million), non-Hispanic Black (19.4% to 14.4%; 5.1 million to 4.0 million), and Hispanic (12.9% to 8.0%; 4.2 million to 3.3 million) adults. For non-Hispanic AIAN adults, prevalence remained around 27%, and a linear increase in the population estimate was observed from 400,000 to 510,000. Relative disparity did not change across racial and ethnic categories. CONCLUSION Linear decreases have occurred between 2011 and 2020 for non-Hispanic White, non-Hispanic Black, and Hispanic adults who smoke, but the number of non-Hispanic AIAN adults who currently smoke has increased by 110,000, and relative disparities persist. To reduce racial and ethnic disparities in smoking, understanding how factors at multiple socioecologic levels impact smoking and helping to inform paths to equitable reach and implementation of tobacco control interventions for all population groups are needed.
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Affiliation(s)
- René A Arrazola
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, S107-7, Atlanta, GA 30341
| | | | - Natasha Buchanan Lunsford
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deirdre Kittner
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Philip Bammeke
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth A Courtney-Long
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian S Armour
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Al-Shawaf M, Grooms KN, Mahoney M, Buchanan Lunsford N, Lawrence Kittner D. Support for Policies to Prohibit the Sale of Menthol Cigarettes and All Tobacco Products Among Adults, 2021. Prev Chronic Dis 2023; 20:E05. [PMID: 36729702 PMCID: PMC9923936 DOI: 10.5888/pcd20.220128] [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: 01/31/2023] Open
Abstract
This study assessed support for commercial tobacco retail policies among adults. Data came from SpringStyles 2021, a web panel survey of adults in the US aged 18 years or older (N = 6,455). Overall, 62.3% of adults supported a policy prohibiting the sale of menthol cigarettes, and 57.3% supported a policy prohibiting the sale of all tobacco products. A majority of adults supported tobacco retail policies aimed at preventing initiation, promoting quitting, and reducing tobacco-related disparities. These findings can help inform federal, state, and local efforts to prohibit the sale of tobacco products, including menthol cigarettes.
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Affiliation(s)
- Maeh Al-Shawaf
- Centers for Disease Control and Prevention, Office on Smoking and Health, Mailstop S107-7, Atlanta, GA 30341.
| | - Kya N. Grooms
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Margaret Mahoney
- Centers for Disease Control and Prevention, Office on Smoking and Health, Atlanta, Georgia
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Siegel DA, Richardson LC, Henley SJ, Wilson RJ, Dowling NF, Weir HK, Tai EW, Buchanan Lunsford N. Pediatric cancer mortality and survival in the United States, 2001-2016. Cancer 2020; 126:4379-4389. [PMID: 32725630 DOI: 10.1002/cncr.33080] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [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: 11/02/2019] [Revised: 04/24/2020] [Accepted: 05/02/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although pediatric cancer mortality and survival have improved in the United States over the past 40 years, differences exist by age, race/ethnicity, cancer site, and economic status. To assess progress, this study examined recent mortality and survival data for individuals younger than 20 years. METHODS Age-adjusted death rates were calculated with the National Vital Statistics System for 2002-2016. Annual percent changes (APCs) and average annual percent changes (AAPCs) were calculated with joinpoint regression. Five-year relative survival was calculated on the basis of National Program of Cancer Registries data for 2001-2015. Death rates and survival were estimated overall and by sex, 5-year age group, race/ethnicity, cancer type, and county-based economic markers. RESULTS Death rates decreased during 2002-2016 (AAPC, -1.5), with steeper declines during 2002-2009 (APC, -2.6), and then plateaued (APC, -0.4). Leukemia and brain cancer were the most common causes of death from pediatric cancer, and brain cancer surpassed leukemia in 2011. Death rates decreased for leukemia and lymphoma but were unchanged for brain, bone, and soft-tissue cancers. From 2001-2007 to 2008-2015, survival improved from 82.0% to 85.1%. Survival was highest in both periods among females, those aged 15 to 19 years, non-Hispanic Whites, and those in counties in the top 25% by economic status. Survival improved for leukemias, lymphomas, and brain cancers but plateaued for bone and soft-tissue cancers. CONCLUSIONS Although overall death rates have decreased and survival has increased, differences persist by sex, age, race/ethnicity, cancer type, and economic status. Improvements in pediatric cancer outcomes may depend on improving therapies, access to care, and supportive and long-term care.
