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Rohan EA, Townsend JS, Bermudez AT, Thompson HL, Holman DM, Reza A, Tharpe FS, Wennerstrom A. Engaging Community Health Workers in Primary Care Practices: Provider Understanding of Roles, Benefits, and Barriers. J Ambul Care Manage 2024; 47:154-167. [PMID: 38775653 DOI: 10.1097/jac.0000000000000501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Community health workers (CHWs) are increasingly addressing health disparities in primary care settings; however, there is little information about how primary care practitioners (PCPs) interact with CHWs or perceive CHW roles. We examined PCP engagement with CHWs in adult primary care settings. Overall, 55% of 1504 PCPs reported working with CHWs; involvement with CHWs differed by some PCP demographic and practice-related factors. While PCPs perceived CHWs as engaging in most nationally endorsed CHW roles, they identified several barriers to integrating CHWs into care teams. Findings can inform ongoing efforts to advance health equity through integrating CHWs into primary care practices.
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Affiliation(s)
- Elizabeth A Rohan
- Author Affiliations: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Chamblee, GA (Drs Rohan, Townsend, Bermudez, and Thompson, Mr Holman, Dr Reza, and Ms Tharpe); Centers for Disease Control and Prevention, Division of Diabetes Translation, Chamblee, GA (Dr Thompson); Department of Behavioral and Community Health Sciences, Louisiana State University, School of Public Health and School of Medicine, Center for Healthcare Value and Equity, New Orleans, Louisiana (Dr Wennerstrom)
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Lacson R, Pianykh O, Hartmann S, Johnston H, Daye D, Flores E, Kapoor N, Khorasani R. Factors Associated With Timeliness and Equity of Access to Outpatient MRI Examinations. J Am Coll Radiol 2024; 21:1049-1057. [PMID: 38215805 DOI: 10.1016/j.jacr.2023.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE The role of MRI in guiding patients' diagnosis and treatment is increasing. Therefore, timely MRI performance prevents delays that can impact patient care. We assessed the timeliness of performing outpatient MRIs using the socio-ecological model approach and evaluated multilevel factors associated with delays. METHODS This institutional review board-approved study included outpatient MRI examinations ordered between October 1, 2021, and December 31, 2022, for performance at a large quaternary care health system. Mean order-to-performed (OtoP) interval (in days) and prolonged OtoP interval (defined as >10 days) for MRI orders with an expected date of 1 day to examination performance were measured. Logistic regression was used to assess patient-level (demographic and social determinants of health), radiology practice-level, and community-level factors associated with prolonged OtoP interval. RESULTS There were 126,079 MRI examination orders with expected performance within 1 day placed during the study period (56% of all MRI orders placed). After excluding duplicates, there were 97,160 orders for unique patients. Of the MRI orders, 48% had a prolonged OtoP interval, and mean OtoP interval was 18.5 days. Factors significantly associated with delay in MRI performance included public insurance (odds ratio [OR] = 1.11, P < .001), female gender (OR = 1.11, P < .001), radiology subspecialty (ie, cardiac, OR = 1.71, P < .001), and patients from areas that are most deprived (ie, highest Area Deprivation Index quintile, OR = 1.70, P < .001). DISCUSSION Nearly half of outpatient MRI orders were delayed, performed >10 days from the expected date selected by the ordering provider. Addressing multilevel factors associated with such delays may help enhance timeliness and equity of access to MRI examinations, potentially reducing diagnostic errors and treatment delays.
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Affiliation(s)
- Ronilda Lacson
- Associate Director, Center for Evidence Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, and Associate Professor of Radiology, Harvard Medical School, Boston, Massachusetts.
| | - Oleg Pianykh
- Assistant Professor of Radiology, Harvard Medical School, Boston, Massachusetts; and Director of Medical Analytics, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Sean Hartmann
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Heather Johnston
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Dania Daye
- Assistant Professor of Radiology, Harvard Medical School, Boston, Massachusetts; and Quality Director, Interventional Radiology Division, and Co-Director of IR Research, Division of Vascular and Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Efren Flores
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Associate Professor of Radiology, Harvard Medical School, Boston, Massachusetts; and Vice Chair, Diversity, Equity & Inclusion, Mass General Brigham, Boston, Massachusetts; Vice Chair of Radiology, Distinguished Chair, Medical Informatics, and Director of Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Professor of Radiology, Harvard Medical School, Boston, Massachusetts; and Vice Chair, Radiology Quality and Safety, Mass General Brigham, Boston, Massachusetts
| | - Neena Kapoor
- Director of Diversity, Inclusion, and Equity and Quality and Safety Officer, Department of Radiology, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; and Assistant Professor of Radiology, Harvard Medical School, Boston, Massachusetts
| | - Ramin Khorasani
- Vice Chair of Radiology, Distinguished Chair, Medical Informatics, and Director of Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Professor of Radiology, Harvard Medical School, Boston, Massachusetts; and Vice Chair, Radiology Quality and Safety, Mass General Brigham, Boston, Massachusetts
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Bellizzi KM, Fritzson E, Ligus K, Park CL. Social Support Buffers the Effect of Social Deprivation on Comorbidity Burden in Adults with Cancer. Ann Behav Med 2024:kaae035. [PMID: 38935875 DOI: 10.1093/abm/kaae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Adults with cancer have higher rates of comorbidity compared to those without cancer, with excess burden in people from lower socioeconomic status (SES). Social deprivation, based on geographic indices, broadens the focus of SES to include the importance of "place" and its association with health. Further, social support is a modifiable resource found to have direct and indirect effects on health in adults with cancer, with less known about its impact on comorbidity. PURPOSE We prospectively examined associations between social deprivation and comorbidity burden and the potential buffering role of social support. METHODS Our longitudinal sample of 420 adults (Mage = 59.6, SD = 11.6; 75% Non-Hispanic White) diagnosed with cancer completed measures at baseline (~6 months post-diagnosis) and four subsequent 3-month intervals for 1 year. RESULTS Adjusting for age, cancer type, and race/ethnicity, we found a statistically significant interaction between social support and the effect of social deprivation on comorbidity burden (β = -0.11, p = 0.012), such that greater social support buffered the negative effect of social deprivation on comorbidity burden. CONCLUSION Implementing routine screening for social deprivation in cancer care settings can help identify patients at risk of excess comorbidity burden. Clinician recognition of these findings could trigger a referral to social support resources for individuals high on social deprivation.
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Affiliation(s)
- Keith M Bellizzi
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT, USA
| | - Emily Fritzson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT, USA
| | - Kaleigh Ligus
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Turner DP, Winn RA, Findlay VJ. Biosocial determinants inform on enduring cancer disparities. Trends Cancer 2024:S2405-8033(24)00094-3. [PMID: 38839546 DOI: 10.1016/j.trecan.2024.05.004] [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: 03/31/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 06/07/2024]
Abstract
Social, environmental, and biological risk factors influence exposures to newly termed 'biosocial determinants of health'. As molecular factors that lie at the intersection between lived experiences and individual biology, biosocial determinants may inform on the enduring complexity of cancer disparity across transdisciplinary studies.
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Affiliation(s)
- David P Turner
- Department of Surgery, Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, VA, USA.
| | - Robert A Winn
- Department of Medicine, Massey Comprehensive Cancer Center, Virginia Commonwealth, University, Richmond, VA, USA
| | - Victoria J Findlay
- Department of Surgery, Massey Comprehensive Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
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Karmali R, Machhi R, Epperla N, Shouse G, Romancik J, Moyo TK, Kenkre V, Ollila TA, Fitzgerald L, Hess B, David K, Roy I, Zurko J, Chowdhury SM, Annunzio K, Ferdman R, Bhansali RS, Harris EI, Liu J, Nizamuddin I, Ma S, Moreira J, Winter J, Pro B, Stephens DM, Danilov A, Shah NN, Cohen JB, Barta SK, Torka P, Gordon LI. Impact of race and social determinants of health on outcomes in patients with aggressive B-cell NHL treated with CAR-T therapy. Blood Adv 2024; 8:2592-2599. [PMID: 38531057 PMCID: PMC11145749 DOI: 10.1182/bloodadvances.2023011996] [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: 11/13/2023] [Revised: 02/05/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
ABSTRACT Chimeric antigen receptor (CAR) T-cell (CAR-T) immunotherapy is an effective therapy for relapsed/refractory B-cell non-Hodgkin lymphoma (r/r B-NHL). However, data are limited on the impact of the convergence of race and social determinants of health on outcomes for patients treated with CAR-T therapy. We examined the impact of interactions between race and insurance type on health care use and outcomes in patients treated with CAR-T therapy for aggressive B-NHL. Adult patients with r/r B-NHL treated with CD19 CAR-Ts were identified between 2015 and 2021 across 13 US academic centers. Insurance type, demographic, and clinical data were collected and analyzed. In total, 466 adult patients were included in our analysis. Median follow-up after CAR-T therapy was 12.7 months. Median progression-free survival (mPFS) was longer for Caucasians (11.5 months) than for African Americans (3.5 months; hazard ratio [HR], 1.56 [1.03-2.4]; P = .04) or Asians (2.7 months; HR, 1.7 [1.02-2.67]; P = .04). Differences in median overall survival (mOS) were not significant. For Medicare (n = 206) vs Medicaid (n = 33) vs private insurance (n = 219) vs self-pay (n = 7): mPFS was 15.9 vs 4.2 vs 6.0 vs 0.9 months (P < .001), respectively; and mOS was 31.2 vs 12.8 vs 21.5 vs 3.2 months (P < .001), respectively. Our multicenter retrospective analysis showed that race and insurance status can affect outcomes for patients treated with CAR-T therapy.
