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Murray A, Browe D, Darling KW, Reardon J. Cells and the city: The rise and fall of urban biopolitics in San Francisco, 1970-2020. SOCIAL STUDIES OF SCIENCE 2024:3063127241261376. [PMID: 39041392 DOI: 10.1177/03063127241261376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
STS theories of biocapital conceptualize how biomedical knowledge and capital form together. Though these formations of biocapital often are located in large urban centers, few scholars have attended to how they are transforming urban spaces and places. In this paper we argue that the twinned technological development of cells and cities concentrates economic and symbolic capital and sets in motion contentious practices we name urban biopolitics. We draw on archival research and a nearly decade-long ethnography of the expansion of biomedical campuses in a major American city to show how the speculative logics of land development and biomedical innovation become bound together in a process we describe as speculative revitalization. We examine how the logics of speculative revitalization imagine a future in which cities and biomedicine produce wealth and health harmoniously together. However, in practice-as buildings of new biomedical urban campuses get built-the dreams of billionaire philanthrocapitalists to create global cities clash with the plans of biomedical researchers to create global health. We document the reproduction of stratified and racialized biomedical exclusions that result while also highlighting the unlikely opportunities for creating alliances committed to creating equitable biomedical research and healthcare in urban communities.
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Affiliation(s)
- Andy Murray
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dennis Browe
- University of California, Santa Cruz, Santa Cruz, CA, USA
| | | | - Jenny Reardon
- University of California, Santa Cruz, Santa Cruz, CA, USA
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2
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Goldfinger E, Stoler J, Goel N. A Multiscale Spatiotemporal Epidemiological Analysis of Neighborhood Correlates of Triple-Negative Breast Cancer. Cancer Epidemiol Biomarkers Prev 2024; 33:279-287. [PMID: 37971370 PMCID: PMC11367848 DOI: 10.1158/1055-9965.epi-22-1255] [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: 11/29/2022] [Revised: 02/18/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Women living in disadvantaged neighborhoods present with increased prevalence rates of triple-negative breast cancer (TNBC). This study takes a spatiotemporal epidemiological approach to understand the impact of socioenvironmental contextual factors on TNBC prevalence rates. METHODS We analyzed 935 TNBC cases from a major cancer center registry, between 2005 and 2017, to explore spatial and space-time clusters of TNBC prevalence rates at the census tract and neighborhood scales. Spatial regression analysis was performed to examine relationships between nine socioenvironmental factors and TNBC prevalence rates at both ecological scales. RESULTS We observed spatial clustering of high TNBC prevalence rates along a north-south corridor of Miami-Dade County along Interstate 95, a region containing several majority non-Hispanic Black neighborhoods. Among the ecologic measures, the percent of a region designated as a brownfield was associated with TNBC prevalence rates at the tract-level (β = 4.27; SE = 1.08; P < 0.001) and neighborhood-level (β = 8.61; SE = 2.20; P < 0.001). CONCLUSIONS Our spatiotemporal analysis identified robust patterns of hot spots of TNBC prevalence rates in a corridor of several disadvantaged neighborhoods in the northern half of the county. These patterns of TNBC align with the literature regarding at-risk groups and neighborhood-level effects on TNBC; however, remain to be validated in a population-based sample. IMPACT Spatial epidemiological approaches can help public health officials and cancer care providers improve place-specific screening, patient care, and understanding of socioenvironmental factors that may shape breast cancer subtype through gene-environment and epigenetic interactions.