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Affiliation(s)
- David A Siegel
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa C Richardson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Reda J Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicole F Dowling
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - 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
| | - Eric W Tai
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Ekwueme DU, Lunsford NB, Khushalani JS, Rim SH. Public Health Efforts to Address Mental Health Conditions Among Cancer Survivors. Am J Public Health 2020; 109:S179-S180. [PMID: 31242002 DOI: 10.2105/ajph.2019.305198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Donatus U Ekwueme
- The authors are with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Natasha Buchanan Lunsford
- The authors are with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jaya S Khushalani
- The authors are with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sun Hee Rim
- The authors are with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Mollica MA, Falisi AL, Geiger AM, Jacobsen PB, Lunsford NB, Pratt-Chapman ML, Townsend JS, Nekhlyudov L. Survivorship objectives in comprehensive cancer control plans: a systematic review. J Cancer Surviv 2020; 14:235-243. [PMID: 31953645 PMCID: PMC11057023 DOI: 10.1007/s11764-019-00832-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 07/05/2019] [Accepted: 10/29/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Over a decade ago, the National Academy of Medicine (NAM) recommended that states develop, implement, and evaluate plans that include consideration of survivorship care. The purpose of this study was to review comprehensive cancer control plans in the USA, specifically to identify the inclusion of cancer survivorship-focused goals and objectives and examine alignment of survivorship-focused objectives with the NAM recommendations. METHODS Plans from 50 states, 7 territories, 5 tribal organizations, and the District of Columbia were reviewed to assess inclusion of survivorship goals and objectives. One territory plan was excluded because it did not include a survivorship-focused goal or objective (final n = 62). Objectives were assigned to domains based on NAM survivorship recommendations. RESULTS Plans included between 1 and 19 survivorship-related objectives. Of the 345 survivorship objectives extracted and analyzed, the most prevalent domains addressed were raising awareness, survivorship care plans, healthcare professional capacity, and models of coordinated care. Employment-related concerns, developing and implementing quality measures, and investments in research were not frequently included in objectives. CONCLUSIONS Comprehensive cancer control plans represent an important strategy that may reduce the impact of cancer and its treatment. State, territorial, and tribal coalitions can use these results to systematically focus future survivorship efforts on areas relevant to their region and population. IMPLICATIONS FOR CANCER SURVIVORS The growing number of survivors requires broad-ranging policy strategies. Future efforts are needed to assess the implementation and impact of plan strategies to improve the overall wellness of cancer survivors.
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Affiliation(s)
- Michelle A Mollica
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9762, USA.
| | - Angela L Falisi
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9762, USA
| | - Ann M Geiger
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9762, USA
| | - Paul B Jacobsen
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9762, USA
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mandi L Pratt-Chapman
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Julie S Townsend
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
INTRODUCTION Few studies have examined melanoma incidence and survival rates among non-Hispanic black populations because melanoma risk is lower among this group than among non-Hispanic white populations. However, non-Hispanic black people are often diagnosed with melanoma at later stages, and the predominant histologic types of melanomas that occur in non-Hispanic black people have poorer survival rates than the most common types among non-Hispanic white people. METHODS We used the US Cancer Statistics 2001-2015 Public Use Research Database to examine melanoma incidence and 5-year survival among non-Hispanic black US populations. RESULTS From 2011 through 2015, the overall incidence of melanoma among non-Hispanic black people was 1.0 per 100,000, and incidence increased with age. Although 63.8% of melanomas in non-Hispanic black people were of unspecified histology, the most commonly diagnosed defined histologic type was acral lentiginous melanoma (16.7%). From 2001 through 2014, the relative 5-year melanoma survival rate among non-Hispanic black people was 66.2%. CONCLUSION Although incidence of melanoma is relatively rare among non-Hispanic black populations, survival rates lag behind rates for non-Hispanic white populations. Improved public education is needed about incidence of acral lentiginous melanoma among non-Hispanic black people along with increased awareness among health care providers.
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Affiliation(s)
- MaryBeth B Culp
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia.,American Cancer Society, 250 Williams St, Atlanta, GA 30303.
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Freeman MB, Holman DM, Qin J, Lunsford NB. Merkel cell carcinoma incidence, trends, and survival rates among adults aged ≥50 years from United States Cancer Statistics. J Am Acad Dermatol 2019; 80:1154-1156. [PMID: 30876535 DOI: 10.1016/j.jaad.2018.10.045] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/15/2018] [Accepted: 10/19/2018] [Indexed: 12/21/2022]
Affiliation(s)
- MaryBeth B Freeman
- American Cancer Society, Surveillance and Health Services Research Program, Atlanta, Georgia.
| | - Dawn M Holman
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, Georgia
| | - Jin Qin
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, Georgia
| | - Natasha Buchanan Lunsford
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Atlanta, Georgia
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Schwartz LA, Psihogios AM, Henry-Moss D, Daniel LC, Ver Hoeve ES, Velazquez-Martin B, Butler E, Hobbie WL, Buchanan Lunsford N, Sabatino SA, Barakat LP, Ginsberg JP, Fleisher L, Deatrick JA, Jacobs LA, O'Hagan B, Anderson L, Fredericks E, Amaral S, Dowshen N, Houston K, Vachani C, Hampshire MK, Metz JM, Hill-Kayser CE, Szalda D. Iterative development of a tailored mHealth intervention for adolescent and young adult survivors of childhood cancer. Clinical Practice in Pediatric Psychology 2019. [DOI: 10.1037/cpp0000272] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ragan KR, Buchanan Lunsford N, Thomas CC, Tai EW, Sussell A, Holman DM. Skin Cancer Prevention Behaviors Among Agricultural and Construction Workers in the United States, 2015. Prev Chronic Dis 2019; 16:E15. [PMID: 30730830 PMCID: PMC6395080 DOI: 10.5888/pcd16.180446] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction Nearly 5 million people are treated for skin cancer each year in the United States. Agricultural and construction workers (ACWs) may be at increased risk for skin cancer because of high levels of ultraviolet radiation exposure from the sun. This is the first study that uses nationally representative data to assess sun-protection behaviors among ACWs. Methods We analyzed data from the 2015 National Health Interview Survey Cancer Control Supplement to examine the prevalence of sun-protection behaviors among ACWs. We calculated national, weighted, self-reported prevalence estimates. We used χ2 tests to assess differences between ACWs by industry and occupation. Results Most of the 2,298 agricultural and construction workers studied were male (by industry, 72.4% in agriculture and 89.3% in construction; by occupation, 66.1% in agriculture and 95.6% in construction) and non-Hispanic white. About one-third had at least 1 sunburn in the past year. The prevalence of sunscreen use and shade seeking was low and did not significantly differ among groups, ranging from 15.1% to 21.4% for sunscreen use and 24.5% to 29.1% for shade seeking. The prevalence of wearing protective clothing was significantly higher among agricultural workers than among construction workers by industry (70.9% vs 50.7%) and occupation (70.5% vs 53.0%). Conclusion Our findings could be used to improve occupational health approaches to reducing skin cancer risk among ACWs and to inform education and prevention initiatives addressing skin cancer. Sun-safety initiatives may include modifying work sites to increase shade and adding sun safety to workplace policies and training. Employers can help reduce occupational health inequities and protect workers by creating workplaces that facilitate sun protection.