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Affiliation(s)
- Reem Karmali
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | - Rushad Machhi
- Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Narendranath Epperla
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH
| | | | | | | | - Vaishalee Kenkre
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, WI
| | | | | | - Brian Hess
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | - Kevin David
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ
| | - Ishan Roy
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Joanna Zurko
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, WI
| | - Sayan Mullick Chowdhury
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH
| | - Kaitlin Annunzio
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH
| | | | - Rahul S. Bhansali
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Elyse I. Harris
- Carbone Cancer Center, University of Wisconsin–Madison, Madison, WI
| | - Jieqi Liu
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ
| | - Imran Nizamuddin
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | - Shuo Ma
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | - Jonathan Moreira
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | - Jane Winter
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | - Barbara Pro
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | | | | | - Nirav N. Shah
- MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI
| | | | - Stefan K. Barta
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Pallawi Torka
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Leo I. Gordon
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
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Wang Y, He Y, Shi Y, Qian DC, Gray KJ, Winn R, Martin AR. Aspiring toward equitable benefits from genomic advances to individuals of ancestrally diverse backgrounds. Am J Hum Genet 2024; 111:809-824. [PMID: 38642557 PMCID: PMC11080611 DOI: 10.1016/j.ajhg.2024.04.002] [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: 10/05/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/22/2024] Open
Abstract
Advancements in genomic technologies have shown remarkable promise for improving health trajectories. The Human Genome Project has catalyzed the integration of genomic tools into clinical practice, such as disease risk assessment, prenatal testing and reproductive genomics, cancer diagnostics and prognostication, and therapeutic decision making. Despite the promise of genomic technologies, their full potential remains untapped without including individuals of diverse ancestries and integrating social determinants of health (SDOHs). The NHGRI launched the 2020 Strategic Vision with ten bold predictions by 2030, including "individuals from ancestrally diverse backgrounds will benefit equitably from advances in human genomics." Meeting this goal requires a holistic approach that brings together genomic advancements with careful consideration to healthcare access as well as SDOHs to ensure that translation of genetics research is inclusive, affordable, and accessible and ultimately narrows rather than widens health disparities. With this prediction in mind, this review delves into the two paramount applications of genetic testing-reproductive genomics and precision oncology. When discussing these applications of genomic advancements, we evaluate current accessibility limitations, highlight challenges in achieving representativeness, and propose paths forward to realize the ultimate goal of their equitable applications.
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Affiliation(s)
- Ying Wang
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
| | - Yixuan He
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Yue Shi
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Reproductive Medicine Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - David C Qian
- Department of Thoracic Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kathryn J Gray
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Robert Winn
- Virginia Commonwealth University Massey Cancer Center, Richmond, VA, USA
| | - Alicia R Martin
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
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Neagu AN, Bruno P, Johnson KR, Ballestas G, Darie CC. Biological Basis of Breast Cancer-Related Disparities in Precision Oncology Era. Int J Mol Sci 2024; 25:4113. [PMID: 38612922 PMCID: PMC11012526 DOI: 10.3390/ijms25074113] [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: 03/03/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Precision oncology is based on deep knowledge of the molecular profile of tumors, allowing for more accurate and personalized therapy for specific groups of patients who are different in disease susceptibility as well as treatment response. Thus, onco-breastomics is able to discover novel biomarkers that have been found to have racial and ethnic differences, among other types of disparities such as chronological or biological age-, sex/gender- or environmental-related ones. Usually, evidence suggests that breast cancer (BC) disparities are due to ethnicity, aging rate, socioeconomic position, environmental or chemical exposures, psycho-social stressors, comorbidities, Western lifestyle, poverty and rurality, or organizational and health care system factors or access. The aim of this review was to deepen the understanding of BC-related disparities, mainly from a biomedical perspective, which includes genomic-based differences, disparities in breast tumor biology and developmental biology, differences in breast tumors' immune and metabolic landscapes, ecological factors involved in these disparities as well as microbiomics- and metagenomics-based disparities in BC. We can conclude that onco-breastomics, in principle, based on genomics, proteomics, epigenomics, hormonomics, metabolomics and exposomics data, is able to characterize the multiple biological processes and molecular pathways involved in BC disparities, clarifying the differences in incidence, mortality and treatment response for different groups of BC patients.
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Affiliation(s)
- Anca-Narcisa Neagu
- Laboratory of Animal Histology, Faculty of Biology, "Alexandru Ioan Cuza" University of Iași, Carol I bvd. 20A, 700505 Iasi, Romania
| | - Pathea Bruno
- Biochemistry & Proteomics Laboratories, Department of Chemistry and Biochemistry, Clarkson University, Potsdam, NY 13699-5810, USA
| | - Kaya R Johnson
- Biochemistry & Proteomics Laboratories, Department of Chemistry and Biochemistry, Clarkson University, Potsdam, NY 13699-5810, USA
| | - Gabriella Ballestas
- Biochemistry & Proteomics Laboratories, Department of Chemistry and Biochemistry, Clarkson University, Potsdam, NY 13699-5810, USA
| | - Costel C Darie
- Biochemistry & Proteomics Laboratories, Department of Chemistry and Biochemistry, Clarkson University, Potsdam, NY 13699-5810, USA
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Hutchings H, Behinaein P, Enofe N, Brue K, Tam S, Chang S, Movsas B, Poisson L, Wang A, Okereke I. Association of Social Determinants with Patient-Reported Outcomes in Patients with Cancer. Cancers (Basel) 2024; 16:1015. [PMID: 38473374 DOI: 10.3390/cancers16051015] [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: 02/04/2024] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
Patient-reported outcome (PRO) scores have been utilized more frequently, but the relationship of PRO scores to determinants of health and social inequities has not been widely studied. Our goal was to determine the association of PRO scores with social determinants. All patients with a new cancer diagnosis who completed a PRO survey from 2020 to 2022 were included. The PRO survey recorded scores for depression, fatigue, pain interference and physical function. Higher depression, fatigue and pain scores indicated more distress. Higher physical condition scores indicated improved functionality. A total of 1090 patients were included. Married patients had significantly better individual PRO scores for each domain. Patients who were able to use the online portal to complete their survey also had better individual scores. Male patients and non-White patients had worse pain scores than female and White patients, respectively. Patients with prostate cancer had the best scores while patients with head and neck and lung cancer had the worst scores. PRO scores varied by cancer disease site and stage. Social support may act in combination with specific patient/tumor factors to influence PRO scores. These findings present opportunities to address patient support at institutional levels.
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Affiliation(s)
- Hollis Hutchings
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
| | - Parnia Behinaein
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - Nosayaba Enofe
- Division of Surgical Oncology, Department of Thoracic Surgery, Fox Chase Cancer Center, Temple University Hospital, Philadelphia, PA 19140, USA
| | - Kellie Brue
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - Samantha Tam
- Department of Otolaryngology, Henry Ford Health, Detroit, MI 48202, USA
| | - Steven Chang
- Department of Otolaryngology, Henry Ford Health, Detroit, MI 48202, USA
| | - Benjamin Movsas
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI 48202, USA
| | - Laila Poisson
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI 48202, USA
| | - Anqi Wang
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI 48202, USA
| | - Ikenna Okereke
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
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Jansen JP, Brewer IP, Chung S, Sullivan P, Espinosa OD, Grossman JP. The Health Inequality Impact of a New Cancer Therapy Given Treatment and Disease Characteristics. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:143-152. [PMID: 37952840 DOI: 10.1016/j.jval.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 10/02/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES This study aimed to perform a simulation study to quantify the health inequality impact of a cancer therapy given cancer and treatment characteristics using the distributional cost-effectiveness framework. METHODS The following factors were varied in 10 000 simulations: lifetime risk of the disease, median overall survival (OS) with standard of care (SOC), difference in OS between non-Hispanic (NH)-Black and NH-White patients (prognostic effect), treatment effect of the new therapy relative to SOC, whether the treatment effect differs between NH-Black and NH-White patients (effect modification), health utility, drug costs, and preprogression and postprogression costs. Based on these characteristics, the incremental population net health benefits were calculated for the new therapy and applied to a US distribution of quality-adjusted life expectancy at birth. The health inequality impact was quantified as the difference in the degree of inequality in the "post-new therapy" versus "pre-new therapy" quality-adjusted life expectancy distributions. RESULTS For cancer types characterized by relatively large lifetime risk, large median OS with SOC, large treatment effect, and large effect modification, the direction of the impact of the new therapy on inequality is easy to predict. When effect modification is minor or absent, which is a realistic scenario, the direction of the inequality impact is difficult to predict. Larger incremental drug costs have a worsening effect on health inequality. CONCLUSIONS The findings provide a guide to help decision makers and other stakeholders make an initial assessment whether a new therapy with known treatment effects for a specific tumor type can have a positive or negative health inequality impact.
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Asiedu C, McKinney NS, Willis AI, Lewis FM, Virtue S, Davey A. Cancer and the family: Variations by sex and race/ethnicity. Cancer Med 2024; 13:e6969. [PMID: 38379329 PMCID: PMC10831911 DOI: 10.1002/cam4.6969] [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: 06/09/2023] [Revised: 01/08/2024] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Cancer affects patients and their families, but few data are available on factors associated with diversity of family structures among patients with cancer. Family is a source of both support and responsibility that must be understood to support patients and their families. METHODS Pooled data (2004-2015) from the National Health Interview Study were used to compare characteristics of cancer survivors with and without minor children and differences by sex and race/ethnicity among survivors with minor children. RESULTS 13.9% of cancer survivors have minor children in the household, and this experience is more likely for women and people who identify as other than non-Hispanic White. CONCLUSION There are considerable differences by sex and race/ethnicity in the characteristics of cancer survivors with minor children. Clinicians should make consideration of family circumstances a routine part of their history. Doing so will help to identify potential sources of support and responsibility that may affect adherence.
