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Gallaway MS, Huang B, Chen Q, Tucker TC, McDowell JK, Durbin E, Stewart SL, Tai E. Smoking and Smoking Cessation Among Persons with Tobacco- and Non-tobacco-Associated Cancers. J Community Health 2019; 44:552-560. [PMID: 30767102 PMCID: PMC6504566 DOI: 10.1007/s10900-019-00622-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine smoking and use of smoking cessation aids among tobacco-associated cancer (TAC) or non-tobacco-associated cancer (nTAC) survivors. Understanding when and if specific types of cessation resources are used can help with planning interventions to more effectively decrease smoking among all cancer survivors, but there is a lack of research on smoking cessation modalities used among cancer survivors. METHODS Kentucky Cancer Registry data on incident lung, colorectal, pancreatic, breast, ovarian, and prostate cancer cases diagnosed 2007-2011, were linked with health administrative claims data (Medicaid, Medicare, private insurers) to examine the prevalence of smoking and use of smoking cessation aids 1 year prior and 1 year following the cancer diagnosis. TACs included colorectal, pancreatic, and lung cancers; nTAC included breast, ovarian, and prostate cancers. RESULTS There were 10,033 TAC and 13,670 nTAC survivors. Smoking before diagnosis was significantly higher among TAC survivors (p < 0.0001). Among TAC survivors, smoking before diagnosis was significantly higher among persons who: were males (83%), aged 45-64 (83%), of unknown marital status (84%), had very low education (78%), had public insurance (89%), Medicaid (85%) or were uninsured (84%). Smoking cessation counseling and pharmacotherapy were more common among TAC than nTAC survivors (p < 0.01 and p = 0.05, respectively). DISCUSSION While smoking cessation counseling and pharmacotherapy were higher among TAC survivors, reducing smoking among all cancer survivors remains a priority, given cancer survivors are at increased risk for subsequent chronic diseases, including cancer. Tobacco cessation among all cancer survivors (not just those with TAC) can help improve prognosis, quality of life and reduce the risk of further disease. Health care providers can recommend for individual, group and telephone counseling and/or pharmacotherapy recommendations. These could also be included in survivorship care plans.
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Affiliation(s)
- M Shayne Gallaway
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, 4770 Buford Highway, MS F76, Atlanta, GA, 30341, Georgia.
| | - Bin Huang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
- Kentucky Cancer Registry, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Quan Chen
- Kentucky Cancer Registry, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Thomas C Tucker
- Kentucky Cancer Registry, College of Medicine, University of Kentucky, Lexington, KY, USA
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Jaclyn K McDowell
- Kentucky Cancer Registry, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Eric Durbin
- Kentucky Cancer Registry, College of Medicine, University of Kentucky, Lexington, KY, USA
- Division of Biomedical Informatics, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Sherri L Stewart
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, 4770 Buford Highway, MS F76, Atlanta, GA, 30341, Georgia
| | - Eric Tai
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, 4770 Buford Highway, MS F76, Atlanta, GA, 30341, Georgia
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Gallaway MS, Huang B, Chen Q, Tucker T, McDowell J, Durbin E, Siegel D, Tai E. Identifying Smoking Status and Smoking Cessation Using a Data Linkage Between the Kentucky Cancer Registry and Health Claims Data. JCO Clin Cancer Inform 2019; 3:1-8. [PMID: 31095418 DOI: 10.1200/cci.19.00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Linkage of cancer registry data with complementary data sources can be an informative way to expand what is known about patients and their treatment and improve delivery of care. The purpose of this study was to explore whether patient smoking status and smoking-cessation modalities data in the Kentucky Cancer Registry (KCR) could be augmented by linkage with health claims data. METHODS The KCR conducted a data linkage with health claims data from Medicare, Medicaid, state employee insurance, Humana, and Anthem. Smoking status was defined as documentation of personal history of tobacco use (International Classification of Diseases, Ninth Revision [ICD-9] code V15.82) or tobacco use disorder (ICD-9 305.1) before and after a cancer diagnosis. Use of smoking-cessation treatments before and after the cancer diagnosis was defined as documentation of smoking-cessation counseling (Healthcare Common Procedure Coding System codes 99406, 99407, G0375, and G0376) or pharmacotherapy (eg, nicotine replacement therapy, bupropion, varenicline). RESULTS From 2007 to 2011, among 23,703 patients in the KCR, we discerned a valid prediagnosis smoking status for 78%. KCR data only (72%), claims data only (6%), and a combination of both data sources (22%) were used to determine valid smoking status. Approximately 4% of patients with cancer identified as smokers (n = 11,968) and were provided smoking-cessation counseling, and 3% were prescribed pharmacotherapy for smoking cessation. CONCLUSION Augmenting KCR data with medical claims data increased capture of smoking status and use of smoking-cessation modalities. Cancer registries interested in exploring smoking status to influence treatment and research activities could consider a similar approach, particularly if their registry does not capture smoking status for a majority of patients.
