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Arbour C, Lapierre A, Hjeij D, Bilodeau K. Do All Patients Benefit From the Soothing Properties of a Conversational Nursing Intervention to Reduce Symptom Burden During Outpatient Chemotherapy?: A Multimethod Secondary Analysis. Cancer Nurs 2024:00002820-990000000-00259. [PMID: 38865610 DOI: 10.1097/ncc.0000000000001376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
BACKGROUND Soothing conversation (SC) is particularly promising for symptom management during outpatient chemotherapy. However, we know little about the profile of patients who are most likely to benefit from this intervention. OBJECTIVE To gain a better understanding of the profile of patients most likely to benefit from SC to reduce symptom burden during outpatient chemotherapy. METHODS We performed a multimethod secondary analysis of 2 data sets: the first gathered during a quantitative pilot trial investigating the impact of SC on patients' symptom fluctuations during chemotherapy perfusion (n = 24); the second derived from qualitative interviews about nurses' experiences with SC in this context (n = 6). RESULTS Secondary quantitative analysis suggests that symptom control with SC is more effective in older patients, reporting lower education, widowed status, work incapacity, advanced cancer, and undergoing chemotherapy perfusion for less than 1 hour. According to nurses' interviews, SC could best benefit patients (1) prone to anxiety and fear, (2) with unalleviated pain, (3) who are unaccompanied during treatment, and contrary to what was shown with quantitative data, (4) undergoing longer perfusion duration. CONCLUSION Although this study provides valuable insights, much work remains to be done to fully understand the factors that predispose patients to respond positively to SC during outpatient chemotherapy. IMPLICATIONS FOR PRACTICE This study extends previous research on the effectiveness of SC for symptom management during outpatient chemotherapy by comparing nurses' experience with the intervention to patients' results. Results could be used to inform the assignment and delivery of supportive communication-based interventions during chemotherapy protocols.
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Affiliation(s)
- Caroline Arbour
- Author Affiliations: Hôpital du Sacré-Cœur de Montréal, CIUSSS du Nord-de-l'Île-de-Montréal (Drs Arbour and Lapierre and Mrs Hjeij); Faculty of Nursing, Université de Montréal (Drs Arbour, Lapierre, and Bilodeau); Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal (Dr Bilodeau), Quebec, Canada
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Burden of liver cancer mortality by county, race, and ethnicity in the USA, 2000-19: a systematic analysis of health disparities. Lancet Public Health 2024; 9:e186-e198. [PMID: 38429018 PMCID: PMC10986755 DOI: 10.1016/s2468-2667(24)00002-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Understanding how specific populations are affected by liver cancer is important for identifying priorities, policies, and interventions to mitigate health risks and reduce disparities. This study aims to provide comprehensive analysis of rates and trends in liver cancer mortality for different racial and ethnic populations in the USA nationally and at the county level from 2000 to 2019. METHODS We applied small-area estimation methods to death registration data from the US National Vital Statistics System and population data from the US National Center for Health Statistics to estimate liver cancer mortality rates by county, racial and ethnic population, and year (2000-19) in the USA. Race and ethnicity were categorised as non-Latino and non-Hispanic American Indian or Alaska Native (AIAN), non-Latino and non-Hispanic Asian or Pacific Islander (Asian), non-Latino and non-Hispanic Black (Black), Latino or Hispanic (Latino), and non-Latino and non-Hispanic White (White). Estimates were adjusted using published misclassification ratios to correct for inaccuracies in race or ethnicity as recorded on death certificates, and then age-standardised. Mortality rate estimates are presented for all county and racial and ethnic population combinations with a mean annual population greater than 1000. FINDINGS Nationally, the age-standardised liver cancer mortality rate increased between the years 2000 (4·2 deaths per 100 000 population [95% uncertainty interval 4·1-4·3]) and 2016 (6·0 per 100 000 [5·9-6·1]), followed by a stabilisation in rates from 2016 to 2019 (6·1 per 100 000 [6·0-6·2]). Similar trends were observed across the AIAN, Black, Latino, and White populations, whereas the Asian population showed an overall decrease across the 20-year study period. Qualitatively similar trends were observed in most counties; however, the mortality rate and the rate of change varied substantially across counties, both within and across racial and ethnic populations. For the 2016-19 period, mortality continued to increase at a substantial rate in some counties even while it stabilised nationally. Nationally, the White population had the lowest mortality rate in all years, while the racial and ethnic population with the highest rate changed from the Asian population in 2000 to the AIAN population in 2019. Racial and ethnic disparities were substantial: in 2019, mortality was highest in the AIAN population (10·5 deaths per 100 000 [9·1-12·0]), notably lower for the Asian (7·5 per 100 000 [7·1-7·9]), Black (7·6 per 100 000 [7·3-7·8]), and Latino (7·7 per 100 000 [7·5-8·0]) populations, and lowest for the White population (5·5 [5·4-5·6]). These racial and ethnic disparities in mortality were prevalent throughout the country: in 2019, mortality was higher in minoritised racial and ethnic populations than in the White population living in the same county in 408 (87·7%) of 465 counties with unmasked estimates for the AIAN population, 604 (90·6%) of 667 counties for the Asian population, 1207 (81·2%) of 1486 counties for the Black population, and 1073 (73·0%) of 1469 counties for the Latino population. INTERPRETATION Although the plateau in liver cancer mortality rates in recent years is encouraging, mortality remains too high in many locations throughout the USA, particularly for minoritised racial and ethnic populations. Addressing population-specific risk factors and differences in access to quality health care is essential for decreasing the burden and disparities in liver cancer mortality across racial and ethnic populations and locations. FUNDING US National Institutes of Health (Intramural Research Program, National Institute on Minority Health and Health Disparities; National Heart, Lung, and Blood Institute; Intramural Research Program, National Cancer Institute; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Office of Disease Prevention; and Office of Behavioral and Social Sciences Research).
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Errisuriz VL, Zambrana RE, Parra-Medina D. Critical analyses of Latina mortality: disentangling the heterogeneity of ethnic origin, place, nativity, race, and socioeconomic status. BMC Public Health 2024; 24:190. [PMID: 38229037 PMCID: PMC10790397 DOI: 10.1186/s12889-024-17721-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/09/2024] [Indexed: 01/18/2024] Open
Abstract
Despite the significant body of research on social determinants of health (SDH) and mortality, limited knowledge is available on the epidemiology of aggregated Latino health overall, and by women and subgroups. In population health studies, U.S. Latinos often are considered a monolithic population and presented as an aggregate, obscuring the diversity and variations within and across Latino subgroups, contributing to missed opportunities to identify SDH of health outcomes, and limiting the understanding of health differences. Given diverse environmental, racial, class, and geographic factors, a specific focus on women facilitates a more in-depth view of health disparities. This paper provides a scoping review of current gaps in research that assesses the relationships between SDH and mortality rates for the five leading causes of chronic-disease related deaths among Latinas by ethnic origin, place, race, and SES. We analyzed 2020 national mortality statistics from the CDC WONDER Online database jointly with reviews of empirical articles on Latina health, employing the EBSCOhost MEDLINE databases. These findings challenge the phenomenon of the Hispanic paradox that identified Latinos as a relatively healthy population compared to non-Hispanic White populations despite their lower economic status. The findings confirm that prior research on Latino women had methodological limitations due to the exclusion of SDH and an overemphasis on culturalist perspectives, while overlooking the critical role of socioeconomic impacts on health. Findings indicate major knowledge gaps in Latina mortality by SDH and subgroups that may undermine surveillance efforts and treatment efficacy. We offer forward-looking recommendations to assure the inclusion of key SDH associated with Latina mortality by subgroup as essential to inform future studies, intervention programs, and health policy.
