Annals of Surgical Oncology, Journal Year: 2023, Volume and Issue: 31(2), P. 911 - 919
Published: Oct. 19, 2023
Language: Английский
CA A Cancer Journal for Clinicians, Journal Year: 2023, Volume and Issue: 74(2), P. 136 - 166
Published: Nov. 14, 2023
Abstract In 2021, the American Cancer Society published its first biennial report on status of cancer disparities in United States. this second report, authors provide updated data racial, ethnic, socioeconomic (educational attainment as a marker), and geographic (metropolitan status) occurrence outcomes contributing factors to these country. The also review programs that have reduced policy recommendations further mitigate inequalities. There are substantial variations risk factors, stage at diagnosis, receipt care, survival, mortality for many cancers by race/ethnicity, educational attainment, metropolitan status. During 2016 through 2020, Black Indian/Alaska Native people continued bear disproportionately higher burden deaths, both overall from major cancers. By rates were about 1.6–2.8 times individuals with ≤12 years education than those ≥16 among White men women. These within each race considerably larger Black–White ranging 1.03 1.5 people, suggesting role racial given disproportionally representation lower groups. Of note, largest who had education. area residence, all leading causes death substantially nonmetropolitan areas large areas. For colorectal cancer, example, versus 23% males 21% females. age group, greater younger 65 aged older. Many observed socioeconomic, align exposure access prevention, early detection, treatment, which largely rooted fundamental inequities social determinants health. Equitable policies levels government, broad interdisciplinary engagement address inequities, equitable implementation evidence‐based interventions, such increasing health insurance coverage, needed reduce disparities.
Language: Английский
Citations
48
Annals of Surgical Oncology, Journal Year: 2024, Volume and Issue: 31(5), P. 3222 - 3232
Published: Feb. 15, 2024
Abstract Background The COVID-19 pandemic disrupted health care delivery, including cancer screening practices. This study sought to determine the impact of lockdown on colorectal (CRC) relative social vulnerability. Methods Using Medicare Standard Analytic File, individuals 65 years old or older who were eligible for guideline-concordant CRC between 2019 and 2021 identified. These data merged with Center Disease Control Social Vulnerability Index (SVI) dataset. Changes in county-level monthly volumes start (March 2020) easing restrictions 2021) assessed SVI. Results Among 10,503,180 continuously enrolled no prior diagnosis CRC, 1,362,457 (12.97%) underwent 2021. With pandemic, decreased markedly across United States (median screening: pre-pandemic [ n = 76,444] vs era 60,826]; median Δ 15,618; p < 0.001). 1-year post-pandemic overall utilization generally rebounded pre-COVID-19 levels (monthly volumes: 60,826] 74,170]; 13,344; Individuals residing counties highest SVI experienced a larger decline odds than low-SVI (reference, low SVI: high [OR, 0.85] 0.81] 0.85]; all Conclusions was associated decrease volumes. Patients resided vulnerability areas greatest pandemic-related decline.
Language: Английский
Citations
7
Bone Marrow Transplantation, Journal Year: 2024, Volume and Issue: 59(4), P. 459 - 465
Published: Jan. 18, 2024
Abstract Autologous hematopoietic stem cell transplantation (ASCT) is the standard of care for eligible patients with multiple myeloma (MM) to prolong progression-free survival (PFS). While several factors affect following ASCT, impact social determinants health such as CDC Social Vulnerability Index (SVI) not well documented. This single-center retrospective analysis evaluated SVI on PFS ASCT in MM patients. 225 who underwent participated, 51% transplanted last 5 years. At years post-transplant, 55 (50%) achieved and 66 (60%) remained alive. Higher values were significantly associated lower odds (OR = 0.521, p < 0.01, 95% CI [0.41, 0.66]) OS 0.592, [0.46, 0.76]) post-transplant. Greater vulnerability scores socioeconomic status 0.890; CI: [0.82, 0.96]), household characteristics 0.912; [0.87, 0.95]), racial ethnic minority 0.854; [0.81, 0.90]) themes worsened PFS. These results suggest high areas may need more resources achieve optimal OS. Future studies will focus addressing within status, characteristics, subthemes, these have a pronounced effect
Language: Английский
Citations
6
Journal of Surgical Oncology, Journal Year: 2023, Volume and Issue: 127(7), P. 1212 - 1222
Published: March 18, 2023