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Affiliation(s)
- Erica Goldfinger
- Department of Geography and Sustainable Development, University of Miami, Coral Gables, FL, USA
- Abess Center for Ecosystem Science and Policy, University of Miami, Coral Gables, FL, USA
| | - Justin Stoler
- Department of Geography and Sustainable Development, University of Miami, Coral Gables, FL, USA
- Abess Center for Ecosystem Science and Policy, University of Miami, Coral Gables, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Neha Goel
- Department of Surgery, Division of Surgical Oncology, University of Miami Miller School of Medicine, Coral Gables, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Coral Gables, FL, USA
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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3
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Valencia CI, Wightman P, Morrill KE, Hsu C, Arif‐Tiwari H, Kauffman E, Gachupin FC, Chipollini J, Lee BR, Garcia DO, Batai K. Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona. Cancer Med 2024; 13:e7007. [PMID: 38400688 PMCID: PMC10891465 DOI: 10.1002/cam4.7007] [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: 09/06/2023] [Revised: 12/21/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Hispanics and American Indians (AI) have high kidney cancer incidence and mortality rates in Arizona. This study assessed: (1) whether racial and ethnic minority patients and patients from neighborhoods with high social vulnerability index (SVI) experience a longer time to surgery after clinical diagnosis, and (2) whether time to surgery, race and ethnicity, and SVI are associated with upstaging to pT3/pT4, disease-free survival (DFS), and overall survival (OS). METHODS Arizona Cancer Registry (2009-2018) kidney and renal pelvis cases (n = 4592) were analyzed using logistic regression models to assess longer time to surgery and upstaging. Cox-regression hazard models were used to test DFS and OS. RESULTS Hispanic and AI patients with T1 tumors had a longer time to surgery than non-Hispanic White patients (median time of 56, 55, and 45 days, respectively). Living in neighborhoods with high (≥75) overall SVI increased odds of a longer time to surgery for cT1a (OR 1.54, 95% CI: 1.02-2.31) and cT2 (OR 2.32, 95% CI: 1.13-4.73). Race and ethnicity were not associated with time to surgery. Among cT1a patients, a longer time to surgery increased odds of upstaging to pT3/pT4 (OR 1.95, 95% CI: 0.99-3.84). A longer time to surgery was associated with PFS (HR 1.52, 95% CI: 1.17-1.99) and OS (HR 1.63, 95% CI: 1.26-2.11). Among patients with cT2 tumor, living in high SVI neighborhoods was associated with worse OS (HR 1.66, 95% CI: 1.07-2.57). CONCLUSIONS High social vulnerability was associated with increased time to surgery and poor survival after surgery.
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Affiliation(s)
- Celina I. Valencia
- Department of Family and Community Medicine, College of Medicine – TucsonThe University of ArizonaTucsonArizonaUSA
| | - Patrick Wightman
- Center for Population Health SciencesThe University of ArizonaTucsonArizonaUSA
| | - Kristin E. Morrill
- Community and Systems Health Science Division, College of NursingThe University of ArizonaTucsonArizonaUSA
| | - Chiu‐Hsieh Hsu
- Department of Epidemiology and BiostatisticsThe University of ArizonaTucsonArizonaUSA
| | - Hina Arif‐Tiwari
- Department of Medical ImagingThe University of ArizonaTucsonArizonaUSA
| | - Eric Kauffman
- Department of UrologyRoswell Park Comprehensive Cancer CenterBuffaloNew YorkUSA
| | - Francine C. Gachupin
- Department of Family and Community Medicine, College of Medicine – TucsonThe University of ArizonaTucsonArizonaUSA
| | - Juan Chipollini
- Department of UrologyThe University of ArizonaTucsonArizonaUSA
| | - Benjamin R. Lee
- Department of UrologyThe University of ArizonaTucsonArizonaUSA
| | - David O. Garcia
- Department of Health Promotion SciencesThe University of ArizonaTucsonArizonaUSA
| | - Ken Batai
- Department of Cancer Prevention and ControlRoswell Park Comprehensive Cancer CenterBuffaloNew YorkUSA
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Mazor M, David D, Moorehead D, Merriman JD, Lin JJ. Community Navigation and Supportive Care Experiences of Low-Income Black and Latina Cancer Survivors: Patient and Navigator Perspectives. JOURNAL OF ONCOLOGY NAVIGATION & SURVIVORSHIP 2023; 14:https://www.jons-online.com/jons-categories?view=article&artid=4883:low-income-black-and-latina-cancer-survivors&catid=128. [PMID: 37293184 PMCID: PMC10249905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Little is known about the role of community-based navigation in supportive care delivery for historically marginalized cancer survivors. The purposes of this study were to evaluate supportive care experiences of low-income, Black and Latina cancer survivors and examine the care role of their community navigator. Methods Qualitative evaluation of semi-structured interviews with Black and Latina cancer survivors (n=10) and navigators (n=4) from a community-based organization for low-income women were conducted and analyzed using content analysis. Results Content analysis yielded six themes that described the supportive care experience over time and before and after navigator support. Navigating supportive care alone: a) internal and external influencers; b) alone and just surviving; c) feeling overwhelmed and distressed. Community Navigator delivered supportive care: a) establishing trust and safety; b) accepting multi-dimensional, navigator assisted supportive care management; c) distress alleviation. Conclusions Low-income Black and Latina women with cancer reported internal strength yet endured cancer care alone leading to a feeling of distress. Subsequently, community navigators provided patient-centric, supportive care and alleviate physical and emotional distress. These findings highlight the importance of increasing awareness of and linkage to community navigators who may be able to meet the supportive care needs of diverse patient populations.
