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Han BH, Masukawa K, Rosenbloom D, Kuerbis A, Helmuth E, Liao DH, Moore AA. Use of web-based screening and brief intervention for unhealthy alcohol use by older adults. J Subst Abuse Treat 2018; 86:70-77. [PMID: 29415854 DOI: 10.1016/j.jsat.2018.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/28/2017] [Accepted: 01/02/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND While the number of older adults who engage in unhealthy drinking is increasing, few studies have examined the role of online alcohol screening and intervention tools for this population. The objective of this study was to describe characteristics of drinking behaviors among older adults who visited an alcohol screening and intervention website, and compare them to younger adults. METHODS We analyzed the responses of visitors to Alcoholscreening.org in 2013 (n=94,221). The prevalence of unhealthy alcohol use, behavioral change characteristics, and barriers to changing drinking were reported by age group (ages 21-49, 50-65, 66-80). Logistic regression models were used to identify characteristics associated with receiving a plan to either help cut back or quit drinking. RESULTS Of the entire study sample, 83% of respondents reported unhealthy drinking (exceeding daily or weekly recommended limits) with 84% among 21-49year olds, 79% among 50-65year olds, and 85% among adults over 65. Older adults reported fewer negative aspects of drinking, lower importance to change, highest confidence and fewer barriers to change, compared to younger adults. In the adjusted model, females (AOR=1.45, p<0.001) and older adults (AOR=1.55, p<0.002) were more likely to receive a plan to change drinking behaviors. DISCUSSION An online screening and intervention tool identified many older adults with unhealthy alcohol use behaviors and most were receptive to change. Web-based screening and interventions for alcohol use have the potential to be widely used among older adults.
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Affiliation(s)
- Benjamin H Han
- Division of Geriatric Medicine and Palliative Care, New York University School of Medicine, United States.
| | - Kristin Masukawa
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, United States
| | | | - Alexis Kuerbis
- CUNY Hunter Silberman School of Social Work, United States
| | - Eric Helmuth
- Boston University School of Public Health, United States
| | - Diana H Liao
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, United States
| | - Alison A Moore
- Division of Geriatrics, University of California, San Diego School of Medicine, United States
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152
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Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, McCullough ML, Patel AV, Ma J, Soerjomataram I, Flanders WD, Brawley OW, Gapstur SM, Jemal A. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin 2018; 68:31-54. [PMID: 29160902 DOI: 10.3322/caac.21440] [Citation(s) in RCA: 835] [Impact Index Per Article: 139.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 12/12/2022] Open
Abstract
Contemporary information on the fraction of cancers that potentially could be prevented is useful for priority setting in cancer prevention and control. Herein, the authors estimate the proportion and number of invasive cancer cases and deaths, overall (excluding nonmelanoma skin cancers) and for 26 cancer types, in adults aged 30 years and older in the United States in 2014, that were attributable to major, potentially modifiable exposures (cigarette smoking; secondhand smoke; excess body weight; alcohol intake; consumption of red and processed meat; low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and 6 cancer-associated infections). The numbers of cancer cases were obtained from the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute; the numbers of deaths were obtained from the CDC; risk factor prevalence estimates were obtained from nationally representative surveys; and associated relative risks of cancer were obtained from published, large-scale pooled analyses or meta-analyses. In the United States in 2014, an estimated 42.0% of all incident cancers (659,640 of 1570,975 cancers, excluding nonmelanoma skin cancers) and 45.1% of cancer deaths (265,150 of 587,521 deaths) were attributable to evaluated risk factors. Cigarette smoking accounted for the highest proportion of cancer cases (19.0%; 298,970 cases) and deaths (28.8%; 169,180 deaths), followed by excess body weight (7.8% and 6.5%, respectively) and alcohol intake (5.6% and 4.0%, respectively). Lung cancer had the highest number of cancers (184,970 cases) and deaths (132,960 deaths) attributable to evaluated risk factors, followed by colorectal cancer (76,910 cases and 28,290 deaths). These results, however, may underestimate the overall proportion of cancers attributable to modifiable factors, because the impact of all established risk factors could not be quantified, and many likely modifiable risk factors are not yet firmly established as causal. Nevertheless, these findings underscore the vast potential for reducing cancer morbidity and mortality through broad and equitable implementation of known preventive measures. CA Cancer J Clin 2018;68:31-54. © 2017 American Cancer Society.