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Affiliation(s)
- Charlotte Asiedu
- Department of Health Behavior and Nutrition SciencesUniversity of DelawareNewarkDelawareUSA
| | - Nicole S. McKinney
- Department of Counseling and Behavioral HealthThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
| | - Alliric I. Willis
- Department of Surgery, Surgical OncologyThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
| | - Frances M. Lewis
- Department of Child, Family, and Population Health NursingUniversity of WashingtonSeattleWashingtonUSA
| | - Shannon Virtue
- Helen F Graham Cancer Center and Research Institute, Christiana Care Health SystemNewarkDelawareUSA
| | - Adam Davey
- Department of Health Behavior and Nutrition SciencesUniversity of DelawareNewarkDelawareUSA
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Graham AJ, Robinson MT, Kahler J, Azadi JR, Maleki Z. Rapid on-site evaluation (ROSE) of image-guided FNA specimens improves subsequent core biopsy adequacy in clinical trial patients: The impact of preanalytical factors and its correlation with survival. Cancer Cytopathol 2024; 132:30-40. [PMID: 37768842 DOI: 10.1002/cncy.22764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/09/2023] [Accepted: 08/02/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Sufficient tumor collection has become of utmost importance in therapeutic experimental protocols. Rapid on-site evaluation (ROSE) ensures adequate sampling for quantification of biomarkers, molecular analyses, and other ancillary studies. The objectives of this study were to evaluate the role of ROSE in trial-associated fine-needle aspiration (FNA) and to analyze predictors of adequacy and cumulative survival from in-house FNA cases used in clinical trials. METHODS Clinical trial FNA biopsies performed at a large academic institution were analyzed over 10 months using a comprehensive chart review of the electronic medical records. SPSS version 28 was used for statistical analysis. RESULTS Three hundred twenty-five FNAs were collected for 57 clinical trials. In total, 225 individual patients had an average of 1.4 FNA procedures each as a result of a multidepartmental collaborative effort. ROSE was performed for all patients, and adequacy was evaluated by cytotechnologists. Seventy-eight percent of samples were considered adequate, 14% were considered less than optimal, and 8% were considered inadequate, with the latter two categories designated together as less than adequate. The imaging modalities were mainly ultrasound-guided (n = 267; 82%) and computed tomography-guided (n = 58; 18%). There was a statistically significant association between adequate sampling and ultrasound-guided biopsies (83%) compared with computed tomography-guided biopsies (59%; p < .01). The effect of body mass index (BMI) on mortality was also a significant finding. The authors observed a survival benefit in patients who had elevated BMIs (range, 25.0-34.9 kg/m2 ) compared with those who were underweight (BMI, <18.5 kg/m2 ) or class III obese (BMI, >35.0 kg/m2 ; p < .01). Therefore, the best predictors of adequacy and mortality were imaging modality and BMI, respectively. CONCLUSIONS Ultrasound-guided modalities are recommended for obtaining adequate FNA sampling for clinical trials. In addition, patients with cancer who had slightly elevated BMIs (25.0-34.0 kg/m2 ) had increased overall survival in this cohort.
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Affiliation(s)
- Ashleigh J Graham
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mahalia T Robinson
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jessica Kahler
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Javad R Azadi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zahra Maleki
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Xu J, Hoover RL, Woodard N, Leeman J, Hirschey R. A Systematic Review of Dietary Interventions for Cancer Survivors and Their Families or Caregivers. Nutrients 2023; 16:56. [PMID: 38201886 PMCID: PMC10780967 DOI: 10.3390/nu16010056] [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: 12/01/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Family or caregiver engagement has the potential to support healthy dietary changes among cancer survivors. However, little is known about these family- or caregiver-involved dietary interventions and their effects. This systematic review aimed to identify the behavior change techniques (BCTs) used in dietary interventions for cancer survivors and their families or caregivers and to synthesize intervention effects on dietary and health outcomes. Following the PRISMA guidelines, we conducted systematic searches in three databases and identified 12 trials (16 peer-reviewed manuscripts) for inclusion in this review. Data were extracted from these manuscripts and the BCT taxonomy was used to identify the BCTs. A total of 38 BCTs were identified from 12 trials, 13 of which were used in at least half of the 12 trials. Ten studies reported significant intervention effects on health outcomes (e.g., adiposity) and six suggested significant improvements in dietary behaviors (e.g., fruit and vegetable intake). Overall, this review found that family- or caregiver-involved interventions for cancer survivors significantly improved dietary and health outcomes. Future research should identify BCTs particularly for dietary changes and develop effective dyadic strategies to facilitate diet-related interactions between survivors and their families or caregivers to enhance their engagement in healthy diets.
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Affiliation(s)
- Jingle Xu
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
| | - Rebecca L. Hoover
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
| | - Nathaniel Woodard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
| | - Jennifer Leeman
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
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13
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de Oliveira RP, de Moraes PHR, Drummond-Lage AP. Impact of the SARS-CoV-2 on the journey of high-risk colon cancer patients within the scope of the Unified Health System in Brazil. BMC Health Serv Res 2023; 23:1102. [PMID: 37845707 PMCID: PMC10580526 DOI: 10.1186/s12913-023-10083-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Colon cancer is an important cause of mortality related to cancer. During the COVID-19 pandemic, an important reallotment of assistance resources was necessary to tackle the crisis, directly impacting medical practice all over the globe. OBJECTIVE To assess the impact of the Sars-Cov-2 pandemic on the time between diagnosis and the beginning of systemic treatment in patients diagnosed with high-risk colon neoplasia. METHODS This is a retrospective study based on the analysis of medical records of patients diagnosed with colon neoplasia who required systemic treatment and were treated between March 2019 and March 2022, in a reference Oncology unit of the Brazilian Unified Health System. The study's population was divided into two groups: (I) Pre-COVID-19: diagnoses made between March 2019 and February 2020, (II) COVID-19: diagnoses made between March 2020 and March 2022. RESULTS The sample consisted of 228 patients, 108 (47.97%) of whom were diagnosed during pre-COVID-19 and 118 (52.21%) diagnosed during the two years-period of COVID-19. Regarding the time between colonoscopy and surgery, the time between surgery and first consultation in clinical oncology, and the time between requesting and beginning of systemic treatment, a statistically significant reduction was observed during the COVID-19 period. CONCLUSION A decrease in time between diagnosis and systemic treatment of patients with colorectal cancer during the COVID-19 pandemic was observed. Yet, even with this improvement, the time to begin treatment remains greater than the recommended by the current guidelines, regardless of the time of diagnosis (before or after the pandemic), which negatively impacts the disease outcome.
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Affiliation(s)
- Raquel Pucci de Oliveira
- Faculdade Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275, Belo Horizonte, 30.130.110, Brazil
| | | | - Ana Paula Drummond-Lage
- Faculdade Ciências Médicas de Minas Gerais, Alameda Ezequiel Dias 275, Belo Horizonte, 30.130.110, Brazil.
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14
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Gonzales MM, Vela G, Philip V, Trevino H, LaRoche A, Wang CP, Parent DM, Kautz T, Satizabal CL, Tanner J, O'Bryant S, Maestre G, Tracy RP, Seshadri S. Demographic and Clinical Characteristics Associated With Serum GFAP Levels in an Ethnically Diverse Cohort. Neurology 2023; 101:e1531-e1541. [PMID: 37813589 PMCID: PMC10585700 DOI: 10.1212/wnl.0000000000207706] [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: 12/27/2022] [Accepted: 06/09/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Elevations in circulating glial fibrillary acidic protein (GFAP), a putative marker of reactive astrocytosis, have been found to associate with cognitive decline and dementia status. Further validation in diverse cohorts and evaluation of potential health disparities are necessary for broader generalization. The goal of this study was to examine the associations between demographics, cardiovascular risk factors, and APOE ε4 status with serum GFAP levels among Mexican American and non-Hispanic White older adults across the continuum from cognitively unimpaired to Alzheimer disease dementia. METHODS Serum GFAP levels were assayed using a Simoa HD-1 analyzer in older adults enrolled in the observational Texas Alzheimer Research and Care Consortium. Associations between demographic and clinical characteristics with serum GFAP levels were evaluated using linear regression. The diagnostic accuracy of serum GFAP was further examined using area under the receiver operating characteristic curves (AUROC) in univariate and adjusted models, and optimal cut points were derived using the maximum Kolmogorov-Smirnov metric. All models were also stratified by ethnicity and disease stage. RESULTS A total of 1,156 Mexican American and 587 non-Hispanic White participants were included (mean age = 68 years, standard deviation = 10; 65% female). Older age (β = 0.562 (95% CI 0.515-0.609), p < 0.001), apolipoprotein ε4 status (β = 0.139 (95% CI 0.092-0.186), p < 0.001), and cognitive impairment (β = 0.150 (95% CI 0.103-0.197), p < 0.001) were positively associated with serum GFAP. By contrast, higher body mass index (β = -0.181 (95% CI -0.228 to -0.134), p < 0.001), diabetes (β = -0.065 (95% CI -0.112 to -0.018), p < 0.001), and tobacco use (β = -0.059 (95% CI -0.106 to -0.012), p < 0.001) were inversely associated with serum GFAP. AUROC values were generally comparable across ethnicities and model fit improved with inclusion of additional covariates. However, optimal cut-off values were consistently lower in Mexican Americans relative to non-Hispanic White participants. DISCUSSION The study results highlight the importance of understanding the role of broader demographic and clinical factors on circulating GFAP levels within diverse cohorts to enhance precision across clinical, research, and community settings.
