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Chen YH, Chen YW, Chang DC, Oseni TO. Disparities in timely surgery among Asian American women with breast cancer. Am J Surg 2024:115928. [PMID: 39237393 DOI: 10.1016/j.amjsurg.2024.115928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 08/14/2024] [Accepted: 08/21/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND We investigated the likelihood of timely surgery for breast cancer patients among diverse Asian subgroups. METHODS We analyzed the National Cancer Database from 2010 to 2019 and included White and Asian women diagnosed with stage I-III breast cancer. Patients with multiple cancers, patients who received chemotherapy, and those diagnosed and treated at different hospitals were excluded. The primary outcome was timely surgery within 8 weeks of diagnosis. Race was the primary independent variable. Asian Americans were stratified by geography. RESULTS A total of 716,701 women were analyzed, with 3.5% Asians. Delayed surgery was experienced by 13.2% of women. Adjusted analysis indicated no difference in receiving timely surgery between all Asians and Whites. However, Southeast Asians were less likely to undergo timely surgery compared to Whites (OR 0.75, 95% CI 0.67-0.84). CONCLUSIONS Variations among Asian ethnicities emphasize the need to explore treatment patterns to address disparities in breast cancer care.
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Affiliation(s)
- Yuan-Hsin Chen
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA; Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St, Suite 403, Boston, MA, 02114, USA
| | - Ya-Wen Chen
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA; Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St, Suite 403, Boston, MA, 02114, USA
| | - David C Chang
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA; Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St, Suite 403, Boston, MA, 02114, USA.
| | - Tawakalitu O Oseni
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA
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Hammad R, Nobre L, Ryall S, Arnoldo A, Siddaway R, Bennett J, Tabori U, Hawkins C. The Clinical Utility of a Tiered Approach to Pediatric Glioma Molecular Characterization for Resource-Limited Settings. JCO Glob Oncol 2024; 10:e2300269. [PMID: 38754050 DOI: 10.1200/go.23.00269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/09/2024] [Accepted: 02/23/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE Molecular characterization is key to optimally diagnose and manage cancer. The complexity and cost of routine genomic analysis have unfortunately limited its use and denied many patients access to precision medicine. A possible solution is to rationalize use-creating a tiered approach to testing which uses inexpensive techniques for most patients and limits expensive testing to patients with the highest needs. Here, we tested the utility of this approach to molecularly characterize pediatric glioma in a cost- and time-sensitive manner. METHODS We used a tiered testing pipeline of immunohistochemistry (IHC), customized fusion panels or fluorescence in situ hybridization (FISH), and targeted RNA sequencing in pediatric gliomas. Two distinct diagnostic algorithms were used for low- and high-grade gliomas (LGGs and HGGs). The percentage of driver alterations identified, associated testing costs, and turnaround time (TAT) are reported. RESULTS The tiered approach successfully characterized 96% (95 of 99) of gliomas. For 82 LGGs, IHC, targeted fusion panel or FISH, and targeted RNA sequencing solved 35% (29 of 82), 29% (24 of 82), and 30% (25 of 82) of cases, respectively. A total of 64% (53 of 82) of samples were characterized without targeted RNA sequencing. Of 17 HGG samples, 13 were characterized by IHC and four were characterized by targeted RNA sequencing. The average cost per sample was more affordable when using the tiered approach as compared with up-front targeted RNA sequencing in LGG ($405 US dollars [USD] v $745 USD) and HGGs ($282 USD v $745 USD). The average TAT per sample was also shorter using the tiered approach (10 days for LGG, 5 days for HGG v 14 days for targeted RNA sequencing). CONCLUSION Our tiered approach molecularly characterized 96% of samples in a cost- and time-sensitive manner. Such an approach may be feasible in neuro-oncology centers worldwide, particularly in resource-limited settings.