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Affiliation(s)
| | - Ruth Enid Zambrana
- Harriet Tubman Department of Women, Gender and Sexuality Studies, University of Maryland, Susquehanna Hall 4200 Lehigh Rd. Room 4117, College Park, MD, 20742, USA
| | - Deborah Parra-Medina
- Latino Research Institute, University of Texas at Austin, 210 W. 24th Street, GWB 1.102, Austin, TX, 78712, USA
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Liu Y, Chai S, Zhang X. Association Between Different Parameters of Adipose Distribution and Transient Elastography-Assessed Hepatic Steatosis in American Adults with Diabetes, Prediabetes and Normal Glucose Tolerance. Diabetes Metab Syndr Obes 2023; 16:299-308. [PMID: 36760579 PMCID: PMC9900240 DOI: 10.2147/dmso.s394564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/22/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To investigate the association between adipose distribution and hepatic steatosis in American adults and to assess whether this association varies among different blood glucose states. METHODS Data from the American National Health and Nutrition Examination Survey (NHANES) 2017-2018 were analyzed. The subjects were divided into three groups: diabetes, prediabetes and normal glucose tolerance (NGT). Hepatic steatosis was quantified by median controlled attenuation parameter (CAP), which was measured by ultrasound transient elastography. Total abdominal fat volume, visceral adipose tissue (VAT) volume, total percent fat, trunk percent fat, android percent fat and android to gynoid ratio (AGR) was measured by dual-energy X-ray absorptiometry (DXA). RESULTS Data pertaining to 2986 participants (1581 with hepatic steatosis) were included in the analysis. In the NGT group, the proportion of S0 (<5% of the hepatocytes with fatty infiltration) was 58.9%, and 25.2% for S3 (≥66% of the hepatocytes with fatty infiltration). In contrast, the proportion of S0 was 11.1%, while S3 accounts for as high as 68.7% in the diabetes group. In the NGT group, all parameters of fat distribution revealed a positive relation with the occurrence of hepatic steatosis (p<0.05) except total percent fat (p=0.872) after adjusting for confounding factors. In the prediabetes group, VAT volume, trunk percent fat, android percent fat and AGR had significant influence on hepatic steatosis (p<0.05). As for diabetes, only AGR remained significantly correlated with hepatic steatosis (p=0.004). CONCLUSION For NGT individuals, high level of total abdominal fat volume, VAT volume, trunk percent fat, android percent fat and AGR all can be used to predict hepatic steatosis. For diabetes, only AGR can predict hepatic steatosis among the surveyed parameters of adipose distribution.
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Affiliation(s)
- Yufang Liu
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, People’s Republic of China
| | - Sanbao Chai
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, People’s Republic of China
| | - Xiaomei Zhang
- Department of Endocrinology, Peking University International Hospital, Beijing, 102206, People’s Republic of China
- Correspondence: Xiaomei Zhang, Email
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Sempokuya T, Warner J, Azawi M, Nogimura A, Wong LL. Current status of disparity in liver disease. World J Hepatol 2022; 14:1940-1952. [PMID: 36483604 PMCID: PMC9724102 DOI: 10.4254/wjh.v14.i11.1940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
Abstract
Disparities have emerged as an important issue in many aspects of healthcare in developed countries and may be based on race, ethnicity, sex, geographical location, and socioeconomic status. For liver disease specifically, these potential disparities can affect access to care and outcome in viral hepatitis, chronic liver disease, and hepatocellular carcinoma. Shortages in hepatologists and medical providers versed in liver disease may amplify these disparities by compromising early detection of liver disease, surveillance for hepatocellular carcinoma, and prompt referral to subspecialists and transplant centers. In the United States, continued efforts have been made to address some of these disparities with better education of healthcare providers, use of telehealth to enhance access to specialists, reminders in electronic medical records, and modifying organ allocation systems for liver transplantation. This review will detail the current status of disparities in liver disease and describe current efforts to minimize these disparities.
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Affiliation(s)
- Tomoki Sempokuya
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
| | - Josh Warner
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
| | - Muaataz Azawi
- Division of Gastroenterology and Hepatology, Sanford Center for Digestive Health, Sioux Falls 57105, SD, Uruguay
| | - Akane Nogimura
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Aichi, Japan
- Division of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Aichi, Japan
| | - Linda L Wong
- Department of Surgery, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96813, United States
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Pavarin RM, Fioritti A, Fabbri C, Sanchini S, De Ronchi D. Comparison of Mortality Rates between Italian and Foreign-born Patients with Alcohol Use Disorders. J Psychoactive Drugs 2022; 54:471-481. [PMID: 34963415 DOI: 10.1080/02791072.2021.2014082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In Italy, although the number of foreign-born residents has grown exponentially, there are no data on mortality risk among migrants who have alcohol use disorders (AUDs). We examined the mortality risk and causes of death for natives and non-natives in a cohort of individuals treated for AUDs in Northern Italy in the period from 01/01/1975 to 31/12/2016. We highlight important characteristics of non-natives compared to Italians: 1) a younger age and a higher proportion of females; 2) a better health status; 3) a better social capital 4) a lower risk of death. We found differences in mortality between the various areas of origin, with a higher risk among participants born in Asia and African countries other than Mediterranean. The excess mortality compared to the reference population (SMRs) was at least three times for Italians and two times for migrants. While the non-native patients with AUDs have in general better health than Italians with AUDs, our results highlighted higher percentage of dropouts from treatment and lower access to Mental Health Services, suggesting that barriers to the access and completion of therapeutic programs still exist.