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Affiliation(s)
- Mitzi M Gonzales
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville.
| | - Gabriel Vela
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Vinu Philip
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Hector Trevino
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Ashley LaRoche
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Chen-Pin Wang
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Danielle M Parent
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Tiffany Kautz
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Claudia L Satizabal
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Jeremy Tanner
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Sid O'Bryant
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Gladys Maestre
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Russell P Tracy
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Sudha Seshadri
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
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Franco-Rocha OY, Lewis KA, Longoria KD, De La Torre Schutz A, Wright ML, Kesler SR. Cancer-related cognitive impairment in racial and ethnic minority groups: a scoping review. J Cancer Res Clin Oncol 2023; 149:12561-12587. [PMID: 37432455 DOI: 10.1007/s00432-023-05088-0] [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: 04/19/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Disparities in cognitive function among racial and ethnic groups have been reported in non-cancer conditions, but cancer-related cognitive impairment (CRCI) in racial and ethnic minority groups is poorly understood. We aimed to synthesize and characterize the available literature about CRCI in racial and ethnic minority populations. METHODS We conducted a scoping review in the PubMed, PsycInfo, and Cumulative Index to Nursing and Allied Health Literature databases. Articles were included if they were published in English or Spanish, reported cognitive functioning in adults diagnosed with cancer, and characterized the race or ethnicity of the participants. Literature reviews, commentaries, letters to the editor, and gray literature were excluded. RESULTS Seventy-four articles met the inclusion criteria, but only 33.8% differentiated the CRCI findings by racial or ethnic subgroups. There were associations between cognitive outcomes and the participants' race or ethnicity. Additionally, some studies found that Black and non-white individuals with cancer were more likely to experience CRCI than their white counterparts. Biological, sociocultural, and instrumentation factors were associated with CRCI differences between racial and ethnic groups. CONCLUSIONS Our findings indicate that racial and ethnic minoritized individuals may be disparately affected by CRCI. Future research should use standardized guidelines for measuring and reporting the self-identified racial and ethnic composition of the sample; differentiate CRCI findings by racial and ethnic subgroups; consider the influence of structural racism in health outcomes; and develop strategies to promote the participation of members of racial and ethnic minority groups.
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Affiliation(s)
- Oscar Y Franco-Rocha
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA.
| | - Kimberly A Lewis
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Kayla D Longoria
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA
| | - Alexa De La Torre Schutz
- Brain Health Neuroscience Lab, School of Nursing, The University of Texas at Austin, 1710 Red River St, Austin, TX, USA
| | - Michelle L Wright
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA
| | - Shelli R Kesler
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, USA
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Molina-Aguilar C, Robles-Espinoza CD. Tackling the lack of diversity in cancer research. Dis Model Mech 2023; 16:dmm050275. [PMID: 37681401 PMCID: PMC10499025 DOI: 10.1242/dmm.050275] [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] [Indexed: 09/09/2023] Open
Abstract
Despite the clear benefit of studying biological samples from diverse genetic backgrounds and geographical locations, our current knowledge of disease is mostly derived from the study of European-descent individuals. In the cancer field, this is reflected in the poor representation of African and Amerindian/Latino samples in most large public data repositories. This lack of diversity is due to several reasons, but here we focus on (1) the lack of support for studies on non-European populations that are performed in low- and middle-income countries (LMICs), and (2) unequal partnerships between scientists in LMICs and those in high-income countries. We argue that expanding access to research funding, increasing the participation of underrepresented scientists in editorial boards and international conferences, facilitating the publication of studies conducted in these countries, and properly acknowledging LMIC researchers' contributions in publications and grant applications will promote equity for scientists working in LMICs. We envisage that this will translate to more impactful research in these countries, which will include more samples from diverse populations. For the cancer field, this will broaden our understanding of pathomechanisms and may help to improve the treatment of patients from all backgrounds.
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Affiliation(s)
- Christian Molina-Aguilar
- Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Santiago de Querétaro 76230, Mexico
| | - C. Daniela Robles-Espinoza
- Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Santiago de Querétaro 76230, Mexico
- Cancer, Ageing and Somatic Mutation, Wellcome Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, UK
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Benidir A, Levert MJ, Bilodeau K. The Role of Islamic Beliefs in Facilitating Acceptance of Cancer Diagnosis. Curr Oncol 2023; 30:7789-7801. [PMID: 37754480 PMCID: PMC10530149 DOI: 10.3390/curroncol30090565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/14/2023] [Accepted: 08/20/2023] [Indexed: 09/28/2023] Open
Abstract
Although survival rates for patients with cancer have increased, this disease continues to affect couples significantly. Religion and culture seem to be part of the therapeutic process for people with cancer. Despite the abundance of the Arab Muslim community in Western countries, there is a lack of documented data on Arab Muslim couples experiencing cancer. A simple exploratory qualitative study was conducted through semi-structured interviews on six married couples (n = 12) identifying with the Arab Muslim culture and being affected by cancer. An iterative data analysis was performed. Results were reported under the following themes: accepting illness through coping strategies provided by Muslim religious beliefs and practices, experiencing problems with the expression of needs and feelings within the couple, experiencing closeness within the family, and experiencing illness in the hospital setting as Muslims. Our results show that Islamic beliefs can facilitate acceptance of a cancer diagnosis. It is also noted that religion seems to unite spouses in supporting each other and maintaining hope in a difficult context. Communication issues may persist between a couple due to stressors related to cancer. The results of this study could raise awareness about the importance of exploring religious and spiritual beliefs when supporting couples affected by cancer.
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Affiliation(s)
- Amina Benidir
- Faculty of Nursing, University of Montreal, Station Centre-Ville, Montreal, QC H3C 3J7, Canada; (M.-J.L.); (K.B.)
| | - Marie-Josée Levert
- Faculty of Nursing, University of Montreal, Station Centre-Ville, Montreal, QC H3C 3J7, Canada; (M.-J.L.); (K.B.)
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, 6363, Hudson Road, Montreal, QC H3S 1M9, Canada
| | - Karine Bilodeau
- Faculty of Nursing, University of Montreal, Station Centre-Ville, Montreal, QC H3C 3J7, Canada; (M.-J.L.); (K.B.)
- Maisonneuve-Rosemont Hospital Research Centre, 5415 Boul. Assomption, Montreal, QC H1T 2M4, Canada
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18
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Dovey Z, Horowitz A, Waingankar N. The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review. BJUI COMPASS 2023; 4:385-416. [PMID: 37334023 PMCID: PMC10268595 DOI: 10.1002/bco2.237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 06/20/2023] Open
Abstract
Background The mostly indolent natural history of prostate cancer (PCa) provides an opportunity for men to explore the benefits of lifestyle interventions. Current evidence suggests appropriate changes in lifestyle including diet, physical activity (PA) and stress reduction with or without dietary supplements may improve both disease outcomes and patient's mental health. Objective This article aims to review the current evidence on the benefits of all lifestyle programmes for PCa patients including those aimed at reducing obesity and stress, explore their affect on tumour biology and highlight any biomarkers that have clinical utility. Evidence acquisition Evidence was obtained from PubMed and Web of Science using keywords for each section on the affects of lifestyle interventions on (a) mental health, (b) disease outcomes and (c) biomarkers in PCa patients. PRISMA guidelines were used to gather the evidence for these three sections (15, 44 and 16 publications, respectively). Evidence synthesis For lifestyle studies focused on mental health, 10/15 demonstrated a positive influence, although for those programmes focused on PA it was 7/8. Similarly for oncological outcomes, 26/44 studies demonstrated a positive influence, although when PA was included or the primary focus, it was 11/13. Complete blood count (CBC)-derived inflammatory biomarkers show promise, as do inflammatory cytokines; however, a deeper understanding of their molecular biology in relation to PCa oncogenesis is required (16 studies reviewed). Conclusions Making PCa-specific recommendations on lifestyle interventions is difficult on the current evidence. Nevertheless, notwithstanding the heterogeneity of patient populations and interventions, the evidence that dietary changes and PA may improve both mental health and oncological outcomes is compelling, especially for moderate to vigorous PA. The results for dietary supplements are inconsistent, and although some biomarkers show promise, significantly more research is required before they have clinical utility.
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Affiliation(s)
- Zach Dovey
- Mount Sinai Health System, Department of UrologyIcahn Medical SchoolNew YorkNew YorkUSA
| | - Amir Horowitz
- Icahn School of MedicineThe Mount Sinai HospitalNew YorkNew YorkUSA
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19
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Okeke B, Hillmon C, Jones J, Obanigba G, Obi A, Nkansah M, Odiase N, Khanipov K, Okereke IC. The relationship of social determinants and distress in newly diagnosed cancer patients. Sci Rep 2023; 13:2153. [PMID: 36750604 PMCID: PMC9905536 DOI: 10.1038/s41598-023-29375-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
Patients with a new cancer diagnosis can experience distress when diagnosed. There are disparities in treatment of cancer patients based on social determinants, but minimal research exists on the relationship of those social determinants and distress after a new cancer diagnosis. Our goals were to determine the social determinants associated with distress after a new cancer diagnosis and determine the relationship of distress with outcome. Patients with a new cancer diagnosis at one institution from January 2019 to December 2020 were analyzed. Patients were given the National Comprehensive Cancer Network (NCCN) distress thermometer during their first visit. Demographics, tumor characteristics, clinical variables and survival were recorded. Patients were also asked to share specific factors that led to distress, including: (1) financial, (2) transportation, (3) childcare and (4) religious. A total of 916 patients returned distress thermometers. Mean age was 59.1 years. Females comprised 71.3 (653/916) percent of the cohort. On Dunn's multiple comparison, the following factors were associated with increased distress level: female (p < 0.01), ages 27 to 45 (p < 0.01), uninsured (p < 0.01) and unemployed (p < 0.01). Patients with higher distress scores also experienced worse overall survival (p < 0.05). Females, young patients, uninsured patients and unemployed patients experience more distress after a new cancer diagnosis. Increased distress is independently associated with worse overall survival. Social determinants can be used to predict which patients may require focused interventions to reduce distress after a new cancer diagnosis.