Abstract Background Area‐level social determinants of health (SDoH) impact access to cancer care and prevention. Little is known about the factors that underlie residential privilege on county‐level screening uptake. Methods Population‐based cross‐sectional study examining data was obtained from Centers for Disease Control Prevention's PLACES database, American Community Survey County Health Rankings Roadmap database. The Index Concentration Extremes (ICE), a validated measure racial economic privilege, examined relative rates US Preventive Services Task Force (USPSTF) guideline‐concordant breast, cervical, colorectal cancers. Generalized structural equation modeling used determine indirect direct effects ICE Results Across 3142 counties, demonstrated geographical variation ranging 54.0% 81.8% breast screening, 39.8% 74.4% 69.9% 89.7% cervical screening. Of note, colorectal, all increased lower (ICE‐Q1) higher (ICE‐Q4) privileged areas (breast: Q1 = 71.0% vs. Q4 72.2%; colorectal: 59.4% 65.0%; cervical: 83.3% 85.2%; p < 0.001). Mediation analysis revealed observed disparities between uptake were explained by mediators such as poverty status, lack insurance or employment, urban–rural location primary physicians accounted 64% (95% confidence interval [CI]: 61%–67%), 85% CI: 80%–89%), 74% 71%–77%) effect respectively. Conclusions In this study, association USPSTF‐recommended complex influenced an interplay sociodemographic, geographical, factors. Understanding underlying area‐level SDoH mediate in prevention strategies can help focus interventions improve equity
Language: Английский
Citations
14
Journal of the American College of Surgeons, Journal Year: 2023, Volume and Issue: 237(3), P. 454 - 464
Published: June 15, 2023
Language: Английский
Citations
13
Surgery, Journal Year: 2024, Volume and Issue: 175(5), P. 1278 - 1284
Published: Feb. 19, 2024
Language: Английский
Citations
4
JACC CardioOncology, Journal Year: 2024, Volume and Issue: 6(3), P. 390 - 401
Published: June 1, 2024
Cardiovascular disease (CVD) is a significant cause of morbidity and mortality in men with prostate cancer; however, data on racial disparities CVD outcomes are limited. We quantified the according to self-identified race role structural social determinants health mediating cancer patients. A retrospective cohort study 3,543 patients treated systemic androgen deprivation therapy (ADT) between 2008 2021 at quaternary, multisite care system was performed. The multivariable adjusted association self-reported (Black vs White) incident major adverse cardiovascular events (MACE) after ADT initiation evaluated using cause-specific proportional hazards. Mediation analysis determined theme-specific overall vulnerability index (SVI) explaining outcomes. Black associated an increased hazard MACE (HR: 1.38; 95% CI: 1.16-1.65; P < 0.001). strongest for heart failure 1.79; 1.32-2.43), cerebrovascular 1.98; 1.37-2.87), peripheral artery 1.76; 1.26-2.45) (P SVI, specifically socioeconomic status theme, mediated 98% disparity risk White significantly more likely experience compared their counterparts. These by other as captured census tract SVI. Our findings motivate multilevel interventions focused addressing vulnerability.
Language: Английский
Citations
4
Environmental Pollution, Journal Year: 2024, Volume and Issue: 363, P. 125097 - 125097
Published: Oct. 9, 2024
Language: Английский
Citations
4
Cancer Medicine, Journal Year: 2025, Volume and Issue: 14(1)
Published: Jan. 1, 2025
ABSTRACT Background Cancer is a leading cause of death globally, with significant variations in incidence and mortality rates among different cancer types regions. In Taiwan, breast (BC), cervical (CxCa), colorectal (CRC), oral (OC) are prevalent have prompted government‐led screening programs to mitigate their impact. This study aims assess the burden these cancers at county scale using disability‐adjusted life years (DALYs) as metric, focusing on 2010, 2015, 2018, 2019, 2020. Methods Data incidence, mortality, disability weights, treatment outcomes were sourced from Taiwan HPA, Ministry Health Welfare, Registry. Years lost (YLLs) lived (YLDs) calculated for each cancer, considering age, stage, treatment. The correlation between disease also conducted. Results analysis highlights trends 2010 BC CRC showed rising ASMR DALYs rates, while CxCa experienced consistent declines. OC had fluctuating pattern, particularly eastern YLLs contributed significantly all cancers, emphasizing premature mortality's role burden. Screening CxCa, correlated changes burden, increasing decreasing, reflecting impact preventive measures outcomes. Conclusions findings underscore importance targeted interventions evidence‐informed resource allocation address regional differences Taiwan.
Language: Английский
Citations
0
Journal of Community Genetics, Journal Year: 2025, Volume and Issue: unknown
Published: April 30, 2025
Language: Английский
Citations
0