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Affiliation(s)
- Melissa Mazor
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Drs. Lin and Mazor); Rory Meyers College of Nursing, New York University, New York, New York (Drs. David and Merriman); Women's Cancer Resource Center, Berkeley, California (Ms. Moorehead)
| | - Daniel David
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Drs. Lin and Mazor); Rory Meyers College of Nursing, New York University, New York, New York (Drs. David and Merriman); Women's Cancer Resource Center, Berkeley, California (Ms. Moorehead)
| | - Dolores Moorehead
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Drs. Lin and Mazor); Rory Meyers College of Nursing, New York University, New York, New York (Drs. David and Merriman); Women's Cancer Resource Center, Berkeley, California (Ms. Moorehead)
| | - John D Merriman
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Drs. Lin and Mazor); Rory Meyers College of Nursing, New York University, New York, New York (Drs. David and Merriman); Women's Cancer Resource Center, Berkeley, California (Ms. Moorehead)
| | - Jenny J Lin
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York (Drs. Lin and Mazor); Rory Meyers College of Nursing, New York University, New York, New York (Drs. David and Merriman); Women's Cancer Resource Center, Berkeley, California (Ms. Moorehead)
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Du XL, Song L. Age and Racial Disparities in the Utilization of Anticancer, Antihypertension, and Anti-diabetes Therapies, and in Mortality in a Large Population-Based Cohort of Older Women with Breast Cancer. J Racial Ethn Health Disparities 2023; 10:446-461. [PMID: 35040106 PMCID: PMC10721385 DOI: 10.1007/s40615-022-01235-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study examined the receipt of therapies for cancer, hypertension, and diabetes in association with age and racial disparities in mortality among women with breast cancer. METHODS This study identified 92,829 women diagnosed with breast cancer at age ≥ 65 years in 2007-2015 with follow-up to 2016 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. RESULTS There were substantial age and racial disparities in the prevalence of hypertension and diabetes, which was higher in women ≥ 75 (86.3% and 32.0%) than younger women 65-74 (72.8% and 29.3%), and the highest in Black women (91.1% and 49.1%), followed by Asian women (80.2% and 40.5%), and White women (77.6 and 27.8%). Black women were significantly less likely to receive chemotherapy (odds ratio: 0.70, 95% CI: 0.64-0.75), radiation therapy (0.87, 0.83-0.92), and hormone therapy (0.80, 0.76-0.85), but significantly more likely to receive antihypertensive (1.26, 1.19-1.33) and antidiabetic (1.19, 1.10-1.28) drugs than White women, after adjusting for sociodemographic and tumor factors. As compared to White women, Black women had a significantly higher risk of all-cause mortality (1.46, 1.41-1.52), but it became insignificant after adjusting for treatment factors (1.01, 0.97-1.06), whereas the adjusted risk of breast cancer-specific mortality remained significantly higher (1.08, 1.01-1.15) in Black women; Asian and other ethnic women had a significantly lower risk of all-cause and breast cancer-specific mortality. CONCLUSIONS There were substantial age and racial disparities in the prevalence of hypertension and diabetes and in the receipt of medications. Black women did not have a significantly higher risk of all-cause mortality but had a significantly higher risk of breast cancer-specific mortality as compared to White women.