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Affiliation(s)
- Brandon Okeke
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Cheron Hillmon
- Department of Care Management, University of Texas Medical Branch, Galveston, TX, USA
| | - Jasmine Jones
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Grace Obanigba
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Ann Obi
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Meagan Nkansah
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Nicholas Odiase
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Kamil Khanipov
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, USA
| | - Ikenna C Okereke
- Department of Surgery, Henry Ford Health System, 2799 W. Grand Blvd, Detroit, MI, 48202, USA.
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20
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Ruiz-Whalen DM, Aichele CP, Dyson ER, Gallen KC, Stark JV, Saunders JA, Simonet JC, Ventresca EM, Fuentes IM, Marmol N, Moise E, Neubert BC, Riggs DJ, Self AM, Alexander JI, Boamah E, Browne AJ, Correa I, Foster MJ, Harrington N, Holiday TJ, Henry RA, Lee EH, Longo SM, Lorenz LD, Martinez E, Nikonova A, Radu M, Smith SC, Steele LA, Strochlic TI, Archer NF, Aykit YJ, Bolotsky AJ, Boyle M, Criollo J, Eldor O, Cruz G, Fortuona VN, Gounder SD, Greenwood N, Ji KW, Johnson A, Lara S, Montanez B, Saurman M, Singh T, Smith DR, Stapf CA, Tondapu T, Tsiobikas C, Habas R, O'Reilly AM. Gaining Wings to FLY: Using Drosophila Oogenesis as an Entry Point for Citizen Scientists in Laboratory Research. Methods Mol Biol 2023; 2626:399-444. [PMID: 36715918 DOI: 10.1007/978-1-0716-2970-3_22] [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: 01/31/2023]
Abstract
Citizen science is a productive approach to include non-scientists in research efforts that impact particular issues or communities. In most cases, scientists at advanced career stages design high-quality, exciting projects that enable citizen contribution, a crowdsourcing process that drives discovery forward and engages communities. The challenges of having citizens design their own research with no or limited training and providing access to laboratory tools, reagents, and supplies have limited citizen science efforts. This leaves the incredible life experiences and immersion of citizens in communities that experience health disparities out of the research equation, thus hampering efforts to address community health needs with a full picture of the challenges that must be addressed. Here, we present a robust and reproducible approach that engages participants from Grade 5 through adult in research focused on defining how diet impacts disease signaling. We leverage the powerful genetics, cell biology, and biochemistry of Drosophila oogenesis to define how nutrients impact phenotypes associated with genetic mutants that are implicated in cancer and diabetes. Participants lead the project design and execution, flipping the top-down hierarchy of the prevailing scientific culture to co-create research projects and infuse the research with cultural and community relevance.
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Affiliation(s)
- Dara M Ruiz-Whalen
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA. .,eCLOSE Institute, Huntingdon Valley, PA, USA.
| | - Christopher P Aichele
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Ebony R Dyson
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Katherine C Gallen
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Jennifer V Stark
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jasmine A Saunders
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jacqueline C Simonet
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,Arcadia University, Glenside, PA, USA
| | - Erin M Ventresca
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,Albright College, Reading, PA, USA
| | - Isabela M Fuentes
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Nyellis Marmol
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Emly Moise
- eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Benjamin C Neubert
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Devon J Riggs
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Ava M Self
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jennifer I Alexander
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Ernest Boamah
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Amanda J Browne
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Iliana Correa
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Maya J Foster
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Nicole Harrington
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Troy J Holiday
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Ryan A Henry
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,Wilkes University, Wilkes-Barre, PA, USA
| | - Eric H Lee
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Sheila M Longo
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Laurel D Lorenz
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Esteban Martinez
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Anna Nikonova
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Maria Radu
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Shannon C Smith
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Lindsay A Steele
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Todd I Strochlic
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,Department of Biochemistry and Molecular Biology, Drexel University, Philadelphia, PA, USA
| | - Nicholas F Archer
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Y James Aykit
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Adam J Bolotsky
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Megan Boyle
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jennifer Criollo
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Oren Eldor
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Gabriela Cruz
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Valerie N Fortuona
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Shreeya D Gounder
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Nyim Greenwood
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Kayla W Ji
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Aminah Johnson
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA.,eCLOSE Institute, Huntingdon Valley, PA, USA
| | - Sophie Lara
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Maxwell Saurman
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Tanu Singh
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Daniel R Smith
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Catherine A Stapf
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Tarang Tondapu
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Raymond Habas
- Department of Biology, Temple University, Philadelphia, PA, USA
| | - Alana M O'Reilly
- Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA. .,eCLOSE Institute, Huntingdon Valley, PA, USA.
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21
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Pichardo MS, Minas TZ, Pichardo CM, Bailey-Whyte M, Tang W, Dorsey TH, Wooten W, Ryan BM, Loffredo CA, Ambs S. Association of Neighborhood Deprivation With Prostate Cancer and Immune Markers in African American and European American Men. JAMA Netw Open 2023; 6:e2251745. [PMID: 36662526 PMCID: PMC9860532 DOI: 10.1001/jamanetworkopen.2022.51745] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/28/2022] [Indexed: 01/21/2023] Open
Abstract
Importance Neighborhood variables may be factors in the excessive burden of prostate cancer among African American men. Objective To examine associations between neighborhood deprivation, circulating immune-oncology markers, and prostate cancer among African American and European American men. Design, Setting, and Participants A case-control study was conducted between January 1, 2005, and January 1, 2016. Participants included men with prostate cancer and age- and race-frequency-matched population controls. Participants were recruited at the Baltimore Veterans Affairs Medical Center and University of Maryland Medical Center; controls were obtained through the Maryland Motor Vehicle Administration database. National Death Index follow-up was performed through December 31, 2020, and data analysis was conducted from February 1, 2022, through October 31, 2022. Exposures 2000 Census-tract Neighborhood Deprivation Index as a standardized score. Main Outcomes and Measures Primary outcomes included prostate cancer, all-cause mortality, and disease-specific mortality. Secondary outcomes included the National Comprehensive Cancer Network risk score and serum proteomes for 82 immune-oncology markers with pathway annotation. Results Participants included men with prostate cancer (n = 769: 405 African American, 364 European American men) and age- and race-frequency-matched population controls (n = 1023: 479 African American, 544 European American men). The median survival follow-up was 9.70 years (IQR, 5.77 years), with 219 deaths. Among 884 African American men, mean (SD) age at recruitment was 63.8 (7.6) years; mean (SD) age at recruitment among 908 European American men was 66.4 (8.1) years. In the multivariable logistic regression analysis with individual socioeconomic status adjustment, neighborhood deprivation was associated with 55% increased odds of prostate cancer among African American men (odds ratio [OR], 1.55; 95% CI, 1.33-1.81), but was not associated with the disease among European American men. Residing in the most-deprived vs least-deprived neighborhoods corresponded to 88% higher disease odds (OR, 1.88; 95% CI, 1.30-2.75) among all men and an approximate 3-fold increase among African American men (OR, 3.58; 95% CI, 1.72-7.45), but no association was noted among European American men. In Cox proportional hazard regression analyses, socioeconomic status-adjusted neighborhood deprivation was associated with an increased all-cause mortality only among African American men (hazard ratio [HR], 1.28; 95% CI, 1.08-1.53), whereas it was associated with metastatic disease and a 50% increased hazard of a prostate cancer-specific death among all men (HR, 1.50; 95% CI, 1.07-2.09). In analyses restricted to controls, neighborhood deprivation was associated with increased activity scores of serum proteome-defined chemotaxis, inflammation, and tumor immunity suppression. Conclusions and Relevance The findings of this study suggest that deprived neighborhood residency may increase the risk of African American men for prostate cancer and a related mortality, potentially through its association with systemic immune function and inflammation.
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Affiliation(s)
- Margaret S. Pichardo
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
- Department of Surgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia
| | - Tsion Zewdu Minas
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Catherine M. Pichardo
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
- Division of Cancer Control and Population Sciences, NCI, NIH, Rockville, Maryland
| | - Maeve Bailey-Whyte
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Wei Tang
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
- Data Science & Artificial Intelligence, R&D, AstraZeneca, Gaithersburg, Maryland
| | - Tiffany H. Dorsey
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - William Wooten
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center Biostatistics Shared Service, Baltimore
| | - Brid M. Ryan
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
| | - Christopher A. Loffredo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland
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22
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Arnold JT. Integrating ayurvedic medicine into cancer research programs part 1: Ayurveda background and applications. J Ayurveda Integr Med 2022:100676. [DOI: 10.1016/j.jaim.2022.100676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
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23
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Ratnapradipa K, Watanabe-Galloway S, Hymel E, High R, Farazi PA. Predictors of behavioral cancer risk factors and preventive behaviors among Nebraskans. Cancer Epidemiol 2022; 81:102264. [PMID: 36195016 DOI: 10.1016/j.canep.2022.102264] [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: 06/30/2022] [Revised: 09/02/2022] [Accepted: 09/16/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND The overall incidence rate of cancer in Nebraska is higher than the national average with cancer being the second leading cause of death in the state. Interventions are required to reduce the cancer burden; however, further research is first needed to identify behavioral cancer risk factors and preventive behaviors among Nebraskans that can be targeted. METHODS A statewide cross-sectional survey of Nebraskans aged 19 and older was conducted in 2019 using an address-based sampling method (n = 1640). Multivariable logistic regression was used to examine factors associated with being up-to-date on cancer screening and with behavioral cancer risk factors and preventive behaviors. RESULTS 93.42% of Nebraskans did not meet the daily recommended consumption of fruits and vegetables, and 71.51% did not meet weekly physical activity guidelines. The proportion of adults up to date on cancer screening was 64.57% for breast, 68.83% for cervical, 69.01% for colorectal, and 24.07% for skin cancers. Individuals 65-74 (OR: 3.40, 95% CI: 1.52-7.62) and 75 or older (OR: 3.30, 95% CI: 1.35-8.07) were more likely to be current with their colorectal cancer screening compared to ages 50-64. Hispanics were less likely to be current with mammograms (OR: 0.06, 95% CI: 0.01-0.71) and ever screened for cervical cancer (OR:0.13, 95% CI: 0.02-0.94) compared to Non-Hispanic Whites. CONCLUSIONS Disparities in cancer screening and risk and preventive behaviors exist in Nebraska. IMPACT The study highlights a need for continuing efforts to improve preventive cancer behaviors for the entire population as well as some high-risk populations in Nebraska.