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Affiliation(s)
- Rawan Hammad
- Haematology Department, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
- Division of Pediatric Haematology Oncology, The Hospital for Sick Children, Toronto, Canada
| | - Liana Nobre
- Division of Pediatric Haematology Oncology, The Hospital for Sick Children, Toronto, Canada
- Division of Hematology, Oncology and Palliative Care, Department of Pediatrics, University of Alberta & Stollery Children's Hospital, Edmonton, Canada
| | - Scott Ryall
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
| | - Anthony Arnoldo
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Robert Siddaway
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
| | - Julie Bennett
- Division of Pediatric Haematology Oncology, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Uri Tabori
- Division of Pediatric Haematology Oncology, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Cynthia Hawkins
- Division of Pathology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- The Hospital for Sick Children, Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
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Feliciano EJG, Ho FDV, Yee K, Paguio JA, Eala MAB, Robredo JPG, Ng K, Lim J, Pyone KT, Peralta CA, Flores JA, Yao JS, Santos PMG, Ang CDU, Lasco G, Chan JSK, Tse G, Tangco ED, Kingham TP, Chitapanarux I, Bhoo-Pathy N, Legaspi GD, Dee EC. Cancer disparities in Southeast Asia: intersectionality and a call to action. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100971. [PMID: 38053740 PMCID: PMC10694578 DOI: 10.1016/j.lanwpc.2023.100971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/27/2023] [Accepted: 11/05/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Erin Jay G. Feliciano
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
- Department of Medicine, NYC H+H/Elmhurst, Icahn School of Medicine at Mt. Sinai, Queens, NY, USA
| | | | - Kaisin Yee
- SingHealth Duke-NUS Global Health Institute, Singapore, Singapore
| | - Joseph A. Paguio
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Michelle Ann B. Eala
- University of the Philippines College of Medicine, Manila, Philippines
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Janine Patricia G. Robredo
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
| | - Kenrick Ng
- Department of Medical Oncology, St Bartholomew’s Hospital, Bart’s Health NHS Trust, London, UK
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khin Thuzar Pyone
- Radiation Oncology Department, Yangon General Hospital Yangon, Myanmar
| | | | | | - J. Seth Yao
- Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Patricia Mae G. Santos
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christian Daniel U. Ang
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | - Gideon Lasco
- Development Studies Program, Ateneo de Manila University, Quezon City, Philippines
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | | | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
- Kent and Medway Medical School, Canterbury, UK
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Enrico D. Tangco
- Department of Radiation Oncology, The Medical City, Pasig City, Philippines
| | - T. Peter Kingham
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Imjai Chitapanarux
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence Based Practice, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Gerardo D. Legaspi
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines Manila, Philippine General Hospital, Metro Manila, Philippines
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Dee EC, Eala MAB, Robredo JPG, Ramiah D, Hubbard A, Ho FDV, Sullivan R, Aggarwal A, Booth CM, Legaspi GD, Nguyen PL, Pramesh CS, Grover S. Leveraging national and global political determinants of health to promote equity in cancer care. J Natl Cancer Inst 2023; 115:1157-1163. [PMID: 37402623 PMCID: PMC10560599 DOI: 10.1093/jnci/djad123] [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: 03/03/2023] [Revised: 05/26/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023] Open
Abstract
Health and politics are deeply intertwined. In the context of national and global cancer care delivery, political forces-the political determinants of health-influence every level of the cancer care continuum. We explore the "3-I" framework, which structures the upstream political forces that affect policy choices in the context of actors' interests, ideas, and institutions, to examine how political determinants of health underlie cancer disparities. Borrowing from the work of PA Hall, M-P Pomey, CJ Ho, and other thinkers, interests are the agendas of individuals and groups in power. Ideas represent beliefs or knowledge about what is or what should be. Institutions define the rules of play. We provide examples from around the world: Political interests have helped fuel the establishment of cancer centers in India and have galvanized the 2022 Cancer Moonshot in the United States. The politics of ideas underlie global disparities in cancer clinical trials-that is, in the distribution of epistemic power. Finally, historical institutions have helped perpetuate disparities related to racist and colonialist legacies. Present institutions have also been used to improve access for those in greatest need, as exemplified by the Butaro Cancer Center of Excellence in Rwanda. In providing these global examples, we demonstrate how interests, ideas, and institutions influence access to cancer care across the breadth of the cancer continuum. We argue that these forces can be leveraged to promote cancer care equity nationally and globally.
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Affiliation(s)
- Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Michelle Ann B Eala
- College of Medicine, University of the Philippines, Manila, Philippines
- Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Janine Patricia G Robredo
- School of Medicine and Public Health, Ateneo de Manila University, Pasig City, Philippines
- Blavatnik Institute of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Duvern Ramiah
- Division of Radiation Oncology, University of the Witwatersrand, Johannesburg and Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Anne Hubbard
- American Society for Radiation Oncology, Arlington, VA, USA
| | | | - Richard Sullivan
- Kings Health Partners Comprehensive Cancer Centre, King's College London, Institute of Cancer Policy, London, UK
| | - Ajay Aggarwal
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Clinical Effectiveness Unit, Institute of Cancer Policy, King’s College London, London, UK
| | - Christopher M Booth
- Department of Oncology, Queen’s University, Kingston, ON, Canada
- Cancer Care and Epidemiology, Cancer Research Institute, Queen’s University, Kingston, ON, Canada
| | - Gerardo D Legaspi
- Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA, USA
| | - C S Pramesh
- Tata Memorial Hospital, Thoracic Surgery (Surgical Oncology) at Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Surbhi Grover
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
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Aldayyeni H, Hjazi A, Shahab S, Gupta J, Alsaab HO, Motea YH, Alazbjee AAA, Romero-Parra RM, Obaid RF, Hussien BM, Hosseini-Fard SR. Functions, mechanisms, and clinical applications of lncRNA LINC00857 in cancer pathogenesis. Hum Cell 2023; 36:1656-1671. [PMID: 37378889 DOI: 10.1007/s13577-023-00936-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Emerging data indicated that long noncoding RNAs (lncRNAs) are crucial players in the biological processes via regulating epigenetics, transcription, and protein translation. A novel lncRNA, LINC00857, was indicated to upregulate in several types of cancer. In addition, LINC00857 was functionally related to the modulation of the cancer-linked behaviors, including invasion, migration, proliferation, epithelial-mesenchymal transition (EMT), cell cycle, and apoptosis. The importance of LINC00857 in cancer onset and development proposed that LINC00857 has major importance in the cancer progression and may be considered as a novel prognostic/diagnostic biomarker as well as a treatment target. Here, we retrospectively investigate the available progress in biomedical research investigating the functions of LINC00857 in cancer, focusing on finding the molecular mechanisms affecting various cancer-related behaviors and exploring its clinical applications.