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Affiliation(s)
- Kathleen R Ragan
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, Georgia.,Division of Cancer Prevention and Control; Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F76, Atlanta, GA 30341.
| | - Natasha Buchanan Lunsford
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, Georgia
| | - Cheryll C Thomas
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, Georgia
| | - Eric W Tai
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, Georgia
| | - Aaron Sussell
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Spokane Mining Research Division, Spokane, Washington
| | - Dawn M Holman
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, Georgia
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Gallaway MS, Glover-Kudon R, Momin B, Puckett M, Lunsford NB, Ragan KR, Rohan EA, Babb S. Smoking cessation attitudes and practices among cancer survivors - United States, 2015. J Cancer Surviv 2019; 13:66-74. [PMID: 30612253 PMCID: PMC6387634 DOI: 10.1007/s11764-018-0728-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [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: 04/13/2018] [Accepted: 12/19/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE The prevalence of smoking among cancer survivors is similar to the general population. However, there is little evidence on the prevalence of specific smoking cessation behaviors among adult cancer survivors. METHODS The 2015 National Health Interview Survey (NHIS) data were analyzed to examine the prevalence of smoking cessation behaviors and use of treatments among cancer survivors. Weighted self-reported prevalence estimates and 95% confidence intervals were calculated using a sample of 2527 cancer survivors. RESULTS Among this sample of US cancer survivors, 12% were current smokers, 37% were former smokers, and 51% were never smokers. Compared with former and never smokers, current smokers were younger (< 65 years), less educated, and less likely to report being insured or Medicaid health insurance (p < 0.01). More males were former smokers than current or never smokers. Current smokers reported wanting to quit (57%), a past year quit attempt (49%), or a health professional advised them to quit (66%). Current smokers reported the use of smoking cessation counseling (8%) or medication (38%). CONCLUSIONS Even after a cancer diagnosis, about one in eight cancer survivors continued to smoke. All could have received advice to quit smoking by a health professional, but a third did not. IMPLICATIONS FOR CANCER SURVIVORS Health professionals could consistently advise cancer survivors about the increased risks associated with continued smoking, provide them with cessation counseling and medications, refer them to other free cessation resources, and inform them of cessation treatments covered by their health insurance.
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Affiliation(s)
- M Shayne Gallaway
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, MS-F76, Atlanta, GA, 30341, USA.
| | - Rebecca Glover-Kudon
- Centers for Disease Control and Prevention, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - Behnoosh Momin
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, MS-F76, Atlanta, GA, 30341, USA
| | - Mary Puckett
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, MS-F76, Atlanta, GA, 30341, USA
| | - Natasha Buchanan Lunsford
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, MS-F76, Atlanta, GA, 30341, USA
| | - Kathleen R Ragan
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, MS-F76, Atlanta, GA, 30341, USA
| | - Elizabeth A Rohan
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, MS-F76, Atlanta, GA, 30341, USA
| | - Stephen Babb
- Centers for Disease Control and Prevention, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
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Ports KA, Holman DM, Guinn AS, Pampati S, Dyer KE, Merrick MT, Lunsford NB, Metzler M. Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015. J Pediatr Nurs 2019; 44:81-96. [PMID: 30683285 PMCID: PMC6355255 DOI: 10.1016/j.pedn.2018.10.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 02/07/2023]
Abstract
Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.
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Affiliation(s)
- Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Dawn M Holman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Angie S Guinn
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sanjana Pampati
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Karen E Dyer
- Virginia Commonwealth University, School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.
| | - Melissa T Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Marilyn Metzler
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Kline RM, Arora NK, Bradley CJ, Brauer ER, Graves DL, Lunsford NB, McCabe MS, Nasso SF, Nekhlyudov L, Rowland JH, Schear RM, Ganz PA. Long-Term Survivorship Care After Cancer Treatment - Summary of a 2017 National Cancer Policy Forum Workshop. J Natl Cancer Inst 2018; 110:1300-1310. [PMID: 30496448 PMCID: PMC6658871 DOI: 10.1093/jnci/djy176] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [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: 04/20/2018] [Revised: 07/31/2018] [Accepted: 08/31/2018] [Indexed: 12/17/2022] Open
Abstract
The National Cancer Policy Forum of the National Academies of Sciences, Engineering and Medicine sponsored a workshop on July 24 and 25, 2017 on Long-Term Survivorship after Cancer Treatment. The workshop brought together diverse stakeholders (patients, advocates, academicians, clinicians, research funders, and policymakers) to review progress and ongoing challenges since the Institute of Medicine (IOM)'s seminal report on the subject of adult cancer survivors published in 2006. This commentary profiles the content of the meeting sessions and concludes with recommendations that stem from the workshop discussions. Although there has been progress over the past decade, many of the recommendations from the 2006 report have not been fully implemented. Obstacles related to the routine delivery of standardized physical and psychosocial care services to cancer survivors are substantial, with important gaps in care for patients and caregivers. Innovative care models for cancer survivors have emerged, and changes in accreditation requirements such as the Commission on Cancer's (CoC) requirement for survivorship care planning have put cancer survivorship on the radar. The Center for Medicare & Medicaid Innovation's Oncology Care Model (OCM), which requires psychosocial services and the creation of survivorship care plans for its beneficiary participants, has placed increased emphasis on this service. The OCM, in conjunction with the CoC requirement, is encouraging electronic health record vendors to incorporate survivorship care planning functionality into updated versions of their products. As new models of care emerge, coordination and communication among survivors and their clinicians will be required to implement patient- and community-centered strategies.