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Affiliation(s)
- Kendra Ratnapradipa
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, United States
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, United States
| | - Emma Hymel
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, United States
| | - Robin High
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, United States
| | - Paraskevi A Farazi
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, United States.
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24
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Huang R, Li Z, Weng S, Wu S. Simultaneous triple primary malignancies, including bladder cancer, lymphoma, and lung cancer, in an elderly male: A case report. Open Life Sci 2022; 17:1263-1268. [PMID: 36249529 PMCID: PMC9518660 DOI: 10.1515/biol-2022-0500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/02/2022] [Accepted: 08/25/2022] [Indexed: 12/04/2022] Open
Abstract
Multiple primary malignancies (MPMs) are defined as the coexistence of at least two unrelated primary malignancies in a single patient, with the tumors differing in their histology. MPMs in the same patient, when present within 6 months of the primary tumor diagnosis, are considered a synchronous occurrence. In this case report, we describe a 61-year-old man who presented with three distinct tumors concurrently in 2021: noninvasive urothelial carcinoma of the bladder, diffuse large B-cell lymphoma, and squamous cell carcinoma of the lung. We discuss the process of therapy and briefly review the literature. MPMs are increasing in incidence, requiring an interdisciplinary approach to diagnosis and treatment.
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Affiliation(s)
- Risheng Huang
- Department of Thoracic Surgery, The Dingli Clinical College of Wenzhou Medical University (The Second Affiliated Hospital of Shanghai University, Wenzhou Central Hospital), Wenzhou City, Zhejiang Province, China
| | - Zhijia Li
- Department of Urology Surgery, The Dingli Clinical College of Wenzhou Medical University (The Second Affiliated Hospital of Shanghai University, Wenzhou Central Hospital), Wenzhou City, Zhejiang Province, China
| | - Shanshan Weng
- Department of Hematology, The Dingli Clinical College of Wenzhou Medical University (The Second Affiliated Hospital of Shanghai University Wenzhou Central Hospital), Wenzhou City, Zhejiang Province, China
| | - Shenghao Wu
- Department of Hematology, The Dingli Clinical College of Wenzhou Medical University (The Second Affiliated Hospital of Shanghai University Wenzhou Central Hospital), Wenzhou City, Zhejiang Province, China
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25
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Wahab A, Abdelazeem B, Masood A, Khakwani M, Kumar Jakka B, Koduru U, Ehsan H. Association of medical uninsurance with sociodemographic attributes in US cancer population: A cross-sectional study of NHANES data 2013 to 2018. Medicine (Baltimore) 2022; 101:e30539. [PMID: 36197243 PMCID: PMC9509149 DOI: 10.1097/md.0000000000030539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Medical uninsurance (MU) is associated with cancer disparities, particularly among underprivileged and minority sections of the United States. In this cross-sectional study of National Health and Nutritional Examination Survey (NHANES) data from 2013 to 2018, we evaluated sociodemographic attributes of MU disparity in the US cancer population. Those aged ≥20 years with a history of cancer and disclosed MU status were included. We calculated the descriptive statistics of the population stratified by insurance type and performed bivariate and multivariate logistic regression models to assess the association of sociodemographic attributes and MU and reported unadjusted (UOR) and adjusted odds ratios (AOR). Among the 1681 participants (US estimated, 25,982,352), 4.3% ± 0.62 were uninsured. Uninsured individuals were 13.5-year younger, largely female, less educated, and non-US born compared to insured individuals. Age (UOR: 0.94, 95% CI: 0.93-0.96), female sex (UOR: 3.53, 95% CI: 1.73-7.19), Hispanics (UOR: 4.30, 95% CI: 2.45-7.54), <high school education (UOR: 7.41, 95% CI: 2.51-21.86), and non-US born with <20-years-stay in US (UOR: 7.69, 95% CI: 3.32-17.82) were associated with MU. In the multivariate model, age (AOR: 0.95, 95% CI: 0.93-0.96), female sex (AOR: 2.88, 95% CI: 1.25-6.62), <high school education (AOR: 4.02, 95% CI: 1.24-13.00), and non-US-born status with <20-years stay (AOR: 3.42, 95% CI: 1.44-8.11) were independent predictors of MU. Income was not a predictor of MU. The US cancer population has unique determinants of MU. Ethnicity alone is not a predictor of MU, whereas income is not correlated with MU. Public health interventions focusing on the attributes of MU are needed.
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Affiliation(s)
- Ahsan Wahab
- Internal Medicine/Hospital Medicine, Baptist Medical Center South, Prattville Baptist Hospital, Montgomery, AL
- * Correspondence: Ahsan Wahab, MD, MPH (Epidemiology), FACP, 124 South Memorial Drive, Prattville Baptist Hospital, Prattville, AL. (e-mail: )
| | - Basel Abdelazeem
- Internal Medicine, Mclaren Regional Medical Center, Michigan State University, Flint, MI
| | - Adeel Masood
- Hospital Medicine, Tidal Health Peninsula Regional, Salisbury, MD
| | - Maria Khakwani
- Internal Medicine, Lahore Medical and Dental College, Lahore, Pakistan
| | - Bharath Kumar Jakka
- Internal Medicine/Hospital Medicine, Baptist Medical Center South, Prattville Baptist Hospital, Montgomery, AL
| | - Ujwala Koduru
- Internal Medicine/Hospital Medicine, Mclaren Bay, Bay City, MI, and
| | - Hamid Ehsan
- Division of Hematology and Oncology, Clinical Hematology and Oncology Fellow, Levine Cancer Institute, Atrium Health, Charlotte, NC
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Carrasco-Aguilar A, Galán JJ, Carrasco RA. Obamacare: A bibliometric perspective. Front Public Health 2022; 10:979064. [PMID: 36033824 PMCID: PMC9416003 DOI: 10.3389/fpubh.2022.979064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/22/2022] [Indexed: 01/25/2023] Open
Abstract
Obamacare is the colloquial name given to the Affordable Care Act (ACA) signed into law by President Obama in the USA, which ultimately aims to provide universal access to health care services for US citizens. The aim of this paper is to provide an overview of the political-legal, economic, social, management (or administrative), and medical (or health) repercussions of this law, using a bibliometric methodology as a basis. In addition, the main contributors to research on ACA issues have been identified in terms of authors, organizations, journals, and countries. The downward trend in scientific production on this law has been noted, and it has been concluded that a balance has not yet been reached between the coexistence of private and public health care that guarantees broad social coverage without economic or other types of barriers. The law requires political consensus to be implemented in a definitive and global manner for the whole of the United States.
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Lu Y, Li M, Zhou Q, Fang D, Wu R, Li Q, Chen L, Su S. Dynamic network biomarker analysis and system pharmacology methods to explore the therapeutic effects and targets of Xiaoyaosan against liver cirrhosis. JOURNAL OF ETHNOPHARMACOLOGY 2022; 294:115324. [PMID: 35489663 DOI: 10.1016/j.jep.2022.115324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/26/2022] [Accepted: 04/22/2022] [Indexed: 06/14/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Xiaoyaosan is a traditional Chinese herbal formula that has long been used to treat liver cirrhosis, liver failure, and hepatocarcinoma (HCC). However, little is known about its mechanism of action and targets in treating chronic liver disease. AIM OF THE STUDY This study aimed to detect the critical transition of HCC progression and to explore the regulatory mechanism and targets of Xiaoyaosan treating liver cirrhosis (cirrhosis) using integrative medicinal research involving system biology and pharmacology. MATERIALS AND METHODS We recruited chronic liver disease participants to obtain gene expression data and applied the dynamic network biomarker (DNB) method to identify molecular markers and the critical transition. We combined network pharmacology and DNB analysis to locate the potential DNBs (targets). Then we validated the DNBs in the liver cirrhosis rat models using Xiaoyaosan treatment. The expression of genes encoding the four DNBs, including Cebpa, Csf1, Egfr, and Il7r, were further validated in rat liver tissue using Western blot analysis. RESULTS We found EGFR, CEBPA, Csf1, Ccnb1, Rrmm2, C3, Il7r, Ccna2, and Peg10 overlap in the DNB list and Xiaoyaosan-Target-Disease (XTD) network constructed using network pharmacology databases. We investigated the diagnostic ability of each member in the DNB cluster and found EGFR, CEBPA, CSF1, and IL7R had high diagnostic abilities with AUC >0.7 and P-value < 0.05. We validated these findings in rats and found that liver function improved significantly and fibrotic changes were relieved in the Xiaoyaosan treatment group. The expression levels of CSF1 and IL7R in the Xiaoyaosan group were significantly lower than those in the cirrhosis model group. In contrast, CEBPA expression in the Xiaoyaosan group was significantly higher than that in the cirrhosis model group. The expression of EGFR in the Xiaoyaosan group was slightly decreased than in the model group but not significantly. CONCLUSION Using the DNB method and network pharmacology approach, this study revealed that CEBPA, IL7R, EGFR, and CSF1 expression was remarkably altered in chronic liver disease and thus, may play an important role in driving the progression of cirrhosis. Therefore, CEBPA, IL7R, EGFR, and CSF1 may be important targets of Xiaoyaosan in treating cirrhosis and can be considered for developing novel therapeutics.