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Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Bologna, Italian Society of Substance Abuse (SITD), Italy
| | - Angelo Fioritti
- Department of Mental Health and Pathological Addictions, Local Health Unit of Bologna, Italy
| | - Chiara Fabbri
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Samantha Sanchini
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Forli, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
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Rodriguez RM, Menor M, Hernandez BY, Deng Y, Khadka VS. Bacterial Diversity Correlates with Overall Survival in Cancers of the Head and Neck, Liver, and Stomach. Molecules 2021; 26:5659. [PMID: 34577130 PMCID: PMC8468759 DOI: 10.3390/molecules26185659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
One in five cancers is attributed to infectious agents, and the extent of the impact on the initiation, progression, and disease outcomes may be underestimated. Infection-associated cancers are commonly attributed to viral, and to a lesser extent, parasitic and bacterial etiologies. There is growing evidence that microbial community variation rather than a single agent can influence cancer development, progression, response to therapy, and outcome. We evaluated microbial sequences from a subset of infection-associated cancers-namely, head and neck squamous cell carcinoma (HNSC), liver hepatocellular carcinoma (LIHC), and stomach adenocarcinoma (STAD) from The Cancer Genome Atlas (TCGA). A total of 470 paired tumor and adjacent normal samples were analyzed. In STAD, concurrent presence of EBV and Selemonas sputigena with a high diversity index were associated with poorer survival (HR: 2.23, 95% CI 1.26-3.94, p = 0.006 and HR: 2.31, 95% CI 1.1-4.9, p = 0.03, respectively). In LIHC, lower microbial diversity was associated with poorer overall survival (HR: 2.57, 95% CI: 1.2, 5.5, p = 0.14). Bacterial within-sample diversity correlates with overall survival in infection-associated cancers in a subset of TCGA cohorts.
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Affiliation(s)
- Rebecca M. Rodriguez
- Bioinformatics Core, Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii Mānoa, Honolulu, HI 96813, USA; (R.M.R.); (M.M.)
- Population Sciences in the Pacific Program-Cancer Epidemiology, University of Hawaii Cancer Center, Honolulu, HI 96813, USA;
- National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD 20892, USA
| | - Mark Menor
- Bioinformatics Core, Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii Mānoa, Honolulu, HI 96813, USA; (R.M.R.); (M.M.)
| | - Brenda Y. Hernandez
- Population Sciences in the Pacific Program-Cancer Epidemiology, University of Hawaii Cancer Center, Honolulu, HI 96813, USA;
| | - Youping Deng
- Bioinformatics Core, Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii Mānoa, Honolulu, HI 96813, USA; (R.M.R.); (M.M.)
| | - Vedbar S. Khadka
- Bioinformatics Core, Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii Mānoa, Honolulu, HI 96813, USA; (R.M.R.); (M.M.)
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Kuassi-Kpede AP, Dolou E, Zohoncon TM, Traore IMA, Katawa G, Ouedraogo RA, Traore EM, Bado P, Ouedraogo TC, Djigma FW, Karou SD, Simpore J. Molecular characterization of high-risk human papillomavirus (HR-HPV) in women in Lomé, Togo. BMC Infect Dis 2021; 21:278. [PMID: 33740909 PMCID: PMC7977574 DOI: 10.1186/s12879-021-05956-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/03/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The causative agent of cervical cancer referred to as Human papillomavirus (HPV) remains a real public health problem. Many countries in West Africa, such as Togo have no data on the high-risk HPV (HR-HPV) infection and genotypes distribution. In order to fill the knowledge gap in the field in Togo, the main objective of this study was to determine the prevalence of pre-cancerous lesions of the cervix and HR-HPV genotypes among Togolese women. METHODS Samples were collected from 240 women by introducing a swab in the cervix. Then, the screening of precancerous cervical lesions using the visual inspection with acetic acid and lugol (VIA / VIL) was conducted. The HR-HPV genotypes were characterised by real-time multiplex PCR. RESULTS Out of 240 women recruited, 128 (53.3%) were infected by HR-HPV. The most common genotypes were HPV 56 (22.7%), followed by HPV 51 (20.3%), HPV 31 (19.5%), HPV 52 (18.8%) and HPV 35 (17.2%). The least common genotypes were HPV 33 (2.3%) and HPV 16 (2.3%). Among the women, 1.3% (3/240) were positive to VIA/VIL. CONCLUSION This study allowed HR-HPV genotypes to be characterised for the first time in Lomé, Togo. This will help in mapping the HR-HPV genotypes in West Africa.
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Affiliation(s)
- Akouélé P Kuassi-Kpede
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
| | - Essolakina Dolou
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
| | - Théodora M Zohoncon
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Ina Marie Angèle Traore
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso.
- Pietro Annigoni Biomolecular Research Centre (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso.
| | - Gnatoulma Katawa
- Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA-UL), University of Lomé, Lomé, Togo
| | - R Alice Ouedraogo
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Esther Mah Traore
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Prosper Bado
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - T Clarisse Ouedraogo
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Florencia Wendkuuni Djigma
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
| | - Simplice Damintoti Karou
- Ecole Supérieure des Techniques Biologiques et Alimentaires (ESTBA-UL), University of Lomé, Lomé, Togo
| | - Jacques Simpore
- Molecular Biology and Genetics Laboratory (LABIOGENE), Department of Biochemistry and Microbiology, University JOSEPH KI-ZERBO, P.O. Box 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), P.O. Box 364, Ouagadougou 01, Burkina Faso
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Jarroch R, Tajik B, Tuomainen TP, Kauhanen J. ECONOMIC RECESSION AND THE RISK OF CANCER - A Cohort Study from Eastern Finland. J Epidemiol 2021; 32:384-390. [PMID: 33716271 PMCID: PMC9263616 DOI: 10.2188/jea.je20200595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BackgroundLittle is known about the role of economic recessions in the risk of cancer. Therefore, we evaluated the impact of the severe economic recession in Finland between 1991-1994 on the incidence of all cancers and cancer subtypes among middle-age and older population.MethodsFrom the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), a population-based sample of 1620 women and men aged 53-73 years were examined between 1998-2001. The cancer-free participants completed a questionnaire on the possible impact of the 1990s recession in Finland on their lives. Incident cases of cancer were obtained through record linkage with the Finnish Cancer Registry. Cox proportional hazards regression was used to estimate hazard ratios (HR) of incident cancer events after adjusting for possible confounders.ResultsA total of 1096 cancer-free participants had experienced socioeconomic hardships due to the recession at the baseline. During 20 years of follow-up, 473 participants developed cancer. After adjustment for age, baseline socioeconomic position and lifestyle factors, the risk of all cancers was 32% higher among men who experienced socioeconomic hardships compared to those who did not (HR 1.32, 95%CI, 0.99-1.75, p=0.05). Prostate-genital cancer was 71% higher among men with hardships (n=103, HR=1.71, 95%CI, 1.06-2.74, p=0.02). No association was observed between socioeconomic hardships and subsequent risk of total or any subtype of cancer among women.Conclusions:The 1990s economic recession was associated with increased risk of all cancers, especially prostate-genital cancer among Finnish middle-age and older men, but no association with cancer was observed in women.