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Affiliation(s)
| | - Bin Huang
- University of Kentucky, Lexington, KY
| | - Quan Chen
- University of Kentucky, Lexington, KY
| | | | | | | | - David Siegel
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Eric Tai
- Centers for Disease Control and Prevention, Atlanta, GA
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Muller J, Grosclaude P, Lapôtre-Ledoux B, Woronoff AS, Guizard AV, Bara S, Colonna M, Troussard X, Bouvier V, Trétarre B, Velten M, Jégu J. Trends in the risk of second primary cancer among bladder cancer survivors: a population-based cohort of 10 047 patients. BJU Int 2015; 118:53-9. [DOI: 10.1111/bju.13351] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Joris Muller
- Bas-Rhin Cancer Registry; EA 3430, FMTS; University of Strasbourg; Strasbourg France
- Department of Public Health; University Hospital of Strasbourg; Strasbourg France
| | - Pascale Grosclaude
- Tarn Cancer Registry; Albi France
- Francim: Réseau français des registres des cancers; Toulouse France
| | - Bénédicte Lapôtre-Ledoux
- Francim: Réseau français des registres des cancers; Toulouse France
- Somme Cancer Registry; Department of Hygiene and Public Health; University Hospital of Amiens; Amiens France
| | - Anne-Sophie Woronoff
- Francim: Réseau français des registres des cancers; Toulouse France
- Doubs and Belfort Territory Cancer Registry; University Hospital of Besançon; Besançon France
| | - Anne-Valérie Guizard
- Francim: Réseau français des registres des cancers; Toulouse France
- Calvados General Cancer Registry, Cancers & Préventions; U 1086 Inserm; François Baclesse Centre; Caen France
| | - Simona Bara
- Francim: Réseau français des registres des cancers; Toulouse France
- Manche Cancer Registry; Cotentin Hospital; Cherbourg-Octeville France
| | - Marc Colonna
- Francim: Réseau français des registres des cancers; Toulouse France
- Isère Cancer Registry; University Hospital of Grenoble; Grenoble France
| | - Xavier Troussard
- Francim: Réseau français des registres des cancers; Toulouse France
- Basse-Normandie Haematological Malignancies Cancer Registry; University Hospital of Caen; Caen France
| | - Véronique Bouvier
- Francim: Réseau français des registres des cancers; Toulouse France
- Calvados Digestive Cancer Registry Cancers & Préventions; U 1086 Inserm; François Baclesse Centre; Caen France
| | - Brigitte Trétarre
- Francim: Réseau français des registres des cancers; Toulouse France
- Hérault Cancer Registry; Research Center; Montpellier France
| | - Michel Velten
- Bas-Rhin Cancer Registry; EA 3430, FMTS; University of Strasbourg; Strasbourg France
- Department of Public Health; University Hospital of Strasbourg; Strasbourg France
- Francim: Réseau français des registres des cancers; Toulouse France
- Department of Epidemiology and Biostatistics; Paul Strauss Center; Strasbourg France
| | - Jérémie Jégu
- Bas-Rhin Cancer Registry; EA 3430, FMTS; University of Strasbourg; Strasbourg France
- Department of Public Health; University Hospital of Strasbourg; Strasbourg France
- Francim: Réseau français des registres des cancers; Toulouse France
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Yu Y, Rajan SS, Essien EJ, Yang M, Abughosh S. The relationship between obesity and prescription of smoking cessation medications. Popul Health Manag 2014; 17:172-9. [PMID: 24784163 DOI: 10.1089/pop.2013.0059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The objective of this study was to examine the differences in prescription of smoking cessation medications among smokers with different body mass index (BMI) classifications. A retrospective cross-sectional study was conducted using National Ambulatory Medical Care Survey data (2006-2010). Self-reported current smokers aged 18 years and older were included in the study. The outcome of interest was receiving a prescription for a Food and Drug Administration-approved smoking cessation medication. Multivariate logistic regression was performed to assess the association between the outcome variable and the main independent variable (BMI classification), controlling for other covariates. The results showed that overweight, obese, and severely obese smokers were less likely to be prescribed a smoking cessation medication as compared to normal weight smokers. Although 5.11% of normal weight smokers were prescribed a smoking cessation medication, only 3.70% of overweight smokers, 3.41% of obese smokers, and 2.50% of severely obese smokers were prescribed a smoking cessation medication. In addition, older smokers, whites, smokers visiting primary care providers, smokers receiving tobacco counseling, and nondiabetic smokers were more likely to be prescribed a smoking cessation medication. Lower prescription of smoking cessation medications among overweight, obese, and severely obese smokers might be driven by patients' health concerns and behavioral factors or providers' treatment preferences or biases. The disparity in smoking cessation medication prescription among smokers with different BMI classifications raises quality of care and health care concerns for overweight, obese, and severely obese smokers.