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Affiliation(s)
- Farhad Islami
- Strategic Director, Cancer Surveillance Research, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Ann Goding Sauer
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Kimberly D Miller
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Rebecca L Siegel
- Strategic Director, Surveillance Information, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Stacey A Fedewa
- Strategic Director, Risk Factors and Screening Surveillance, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Eric J Jacobs
- Strategic Director, Pharmacoepidemiology, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Marjorie L McCullough
- Strategic Director, Nutritional Epidemiology, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Alpa V Patel
- Strategic Director, Cancer Prevention Study-3, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Jiemin Ma
- Strategic Director, Cancer Interventions Surveillance, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Isabelle Soerjomataram
- Scientist, Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - W Dana Flanders
- Professor, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Otis W Brawley
- Chief Medical and Science Officer, Executive Vice President, Research, American Cancer Society, Atlanta, GA
| | - Susan M Gapstur
- Vice President, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Vice President, Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA
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153
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Insomnia treatment in the context of alcohol use disorder: A systematic review and meta-analysis. Drug Alcohol Depend 2017; 181:200-207. [PMID: 29096290 PMCID: PMC5683932 DOI: 10.1016/j.drugalcdep.2017.09.029] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/28/2017] [Accepted: 09/22/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the efficacy of behavioral and pharmacological interventions for insomnia among individuals with alcohol use disorder (AUD). PROCEDURES Comprehensive literature searches of psychological, medical, and educational databases were conducted through October 2016. Eligible studies evaluated the efficacy of an insomnia intervention, included a comparison condition, sampled individuals with AUD and either insomnia disorder or complaints of insomnia, assessed sleep-related outcomes, and provided relevant statistics to calculate between-group effect sizes. Effect sizes were estimated for sleep quality, days of alcohol abstinence, and symptoms of depression. Type of intervention (behavioral versus pharmacological) was tested as a moderator of intervention efficacy. MAIN FINDINGS Nine studies met eligibility criteria and were included in the final review and meta-analysis. Random-effects models indicated that intervention participants reported greater improvements in sleep quality (d+=0.62, 95% CI=0.28, 0.97) and symptoms of depression (d+=0.52, 95% CI=0.06, 0.98) than control participants. Participants reported significantly greater improvements in sleep quality in response to behavioral (d+=1.20, 95% CI=0.70, 1.70) as opposed to pharmacological (d+=0.43, 95% CI=0.19, 0.67) interventions. Behavioral (d+=0.74, 95% CI=0.31, 1.18) and pharmacological (d+=0.08, 95% CI=-0.64, 0.78) interventions did not have significantly different effects on depressive symptoms. Neither behavioral nor pharmacological interventions improved rates of alcohol abstinence. CONCLUSIONS Insomnia interventions improve sleep quality and reduce symptoms of depression among individuals with comorbid AUD. Given the methodological weaknesses of studies reviewed, additional research is needed to determine the efficacy of insomnia treatment in improving rates of alcohol relapse within this population.
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154
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Palamar JJ, Mauro PM, Han BH, Martins SS. Shifting characteristics of ecstasy users ages 12-34 in the United States, 2007-2014. Drug Alcohol Depend 2017; 181:20-24. [PMID: 29028555 PMCID: PMC5683908 DOI: 10.1016/j.drugalcdep.2017.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 09/16/2017] [Accepted: 09/17/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Ecstasy/MDMA has been one of the most prevalent party drugs for decades, and powder ecstasy recently increased in popularity. We examined trends in use to determine who to best target for prevention and harm reduction. METHODS Secondary analysis of the 2007-2014 National Survey on Drug Use and Health, a repeated cross-sectional, nationally representative probability sample, was conducted. Linear trends in past-year ecstasy use and trends in demographic and other past-year substance use characteristics among ecstasy users were examined among participants ages 12-34 (N=332,560). RESULTS Past-year prevalence of ecstasy use was stable across years at 2% (P=0.693). Over time, the proportion of ecstasy users with a college degree increased from 11.5% in 2007/08 to 24.5% in 2013/14 (P<0.001). The proportion of users who were age 12-17 decreased, as did proportions of users who are non-Hispanic black, and reported income <$20,000/year (Ps<0.001). Prevalence of past-year use of marijuana, LSD, ketamine, and DMT/AMT/Foxy increased among ecstasy users (Ps<0.05); DMT/AMT/Foxy use increased more than four-fold from 2.1% in 2007/08 to 8.7% in 2013/14. Perception of great risk associated with LSD use decreased among users and ease of obtaining LSD increased (Ps<0.05). Past-year use of 5 or more other substances also increased over time (P<0.05). CONCLUSIONS Ecstasy use in the US appears to be increasing among those with college degrees and use of other substances among ecstasy users is growing-particularly use of otherwise rare substances such as tryptamines. Results inform prevention and harm reduction strategies in this increasingly shifting group of ecstasy users.