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Affiliation(s)
| | - Ahmed Hjazi
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Sana Shahab
- Department of Business Administration, College of Business Administration, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
| | - Jitendra Gupta
- Institute of Pharmaceutical Research, GLA University, Mathura, Uttar Pradesh, 281406, India
| | - Hashem O Alsaab
- Department of Pharmaceutics and Pharmaceutical Technology, Taif University, Taif, 21944, Saudi Arabia
| | | | | | | | - Rasha Fadhel Obaid
- Department of Biomedical Engineering, Al-Mustaqbal University College, Babylon, Iraq
| | - Beneen M Hussien
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | - Seyed Reza Hosseini-Fard
- Department of Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Feng Y, Maimaitiming M, Shi J, Wang M, Li N, Jin Y, Zheng ZJ. Inequity of maternal-child health services in ASEAN member states from 1993 to 2021. Int J Equity Health 2023; 22:149. [PMID: 37550702 PMCID: PMC10408145 DOI: 10.1186/s12939-023-01974-8] [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: 05/18/2023] [Accepted: 07/24/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Inequity in maternal-child health services is a challenge to global health as it hinders the achievement of Sustainable Development Goals (SDGs) and Universal Health Coverage. Though the Association of Southeast Asian Nations (ASEAN) has made remarkable achievements in maternal-child health, there remain gaps in reaching global goals. This study aimed to compare and investigate the inequity in maternal-child health (MCH) services in ASEAN member states to help guide policy decisions to improve equitable health services in the SDG era and beyond. METHODS Using the WHO Health Inequality Monitor, we identified inequity summary measures for five MCH services in ASEAN member states from 1993 to 2021: antenatal care, births attended by skilled health personnel, diphtheria, tetanus and pertussis (DTP3) immunization, measles immunization, and polio immunization. We divided the analysis dimension of inequity into urban-rural inequity, economic status inequity, and sub-regional inequity. Trends of absolute and relative inequity in every dimension of MCH services in ASEAN member states were examined with the principal component analysis (PCA). RESULTS The mean coverages of MCH services are 98.80% (Thailand), 86.72% (Cambodia), 84.54% (Viet Nam), 78.52 (Indonesia), 76.94% (Timor-Leste), 72.40% (Lao PDR), 68.10% (Philippines) and 48.52% (Myanmar) in 2021. Thailand have the lowest MCH services absolute inequity indexes of -1.945, followed by Vietnam (-1.449). Lao PDR and Myanmar have relatively higher MCH services absolute inequity indexes of 0.852 and 0.054 respectively. The service in Cambodia, Indonesia, and the Philippines is pro-specific regions (with subnational region absolute inequity indexes of -0.02, 0.01, and 1.01 respectively). The service in Myanmar is pro-rich (with economic status absolute inequity index of 0.43). The service in Lao PDR and Timor-Leste is pro-urban areas, pro-rich, and pro-specific regions. CONCLUSION The inequity of MCH services in ASEAN persists but is in a declining trend. Thailand and Vietnam have performed well in ensuring MCH services equity, while Laos and Myanmar are still facing serious inequity dilemmas. The progress of MCH service equity in Myanmar, Cambodia, the Philippines, and Indonesia is uneven. It is acceptable to learn from the successful experiences of Thailand and Vietnam to improve the equities in other ASEAN countries. Policies should be developed according to the specific types of MCH inequity in member states to improve equity levels.
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Affiliation(s)
- Yikai Feng
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Mailikezhati Maimaitiming
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Junyi Shi
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Minmin Wang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Na Li
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
- Institute for Global Health and Development, Peking University, Beijing, China.
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
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Martin MFEB, Ting FIL. To Chemo or Not to Chemo… That Is the Question. JCO Glob Oncol 2023; 9:e2300164. [PMID: 37535887 PMCID: PMC10581605 DOI: 10.1200/go.23.00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/08/2023] [Indexed: 08/05/2023] Open
Abstract
The best practices and clinical consensus statements often differ from real-world practice.
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Affiliation(s)
| | - Frederic Ivan L. Ting
- Department of Medicine, Dr Pablo O. Torre Memorial Hospital, Bacolod City, Philippines
- Department of Clinical Sciences, College of Medicine, University of St La Salle, Bacolod City, Philippines
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