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Affiliation(s)
- Ronald M Kline
- Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services, Baltimore, MD
| | - Neeraj K Arora
- Healthcare Delivery and Disparities Research Program, Patient Centered Outcomes Research Institute, Washington, DC
| | - Cathy J Bradley
- Department of Health Systems, Management, and Policy, School of Public Health, University of Colorado, Denver, CO
| | - Eden R Brauer
- Jonsson Comprehensive Cancer Center, University of California – Los Angeles, Los Angeles, CA
| | - Darci L Graves
- Office of Minority Health, Centers for Medicare & Medicaid Services, Baltimore, MD
| | | | - Mary S McCabe
- Independent Consultant in Survivorship and Medical Ethics, Arlington, VA
| | | | - Larissa Nekhlyudov
- Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA
| | - Julia H Rowland
- Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
- Smith Center for Healing and the Arts, Washington, DC
| | - Rebekkah M Schear
- LIVESTRONG Cancer Institutes at Dell Medical School, University of Texas at Austin, Austin, TX
- Department of Health Policy & Management and Medicine, Schools of Public Health and Medicine, Jonsson Comprehensive Cancer Center, University of California – Los Angeles, Los Angeles, CA
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California – Los Angeles, Los Angeles, CA
- Department of Health Policy & Management and Medicine, Schools of Public Health and Medicine, Jonsson Comprehensive Cancer Center, University of California – Los Angeles, Los Angeles, CA
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Abstract
November marks Lung Cancer Awareness Month, and reminds us that lung cancer is the leading cause of cancer death among women in the United States. In this brief report, we highlight CDC resources that can be used to examine the most recent data on lung cancer incidence, survival, prevalence, and mortality among women. Using the U.S. Cancer Statistics Data Visualizations tool, we report that in 2015, 104,992 new cases of lung cancer and 70,073 lung cancer deaths were reported among women in the United States. The 5-year relative survival among females diagnosed with lung cancer was 22%, and as of 2015, ∼185,759 women were living with a lung cancer diagnosis. We also describe ways CDC works to collect and disseminate quality cancer surveillance data, prevent initiation of tobacco use, promote cessation, eliminate exposure to secondhand smoke, identify and eliminate disparities, promote lung cancer screening, and help cancer survivors live longer by improving health outcomes.
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Affiliation(s)
- S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Shayne Gallaway
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Simple D Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Mary Elizabeth O'Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Behnoosh Momin
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Thomas B Richards
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
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Buchanan Lunsford N, Berktold J, Holman DM, Stein K, Prempeh A, Yerkes A. Skin cancer knowledge, awareness, beliefs and preventive behaviors among black and hispanic men and women. Prev Med Rep 2018; 12:203-209. [PMID: 30364862 PMCID: PMC6199782 DOI: 10.1016/j.pmedr.2018.09.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 08/30/2018] [Accepted: 09/29/2018] [Indexed: 12/20/2022] Open
Abstract
Black and Hispanic populations perceive their skin cancer risk to be low and are less likely to use sun protection strategies. We conducted formative research to understand knowledge, awareness, beliefs, and behaviors among these groups. In 2017, eighteen focus groups were conducted with black and Hispanic respondents(18-44 years) in four US cities. Groups were segmented by participant characteristics associated with elevated or lower risk for skin cancer, by race/ethnicity, gender, and age. A professional moderator followed a semi-structured discussion guide, and focus group transcripts were analyzed using conventional content analysis and NVIVO 11 Software. Most participants perceived themselves to be at low skin cancer risk due to their "darker skin tone" and/or "lack of family history." Skin cancer signs and symptoms were more inconsistently reported by blacks than Hispanics. Few participants reported regular sun protection behaviors. Those who did used sunscreen, wore protective clothing, and had elevated risk based on sun sensitivity or UV exposure. While most participants recalled family discussions (as youth) about sunscreen and sun protection, the understood intent was to warn against "further skin darkening" or to "prevent aging," not to reduce sun burns or skin cancer risk. Tanning bed use was low across all segments, especially among black respondents. Tailored skin cancer prevention campaigns need to address misperceptions about risks and benefits of skin cancer prevention behaviors among black and Hispanic populations. Families, peer groups, and healthcare providers need to be engaged in the creation of educational interventions and messaging efforts that target these populations.