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Affiliation(s)
- Xianglin L Du
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX, 77030, USA.
| | - Lulu Song
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX, 77030, USA
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Tatalovich Z, Stinchcomb DG, Ng D, Yu M, Lewis DR, Zhu L, Feuer EJR. Developing Geographic Areas for Cancer Reporting Using Automated Zone Design. Am J Epidemiol 2022; 191:2109-2119. [PMID: 36043397 DOI: 10.1093/aje/kwac155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 08/03/2022] [Accepted: 08/23/2022] [Indexed: 02/01/2023] Open
Abstract
The reporting and analysis of population-based cancer statistics in the United States has traditionally been done for counties. However, counties are not ideal for analysis of cancer rates, due to wide variation in population size, with larger counties having considerable sociodemographic variation within their borders and sparsely populated counties having less reliable estimates of cancer rates that are often suppressed due to confidentiality concerns. There is a need and an opportunity to utilize zone design procedures in the context of cancer surveillance to generate coherent, statistically stable geographic units that are more optimal for cancer reporting and analysis than counties. To achieve this goal, we sought to create areas within each US state that are: 1) similar in population size and large enough to minimize rate suppression; 2) sociodemographically homogeneous; 3) compact; and 4) custom crafted to represent areas that are meaningful to cancer registries and stakeholders. The resulting geographic units reveal the heterogeneity of rates that are hidden when reported at the county-level while substantially reducing the need to suppress data. We believe this effort will facilitate more meaningful comparative analysis of cancer rates for small geographic areas and will advance the understanding of cancer burden in the United States.
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McClintock NC, Ayabe RI, Salas Parra RD, Kaji AH, Orozco JIJ, Marzese DM, Samuels E, Stern SL, Dauphine C, Ozao-Choy JJ. A Microcosm of Disparities in Breast Cancer: Comparison Between a Private Hospital and a Safety-Net County Hospital Within Los Angeles County. Am Surg 2022; 88:1653-1656. [PMID: 33629873 DOI: 10.1177/0003134821998668] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breast cancer survival is improving due to early detection and treatment advances. However, racial/ethnic differences in tumor biology, stage, and mortality remain. The objective of this study was to analyze presumed disparities at a local level. METHODS Breast cancer patients at a county hospital and private hospital from 2010 to 2012 were retrospectively reviewed. Demographic, clinical, pathologic, and surgical data were collected. Comparisons were made between hospital cohorts and between racial/ethnic groups from both hospitals combined. RESULTS 754 patients were included (322 from county hospital and 432 from private hospital). All patients were female. The median age was 54 years at county hospital and 60 years at private hospital (P < .0001). Racial/ethnic minorities comprised 85% of county hospital patients vs. 12% of private hospital patients (P < .0001). County hospital patients had a higher grade, clinical/pathologic stage, HER2-positive rate, and mastectomy rate. Compared to other racial/ethnic groups, non-Hispanic white women were more likely to have lower grade and ER-positive tumors. Hispanic/Latina women were younger and were more likely to have HER2-positive tumors. Both Hispanic/Latina and non-Hispanic black women presented at higher clinical stages and were more likely to undergo neoadjuvant chemotherapy and mastectomy. DISCUSSION At county hospital compared to private hospital, the proportion of racial/ethnic minorities was higher, and patients presented at younger ages with more aggressive tumors and more advanced disease. The racial/ethnic disparities that were identified locally are largely consistent with those identified in national database studies. These marked differences at hospitals within a diverse city highlight the need for further research into the disparities.