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Affiliation(s)
- Yiyu Lu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Meiyi Li
- Institute of Digestive Disease, Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Shenzhen Research Institute, Sha Tin, New Territories, Hong Kong, China
| | - Qianmei Zhou
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Dongdong Fang
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Rong Wu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Qingya Li
- Henan University of Chinese Medicine, Henan, 450046, China
| | - Luonan Chen
- Key Laboratory of Systems Biology, CAS Center for Excellence in Molecular Cell Science, Institute of Biochemistry and Cell Biology, Shanghai Institute of Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China; CAS Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, 650223, China.
| | - Shibing Su
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
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Arenas-Gallo C, Owiredu J, Weinstein I, Lewicki P, Basourakos SP, Vince R, Al Hussein Al Awamlh B, Schumacher FR, Spratt DE, Barbieri CE, Shoag JE. Race and prostate cancer: genomic landscape. Nat Rev Urol 2022; 19:547-561. [PMID: 35945369 DOI: 10.1038/s41585-022-00622-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/09/2022]
Abstract
In the past 20 years, new insights into the genomic pathogenesis of prostate cancer have been provided. Large-scale integrative genomics approaches enabled researchers to characterize the genetic and epigenetic landscape of prostate cancer and to define different molecular subclasses based on the combination of genetic alterations, gene expression patterns and methylation profiles. Several molecular drivers of prostate cancer have been identified, some of which are different in men of different races. However, the extent to which genomics can explain racial disparities in prostate cancer outcomes is unclear. Future collaborative genomic studies overcoming the underrepresentation of non-white patients and other minority populations are essential.
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Affiliation(s)
- Camilo Arenas-Gallo
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jude Owiredu
- Department of Urology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Ilon Weinstein
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Patrick Lewicki
- Department of Urology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Spyridon P Basourakos
- Department of Urology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Randy Vince
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Bashir Al Hussein Al Awamlh
- Department of Urology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA.,Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fredrick R Schumacher
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Daniel E Spratt
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Christopher E Barbieri
- Department of Urology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Jonathan E Shoag
- Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. .,Department of Urology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA. .,Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
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Ponce SEB, Thomas CR, Diaz DA. Social determinants of health, workforce diversity, and financial toxicity: A review of disparities in cancer care. Curr Probl Cancer 2022; 46:100893. [DOI: 10.1016/j.currproblcancer.2022.100893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
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Obeng-Gyasi S, Li Y, Carson WE, Reisenger S, Presley CJ, Shields PG, Carbone DP, Ceppa DP, Carlos RC, Andersen BL. Association of Allostatic Load With Overall Mortality Among Patients With Metastatic Non-Small Cell Lung Cancer. JAMA Netw Open 2022; 5:e2221626. [PMID: 35797043 PMCID: PMC9264034 DOI: 10.1001/jamanetworkopen.2022.21626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/11/2022] [Indexed: 01/13/2023] Open
Abstract
Importance Adverse social determinants of health (SDHs) (eg, poverty) are associated with poor oncologic outcomes among patients with lung cancer. However, no studies have evaluated biological correlates of adverse SDHs, operationalized as allostatic load (AL), with mortality due to lung cancer. Objective To examine the association among AL, SDHs, and mortality among patients with metastatic non-small cell lung cancer (NSCLC). Design, Setting, and Participants This cross-sectional study of an observational cohort was performed at a National Cancer Institute-designated comprehensive cancer center with data accrued from June 1, 2017, to August 31, 2019. Patients with metastatic (stage IV) NSCLC enrolled at diagnosis into a prospective observational cohort study were included in the present analysis if they had all the biomarkers to calculate an AL score (N = 143). Follow-up was completed on August 31, 2021, and data were analyzed from July 1 to September 30, 2021. Exposures Social determinants of health. Main Outcomes and Measures Overall mortality and AL. Results A total of 143 patients met the study criteria with a median age of 63 (IQR, 55-71) years (89 men [62.2%] and 54 women [37.8%]). In terms of race and ethnicity, 1 patient (0.7%) was Asian, 7 (4.9%) were Black, 117 (81.8%) were White, 17 (11.9%) were of multiple races, and 1 (0.7%) was of other race or ethnicity. The mean (SD) AL was 2.90 (1.37). Elevated AL covaried with lower educational level (r = -0.26; P = .002), male sex (r = 0.19; P = .02), limited mobility (r = 0.19; P = .04), worsening self-care (r = 0.30; P < .001), problems engaging in usual activities (r = 0.21; P = .01), depressive symptoms (r = 0.23; P = .005), and a high number of stressful life events (r = 0.30; P < .001). Multivariable analysis found only increasing difficulty with mobility (r = 0.37 [95% CI, 0.13-0.60]; P = .002) and male sex (r = 0.63 [95% CI, 0.19-1.08]; P = .005) associated with higher AL. On adjusted analysis, elevated AL (hazard ratio, 1.43 [95% CI, 1.16-1.79]; P = .001) and low educational level (hazard ratio, 2.11 [95% CI, 1.03-4.34]; P = .04) were associated with worse overall mortality. Conclusions and Relevance The findings of this cross-sectional study suggest that higher AL was associated with adverse SDHs and worse overall mortality among patients with advanced NSCLC. These results provide a framework for replication and further studies of AL as a biological correlate for SDH and future prognostic marker.
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Affiliation(s)
- Samilia Obeng-Gyasi
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus
| | - Yaming Li
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - William E. Carson
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus
| | - Sarah Reisenger
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus
| | - Carolyn J. Presley
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus
| | - Peter G. Shields
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus
| | - David P. Carbone
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus
| | - DuyKhanh P. Ceppa
- Department of Surgery, Indiana University School of Medicine, Indianapolis
| | - Ruth C. Carlos
- University of Michigan Comprehensive Cancer Center, Ann Arbor
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A Flexible Method for Identifying Spatial Clusters of Breast Cancer Using Individual-Level Data. Ann Epidemiol 2022; 73:9-16. [PMID: 35772615 DOI: 10.1016/j.annepidem.2022.06.006] [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: 02/04/2022] [Revised: 05/16/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022]
Abstract
Prior research has shown that cancer risk varies by geography, but scan statistics methods for identifying cancer clusters in case-control studies have been limited in their ability to identify multiple clusters and adjust for participant-level risk factors. We develop a method to identify geographic patterns of breast cancer odds using the Wisconsin Women's Health Study, a series of 5 population-based case-control studies of female Wisconsin residents aged 20-79 enrolled in 1988-2004 (cases=16,076, controls=16,795). We create sets of potential clusters by overlaying a 1 km grid over each county-neighborhood and enumerating a series of overlapping circles. Using a two-step approach, we fit a penalized binomial regression model to the number of cases and trials in each grid cell, penalizing all potential clusters by the least absolute shrinkage and selection operator (Lasso). We use BIC to select the number of clusters, which are included in a participant-level logistic regression model. We identify 15 geographic clusters, resulting in 23 areas of unique geographic odds ratios. After adjustment for known risk factors, confidence intervals narrowed but breast cancer odds ratios did not meaningfully change; one additional hotspot was identified. By considering multiple overlapping spatial clusters simultaneously, we discern gradients of spatial odds across Wisconsin.
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Zhang M, Yu X, Zhang Q, Sun Z, He Y, Guo W. MIR4435-2HG: A newly proposed lncRNA in human cancer. Biomed Pharmacother 2022; 150:112971. [PMID: 35447550 DOI: 10.1016/j.biopha.2022.112971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 12/24/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) play important roles in the occurrence and progression of tumors. Extensive research has contributed to the current understanding of the critical roles played by lncRNAs in various cancers. LncRNA MIR4435-2HG has been found to be crucial in many cancers, such as breast, cervical, colorectal, and gastric cancer. Expression of MIR4435-2HG is generally upregulated in cancers and MIR4435-2HG participates in many biological functions through molecular mechanism of competitive endogenous RNA networks. This review profiles recent research findings on the expression, functions, mechanism, and clinical value of MIR4435-2HG in cancer, and serves as a reference for further MIR4435-2HG-related research and clinical trials.
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Affiliation(s)
- Menggang Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Open and Key Laboratory of Hepatobiliary & Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, China; Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, China
| | - Xiao Yu
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Open and Key Laboratory of Hepatobiliary & Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, China; Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, China
| | - Qiyao Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Open and Key Laboratory of Hepatobiliary & Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, China; Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, China
| | - Zongzong Sun
- Department of Obstetrics and Gynaecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan, China
| | - Yuting He
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Open and Key Laboratory of Hepatobiliary & Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, China; Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, China.
| | - Wenzhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Open and Key Laboratory of Hepatobiliary & Pancreatic Surgery and Digestive Organ Transplantation at Henan Universities, Zhengzhou 450052, China; Henan Key Laboratory of Digestive Organ Transplantation, Zhengzhou 450052, China.