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Affiliation(s)
- Natasha Buchanan Lunsford
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, GA, United States of America
- Corresponding author at: Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, 4770 Buford Highway, N.E., MS F76, Atlanta, GA 30341, United States of America.
| | | | - Dawn M. Holman
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, GA, United States of America
| | - Karen Stein
- Westat, Inc, Rockville, MD, United States of America
| | - Adwoa Prempeh
- Westat, Inc, Rockville, MD, United States of America
| | - Adeline Yerkes
- National Association of Chronic Disease Directors, Atlanta, GA, United States of America
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Khushalani JS, Qin J, Cyrus J, Lunsford NB, Rim SH, Han X, Yabroff KR, Ekwueme DU. Systematic review of healthcare costs related to mental health conditions among cancer survivors. Expert Rev Pharmacoecon Outcomes Res 2018; 18:505-517. [PMID: 29869568 PMCID: PMC6103822 DOI: 10.1080/14737167.2018.1485097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/03/2018] [Indexed: 01/18/2023]
Abstract
INTRODUCTION This systematic review examines healthcare costs associated with mental health conditions among cancer survivors in the United States. AREAS COVERED Ten published studies were identified. Studies varied substantially in terms of population, mental health conditions examined, data collection methods, and type of cost reported. Cancer survivors with mental health conditions incurred significantly higher total medical costs and costs of most service types compared to cancer survivors without a mental health condition. Additionally, the total healthcare expenditure related to mental health was higher among cancer survivors compared with people without history of cancer. EXPERT COMMENTARY Mental health conditions are associated with increased healthcare costs among cancer survivors. Future examination of other components of economic burden, including patient out-of-pocket costs, nonmedical costs, such as transportation, childcare, and productivity losses for patients and their caregivers, will be important. Additionally, evaluation of economic burden by cancer site, stage at diagnosis, duration of survivorship, and treatment(s) will increase understanding of the overall impact of mental health conditions on cancer survivors and on the healthcare system.
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Affiliation(s)
| | - Jin Qin
- Division of Cancer Prevention and Control, CDC, Atlanta, United States
| | - John Cyrus
- Tompkins-McCaw Library, Virginia Commonwealth University, Richmond, Virginia, United States
| | | | - Sun Hee Rim
- Division of Cancer Prevention and Control, CDC, Atlanta, United States
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Siegel DA, Li J, Henley SJ, Wilson RJ, Lunsford NB, Tai E, Van Dyne EA. Geographic Variation in Pediatric Cancer Incidence - United States, 2003-2014. MMWR Morb Mortal Wkly Rep 2018; 67:707-713. [PMID: 29953430 PMCID: PMC6023185 DOI: 10.15585/mmwr.mm6725a2] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Massetti GM, Holland KM, Jack SPD, Ragan KR, Lunsford NB. Circumstances of suicide among individuals with a history of cancer. Psychooncology 2018; 27:1750-1756. [PMID: 29624792 DOI: 10.1002/pon.4720] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 01/11/2018] [Revised: 03/19/2018] [Accepted: 03/24/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Cancer can trigger psychological distress, which may be associated with risk of suicide. We explored precipitating circumstances of suicides among decedents with and without a history of cancer. METHODS Coroner or medical examiner and law enforcement narratives of adult suicides were coded from 17 participating states in Centers for Disease Control and Prevention's National Violent Death Reporting System during 2004 to 2013. Bivariate and multivariate analyses examined associations between cancer history and factors that precipitated suicide. RESULTS Of 90 581 suicides, 4182 decedents (4.6%) had a history of cancer. Significantly more decedents with a history of cancer (versus without) were male, non-Hispanic white, married, veterans, and aged 55 or older (P < .001). Decedents with a history of cancer were more likely to die of suicide by firearm and less likely to die of suicide by suffocation compared to poisoning. In matched case analyses controlling for demographic and recent circumstances, fewer decedents with a history of cancer had mental health problems, history of suicide attempts, alcohol use problems, intimate partner problems, financial problems, job problems, and recent crisis. CONCLUSIONS Findings highlight the potential to identify high-risk populations for suicide prevention in clinical practice.
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Affiliation(s)
| | | | - Shane P D Jack
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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19
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Tai E, Hallisey E, Peipins LA, Flanagan B, Lunsford NB, Wilt G, Graham S. Geographic Access to Cancer Care and Mortality Among Adolescents. J Adolesc Young Adult Oncol 2018; 7:22-29. [PMID: 28933979 PMCID: PMC6125785 DOI: 10.1089/jayao.2017.0066] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Adolescents with cancer have had less improvement in survival than other populations in the United States. This may be due, in part, to adolescents not receiving treatment at Children's Oncology Group (COG) institutions, which have been shown to increase survival for some cancers. The objective of this ecologic study was to examine geographic distance to COG institutions and adolescent cancer mortality. METHODS We calculated cancer mortality among adolescents and sociodemographic and healthcare access factors in four geographic zones at selected distances surrounding COG facilities: Zone A (area within 10 miles of any COG institution), Zones B and C (concentric rings with distances from a COG institution of >10-25 miles and >25-50 miles, respectively), and Zone D (area outside of 50 miles). RESULTS The adolescent cancer death rate was highest in Zone A at 3.21 deaths/100,000, followed by Zone B at 3.05 deaths/100,000, Zone C at 2.94 deaths/100,000, and Zone D at 2.88 deaths/100,000. The United States-wide death rate for whites without Hispanic ethnicity, blacks without Hispanic ethnicity, and persons with Hispanic ethnicity was 2.96 deaths/100,000, 3.10 deaths/100,000, and 3.26 deaths/100,000, respectively. Zone A had high levels of poverty (15%), no health insurance coverage (16%), and no vehicle access (16%). CONCLUSIONS Geographic access to COG institutions, as measured by distance alone, played no evident role in death rate differences across zones. Among adolescents, socioeconomic factors, such as poverty and health insurance coverage, may have a greater impact on cancer mortality than geographic distance to COG institution.