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Affiliation(s)
- Rand Jarroch
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition
| | - Behnam Tajik
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition
| | - Tomi-Pekka Tuomainen
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition
| | - Jussi Kauhanen
- University of Eastern Finland, Institute of Public Health and Clinical Nutrition
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Brewster R, Deb S, Pendharkar AV, Ratliff J, Li G, Desai A. The effect of socioeconomic status on age at diagnosis and overall survival in patients with intracranial meningioma. Int J Neurosci 2020; 132:413-420. [PMID: 32878534 DOI: 10.1080/00207454.2020.1818742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Intracranial meningiomas are the most common primary tumors of the central nervous system. How socioeconomic status (SES) impacts treatment access and outcomes for brain tumor subtypes is an emerging area of research. Few studies have examined the relationship between SES and meningioma survival and management with reference to relevant clinical factors, including age at diagnosis. We studied the independent effects of SES on receiving surgery and survival probability in patients with intracranial meningioma. METHODS 54,282 patients diagnosed with intracranial meningioma between 2003 and 2012 from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute database were included. Patient SES was divided into tertiles. Patient age groups included 'older' (>65, the median patient age) and 'younger'. Multivariable linear regression and Cox proportional hazards model were used with SAS v9.4. Results were adjusted for race, sex, and tumor grade. Kaplan-Meier survival curves were constructed according to SES tertiles and age groups. RESULTS Meningioma prevalence increased with higher SES tertile. Higher SES tertile was also associated with younger age at diagnosis (OR = 0.890, p < 0.05), an increased likelihood of undergoing gross total resection (GTR) (OR = 1.112, p < 0.05), and a trend toward greater 5-year survival probability (HR = 1.773, p = 0.0531). Survival probability correlated with younger age at diagnosis (HR = 2.597, p < 0.001), but not with GTR receipt. CONCLUSION The findings from this national longitudinal study on patients with meningioma suggest that SES affects age at diagnosis and treatment access for intracranial meningiomas patients. Further studies are required to understand and address the mechanisms underlying these disparities.
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Affiliation(s)
- Ryan Brewster
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Sayantan Deb
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Arjun Vivek Pendharkar
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - John Ratliff
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Gordon Li
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Atman Desai
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
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Evaluation of cancer-related deaths in Turkey between 2009-2018: An epidemiological study. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.779292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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Shen Y, Risch H, Lu L, Ma X, Irwin ML, Lim JK, Taddei T, Pawlish K, Stroup A, Brown R, Wang Z, Jia W, Wong L, Mayne ST, Yu H. Risk factors for hepatocellular carcinoma (HCC) in the northeast of the United States: results of a case-control study. Cancer Causes Control 2020; 31:321-332. [PMID: 32060838 DOI: 10.1007/s10552-020-01277-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/10/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE HCC incidence has been continuously rising in the US for the past 30 years. To understand the increase in HCC risk, we conducted a case-control study in Connecticut, New Jersey and part of New York City. METHODS Through rapid case ascertainment and random digit dialing, we recruited 673 incident HCC patients and 1,166 controls. Information on demographic and anthropometric characteristics, lifestyle factors, medical and family cancer histories, were ascertained through telephone interviews using a structured questionnaire. Saliva specimens were collected for testing hepatitis C virus (HCV) antibodies. Unconditional logistic regression models were utilized to calculate odds ratio (OR) and 95% confidence interval (CI) to determine HCC associations with risk factors. RESULTS The study confirmed that HCV infection and obesity were important risk factors for HCC, ORs 110 (95% CI 59.2-204) and 2.13 (95% CI 1.52-3.00), respectively. High BMI and HCV infection had synergy in association with elevated HCC risk. Patients both obese and infected with HCV had HCC detected on average nearly 10 years earlier than those with neither factor. Diabetes, cigarette smoking and heavy alcohol intake were all associated with increased risk of HCC, whereas aspirin and other NSAID use were associated with reduced risk. HCC cases tended to attain less education, with lower household incomes, unmarried, and to have had more sexual partners than the controls. CONCLUSIONS Individuals at risk of HCC in the US comprise a unique population with low socioeconomic status and unhealthy lifestyle choices. Given the multifactorial nature, a comprehensive approach is needed in HCC prevention.
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Affiliation(s)
- Yi Shen
- Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Harvey Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Joseph K Lim
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Tamar Taddei
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Karen Pawlish
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ, USA
| | - Antoinette Stroup
- Rutgers Cancer Institute, Rutgers School of Public Health, New Brunswick, NJ, USA
| | - Robert Brown
- Department of Medicine, Weill Cornell Medical College, College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - Zhanwei Wang
- Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Wei Jia
- Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Linda Wong
- Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Susan T Mayne
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, USA
| | - Herbert Yu
- Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
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13
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Dobis EA, Stephens HM, Skidmore M, Goetz SJ. Explaining the spatial variation in American life expectancy. Soc Sci Med 2019; 246:112759. [PMID: 31923836 DOI: 10.1016/j.socscimed.2019.112759] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/30/2019] [Accepted: 12/19/2019] [Indexed: 02/05/2023]
Abstract
Since 1980, average life expectancy in the United States has increased by roughly five years; however, in recent years it has been declining. At the same time, spatial variation in life expectancy has been growing. To explore reasons for this trend, some researchers have focused on morbidity factors, while others have focused on how mortality trends differ by personal characteristics. However, the effect community characteristics may play in expanding the spatial heterogeneity has not yet been fully explored. Using a spatial Durbin error model, we explore how community and demographic factors influence county-level life expectancy in 2014, controlling for life expectancy in 1980 and migration over time, and analyzing men and women separately. We find that community characteristics are important in determining life expectancy and that there may be a role for policy makers in addressing factors that are associated with lower life expectancy in some regions.
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Affiliation(s)
- Elizabeth A Dobis
- Northeast Regional Center for Regional Development, The Pennsylvania State University, University Park, PA, United States.
| | - Heather M Stephens
- Resource Economics and Management, West Virginia University, Morgantown, WV, United States.
| | - Mark Skidmore
- Department of Agricultural, Food, and Resource Economics and North Central Regional Center for Rural Development, Michigan State University, East Lansing, MI, United States.
| | - Stephan J Goetz
- Department of Agricultural Economics, Sociology, and Education and Northeast Regional Center for Regional Development, The Pennsylvania State University, University Park, PA, United States.
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Khan AA, Narejo GB. Analysis of Abdominal Computed Tomography Images for Automatic Liver Cancer Diagnosis Using Image Processing Algorithm. Curr Med Imaging 2019; 15:972-982. [DOI: 10.2174/1573405615666190716122040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/23/2019] [Accepted: 06/13/2019] [Indexed: 01/12/2023]
Abstract
Background:
The application of image processing algorithms for medical image analysis
has been found effectual in the past years. Imaging techniques provide assistance to the radiologists
and physicians for the diagnosis of abnormalities in different organs.
Objective:
The proposed algorithm is designed for automatic computer-aided diagnosis of liver
cancer from low contrast CT images. The idea expressed in this article is to classify the malignancy
of the liver tumor ahead of liver segmentation and to locate HCC burden on the liver.
Methods:
A novel Fuzzy Linguistic Constant (FLC) is designed for image enhancement. To classify
the enhanced liver image as cancerous or non-cancerous, fuzzy membership function is applied.