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Affiliation(s)
- Joseph J. Palamar
- New York University Langone Medical Center, Department of Population Health, New York, NY, USA,Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Pia M. Mauro
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - Benjamin H. Han
- Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, New York, NY, USA,New York University School of Medicine, Department of Medicine, Division of Geriatric Medicine and Palliative Care, New York, NY, USA
| | - Silvia S. Martins
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
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155
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Niño MD, Cai T, Mota-Back X, Comeau J. Gender differences in trajectories of alcohol use from ages 13 to 33 across Latina/o ethnic groups. Drug Alcohol Depend 2017; 180:113-120. [PMID: 28888150 DOI: 10.1016/j.drugalcdep.2017.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 08/02/2017] [Accepted: 08/03/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research examining alcohol use trajectories among Latina/os is scarce. Further, prior findings on alcohol use by ethnic group and gender is mixed. The purpose of this study was twofold: (a.) to examine developmental trajectories for two types of alcohol (drunkenness and heavy drinking) use across four Latina/o ethnic groups (Cubans, Puerto Ricans, Central/South American, and Mexican Americans) and, (b.) to examine the role of gender and ethnicity in developmental trajectories of drunkenness and heavy drinking among Latina/os. METHODS Data were drawn from Waves I-IV of the National Longitudinal Study of Adolescent to Adult Health. The sample consisted of 1670 Latina/os that were followed from adolescence into adulthood. Multi-level logistic regression models were used to estimate drunkenness and heavy drinking trajectories and trajectories by gender. RESULTS indicate that, for all four ethnic groups examined, the probability of drunkenness and heavy drinking gradually increased in adolescence, peaked in "emerging adulthood", and decreased as they transitioned into adulthood. Findings also show divergent age trajectories by gender, but patterns varied across ethnicity and alcohol use outcome. CONCLUSIONS Key findings from this study demonstrate that among Latina/os, there are critical developmental periods for reported drunkenness and heavy drinking in the last 12 months, and that ethnicity and gender play substantial roles in the development of hazardous alcohol use over the life course.
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Affiliation(s)
- Michael D Niño
- Department of Sociology, Willamette University, OR, USA.
| | - Tianji Cai
- Department of Sociology, University of Macau, Avenida da Universidade Taipa, Macau, China
| | - Xóchitl Mota-Back
- Department of Sociology, University of Hawai'i - West O'ahu, 91-1001 Farrington Hwy, Kapolei, HI 96707, USA
| | - Joseph Comeau
- Department of Psychology and Sociology, Georgia Southwestern State University, 800 Georgia Southwestern State University Drive, Americus, 31709, Georgia
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156
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Kim TW, Walley AY, Ventura AS, Patts GJ, Heeren TC, Lerner GB, Mauricio N, Saitz R. Polypharmacy and risk of falls and fractures for patients with HIV infection and substance dependence. AIDS Care 2017; 30:150-159. [PMID: 29034725 DOI: 10.1080/09540121.2017.1384532] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although people with HIV infection (PLWH) are at higher risk of polypharmacy and substance use, there is limited knowledge about potential harms associated with polypharmacy such as falls and fractures in this population. The study objective was to determine whether polypharmacy, as measured by the number and type of medication, is associated with falls and fractures among PLWH and DSM-IV substance dependence in the past year or ever injection drug use (IDU). We identified the number of medications by electronic medical record review in the following categories: (i) systemically active, (ii) non-antiretroviral (non-ARV), (iii) sedating, (iv) non-sedating as well as any opioid medication and any non-opioid sedating medication. Outcomes were self-reported (1) fall/accident requiring medical attention and (2) fracture in the previous year. Separate logistic regression models were fitted for medications in each category and each outcome. Among 250 participants, the odds of a fall requiring medical attention were higher with each additional medication overall (odds ratio [OR] 1.12, 95% Confidence Interval [CI] = 1.05, 1.18), each additional non-ARV medication (OR 1.13, 95%CI = 1.06, 1.20), each additional sedating medication (OR 1.36, 95%CI = 1.14, 1.62), and a non-opioid sedating medication (OR 2.89, 95%CI = 1.06, 7.85) but not with an additional non-sedating medication or opioid medication. In receiver operating characteristic (ROC) curve analyses, optimal cutoffs for predicting falls were: ≥8 overall and ≥2 sedating medications. Odds ratios for fracture in the previous year were OR 1.05, 95%CI = 0.97, 1.13 for each additional medication overall and OR 1.11, 95%CI = 0.89, 1.38 for each additional sedating medication. In PLWH and substance dependence or ever IDU, a higher number of medications was associated with greater odds of having a fall requiring medical attention. The association appeared to be driven largely by sedating medications. Future studies should determine if reducing such polypharmacy, particularly sedating medications, lowers the risk of falls.