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Affiliation(s)
| | - Reed I Ayabe
- 21640Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | - Amy H Kaji
- 21640Harbor-UCLA Medical Center, Torrance, CA, USA
- Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Javier I J Orozco
- Saint John's Cancer Institute (formerly know as John Wayne Cancer Institute), 20279Santa Monica, CA, USA
| | - Diego M Marzese
- Saint John's Cancer Institute (formerly know as John Wayne Cancer Institute), 20279Santa Monica, CA, USA
- Cancer Biology Group, 20279Balearic Islands Health Research Institute (IDISBA), Palma, Spain
| | - Estela Samuels
- Saint John's Cancer Institute (formerly know as John Wayne Cancer Institute), 20279Santa Monica, CA, USA
| | - Stacey L Stern
- Saint John's Cancer Institute (formerly know as John Wayne Cancer Institute), 20279Santa Monica, CA, USA
| | - Christine Dauphine
- 21640Harbor-UCLA Medical Center, Torrance, CA, USA
- Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Junko J Ozao-Choy
- 21640Harbor-UCLA Medical Center, Torrance, CA, USA
- Los Angeles Biomedical Research Institute, Torrance, CA, USA
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Sorice KA, Fang CY, Wiese D, Ortiz A, Chen Y, Henry KA, Lynch SM. Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum. Cancer Med 2022; 11:2125-2144. [PMID: 35166051 PMCID: PMC9119356 DOI: 10.1002/cam4.4601] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/03/2021] [Accepted: 12/28/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND There is extensive interest in understanding how neighborhood socioeconomic status (nSES) may affect cancer incidence or survival. However, variability regarding items included and approaches used to form a composite nSES index presents challenges in summarizing overall associations with cancer. Given recent calls for standardized measures of neighborhood sociodemographic effects in cancer disparity research, the objective of this systematic review was to identify and compare existing nSES indices studied across the cancer continuum (incidence, screening, diagnosis, treatment, survival/mortality) and summarize associations by race/ethnicity and cancer site to inform future cancer disparity studies. METHODS Using PRISMA guidelines, peer-reviewed articles published between 2010 and 2019 containing keywords related to nSES and cancer were identified in PubMed. RESULTS Twenty-four nSES indices were identified from 75 studies. In general, findings indicated a significant association between nSES and cancer outcomes (n = 64/75 studies; 85.33%), with 42/64 (65.63%) adjusting for highly-correlated individual SES factors (e.g., education). However, the direction of association differed by cancer site, race/ethnicity, and nSES index. CONCLUSIONS This review highlights several methodologic and conceptual issues surrounding nSES measurement and potential associations with cancer disparities. Recommendations pertaining to the selection of nSES measures are provided, which may help inform disparity-related disease processes and improve the identification of vulnerable populations in need of intervention.
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Affiliation(s)
- Kristen A. Sorice
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Carolyn Y. Fang
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Daniel Wiese
- Geography and Urban StudiesTemple UniversityPhiladelphiaPAUSA
| | - Angel Ortiz
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Yuku Chen
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Kevin A. Henry
- Geography and Urban StudiesTemple UniversityPhiladelphiaPAUSA
| | - Shannon M. Lynch
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
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Hiatt RA, Sibley A, Venkatesh B, Cheng J, Dixit N, Fox R, Ling P, Nguyen T, Oh D, Palmer NR, Pasick RJ, Potter MB, Somsouk M, Vargas RA, Vijayaraghavan M, Ashworth A. From Cancer Epidemiology to Policy and Practice: the Role of a Comprehensive Cancer Center. CURR EPIDEMIOL REP 2022; 9:10-21. [PMID: 35342686 PMCID: PMC8935108 DOI: 10.1007/s40471-021-00280-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2021] [Indexed: 11/24/2022]
Abstract
Purpose of Review Cancer incidence and mortality are decreasing, but inequities in outcomes persist. This paper describes the San Francisco Cancer Initiative (SF CAN) as a model for the systematic application of epidemiological evidence to reduce the cancer burden and associated inequities. Recent Findings SF CAN is a multi-institutional implementation of existing evidence on the prevention and early detection of five common cancers (i.e., breast, prostate, colorectal, liver, and lung/tobacco-related cancers) accounting for 50% of cancer deaths in San Francisco. Five Task Forces follow individual logic models designating inputs, outputs, and outcomes. We describe the progress made and the challenges faced by each Task Force after 5 years of activity. Summary SF CAN is a model for how the nation’s Comprehensive Cancer Centers are ideally positioned to leverage cancer epidemiology for evidence-based initiatives that, along with genuine community engagement and multiple stakeholders, can reduce the population burden of cancer.