The extracted features are assessed for malignancy and benignancy using the structural similarity
index. The malignant CT image is further processed for automatic tumor segmentation and grading
by applying morphological image processing techniques.
Results:
The validity of the concept is verified on a dataset of 179 clinical cases which consist of
98 benign and 81 malignant liver tumors. Classification accuracy of 98.3% is achieved by Support
Vector Machine (SVM). The proposed method has the ability to automatically segment the tumor
with an improved detection rate of 78% and a precision value of 0.6.
Conclusion:
The algorithm design offers an efficient tool to the radiologist in classifying the malignant
cases from benign cases. The CAD system allows automatic segmentation of tumor and locates
tumor burden on the liver. The methodology adopted can aid medical practitioners in tumor
diagnosis and surgery planning.
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Affiliation(s)
- Ayesha Adil Khan
- Department of Electronics Engineering, NED University of Engineering & Technology, Karachi, Pakistan
| | - Ghous Bakhsh Narejo
- Department of Electronics Engineering, NED University of Engineering & Technology, Karachi, Pakistan
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15
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Ma J, Siegel RL, Islami F, Jemal A. Temporal trends in liver cancer mortality by educational attainment in the United States, 2000-2015. Cancer 2019; 125:2089-2098. [PMID: 30957228 DOI: 10.1002/cncr.32023] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/10/2019] [Accepted: 01/14/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Liver cancer is the most rapidly rising cause of cancer death in the United States. However, it is unclear whether the mortality trend differs by socioeconomic and/or hepatitis C virus (HCV) infection status. METHODS Joinpoint analyses and Poisson regression modeling were performed to examine trends in death rates from liver cancer by education and HCV infection status among persons aged 25 to 74 years from 2000 to 2015. Disparities in liver cancer mortality were measured as a relative index of inequality by education. RESULTS From 2000 to 2015, the overall liver cancer death rate (per 100,000 persons) increased from 7.5 to 11.2 in men and from 2.8 to 3.8 in women. The increase was generally steeper in less educated groups for women and was confined to persons with ≤15 years of education for men. Consequently, the relative disparity increased until 2006 and then levelled off in women, whereas it continued to increase from 3.49 (95% CI, 3.08-3.97) to 7.74 (95% CI, 7.13-8.40) in men, with the increase more pronounced for HCV-related liver cancer than HCV-unrelated liver cancer. CONCLUSIONS The increases in liver cancer death rates in the United States have largely been confined to less educated persons, especially among men. Enhanced and targeted efforts are needed to halt and reverse the undue growing burden of liver cancer in lower socioeconomic groups.
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Affiliation(s)
- Jiemin Ma
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
| | - Rebecca L Siegel
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
| | - Farhad Islami
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, Georgia
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16
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Salehi F, Ahmadi A, Ahmadi Soodejani SS, Shahini Shams Abadi M. THE CHANGING TREND OF MORTALITY CAUSED BY GASTROINTESTINAL CANCERS IN IRAN DURING THE YEARS 2006-2010. ARQUIVOS DE GASTROENTEROLOGIA 2018; 55:237-241. [PMID: 30540084 DOI: 10.1590/s0004-2803.201800000-60] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/29/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cancers are one of the most important causes of death in the world. According to their high incidence and mortality, gastrointestinal cancers have particular importance among other cancers. OBJECTIVE Therefore, this study was conducted to investigate the mortality change trends of gastrointestinal cancers in Iran. METHODS This study was performed by analyzing the reported mortality data in 29 provinces of Iran in 2006-2010. Mortality trend of gastrointestinal cancers was drawn for both sexes in the study years and disaggregated by age groups and their frequency distribution. The WinPepi software was used for analysis. RESULTS In the years 2006-2010, the mortality rate of, gastric, colorectal, liver and pancreatic cancers, has significantly increased. Totally, gastrointestinal mortality is higher in men than women. Also, the results showed that by increasing age, death from these cancers also increased. CONCLUSION The most important causes of death from gastrointestinal cancers were gastric, liver and colorectal cancers in Iran and because of their increasing trend in the country, performing preventive interventions for the cancers' risk factors is necessary.
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Affiliation(s)
- Fatemeh Salehi
- Shahrekord University of Medical Sciences, Modeling in Health Research Center, Shahrekord, Iran
| | - Ali Ahmadi
- Shahrekord University of Medical Sciences, Modeling in Health Research Center, Shahrekord, Iran.,Shahrekord University of Medical Sciences, Department of Epidemiology and Biostatistics, Shahrekord, Iran
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Singh GK, Jemal A. Socioeconomic and Racial/Ethnic Disparities in Cancer Mortality, Incidence, and Survival in the United States, 1950-2014: Over Six Decades of Changing Patterns and Widening Inequalities. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2017; 2017:2819372. [PMID: 28408935 PMCID: PMC5376950 DOI: 10.1155/2017/2819372] [Citation(s) in RCA: 465] [Impact Index Per Article: 66.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/27/2017] [Indexed: 11/17/2022]
Abstract
We analyzed socioeconomic and racial/ethnic disparities in US mortality, incidence, and survival rates from all-cancers combined and major cancers from 1950 to 2014. Census-based deprivation indices were linked to national mortality and cancer data for area-based socioeconomic patterns in mortality, incidence, and survival. The National Longitudinal Mortality Study was used to analyze individual-level socioeconomic and racial/ethnic patterns in mortality. Rates, risk-ratios, least squares, log-linear, and Cox regression were used to examine trends and differentials. Socioeconomic patterns in all-cancer, lung, and colorectal cancer mortality changed dramatically over time. Individuals in more deprived areas or lower education and income groups had higher mortality and incidence rates than their more affluent counterparts, with excess risk being particularly marked for lung, colorectal, cervical, stomach, and liver cancer. Education and income inequalities in mortality from all-cancers, lung, prostate, and cervical cancer increased during 1979-2011. Socioeconomic inequalities in cancer mortality widened as mortality in lower socioeconomic groups/areas declined more slowly. Mortality was higher among Blacks and lower among Asian/Pacific Islanders and Hispanics than Whites. Cancer patient survival was significantly lower in more deprived neighborhoods and among most ethnic-minority groups. Cancer mortality and incidence disparities may reflect inequalities in smoking, obesity, physical inactivity, diet, alcohol use, screening, and treatment.