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Affiliation(s)
- Eric Tai
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elaine Hallisey
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lucy A. Peipins
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Barry Flanagan
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Grete Wilt
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shannon Graham
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, Atlanta, Georgia
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20
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Massetti GM, Thomas CC, King J, Ragan K, Buchanan Lunsford N. Mental Health Problems and Cancer Risk Factors Among Young Adults. Am J Prev Med 2017; 53:S30-S39. [PMID: 28818243 PMCID: PMC5584599 DOI: 10.1016/j.amepre.2017.04.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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: 12/09/2016] [Revised: 04/03/2017] [Accepted: 04/14/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Chronic mental health problems often emerge in young adulthood, when adults begin to develop lifelong health behaviors and access preventive health services. The associations between mental health problems and modifiable cancer risk factors in young adulthood are not well understood. METHODS In 2016, the authors analyzed 2014 Behavioral Risk Factor Surveillance System data on demographic characteristics, health service access and use, health status, and cancer risk factors (tobacco use, alcohol use, overweight or obesity, physical activity, and sleep) for 90,821 young adults aged 18-39 years with mental health problems (depressive disorder or frequent mental distress) compared to other young adults. RESULTS Mental health problems were associated with white race; less than a high school education; lower income; being out of work or unable to work; being uninsured (for men only); poor health; previous diagnosis of asthma, skin cancer, or diabetes; and not having a recent checkup. After controlling for demographic characteristics, health service use, and health status, mental health problems among young adults were associated with smoking, binge drinking, inadequate sleep, having no leisure time physical activity, and being overweight or obese (among women only). Cervical cancer screening was not associated with mental health problems after controlling for demographic characteristics, health service use, and health status. CONCLUSIONS Mental health problems in young adulthood were associated with potentially modifiable factors and behaviors that increase risk for cancer. Efforts to prevent cancer and promote health must attend to mental health disparities to meet the needs of young adults.
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Affiliation(s)
- Greta M Massetti
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Cheryll C Thomas
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jessica King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen Ragan
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Ragan KR, Buchanan Lunsford N, Lee Smith J, Saraiya M, Aketch M. Perspectives of Screening-Eligible Women and Male Partners on Benefits of and Barriers to Treatment for Precancerous Lesions and Cervical Cancer in Kenya. Oncologist 2017; 23:35-43. [PMID: 28798272 PMCID: PMC5759810 DOI: 10.1634/theoncologist.2017-0053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/14/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cervical cancer is the leading cause of female cancer mortality in Kenya. Kenya's National Cervical Cancer Prevention Program Strategic Plan outlines efforts to reduce the burden; however, treatment services remain limited. This study identified male and female perspectives regarding benefits, facilitators, and barriers to treatment for precancerous lesions and cervical cancer. MATERIALS AND METHODS Ten focus groups were conducted in Nairobi and Nyanza in 2014 with females aged 25-49 years (n = 60) and male partners (n = 40). Participants were divided into groups dependent on screening status, sex, language, and geographic location. Qualitative analytic software was used to analyze transcribed and translated data. RESULTS Treatment was endorsed as beneficial for the prevention of death and the improvement of wellness, quality of life, symptoms, and family life. Barriers reported by males and females included the following: (a) concerns about side effects; (b) treatment-related fear and stigma; (c) marital discord; (d) financial and access issues; (e) religious and cultural beliefs; and (f) limited knowledge. Male endorsement of wanting to improve knowledge and communication with their partners, in spite of stigmatizing beliefs and misperceptions regarding females with abnormal screening results or those who have been diagnosed with cancer, was novel. CONCLUSION Incorporating qualitative data on benefits of and barriers to treatment for precancerous lesions and cervical cancer into Kenya's national priorities and activities is important. These findings can be used to inform the development and successful implementation of targeted, region-specific community outreach and health messaging campaigns focused on alleviating the country's cervical cancer burden. IMPLICATIONS FOR PRACTICE This article provides important insight into female and male partner perspectives regarding benefits, facilitators, and barriers to treatment for precancerous lesions and cervical cancer. These novel research findings can inform the development of targeted community health interventions, educational messages, and resources and aid stakeholders in strengthening strategic plans regarding treatment coverage and cervical cancer prevention. Because several treatment barriers identified in this study are similar to barriers associated with cervical cancer screening in low- and middle-resourced countries, effective messaging interventions could address barriers to receipt of both screening and treatment.