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Affiliation(s)
- Robert A Hiatt
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, USA.,Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, USA.,Mission Hall UCSF, 550 16th Street, 2nd Floor, San Francisco, CA 94158 USA
| | - Amanda Sibley
- Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, USA
| | - Brinda Venkatesh
- Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, USA
| | - Joyce Cheng
- Chinese Community Health Resource Center, San Francisco, USA
| | - Niharika Dixit
- Division of Hematology/Oncology, UCSF at Zuckerberg San Francisco General Hospital, San Francisco, USA
| | - Rena Fox
- Department of Medicine, UCSF, San Francisco, USA
| | - Pamela Ling
- Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, USA.,Department of Medicine, UCSF, San Francisco, USA.,Center for Tobacco Control Research and Education, UCSF, San Francisco, USA
| | - Tung Nguyen
- Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, USA.,Department of Medicine, UCSF, San Francisco, USA
| | - Debora Oh
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, USA
| | | | | | - Michael B Potter
- Department of Family and Community Medicine, UCSF, San Francisco, USA
| | - Ma Somsouk
- Division of Gastroenterology, UCSF, San Francisco, USA
| | - Roberto Ariel Vargas
- Center for Community Engagement, UCSF, San Francisco, USA.,Clinical and Translational Science Institute, UCSF, San Francisco, USA
| | | | - Alan Ashworth
- Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, USA
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10
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Cancer healthcare disparities among African Americans in the United States. J Natl Med Assoc 2022; 114:236-250. [DOI: 10.1016/j.jnma.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/10/2022] [Indexed: 12/16/2022]
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11
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Williams AD, Buckley M, Ciocca RM, Sabol JL, Larson SL, Carp NZ. Racial and socioeconomic disparities in breast cancer diagnosis and mortality in Pennsylvania. Breast Cancer Res Treat 2022; 192:191-200. [PMID: 35064367 DOI: 10.1007/s10549-021-06492-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Many studies have demonstrated disparities in breast cancer (BC) incidence and mortality among Black women. We hypothesized that in Pennsylvania (PA), a large economically diverse state, BC diagnosis and mortality would be similar among races when stratified by a municipality's median income. METHODS We collected the frequencies of BC diagnosis and mortality for years 2011-2015 from the Pennsylvania Cancer Registry and demographics from the 2010 US Census. We analyzed BC diagnoses and mortalities after stratifying by median income, municipality size, and race with univariable and multivariable logistic regression models. RESULTS In this cohort, of 5,353,875 women there were 54,038 BC diagnoses (1.01% diagnosis rate) and 9,828 BC mortalities (0.18% mortality rate). Unadjusted diagnosis rate was highest among white women (1.06%) but Black women had a higher age-adjusted diagnosis rate (1.06%) than white women (1.02%). Race, age and income were all significantly associated with BC diagnosis, but there were no differences in BC diagnosis between white and Black women across all levels of income in the multivariable model. BC mortality was highest in Black women, a difference which persisted when adjusted for age. Black women 35 years and older had a higher mortality rate in all income quartiles. CONCLUSION We found that in PA, age, race and income are all associated with BC diagnosis and mortality with noteworthy disparities for Black women. Continued surveillance of differences in both breast cancer diagnosis and mortality, and targeted interventions related to education, screening and treatment may help to eliminate these socioeconomic and racial disparities.