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Affiliation(s)
- Gopal K. Singh
- US Department of Health and Human Services, Office of Health Equity, Health Resources and Services Administration, 5600 Fishers Lane, Room 13N42, Rockville, MD 20857, USA
| | - Ahmedin Jemal
- American Cancer Society, Inc., Surveillance & Health Services Research, 250 Williams Street NW, Corporate Center, Atlanta, GA 30303, USA
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18
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Gomez SL, Canchola AJ, Nelson DO, Keegan THM, Clarke CA, Cheng I, Shariff-Marco S, DeRouen M, Catalano R, Satariano WA, Davidson-Allen K, Glaser SL. Recent declines in cancer incidence: related to the Great Recession? Cancer Causes Control 2017; 28:145-154. [PMID: 28130633 DOI: 10.1007/s10552-016-0846-y] [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: 05/09/2016] [Accepted: 12/22/2016] [Indexed: 01/03/2023]
Abstract
PURPOSE In recent years, cancer case counts in the U.S. underwent a large, rapid decline-an unexpected change given population growth for older persons at highest cancer risk. As these declines coincided with the Great Recession, we examined whether they were related to economic conditions. METHODS Using California Cancer Registry data from California's 30 most populous counties, we analyzed trends in cancer incidence during pre-recession (1996-2007) and recession/recovery (2008-2012) periods for all cancers combined and the ten most common sites. We evaluated the recession's association with rates using a multifactorial index that measured recession impact, and modeled associations between case counts and county-level unemployment rates using Poisson regression. RESULTS Yearly cancer incidence rate declines were greater during the recession/recovery (3.3% among males, 1.4% among females) than before (0.7 and 0.5%, respectively), particularly for prostate, lung, and colorectal cancers. Lower case counts, especially for prostate and liver cancer among males and breast cancer, melanoma, and ovarian cancer among females, were associated with higher unemployment rates, irrespective of time period, but independent of secular effects. The associations for melanoma translated up to a 3.6% decrease in cases with each 1% increase in unemployment. Incidence declines were not greater in counties with higher recession impact index. CONCLUSIONS Although recent declines in incidence of certain cancers are not differentially impacted by economic conditions related to the Great Recession relative to pre-recession conditions, the large recent absolute declines in the case counts of some cancer may be attributable to the large declines in unemployment in the recessionary period. This may occur through decreased engagement in preventive health behaviors, particularly for clinically less urgent cancers. Continued monitoring of trends is important to detect any rises in incidence rates as deferred diagnoses come to clinical attention.
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Affiliation(s)
- Scarlett Lin Gomez
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA. .,Department of Health Research & Policy (Epidemiology), School of Medicine, Stanford, CA, USA. .,Stanford Cancer Institute, Stanford, USA.
| | - Alison J Canchola
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA
| | - David O Nelson
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA.,Department of Health Research & Policy (Epidemiology), School of Medicine, Stanford, CA, USA.,Stanford Cancer Institute, Stanford, USA
| | - Theresa H M Keegan
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Christina A Clarke
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA.,Department of Health Research & Policy (Epidemiology), School of Medicine, Stanford, CA, USA.,Stanford Cancer Institute, Stanford, USA
| | - Iona Cheng
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA.,Stanford Cancer Institute, Stanford, USA
| | - Salma Shariff-Marco
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA.,Department of Health Research & Policy (Epidemiology), School of Medicine, Stanford, CA, USA.,Stanford Cancer Institute, Stanford, USA
| | - Mindy DeRouen
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley, CA, USA
| | | | - Kathleen Davidson-Allen
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA
| | - Sally L Glaser
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94536, USA.,Department of Health Research & Policy (Epidemiology), School of Medicine, Stanford, CA, USA.,Stanford Cancer Institute, Stanford, USA
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19
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Antunes JLF. The impact of unemployment on cancer mortality, and how to avoid it. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:404. [PMID: 27867956 DOI: 10.21037/atm.2016.08.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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20
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Maruthappu M, Watkins J, Noor AM, Williams C, Ali R, Sullivan R, Zeltner T, Atun R. Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries, 1990-2010: a longitudinal analysis. Lancet 2016; 388:684-95. [PMID: 27236345 DOI: 10.1016/s0140-6736(16)00577-8] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care (PEH). We estimated the effects of changes in unemployment and PEH on cancer mortality, and identified how universal health coverage (UHC) affected these relationships. METHODS For this longitudinal analysis, we obtained data from the World Bank and WHO (1990-2010). We aggregated mortality data for breast cancer in women, prostate cancer in men, and colorectal cancers in men and women, which are associated with survival rates that exceed 50%, into a treatable cancer class. We likewise aggregated data for lung and pancreatic cancers, which have 5 year survival rates of less than 10%, into an untreatable cancer class. We used multivariable regression analysis, controlling for country-specific demographics and infrastructure, with time-lag analyses and robustness checks to investigate the relationship between unemployment, PEH, and cancer mortality, with and without UHC. We used trend analysis to project mortality rates, on the basis of trends before the sharp unemployment rise that occurred in many countries from 2008 to 2010, and compared them with observed rates. RESULTS Data were available for 75 countries, representing 2.106 billion people, for the unemployment analysis and for 79 countries, representing 2.156 billion people, for the PEH analysis. Unemployment rises were significantly associated with an increase in all-cancer mortality and all specific cancers except lung cancer in women. By contrast, untreatable cancer mortality was not significantly linked with changes in unemployment. Lag analyses showed significant associations remained 5 years after unemployment increases for the treatable cancer class. Rerunning analyses, while accounting for UHC status, removed the significant associations. All-cancer, treatable cancer, and specific cancer mortalities significantly decreased as PEH increased. Time-series analysis provided an estimate of more than 40,000 excess deaths due to a subset of treatable cancers from 2008 to 2010, on the basis of 2000-07 trends. Most of these deaths were in non-UHC countries. INTERPRETATION Unemployment increases are associated with rises in cancer mortality; UHC seems to protect against this effect. PEH increases are associated with reduced cancer mortality. Access to health care could underlie these associations. We estimate that the 2008-10 economic crisis was associated with about 260,000 excess cancer-related deaths in the Organisation for Economic Co-operation and Development alone. FUNDING None.
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Affiliation(s)
| | - Johnathan Watkins
- Institute for Mathematical & Molecular Biomedicine, King's College London, London, UK; Department of Research Oncology, King's College London, London, UK; PILAR Research and Education, Cambridge, UK
| | - Aisyah Mohd Noor
- Department of Research Oncology, King's College London, London, UK
| | | | - Raghib Ali
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK; Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Richard Sullivan
- Kings Health Partners, Integrated Cancer Centre, Guy's Hospital Campus, King's College London, London, UK
| | - Thomas Zeltner
- World Health Organization, Geneva, Switzerland; University of Bern, Bern, Switzerland
| | - Rifat Atun
- Harvard School of Public Health, Harvard University, Boston, MA, USA
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Singh GK, Siahpush M. Inequalities in US Life Expectancy by Area Unemployment Level, 1990-2010. SCIENTIFICA 2016; 2016:8290435. [PMID: 27073716 PMCID: PMC4814707 DOI: 10.1155/2016/8290435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 02/29/2016] [Indexed: 06/05/2023]
Abstract
This study examined the association between unemployment and life expectancy in the United States during 1990-2010. Census-based unemployment rates were linked to US county-level mortality data. Life expectancies were calculated by age, sex, race, and unemployment level during 1990-2010. Differences in life expectancy were decomposed by age and cause of death. Life expectancy was consistently lower in areas with higher unemployment rates. In 2006-2010, those in areas with high unemployment rates (≥9%) had a life expectancy of 76.9 years, compared with 80.7 years for those in areas with low unemployment rates (<3%). The association between unemployment and life expectancy was stronger for men than for women. Life expectancy ranged from 69.9 years among black men in high unemployment areas to 90.0 years among Asian/Pacific Islander women in low unemployment areas. Disparities persisted over time. In 1990-1992, life expectancy was 4.7 years shorter in high unemployment than in low unemployment areas. In 2006-2010, the life expectancy difference between the lowest and highest unemployment areas decreased to 3.8 years. Heart disease, cancer, homicide, unintentional injuries, diabetes, HIV/AIDS, and liver cirrhosis contributed most to the lower life expectancy in high unemployment areas. High unemployment areas recorded larger gains in life expectancy than low unemployment areas, contributing to the narrowing gap during 1990-2010.