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Affiliation(s)
- Theresa W Kim
- a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center , Boston University School of Medicine , Boston , MA , USA
| | - Alexander Y Walley
- a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center , Boston University School of Medicine , Boston , MA , USA
| | - Alicia S Ventura
- a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center , Boston University School of Medicine , Boston , MA , USA
| | - Gregory J Patts
- b Data Coordinating Center , Boston University School of Public Health , Boston , MA , USA
| | - Timothy C Heeren
- c Department of Biostatistics , Boston University School Public Health , Boston , MA , USA
| | | | | | - Richard Saitz
- a Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center , Boston University School of Medicine , Boston , MA , USA.,e Department of Community Health Sciences , Boston University School of Public Health , Boston , MA , USA
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157
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Grant BF, Chou SP, Saha TD, Pickering RP, Kerridge BT, Ruan WJ, Huang B, Jung J, Zhang H, Fan A, Hasin DS. Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: Results From the National Epidemiologic Survey on Alcohol and Related Conditions. JAMA Psychiatry 2017; 74:911-923. [PMID: 28793133 PMCID: PMC5710229 DOI: 10.1001/jamapsychiatry.2017.2161] [Citation(s) in RCA: 904] [Impact Index Per Article: 129.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Lack of current and comprehensive trend data derived from a uniform, reliable, and valid source on alcohol use, high-risk drinking, and DSM-IV alcohol use disorder (AUD) represents a major gap in public health information. OBJECTIVE To present nationally representative data on changes in the prevalences of 12-month alcohol use, 12-month high-risk drinking, 12-month DSM-IV AUD, 12-month DSM-IV AUD among 12-month alcohol users, and 12-month DSM-IV AUD among 12-month high-risk drinkers between 2001-2002 and 2012-2013. DESIGN, SETTING, AND PARTICIPANTS The study data were derived from face-to-face interviews conducted in 2 nationally representative surveys of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions, with data collected from April 2001 to June 2002, and the National Epidemiologic Survey on Alcohol and Related Conditions III, with data collected from April 2012 to June 2013. Data were analyzed in November and December 2016. MAIN OUTCOMES AND MEASURES Twelve-month alcohol use, high-risk drinking, and DSM-IV AUD. RESULTS The study sample included 43 093 participants in the National Epidemiologic Survey on Alcohol and Related Conditions and 36 309 participants in the National Epidemiologic Survey on Alcohol and Related Conditions III. Between 2001-2002 and 2012-2013, 12-month alcohol use, high-risk drinking, and DSM-IV AUD increased by 11.2%, 29.9%, and 49.4%, respectively, with alcohol use increasing from 65.4% (95% CI, 64.3%-66.6%) to 72.7% (95% CI, 71.4%-73.9%), high-risk drinking increasing from 9.7% (95% CI, 9.3%-10.2%) to 12.6% (95% CI, 12.0%-13.2%), and DSM-IV AUD increasing from 8.5% (95% CI, 8.0%-8.9%) to 12.7% (95% CI, 12.1%-13.3%). With few exceptions, increases in alcohol use, high-risk drinking, and DSM-IV AUD between 2001-2002 and 2012-2013 were also statistically significant across sociodemographic subgroups. Increases in all of these outcomes were greatest among women, older adults, racial/ethnic minorities, and individuals with lower educational level and family income. Increases were also seen for the total sample and most sociodemographic subgroups for the prevalences of 12-month DSM-IV AUD among 12-month alcohol users from 12.9% (95% CI, 12.3%-17.5%) to 17.5% (95% CI, 16.7%-18.3%) and 12-month DSM-IV AUD among 12-month high-risk drinkers from 46.5% (95% CI, 44.3%-48.7%) to 54.5% (95% CI, 52.7%-56.4%). CONCLUSIONS AND RELEVANCE Increases in alcohol use, high-risk drinking, and DSM-IV AUD in the US population and among subgroups, especially women, older adults, racial/ethnic minorities, and the socioeconomically disadvantaged, constitute a public health crisis. Taken together, these findings portend increases in many chronic comorbidities in which alcohol use has a substantial role.