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Affiliation(s)
| | - Meghan Buckley
- Main Line Health Center for Population Health Research at Lankenau Institute for Medical Research, Wynnewood, PA, USA
| | - Robin M Ciocca
- Department of Surgery, Lankenau Medical Center, Wynnewood, PA, USA
| | - Jennifer L Sabol
- Department of Surgery, Lankenau Medical Center, Wynnewood, PA, USA
| | - Sharon L Larson
- Main Line Health Center for Population Health Research at Lankenau Institute for Medical Research, Wynnewood, PA, USA
| | - Ned Z Carp
- Department of Surgery, Lankenau Medical Center, Wynnewood, PA, USA
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12
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Boeck MA, Wei W, Robles AJ, Nwabuo AI, Plevin RE, Juillard CJ, Bibbins-Domingo K, Hubbard A, Dicker RA. The Structural Violence Trap: Disparities in Homicide, Chronic Disease Death, and Social Factors Across San Francisco Neighborhoods. J Am Coll Surg 2022; 234:32-46. [PMID: 34662736 PMCID: PMC8719511 DOI: 10.1016/j.jamcollsurg.2021.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/26/2021] [Accepted: 09/22/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND On average, a person living in San Francisco can expect to live 83 years. This number conceals significant variation by sex, race, and place of residence. We examined deaths and area-based social factors by San Francisco neighborhood, hypothesizing that socially disadvantaged neighborhoods shoulder a disproportionate mortality burden across generations, especially deaths attributable to violence and chronic disease. These data will inform targeted interventions and guide further research into effective solutions for San Francisco's marginalized communities. STUDY DESIGN The San Francisco Department of Public Health provided data for the 2010-2014 top 20 causes of premature death by San Francisco neighborhood. Population-level demographic data were obtained from the US American Community Survey 2015 5-year estimate (2011-2015). The primary outcome was the association between years of life loss (YLL) and adjusted years of life lost (AYLL) for the top 20 causes of death in San Francisco and select social factors by neighborhood via linear regression analysis and heatmaps. RESULTS The top 20 causes accounted for N = 15,687 San Francisco resident deaths from 2010-2014. Eight neighborhoods (21.0%) accounted for 47.9% of city-wide YLLs, with 6 falling below the city-wide median household income and many having a higher percent population Black, and lower education and higher unemployment levels. For chronic diseases and homicides, AYLLs increased as a neighborhood's percent Black, below poverty level, unemployment, and below high school education increased. CONCLUSIONS Our study highlights the mortality inequity burdening socially disadvantaged San Francisco neighborhoods, which align with areas subjected to historical discriminatory policies like redlining. These data emphasize the need to address past injustices and move toward equal access to wealth and health for all San Franciscans.
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Affiliation(s)
- Marissa A Boeck
- From the Department of Surgery, Zuckerberg San Francisco General Hospital (Boeck, Robles, Nwabuo, Plevin, Juillard, Dicker), University of California, San Francisco, CA
| | - Waverly Wei
- the Department of Biostatistics, University of California Berkeley, Berkeley, CA (Wei, Hubbard)
| | - Anamaria J Robles
- From the Department of Surgery, Zuckerberg San Francisco General Hospital (Boeck, Robles, Nwabuo, Plevin, Juillard, Dicker), University of California, San Francisco, CA
| | - Adaobi I Nwabuo
- From the Department of Surgery, Zuckerberg San Francisco General Hospital (Boeck, Robles, Nwabuo, Plevin, Juillard, Dicker), University of California, San Francisco, CA
| | - Rebecca E Plevin
- From the Department of Surgery, Zuckerberg San Francisco General Hospital (Boeck, Robles, Nwabuo, Plevin, Juillard, Dicker), University of California, San Francisco, CA
| | - Catherine J Juillard
- From the Department of Surgery, Zuckerberg San Francisco General Hospital (Boeck, Robles, Nwabuo, Plevin, Juillard, Dicker), University of California, San Francisco, CA
- the Department of Surgery, University of California, Los Angeles, CA (Juillard, Dicker)
| | - Kirsten Bibbins-Domingo
- the Department of Epidemiology and Biostatistics (Bibbins-Domingo), University of California, San Francisco, CA
| | - Alan Hubbard
- the Department of Biostatistics, University of California Berkeley, Berkeley, CA (Wei, Hubbard)
| | - Rochelle A Dicker
- From the Department of Surgery, Zuckerberg San Francisco General Hospital (Boeck, Robles, Nwabuo, Plevin, Juillard, Dicker), University of California, San Francisco, CA
- the Department of Surgery, University of California, Los Angeles, CA (Juillard, Dicker)
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Velazquez AI, Hayward JH, Gregory B, Dixit N. Trends in Breast Cancer Screening in a Safety-Net Hospital During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2119929. [PMID: 34357398 PMCID: PMC8346942 DOI: 10.1001/jamanetworkopen.2021.19929] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/03/2021] [Indexed: 12/15/2022] Open