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Affiliation(s)
- Kathleen R Ragan
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, Georgia, USA
| | - Natasha Buchanan Lunsford
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, Georgia, USA
| | - Judith Lee Smith
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, Georgia, USA
| | - Mona Saraiya
- Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, Georgia, USA
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Hallisey E, Tai E, Berens A, Wilt G, Peipins L, Lewis B, Graham S, Flanagan B, Lunsford NB. Transforming geographic scale: a comparison of combined population and areal weighting to other interpolation methods. Int J Health Geogr 2017; 16:29. [PMID: 28784135 PMCID: PMC5547484 DOI: 10.1186/s12942-017-0102-z] [Citation(s) in RCA: 12] [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: 02/17/2017] [Accepted: 07/29/2017] [Indexed: 11/10/2022] Open
Abstract
Background Transforming spatial data from one scale to another is a challenge in geographic analysis. As part of a larger, primary study to determine a possible association between travel barriers to pediatric cancer facilities and adolescent cancer mortality across the United States, we examined methods to estimate mortality within zones at varying distances from these facilities: (1) geographic centroid assignment, (2) population-weighted centroid assignment, (3) simple areal weighting, (4) combined population and areal weighting, and (5) geostatistical areal interpolation. For the primary study, we used county mortality counts from the National Center for Health Statistics (NCHS) and population data by census tract for the United States to estimate zone mortality. In this paper, to evaluate the five mortality estimation methods, we employed address-level mortality data from the state of Georgia in conjunction with census data. Our objective here is to identify the simplest method that returns accurate mortality estimates. Results The distribution of Georgia county adolescent cancer mortality counts mirrors the Poisson distribution of the NCHS counts for the U.S. Likewise, zone value patterns, along with the error measures of hierarchy and fit, are similar for the state and the nation. Therefore, Georgia data are suitable for methods testing. The mean absolute value arithmetic differences between the observed counts for Georgia and the five methods were 5.50, 5.00, 4.17, 2.74, and 3.43, respectively. Comparing the methods through paired t-tests of absolute value arithmetic differences showed no statistical difference among the methods. However, we found a strong positive correlation (r = 0.63) between estimated Georgia mortality rates and combined weighting rates at zone level. Most importantly, Bland–Altman plots indicated acceptable agreement between paired arithmetic differences of Georgia rates and combined population and areal weighting rates. Conclusions This research contributes to the literature on areal interpolation, demonstrating that combined population and areal weighting, compared to other tested methods, returns the most accurate estimates of mortality in transforming small counts by county to aggregated counts for large, non-standard study zones. This conceptually simple cartographic method should be of interest to public health practitioners and researchers limited to analysis of data for relatively large enumeration units.
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Affiliation(s)
- Elaine Hallisey
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F09, Atlanta, GA, 30341-3717, USA.
| | - Eric Tai
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrew Berens
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F09, Atlanta, GA, 30341-3717, USA
| | - Grete Wilt
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F09, Atlanta, GA, 30341-3717, USA
| | - Lucy Peipins
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian Lewis
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F09, Atlanta, GA, 30341-3717, USA
| | - Shannon Graham
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F09, Atlanta, GA, 30341-3717, USA
| | - Barry Flanagan
- Agency for Toxic Substances and Disease Registry, Geospatial Research, Analysis, and Services Program, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F09, Atlanta, GA, 30341-3717, USA
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Holman DM, Berkowitz Z, Guy GP, Lunsford NB, Coups EJ. The association between beliefs about vitamin D and skin cancer risk-related behaviors. Prev Med 2017; 99:326-331. [PMID: 28322879 PMCID: PMC5896002 DOI: 10.1016/j.ypmed.2017.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/08/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
Major health organizations recommend obtaining most of one's vitamin D through dietary sources rather than from sun exposure, given the link between sun exposure and increased skin cancer risk. The purpose of this study is to examine the association between beliefs about vitamin D and skin cancer risk-related behaviors, a topic on which research is limited. We analyzed cross-sectional online survey data collected in the summer of 2015 from 4127U.S. adults aged 18years and older. Overall, 19.7% of adults believed that sun protection would put them at risk of not getting enough vitamin D. However, less than half (43.1%) thought they could get enough vitamin D from dietary sources. Individuals with this belief were more likely to protect their skin when spending time outdoors (71.3%) compared with those who were neutral or disagreed (56.5%; P<0.001). Only 5.1% of adults believed that indoor tanning is an effective way to get vitamin D. Compared to those who disagreed or were neutral, those who thought it was effective were more likely to be outdoor tanners (45.1% vs. 28.5%; P<0.001) and indoor tanners (13.8% vs 1.9%; P<0.001). Beliefs about vitamin D were associated with skin cancer risk-related behaviors. Including information about vitamin D in skin cancer prevention messages may be beneficial.
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Affiliation(s)
- Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA..
| | - Zahava Berkowitz
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Gery P Guy
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903, USA
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Lunsford NB, Sapsis KF, Smither B, Reynolds J, Wilburn B, Fairley T. Young Women's Perceptions Regarding Communication with Healthcare Providers About Breast Cancer, Risk, and Prevention. J Womens Health (Larchmt) 2017; 27:162-170. [PMID: 28472603 DOI: 10.1089/jwh.2016.6140] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/13/2022] Open
Abstract
BACKGROUND Women younger than 45 years old have lower rates of breast cancer, but higher risk of recurrence and mortality after a cancer diagnosis. African American women are at risk for early onset and increased mortality; Ashkenazi Jewish women are at risk for genetic mutations leading to breast and ovarian cancer. Although younger women are encouraged to talk to doctors about their family history, little is known about these discussions. MATERIALS AND METHODS In 2015, 167 women aged 18-44 years participated in 20 focus groups segmented by geographic location, age, race/ethnicity, and family history of breast and ovarian cancer. Transcript data were analyzed using NVivo 10 software. RESULTS Although the majority of women talked to their doctor about breast and ovarian cancer, these conversations were brief and unsatisfying due to a lack of detail. Topics included family history, breast cancer screening, and breast self-examination. Some women with and without family history reported that healthcare providers offered screening and early detection advice based on their inquiries. However, few women took action or changed lifestyle behaviors with the intent to reduce risk as a result of the conversations. CONCLUSIONS Conversations with young women revealed missed opportunities to: enhance patient-provider communication and increase knowledge about breast cancer screening and surveillance for higher risk patients. Physicians, allied health professionals, and the public health community can better assist women in getting accurate and timely information about breast and ovarian cancer, understanding their family history to determine risk, and increasing healthy behaviors.
