New Recommendations for Breast Cancer Screening—In Pursuit of Health Equity

JAMA Network Open, Год журнала: 2024, Номер 7(4), С. e2411638 - e2411638

Опубликована: Апрель 30, 2024

US Preventive Services Task Force; Wanda K. Nicholson, MD, MPH, MBA; Michael Silverstein, MPH; John B. Wong, MD; J. Barry, David Chelmow, Tumaini Rucker Coker, Esa M. Davis, Carlos Roberto Jaén, PhD, MS; Marie Krousel-Wood, MSPH; Sei Lee, MAS; Li Li, Carol Mangione, Goutham Rao, Ruiz, PhD; James Stevermer, Joel Tsevat, Sandra Millon Underwood, RN; Sarah Wiehe, MPH

Язык: Английский

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Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020

JAMA Oncology, Год журнала: 2024, Номер unknown

Опубликована: Дек. 5, 2024

Cancer mortality has decreased over time, but the contributions of different interventions across cancer control continuum to averting deaths have not been systematically evaluated major sites. To quantify prevention, screening (to remove precursors [interception] or early detection), and treatment cumulative number averted from 1975 2020 for breast, cervical, colorectal, lung, prostate cancers. In this model-based study using population-level data, outputs published models developed by Intervention Surveillance Modeling Network were extended through 2020. Model inputs based on national data risk factors, incidence, survival, due other causes, dissemination effects (for interception treatment. Simulated modeled parameters derived multiple birth cohorts US population used. Primary prevention via smoking reduction (lung), (cervix colorectal) detection (breast, cervix, prostate), therapy prostate). The estimated with vs no advances. An 5.94 million cancers combined. efforts 8 10 these (4.75 deaths). contribution each intervention varied site. Screening accounted 25% breast averted. Averted cervical nearly completely removal as advances modest during period. colorectal because precancerous polyps in 79% 21%. Most lung avoided (98%) uptake was low largely palliative before 2014. contributed 56% deaths. Over past 45 years, most causes; however, their site according data. Despite progress, reduce burden will require increased effective new technologies discoveries.

Язык: Английский

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Gerotherapeutics: Aging Mechanism-based Pharmaceutical and Behavioral Interventions to Reduce Cancer Racial and Ethnic Disparities

JNCI Journal of the National Cancer Institute, Год журнала: 2024, Номер unknown

Опубликована: Авг. 27, 2024

Abstract The central premise of this article is that a portion the established relationships between social determinants health and racial ethnic disparities in cancer morbidity mortality mediated through differences rates biological aging processes. We further posit using knowledge about could enable discovery testing new mechanism-based pharmaceutical behavioral interventions (“gerotherapeutics”) to differentially improve survivors from minority populations reduce disparities. These hypotheses are based on evidence lifelong adverse contribute (“social aging”), with individuals minoritized groups experiencing accelerated (ie, steeper slope or trajectory over time relative chronological age) more often than nonminoritized groups. Acceleration can increase risk, age onset, aggressiveness, stage many adult cancers. There also documented negative feedback loops whereby cellular damage caused by its therapies act as drivers additional aging. Together, these dynamic intersectional forces outcomes vs populations. highlight key targetable mechanisms potential applications reducing discuss methodological considerations for preclinical clinical impact gerotherapeutics Ultimately, promise will require broad societal policy changes address structural causes ensure equitable access all control paradigms.

Язык: Английский

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Accelerating Progress to Reduce the Cancer Burden through Prevention and Control in the US

JNCI Journal of the National Cancer Institute, Год журнала: 2024, Номер unknown

Опубликована: Сен. 3, 2024

Improvements in cancer prevention and control are poised to be main contributors reducing the burden of US. We quantify top opportunities accelerate progress using projected life years gained (LYG) deaths averted as measures. project that over next 25 years, realistic gains from tobacco can contribute 0.4 17 million additional LYG per intervention 8.4 improving uptake screening programs lifetime annual cohorts. Additional include addressing modifiable risk factors (excess weight, alcohol consumption), methods prevent or treat oncogenic infections, health disparities. Investment is needed pipeline new preventive agents technologies for early detection continue progress. There also a need research improve access existing emerging interventions address These undeniably within our power realize US population.

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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From equality to equity: Increasing the use and reporting of equity-based approaches in epidemiology

Annals of Epidemiology, Год журнала: 2024, Номер 98, С. 32 - 35

Опубликована: Авг. 14, 2024

Язык: Английский

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