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Affiliation(s)
- Bridget F. Grant
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - S. Patricia Chou
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Tulshi D. Saha
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Roger P. Pickering
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | | | - W. June Ruan
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Boji Huang
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Jeesun Jung
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Haitao Zhang
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Amy Fan
- Epidemiology and Biometry Branch, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | - Deborah S. Hasin
- New York State Psychiatric Institute, New York,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
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158
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Islami F, Miller KD, Siegel RL, Fedewa SA, Ward EM, Jemal A. Disparities in liver cancer occurrence in the United States by race/ethnicity and state. CA Cancer J Clin 2017; 67:273-289. [PMID: 28586094 DOI: 10.3322/caac.21402] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 04/25/2017] [Indexed: 12/11/2022] Open
Abstract
Liver cancer is highly fatal, and death rates in the United States are increasing faster than for any other cancer, having doubled since the mid-1980s. In 2017, it is estimated that the disease will account for about 41,000 new cancer cases and 29,000 cancer deaths in the United States. In this article, data from the Surveillance, Epidemiology, and End Results (SEER) Program and the National Center for Health Statistics are used to provide an overview of liver cancer incidence, mortality, and survival rates and trends, including data by race/ethnicity and state. The prevalence of major risk factors for liver cancer is also reported based on national survey data from the Centers for Disease Control and Prevention. Despite the improvement in liver cancer survival in recent decades, only 1 in 5 patients survives 5 years after diagnosis. There is substantial disparity in liver cancer death rates by race/ethnicity (from 5.5 per 100,000 in non-Hispanic whites to 11.9 per 100,000 in American Indians/Alaska Natives) and state (from 3.8 per 100,000 in North Dakota to 9.6 per 100,000 in the District of Columbia) and by race/ethnicity within states. Differences in risk factor prevalence account for much of the observed variation in liver cancer rates. Thus, in contrast to the growing burden, a substantial proportion of liver cancer deaths could be averted, and existing disparities could be dramatically reduced, through the targeted application of existing knowledge in prevention, early detection, and treatment, including improvements in vaccination against hepatitis B virus, screening and treatment for chronic hepatitis C virus infections, maintaining a healthy body weight, access to high-quality diabetes care, preventing excessive alcohol drinking, and tobacco control, at both the state and national levels. CA Cancer J Clin 2017;67:273-289. © 2017 American Cancer Society.
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Affiliation(s)
- Farhad Islami
- Strategic Director, Cancer Surveillance Research, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Kimberly D Miller
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Rebecca L Siegel
- Strategic Director, Surveillance Information Services, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Stacey A Fedewa
- Strategic Director, Risk Factors and Screening Surveillance, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Elizabeth M Ward
- Senior Vice President, Intramural Research, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Vice President, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
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159
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Kuerbis AN, Hail L, Moore AA, Muench FJ. A pilot study of online feedback for adult drinkers 50 and older: Feasibility, efficacy, and preferences for intervention. J Subst Abuse Treat 2017; 77:126-132. [PMID: 28476264 DOI: 10.1016/j.jsat.2017.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 11/28/2022]
Abstract
Normative (NF) and personalized feedback (PF) are moderately effective brief interventions for at-risk drinking middle-aged and older adults. This study tested the feasibility of online feedback for drinkers 50 and older. This study's aims were to identify whether there is differential effectiveness of PF over NF in prompting drinkers 50years old and older to plan for change and to determine potential preferences for intervention among adult drinkers 50 and older with practical knowledge about computers. METHOD Using Amazon's Mechanical Turk, 138 male and female drinkers aged 50 to 75+ were recruited to complete an online survey that asked about their: perceptions of their drinking, quantity and frequency of drinking, and any comorbid health and/or mental health disorders/medications. They were then provided either NF or PF. NF provided information about how participants' drinking compared to their same age and gendered peers. PF provided information about level of risk to health and provided recommendations for safe levels of drinking. After feedback, participants were evaluated for their reactions (e.g., "How much does this worry you?") and their plan to change their drinking. Participants were asked about preferences for interventions. RESULTS 80% of participants rated themselves a no or low-risk drinker, yet 52.2% were found to be at-risk drinkers. Overall, participants reported feedback was helpful, and 43.9% made some kind of plan to change. Participants in NF were significantly more likely to make a plan for change than those in PF. Participants reported that they most preferred an online (40.9%) or a brief in-person (31.8%) intervention. CONCLUSION Findings revealed that brief online feedback was feasible, though limited to those who are computer knowledgeable. Unexpectedly, NF outperformed PF, suggesting that peer comparisons may be more motivating for adults 50 and older than previously thought. Finally, an online intervention appears to be a preferred intervention for alcohol use among this particular group of drinkers.
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Affiliation(s)
- Alexis N Kuerbis
- Hunter College at the City University of New York, United States.
| | - Lisa Hail
- Department of Psychiatry, University of California San Francisco, United States
| | - Alison A Moore
- Division of Geriatrics, University of California San Diego, United States
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