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Affiliation(s)
- Natasha Buchanan Lunsford
- 1 Division of Cancer Prevention and Control, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Karena F Sapsis
- 2 Office on Smoking and Health, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Betsy Smither
- 3 Oak Ridge Associated Universities , Oak Ridge, Tennessee
| | | | - Ben Wilburn
- 3 Oak Ridge Associated Universities , Oak Ridge, Tennessee
| | - Temeika Fairley
- 1 Division of Cancer Prevention and Control, Centers for Disease Control and Prevention , Atlanta, Georgia
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Buchanan Lunsford N, Ragan K, Lee Smith J, Saraiya M, Aketch M. Environmental and Psychosocial Barriers to and Benefits of Cervical Cancer Screening in Kenya. Oncologist 2017; 22:173-181. [PMID: 28167567 DOI: 10.1634/theoncologist.2016-0213] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 05/25/2016] [Accepted: 09/09/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cervical cancer is the second most commonly diagnosed cancer in females and is a leading cause of cancer-related mortality in Kenya; limited cervical cancer screening services may be a factor. Few studies have examined men's and women's perceptions on environmental and psychosocial barriers and benefits related to screening. MATERIALS AND METHODS In 2014, 60 women aged 25-49 years and 40 male partners participated in 10 focus groups (6 female and 4 male), in both rural and urban settings (Nairobi and Nyanza, Kenya), to explore perceptions about barriers to and benefits of cervical cancer screening. Focus groups were segmented by sex, language, geographic location, and screening status. Data were transcribed, translated into English, and analyzed by using qualitative software. RESULTS Participants identified screening as beneficial for initiating provider discussions about cancer but did not report it as a beneficial method for detecting precancers. Perceived screening barriers included access (transportation, cost), spousal approval, stigma, embarrassment during screening, concerns about speculum use causing infertility, fear of residual effects of test results, lack of knowledge, and religious or cultural beliefs. All participants reported concerns with having a male doctor perform screening tests; however, men uniquely reported the young age of a doctor as a barrier. CONCLUSION Identifying perceived barriers and benefits among people in low- and middle-income countries is important to successfully implementing emerging screening programs. The novel findings on barriers and benefits from this study can inform the development of targeted community outreach activities, communication strategies, and educational messages for patients, families, and providers. The Oncologist 2017;22: 173-181Implications for Practice: This article provides important information for stakeholders in clinical practice and research when assessing knowledge, beliefs, and acceptability of cervical cancer screening and treatment services in low- and middle-resourced countries. Formative research findings provide information that could be used in the development of health interventions, community education messages, and materials. Additionally, this study illuminates the importance of understanding psychosocial barriers and facilitators to cervical cancer screening, community education, and reduction of stigma as important methods of improving prevention programs and increasing rates of screening among women.
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Affiliation(s)
- Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathleen Ragan
- Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Judith Lee Smith
- Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mona Saraiya
- Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Hawkins NA, Soman A, Buchanan Lunsford N, Leadbetter S, Rodriguez JL. Use of Medications for Treating Anxiety and Depression in Cancer Survivors in the United States. J Clin Oncol 2016; 35:78-85. [PMID: 28034075 DOI: 10.1200/jco.2016.67.7690] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose This study used population-based data to estimate the percentage of cancer survivors in the United States reporting current medication use for anxiety and depression and to characterize the survivors taking this type of medication. Rates of medication use in cancer survivors were compared with rates in the general population. Methods We analyzed data from the National Health Interview Survey, years 2010 to 2013, identifying cancer survivors (n = 3,184) and adults with no history of cancer (n = 44,997) who completed both the Sample Adult Core Questionnaire and the Adult Functioning and Disability Supplement. Results Compared with adults with no history of cancer, cancer survivors were significantly more likely to report taking medication for anxiety (16.8% v 8.6%, P < .001), depression (14.1% v 7.8%, P < .001), and one or both of these conditions combined (19.1% v 10.4%, P < .001), indicating that an estimated 2.5 million cancer survivors were taking medication for anxiety or depression in the United States at that time. Survivor characteristics associated with higher rates of medication use for anxiety included being younger than 65 years old, female, and non-Hispanic white, and having public insurance, a usual source of medical care, and multiple chronic health conditions. Survivor characteristics associated with medication use for depression were largely consistent with those for anxiety, with the exceptions that insurance status was not significant, whereas being widowed/divorced/separated was associated with more use. Conclusion Cancer survivors in the United States reported medication use for anxiety and depression at rates nearly two times those reported by the general public, likely a reflection of greater emotional and physical burdens from cancer or its treatment.
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Affiliation(s)
- Nikki A Hawkins
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
| | - Ashwini Soman
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
| | - Natasha Buchanan Lunsford
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
| | - Steven Leadbetter
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
| | - Juan L Rodriguez
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
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