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Affiliation(s)
- Gopal K. Singh
- US Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD 20857, USA
| | - Mohammad Siahpush
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE 68198-4365, USA
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Rau HH, Hsu CY, Lin YA, Atique S, Fuad A, Wei LM, Hsu MH. Development of a web-based liver cancer prediction model for type II diabetes patients by using an artificial neural network. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 125:58-65. [PMID: 26701199 DOI: 10.1016/j.cmpb.2015.11.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 11/02/2015] [Accepted: 11/12/2015] [Indexed: 05/27/2023]
Abstract
BACKGROUND Diabetes mellitus is associated with an increased risk of liver cancer, and these two diseases are among the most common and important causes of morbidity and mortality in Taiwan. PURPOSE To use data mining techniques to develop a model for predicting the development of liver cancer within 6 years of diagnosis with type II diabetes. METHODS Data were obtained from the National Health Insurance Research Database (NHIRD) of Taiwan, which covers approximately 22 million people. In this study, we selected patients who were newly diagnosed with type II diabetes during the 2000-2003 periods, with no prior cancer diagnosis. We then used encrypted personal ID to perform data linkage with the cancer registry database to identify whether these patients were diagnosed with liver cancer. Finally, we identified 2060 cases and assigned them to a case group (patients diagnosed with liver cancer after diabetes) and a control group (patients with diabetes but no liver cancer). The risk factors were identified from the literature review and physicians' suggestion, then, chi-square test was conducted on each independent variable (or potential risk factor) for a comparison between patients with liver cancer and those without, those found to be significant were selected as the factors. We subsequently performed data training and testing to construct artificial neural network (ANN) and logistic regression (LR) prediction models. The dataset was randomly divided into 2 groups: a training group and a test group. The training group consisted of 1442 cases (70% of the entire dataset), and the prediction model was developed on the basis of the training group. The remaining 30% (618 cases) were assigned to the test group for model validation. RESULTS The following 10 variables were used to develop the ANN and LR models: sex, age, alcoholic cirrhosis, nonalcoholic cirrhosis, alcoholic hepatitis, viral hepatitis, other types of chronic hepatitis, alcoholic fatty liver disease, other types of fatty liver disease, and hyperlipidemia. The performance of the ANN was superior to that of LR, according to the sensitivity (0.757), specificity (0.755), and the area under the receiver operating characteristic curve (0.873). After developing the optimal prediction model, we base on this model to construct a web-based application system for liver cancer prediction, which can provide support to physicians during consults with diabetes patients. CONCLUSION In the original dataset (n=2060), 33% of diabetes patients were diagnosed with liver cancer (n=515). After using 70% of the original data to training the model and other 30% for testing, the sensitivity and specificity of our model were 0.757 and 0.755, respectively; this means that 75.7% of diabetes patients can be predicted correctly to receive a future liver cancer diagnosis, and 75.5% can be predicted correctly to not be diagnosed with liver cancer. These results reveal that this model can be used as effective predictors of liver cancer for diabetes patients, after discussion with physicians; they also agreed that model can assist physicians to advise potential liver cancer patients and also helpful to decrease the future cost incurred upon cancer treatment.
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Affiliation(s)
- Hsiao-Hsien Rau
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taiwan
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Science, Taiwan; Master Program in Global Health and Development, Taipei Medical University, Taipei, Taiwan.
| | - Yu-An Lin
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taiwan
| | - Suleman Atique
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taiwan
| | - Anis Fuad
- Graduate Institute of Biomedical Informatics, Taipei Medical University, Taiwan
| | - Li-Ming Wei
- Department of Information Management, National Taipei University of Nursing and Health Science, Taiwan
| | - Ming-Huei Hsu
- Department of Information Management, Ministry of Health and Welfare and Taipei Medical University, Taiwan.
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Pavarin RM, Caputo F, Zoli G, Domenicali M, Bernardi M, Gambini D. Mortality risk in a cohort of Italian alcoholic individuals treated for alcohol dependence. Drug Alcohol Rev 2015; 36:186-191. [PMID: 26643015 DOI: 10.1111/dar.12366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/21/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS The aim of this study was to investigate the mortality risk and to explore the presence of subjects more at risk of dying in a cohort of alcoholic individuals treated for alcohol dependence over a lengthy follow-up period. DESIGN AND METHODS A total of 2363 subjects attending 10 centres for addiction treatment for alcohol dependence were recruited. RESULTS During the 17 year follow-up period, 14.7% of the entire cohort died. Total standardised mortality rates (SMR) were higher in women (SMR = 5.94) as compared with men (SMR = 4.65). Higher SMRs were found for several diseases, for traumatic episodes (SMR = 6.65) and in younger patients (18-44 age group) (SMR = 8.16). Alcoholic women showed a higher survival rate as compared with men. In addition, a higher risk of death for men and unemployed subjects, with a progressive increase of risk in line with the increase of the age of admission to treatment, and with a progressive decrease of risk after 1 year from the beginning of the treatment, was also found. DISCUSSION AND CONCLUSIONS This study confirms that mortality risk in alcoholic individuals in treatment is higher in comparison with the general population. Moreover, alcoholics men, unemployed, >40 years at time of admission and during the first year of treatment are more at risk to die. Thus, much more attention to patients with these characteristics should be planned by the professional staff working in centres for addiction treatment. [ Pavarin R M, Caputo F, Zoli G, Domenicali M, Bernardi M, Gambini D. Mortality risk in a cohort of Italian alcoholic individuals treated for alcohol dependence Drug Alcohol Rev 2017;36:186-191].
