Impact of racial disparities in follow-up and quality of colonoscopy on colorectal cancer outcomes

JNCI Journal of the National Cancer Institute, Год журнала: 2024, Номер 116(11), С. 1807 - 1816

Опубликована: Июль 24, 2024

Abstract Background The benefits of colorectal cancer (CRC) screening programs rely on completing follow-up colonoscopy when a noncolonoscopy test is abnormal and quality as measured by the endoscopists’ adenoma detection rate. Existing data demonstrate substantially lower rates rate for Black Americans than White Americans. However, contributions racial differences in CRC outcomes have not been rigorously evaluated. Methods We used established validated CRC-Adenoma Incidence Mortality (CRC-AIM) model our analysis platform, with inputs from published literature that report adults compared (15% 10% lower, respectively). simulated annual fecal immunochemical test, triennial multitarget stool DNA, every 10 years between ages 45 75 using real-world utilization modalities vs no screening. reported lifetime per 1000 adults. Results Elimination Black-White disparities would reduce incidence mortality 5.2% 9.3%, respectively, improve life-years gained 3.4%. 9.4% 3.7%. both 14.6% 18.7%, 7.1%. Conclusions This modeling study predicts eliminating rates, mortality.

Язык: Английский

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Data gaps and opportunities for modeling cancer health equity

JNCI Monographs, Год журнала: 2023, Номер 2023(62), С. 246 - 254

Опубликована: Ноя. 1, 2023

Abstract Population models of cancer reflect the overall US population by drawing on numerous existing data resources for parameter inputs and calibration targets. Models require that are appropriately representative, collected in a harmonized manner, have minimal missing or inaccurate values, adequate sample sizes. Data resource priorities modeling to support health equity include increasing availability 1) arise from uninsured underinsured individuals those traditionally not included health-care delivery studies, 2) relevant exposures groups historically intentionally excluded across full control continuum, 3) disaggregate categories (race, ethnicity, socioeconomic status, gender, sexual orientation, etc.) their intersections conceal important variation outcomes, 4) identify specific populations interest clinical databases whose outcomes been understudied, 5) enhance records through expanded elements linkage with other types (eg, patient surveys, provider and/or facility level information, neighborhood data), 6) decrease misclassified underrecognized populations, 7) capture potential measures effects systemic racism corresponding intervenable targets change.

Язык: Английский

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Using simulation modeling to guide policy to reduce disparities and achieve equity in cancer outcomes: state of the science and a road map for the future

JNCI Monographs, Год журнала: 2023, Номер 2023(62), С. 159 - 166

Опубликована: Ноя. 1, 2023

Язык: Английский

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Supporting ColoREctal Equitable Navigation (SCREEN): a protocol for a stepped-wedge cluster randomized trial for patient navigation in primary care

Implementation Science Communications, Год журнала: 2024, Номер 5(1)

Опубликована: Июнь 3, 2024

Abstract Background Black individuals in the United States (US) have a higher incidence of and mortality from colorectal cancer (CRC) compared to other racial groups, CRC is second leading cause death among Hispanic/Latino populations US. Patient navigation an evidence-based approach narrow inequities screening patients. Despite this, limited healthcare systems implemented patient for at scale. Methods We are conducting stepped-wedge cluster randomized trial 15 primary care clinics with six steps six-month duration scale program improve rates After months baseline data collection no intervention we will randomize clinics, whereby three join arm every until all cross over intervention. During roll out conduct training education change infrastructure electronic health record, create stakeholder relationships, assess readiness, deliver iterative feedback. Framed by Practical, Robust Implementation Sustainment Model (PRISM) focus on effectiveness, reach, provider adoption, implementation. document adaptations both implementation strategies. To address equity, engage multilevel voices through interviews community advisory board plan, deliver, adapt, measure, disseminate study progress. Provider-level feedback include updates disparities orders completions. Discussion Primary poised close disparity gaps completion but may lack understanding magnitude these how them. aim understand tailor patients providers across diverse wide variation rates, payor mix, proximity specialty care, volume. Findings this inform practices effective sustainable strategies ethnic minorities. Trial registration NCT06401174

Язык: Английский

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Commentary: Some water in the data desert: the Cancer Intervention and Surveillance Modeling Network’s capacity to guide mitigation of cancer health disparities

JNCI Monographs, Год журнала: 2023, Номер 2023(62), С. 167 - 172

Опубликована: Сен. 14, 2023

Despite significant progress in cancer research and treatment, a persistent knowledge gap exists understanding addressing care disparities, particularly among populations that are marginalized. This deficit has led to "data divide," where certain groups lack adequate representation cancer-related data, hindering their access personalized data-driven care. divide disproportionately affects marginalized minoritized communities such as the U.S. Black population. We explore concept of deserts," wherein entire populations, often based on race, ethnicity, gender, disability, or geography, comprehensive high-quality health data. Several factors contribute data deserts, including underrepresentation clinical trials, poor quality, limited digital technologies, rural lower-socioeconomic communities.The consequences divides deserts far-reaching, impeding equitable precision medicine perpetuating disparities. To bridge this divide, we highlight role Cancer Intervention Surveillance Modeling Network (CISNET), which employs population simulation modeling quantify emphasize importance collecting quality from various sources improve model accuracy. CISNET's collaborative approach, utilizing multiple independent models, offers consistent results identifies gaps knowledge. It demonstrates impact systemic racism incidence mortality, paving way for evidence-based policies interventions eliminate suggest potential use voting districts/precincts unit aggregation future CISNET modeling, enabling targeted informed policy decisions.

Язык: Английский

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The Molecular Biology of Cancer Disparities

Interdisciplinary cancer research, Год журнала: 2024, Номер unknown

Опубликована: Янв. 1, 2024

Язык: Английский

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Radial Data Visualization-Based Step-by-Step Eliminative Algorithm to Predict Colorectal Cancer Patients’ Response to FOLFOX Therapy

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(22), С. 12149 - 12149

Опубликована: Ноя. 12, 2024

Application of the FOLFOX scheme to colorectal cancer (CRC) patients often results in development chemo-resistance, leading therapy failure. This study aimed develop a functional and easy-to-use algorithm predict patients’ response treatment. Transcriptomic data CRC patient’s samples treated with were downloaded from Gene Expression Omnibus database (GSE83129, GSE28702, GSE69657, GSE19860 GSE41568). Comparing expression top up- downregulated genes responder non-responder groups, we selected 30 potential markers that used create step-by-step eliminative procedure based on modified radial visualization, which depicts interplay between level chosen attributes (genes) locate points low-dimensional space. Our analysis proved FOLFOX-resistant are predominantly characterized by upregulated levels TMEM182 MCM9 LRRFIP1. Additionally, developed TMEM182, MCM9, LRRFIP1, LAMP1, FAM161A, KLHL36, ETV5, RNF168, SRSF11, NCKAP5, CRTAP, VAMP2, ZBTB49 RIMBP2 be capable predicting response. In conclusion, our approach can give unique insight into clinical decision-making regarding administration, potentially increasing survival and, consequently, medical futility due incorrect application.

Язык: Английский

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Recent racial/ethnic disparities in cancer-specific mortality among patients diagnosed with rectal cancer

Translational Gastroenterology and Hepatology, Год журнала: 2023, Номер 0, С. 0 - 0

Опубликована: Янв. 1, 2023

African American patients frequently receive nonstandard treatment and demonstrate poorer overall survival (OS) outcomes compared to White patients. Our objective was analysis whether racial/ethnic disparities in rectal cancer-specific mortality remain after accounting for clinical characteristics, treatment, access-to-care-related factors.

Язык: Английский

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