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Loughlin DT. Every Patient. Trends Cancer 2022; 8:259-261. [DOI: 10.1016/j.trecan.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 10/18/2022]
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Sharma RK, Irace AL, Overdevest JB, Turner JH, Patel ZM, Gudis DA. Association of Race, Ethnicity, and Socioeconomic Status With Esthesioneuroblastoma Presentation, Treatment, and Survival. OTO Open 2022; 6:2473974X221075210. [PMID: 35174302 PMCID: PMC8841922 DOI: 10.1177/2473974x221075210] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/01/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Socioeconomic and other demographic factors are associated with outcomes in head and neck cancer. This study uses a national cancer database to explore how patient race, ethnicity, and socioeconomic status (SES) are associated with esthesioneuroblastoma outcomes, including 5-year disease-specific survival (DSS), conditional DSS, stage at diagnosis, and treatment. Study Design Retrospective cohort analysis. Setting Patients with esthesioneuroblastomas between 1973 and 2015 from the SEER registry (Surveillance, Epidemiology, and End Results). Methods The National Cancer Institute Yost Index, a census tract–level composite score composed of 7 parameters, was used to categorize the SES of patients. Kaplan-Meier analysis and Cox regression were conducted to assess DSS. Conditional DSS was calculated per estimates from simplified Cox models. Logistic regression was conducted to identify risk factors for advanced cancer stage at diagnosis and the likelihood of receiving multimodal therapy. Results Complete data were included for 561 patients. DSS was significantly associated with SES (log-rank, P < .01) but not race. According to Cox regression, DSS was worse for the lowest SES tertile vs the highest (hazard ratio, 1.70 [95% CI, 1.05-2.75]; P = .03). Patients of the lowest SES tertile exhibited an increased risk of advanced cancer stage at diagnosis as compared with the highest SES tertile (odds ratio, 1.84 [95% CI, 1.06-3.30]; P = .035). Black patients (odds ratio, 0.44 [95% CI, 0.24-0.84]; P = .011) were less likely than other patients to receive multimodal therapy. SES alone was not associated with receiving multimodal therapy. Conclusion SES is significantly associated with DSS and conditional DSS for patients with esthesioneuroblastomas. Inequalities in access to care and treatment likely contribute to these disparities.
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Affiliation(s)
- Rahul K. Sharma
- Department of Otolaryngology–Head and Neck Surgery, Columbia University Irving Medical Center, NewYork–Presbyterian Hospital, New York, New York, USA
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alexandria L. Irace
- Department of Otolaryngology–Head and Neck Surgery, Columbia University Irving Medical Center, NewYork–Presbyterian Hospital, New York, New York, USA
| | - Jonathan B. Overdevest
- Department of Otolaryngology–Head and Neck Surgery, Columbia University Irving Medical Center, NewYork–Presbyterian Hospital, New York, New York, USA
| | - Justin H. Turner
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Zara M. Patel
- Department of Otolaryngology–Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - David A. Gudis
- Department of Otolaryngology–Head and Neck Surgery, Columbia University Irving Medical Center, NewYork–Presbyterian Hospital, New York, New York, USA
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Diversifying preclinical research tools: expanding patient-derived models to address cancer health disparities. Trends Cancer 2022; 8:291-294. [DOI: 10.1016/j.trecan.2022.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 12/15/2022]
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DInur-Schejter Y, Stepensky P. Social determinants of health and primary immunodeficiency. Ann Allergy Asthma Immunol 2021; 128:12-18. [PMID: 34628007 DOI: 10.1016/j.anai.2021.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Inborn errors of immunity (IEI) are rare genetic conditions affecting the immune system. The rate of IEI and their presentation, course, and treatment are all affected by a multitude of social determinants, eventually affecting prognosis. This review summarizes the current knowledge of the social determinants affecting infectious susceptibility, genetic predisposition, diagnosis, and treatment of IEI. DATA SOURCES PubMed. STUDY SELECTIONS Search terms included "consanguinity," "social determinants," and "founder effect." Further studies were selected based on relevant citations. RESULTS Changes in climate and human behavior have modulated the spread of disease vectors and infectious organisms. Consanguinity increases the rate of autosomal recessive conditions, changes the distribution, and affects the severity of IEI. Access to sophisticated genetic and immunologic diagnostic modalities affects genetic counseling and timely diagnosis. Effective genetic counseling should address to the patient's genetic background and ethical code. Access to appropriate and timely treatment of immunodeficiencies is scarce in some regions of the world. CONCLUSION High consanguinity rate and reduced access to prophylactic measures increase the burden of immunodeficiencies in many low- and medium-income countries. Furthermore, poor access to diagnostic and treatment modalities in these regions adversely affects patients' prognosis. Increased awareness among health care professionals and the public and increased collaboration with Western countries aid in diagnosis of these conditions. Further advancements require improved public funding to the prevention, diagnosis, and treatment of IEI.
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Affiliation(s)
- Yael DInur-Schejter
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah Ein Kerem Medical Center, Jerusalem, Israel.
| | - Polina Stepensky
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
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Kiely M, Milne GL, Minas TZ, Dorsey TH, Tang W, Smith CJ, Baker F, Loffredo CA, Yates C, Cook MB, Ambs S. Urinary Thromboxane B2 and Lethal Prostate Cancer in African American Men. J Natl Cancer Inst 2021; 114:123-129. [PMID: 34264335 DOI: 10.1093/jnci/djab129] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/29/2021] [Accepted: 06/23/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Thromboxane A2 (TXA2) is a platelet- and cyclooxygenase-derived eicosanoid that has been linked to metastasis. We investigated the role of TXA2 in the development of lethal prostate cancer in African American (AA) and European American (EA) men. METHODS We measured urinary 11-dehydrothromboxane B2 (TXB2), a stable metabolite of TXA2, with mass-spectrometry. Samples were obtained from 977 cases and 1022 controls at time of recruitment. We applied multivariable logistic and Cox regression modeling to examine associations of TXB2 with prostate cancer and patient survival. Median survival follow-up was 8.4 years with 246 deaths among cases. Aspirin use was assessed with a questionnaire. Race/ethnicity was self-reported. RESULTS Urinary TXB2 was inversely associated with aspirin use. High (> median) TXB2 was associated with prostate cancer in AA (adjusted odds ratio [OR] = 1.50, 95% confidence interval [CI]= 1.13-2.00) but not EA men (OR = 1.07, 95% CI = 0.82-1.40), suggesting upregulated TXA2 synthesis in AA men with prostate cancer. High TXB2 was positively associated with metastatic prostate cancer (OR = 2.60, 95%CI = 1.08-6.28), compared with low (≤ median) TXB2. Furthermore, high TXB2 was also associated with all-cause (adjusted hazard ratio = 1.59, 95% CI = 1.06-2.40) and prostate cancer-specific mortality (hazard ratio = 4.74, 95%CI = 1.62-13.88 in AA men only. CONCLUSION We report a distinct association of TXB2 with prostate cancer outcomes in AA men. In this high-risk group of men, upregulation of TXA2/TXB2 synthesis may promote metastasis and lethal disease. Our observation identifies a potential benefit of aspirin in preventing lethal prostate cancer through inhibition of TXA2 synthesis.
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Affiliation(s)
- Maeve Kiely
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Ginger L Milne
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Tsion Z Minas
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Tiffany H Dorsey
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Wei Tang
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Cheryl J Smith
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Francine Baker
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Christopher A Loffredo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Clayton Yates
- Department of Biology, Center for Cancer Research, Tuskegee University, Tuskegee, Alabama, USA
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USA
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Harris CC. Editor-in-Chief's Editorial 2021 January Issue 42:1. Carcinogenesis 2021; 42:1. [PMID: 33527994 DOI: 10.1093/carcin/bgab003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/09/2021] [Indexed: 11/15/2022] Open
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Kiely M, Ambs S. Immune Inflammation Pathways as Therapeutic Targets to Reduce Lethal Prostate Cancer in African American Men. Cancers (Basel) 2021; 13:2874. [PMID: 34207505 PMCID: PMC8227648 DOI: 10.3390/cancers13122874] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 01/17/2023] Open
Abstract
Despite substantial improvements in cancer survival, not all population groups have benefitted equally from this progress. For prostate cancer, men of African descent in the United States and England continue to have about double the rate of fatal disease compared to other men. Studies suggest that when there is equal access to care, survival disparities are greatly diminished. However, notable differences exist in prostate tumor biology across population groups. Ancestral factors and disparate exposures can lead to altered tumor biology, resulting in a distinct disease etiology by population group. While equal care remains the key target to improve survival, additional efforts should be made to gain comprehensive knowledge of the tumor biology in prostate cancer patients of African descent. Such an approach may identify novel intervention strategies in the era of precision medicine. A growing body of evidence shows that inflammation and the immune response may play a distinct role in prostate cancer disparities. Low-grade chronic inflammation and an inflammatory tumor microenvironment are more prevalent in African American patients and have been associated with adverse outcomes. Thus, differences in activation of immune-inflammatory pathways between African American and European American men with prostate cancer may exist. These differences may influence the response to immune therapy which is consistent with recent observations. This review will discuss mechanisms by which inflammation may contribute to the disparate outcomes experienced by African American men with prostate cancer and how these immunogenic and inflammatory vulnerabilities could be exploited to improve their survival.
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Affiliation(s)
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA;
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Kakarla M, ChallaSivaKanaka S, Hayward SW, Franco OE. Race as a Contributor to Stromal Modulation of Tumor Progression. Cancers (Basel) 2021; 13:cancers13112656. [PMID: 34071280 PMCID: PMC8197868 DOI: 10.3390/cancers13112656] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/18/2021] [Accepted: 05/23/2021] [Indexed: 02/07/2023] Open
Abstract
Stromal cells play crucial roles in tumor development and are increasingly attractive targets for therapy. There are considerable racial disparities in the incidence and progression of many tumors, reflecting both environmental exposure and genetic differences existing between races. Tumorigenesis and tumor progression are linked to both the propensity to suffer an initiating event and the host response to such an event once it occurs, contributing to incidence and outcomes. In this review, we focused on racial disparities in the tumor microenvironment (TME) of different cancers as potential modulators of growth, metastasis, and response to treatment. Several studies suggest that the TME in AA has a distinct tumor biology and may facilitate both early onset and aggressive tumor growth while inhibiting anti-tumorigenic properties. The TME of AA patients often exhibits an immunosuppressive microenvironment with a substantial enrichment of immune inflammatory pathways and genes. As a result, AA patients can potentially benefit more from treatment strategies that modulate the immune system. Focusing on TME components for diagnostic and therapeutic purposes to address racial disparities is a promising area of investigation. Future basic and clinical research studies on personalized cancer diagnosis and treatment should acknowledge the significance of TME in racial disparities.
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