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Affiliation(s)
| | - Fabio Caputo
- Department of Internal Medicine, SS Annunziata Hospital, Cento, Ferrara, Italy.,Department of Medical and Surgical Sciences, 'G. Fontana' Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, University of Bologna, Bologna, Italy
| | - Giorgio Zoli
- Department of Internal Medicine, SS Annunziata Hospital, Cento, Ferrara, Italy
| | - Marco Domenicali
- Department of Medical and Surgical Sciences, 'G. Fontana' Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, University of Bologna, Bologna, Italy
| | - Mauro Bernardi
- Department of Medical and Surgical Sciences, 'G. Fontana' Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, University of Bologna, Bologna, Italy
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Thapa B, Kumar P, Zeng H, Narain R. Asialoglycoprotein Receptor-Mediated Gene Delivery to Hepatocytes Using Galactosylated Polymers. Biomacromolecules 2015; 16:3008-20. [PMID: 26258607 DOI: 10.1021/acs.biomac.5b00906] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Highly efficient, specific, and nontoxic gene delivery vector is required for gene therapy to the liver. Hepatocytes exclusively express asialoglycoprotein receptor (ASGPR), which can recognize and bind to galactose or N-acetylgalactosamine. Galactosylated polymers are therefore explored for targeted gene delivery to the liver. A library of safe and stable galactose-based glycopolymers that can specifically deliver genes to hepatocytes were synthesized having different architectures, compositions, and molecular weights via the reversible addition-fragmentation chain transfer process. The physical and chemical properties of these polymers have a great impact on gene delivery efficacy into hepatocytes, as such block copolymers are found to form more stable complexes with plasmid and have high gene delivery efficiency into ASGPR expressing hepatocytes. Transfection efficiency and uptake of polyplexes with these polymers decreased significantly by preincubation of hepatocytes with free asialofetuin or by adding free asialofetuin together with polyplexes into hepatocytes. The results confirmed that polyplexes with these polymers were taken up specifically by hepatocytes via ASGPR-mediated endocytosis. The results from transfection efficiency and uptake of these polymers in cells without ASGPR, such as SK Hep1 and HeLa cells, further support this mechanism. Since in vitro cytotoxicity assays prove these glycopolymers to be nontoxic, they may be useful for delivery of clinically important genes specifically to the liver.
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Affiliation(s)
- Bindu Thapa
- Department of Chemical and Materials Engineering, University of Alberta , 116 Street and 85 Avenue, Edmonton, AB T6G 2G6, Canada
| | - Piyush Kumar
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta , Edmonton, AB Canada
| | - Hongbo Zeng
- Department of Chemical and Materials Engineering, University of Alberta , 116 Street and 85 Avenue, Edmonton, AB T6G 2G6, Canada
| | - Ravin Narain
- Department of Chemical and Materials Engineering, University of Alberta , 116 Street and 85 Avenue, Edmonton, AB T6G 2G6, Canada
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Ennis KY, Chen MH, Smith GC, D'Amico AV, Zhang Y, Quinn SA, Ryemon SN, Goltz D, Harrison LB, Ennis RD. The Impact of Economic Recession on the Incidence and Treatment of Cancer. J Cancer 2015; 6:727-33. [PMID: 26185534 PMCID: PMC4504108 DOI: 10.7150/jca.11886] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/04/2015] [Indexed: 12/02/2022] Open
Abstract
PURPOSE The impact of economic recessions on the incidence and treatment of cancer is unknown. We test the hypothesis that cancer incidence and treatment rates decrease during a recession, and that this relationship is more pronounced in cancers that present with mild, more easily ignored symptoms. METHODS AND MATERIALS Data on incidence and treatment for all cancers, and breast and pancreatic cancers specifically, from 1973-2008, were collected using Surveillance Epidemiology and End RESULTS (SEER). The data was adjusted for race, income, and education. Unemployment rate was used as the measure of economic recession. Data was log-transformed, and multivariate linear mixed regression was used. RESULTS Adjusting for socioeconomic factors, the data revealed a significant inverse correlation between unemployment and rates of cancer incidence and treatment. Every 1% increase in unemployment was associated with a 2.2% (95% CI: 1.6-2.8%, p<0.001) reduction in cancer incidence, a 2.0% (1.2-2.8%, p=0.0157) decrease in surgery, and a 9.1% (8.2-10.0% p<0.001) decrease in radiation therapy (RT). Breast cancer incidence and treatment had a dramatic inverse relationship - 7.2% (6.3-8.1%), 6.7% (5.7-7.6%), and 19.0% (18.1-19.8%), respectively (p<0.001 for all). The decrease in incidence was only significant for in situ and localized tumors, but not in regional or distant breast cancer. Compared to breast cancer, pancreatic cancer had a weaker relationship between unemployment and incidence: 2.6% (1.8-3.3%, p=0.0005), surgery: 2.4% (2.0-2.7%, p<0.001), and RT: 1.9% (1.5-2.2% p<0.001). CONCLUSIONS Increasing unemployment rates are associated with a decrease in the incidence and treatment of all cancers. This effect is exaggerated in breast cancer, where symptoms can more easily be ignored and where there are widely used screening tests relative to pancreatic cancer.
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Affiliation(s)
| | - Ming-Hui Chen
- 2. Department of Statistics, University of Connecticut
| | | | - Anthony V. D'Amico
- 3. Brigham and Women's Hospital, Dana Farber Cancer Institute, Harvard Medical School
| | | | - S. Aidan Quinn
- 5. Department of Pathology and Cell Biology, Columbia University
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Fu WJ. Racial-Sex Disparities--A Challenging Battle Against Cancer Mortality in the USA. J Racial Ethn Health Disparities 2014; 2:158-66. [PMID: 26863334 DOI: 10.1007/s40615-014-0059-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 08/12/2014] [Accepted: 09/04/2014] [Indexed: 01/05/2023]
Abstract
Decline in US cancer mortality has recently been reported, based on either pooled mortality of all cancer sites or age-adjusted mortality rates of specific sites. While the former could be dominated by a few cancer sites and would not reflect that of other sites, the latter used the US 2000 Population as reference for age-standardization, which was lack of justification. This study aimed to examine US cancer mortality trend and disparities in sites, races, and sex. We studied cancer incidence-based mortality by race and sex from 1974 to 2008 of cervix, prostate, colon and rectum, lung, leukemia, liver, pancreas, and stomach in the Surveillance, Epidemiology, and End Results database. We developed a model-based mortality rate and examined rate ratio of each calendar period to the first period within each race-sex group. Cancer mortality of cervix, colon and rectum, leukemia, and stomach declined in all groups. Prostate cancer increased first in all racial groups and decreased thereafter at different pace. Lung cancer declined among males of all races but increased among females. Liver cancer increased steadily fast among white and black females, doubled in whites and black males, and climbed slowly in other races. Pancreas cancer declined among black males and females, and changed little among others. Cancer mortality trend presents heterogeneity across sites, races, and sex. Recently observed mortality decline may not reflect every cancer site or group. More effort needs to focus on specific race-sex groups that had increasing lung and liver cancer mortality.
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Affiliation(s)
- Wenjiang J Fu
- Department of Epidemiology and Biostatistics, Michigan State University, 909 Fee Road, West Fee Hall, Suite B601, East Lansing, MI, 48824, USA.
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