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Affiliation(s)
- Yuping Yu
- 1 Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston , Houston, Texas
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Samet JM, Avila-Tang E, Boffetta P, Hannan LM, Olivo-Marston S, Thun MJ, Rudin CM. Lung cancer in never smokers: clinical epidemiology and environmental risk factors. Clin Cancer Res 2009; 15:5626-45. [PMID: 19755391 PMCID: PMC3170525 DOI: 10.1158/1078-0432.ccr-09-0376] [Citation(s) in RCA: 363] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
More than 161,000 lung cancer deaths are projected to occur in the United States in 2008. Of these, an estimated 10 to 15% will be caused by factors other than active smoking, corresponding to 16,000 to 24,000 deaths annually. Thus lung cancer in never smokers would rank among the most common causes of cancer mortality in the United States if considered as a separate category. Slightly more than half of the lung cancers caused by factors other than active smoking occur in never smokers. As summarized in the accompanying article, lung cancers that occur in never smokers differ from those that occur in smokers in their molecular profile and response to targeted therapy. These recent laboratory and clinical observations highlight the importance of defining the genetic and environmental factors responsible for the development of lung cancer in never smokers. This article summarizes available data on the clinical epidemiology of lung cancer in never smokers, and several environmental risk factors that population-based research has implicated in the etiology of these cancers. Primary factors closely tied to lung cancer in never smokers include exposure to known and suspected carcinogens including radon, second-hand tobacco smoke, and other indoor air pollutants. Several other exposures have been implicated. However, a large fraction of lung cancers occurring in never smokers cannot be definitively associated with established environmental risk factors, highlighting the need for additional epidemiologic research in this area.
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Polednak AP. Documentation of Alcohol Use in Hospital Records of Newly Diagnosed Cancer Patients: A Population-Based Study. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2009; 33:403-9. [PMID: 17613967 DOI: 10.1080/00952990701315236] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Alcohol use has been associated with increased risk and poorer prognosis of various types of cancer, but the extent of actual screening for alcohol use in hospitalized cancer patients has received limited attention. In a random sample of 618 Connecticut patients diagnosed in 2002 with invasive cancer at age 20 + years, ascertained from a population-based registry, some information on usual frequency of drinking was found in hospital records for 478 (77.3%), but 143 (57.2%) of the 250 current drinkers were poorly described (e.g., "social," "occasional"). Alcohol use disorders were rarely mentioned. Gamma glutamyl transpeptidase was found for only 21 (3.4%). Mean corpuscular volume (MCV) was found for 434 (70.2%) and was associated with heavier drinking, independent of other predictors of MCV. Better screening is needed for all hospitalized cancer patients, to plan for interventions and conduct follow-up studies of prognosis.
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Affiliation(s)
- Anthony P Polednak
- Connecticut Department of Public Health, Hartford, Connecticut 06134-0308, USA.
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Availability and utility of body mass index for population-based cancer surveillance. Cancer Causes Control 2007; 19:51-7. [PMID: 17943455 DOI: 10.1007/s10552-007-9069-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2007] [Accepted: 09/19/2007] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the availability of body height and weight data in the hospital medical record of cancer patients and discuss the utility of the findings to population-based cancer research and the surveillance of overweight and obesity in the United States. METHODS Medical records were reviewed for up to three measures of height and weight for a random sample of 1,739 patients diagnosed (2001-2003) with one of the 12 types of cancer and reported to the population-based Greater Bay Area Cancer Registry of Northern California. RESULTS About 84% of cancer patients had at least one value of height, 91% had at least one value of weight, and 83% had both values recorded in the medical record such that body mass index (BMI) could be computed. About 60% of height and weight values were recorded within 2 months of cancer diagnosis, with most values (71%) recorded after cancer diagnosis. The availability of BMI varied somewhat by race/ethnicity, cancer site, initial treatment, and hospital characteristics. CONCLUSIONS BMI may be sufficiently available to be included routinely in the population-based cancer registries, and, if so, would be useful for studies of cancer diagnoses and outcomes and permit nationwide surveillance of BMI in a large population-representative cohort of cancer patients.
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Polednak AP. Regarding “Prevalence of the Metabolic Syndrome in Relation to Self-Reported Cancer History”. Ann Epidemiol 2006; 16:877-9. [PMID: 16882474 DOI: 10.1016/j.annepidem.2006.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 04/28/2006] [Accepted: 06/02/2006] [Indexed: 11/15/2022]
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