Affiliation(s)
- Ana I. Velazquez
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco
- National Clinician Scholars Program, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
| | - Jessica H. Hayward
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Blake Gregory
- San Francisco Health Network, San Francisco, California
| | - Niharika Dixit
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco
- Division of Hematology/Oncology, Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California
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14
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Dixit N, Rugo H, Burke NJ. Navigating a Path to Equity in Cancer Care: The Role of Patient Navigation. Am Soc Clin Oncol Educ Book 2021; 41:1-8. [PMID: 33830828 DOI: 10.1200/edbk_100026] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Notable barriers exist in the delivery of equitable care for all patients with cancers. Social determinants of health at distal, intermediate, and proximal levels impact cancer care. Patient navigation is a patient-centered intervention that functions across these overlapping determinants to increase access to cancer services throughout the cancer care continuum. There is a need to standardize patient navigation training while remaining responsive to local contexts of care and a need to implement patient navigation programs with a health equity lens to address cancer care inequities.
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Affiliation(s)
- Niharika Dixit
- University of California San Francisco/Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Hope Rugo
- The Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
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15
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Nelson B. How structural racism can kill cancer patients: Black patients with breast cancer and other malignancies face historical inequities that are ingrained but not inevitable. In this article, the second of a 2-part series, we explore the consequences of and potential solutions to racism and inequality in cancer care. Cancer Cytopathol 2020; 128:83-84. [PMID: 32017431 DOI: 10.1002/cncy.22247] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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16
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Abstract
Purpose of the review Breast cancer incidence and mortality rates are lower in some Hispanic/Latino subpopulations compared to Non-Hispanic White women. However, studies suggest that the risk of breast cancer-specific mortality is higher in US Hispanics/Latinas. In this review we summarized current knowledge on factors associated with breast cancer incidence and risk of mortality in women of Hispanic/Latino origin. Recent findings Associative studies have proposed a multiplicity of factors likely contributing to differences in breast cancer incidence and survival between population groups, including socioeconomic/sociodemographic factors, lifestyle choices as well as access to and quality of care. Reports of association between global genetic ancestry overall as well as subtype-specific breast cancer risk among Hispanic/Latinas suggest that incidence and subtype distribution could result from differential exposure to environmental and lifestyle related factors correlated with genetic ancestry as well as germline genetic variation. Summary Hispanic/Latino in the United States have been largely underrepresented in cancer research. It is important to implement inclusive programs that facilitate the access of this population to health services and that also include education programs for the community on the importance of screening. In addition, it is important to continue promoting the inclusion of Hispanics/Latinos in genomic studies that allow understanding the biological behavior of this disease in the context of all human genetic diversity.
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Davis M, Martini R, Newman L, Elemento O, White J, Verma A, Datta I, Adrianto I, Chen Y, Gardner K, Kim HG, Colomb WD, Eltoum IE, Frost AR, Grizzle WE, Sboner A, Manne U, Yates C. Identification of Distinct Heterogenic Subtypes and Molecular Signatures Associated with African Ancestry in Triple Negative Breast Cancer Using Quantified Genetic Ancestry Models in Admixed Race Populations. Cancers (Basel) 2020; 12:E1220. [PMID: 32414099 PMCID: PMC7281131 DOI: 10.3390/cancers12051220] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 12/12/2022] Open
Abstract
Triple negative breast cancers (TNBCs) are molecularly heterogeneous, and the link between their aggressiveness with African ancestry is not established. We investigated primary TNBCs for gene expression among self-reported race (SRR) groups of African American (AA, n = 42) and European American (EA, n = 33) women. RNA sequencing data were analyzed to measure changes in genome-wide expression, and we utilized logistic regressions to identify ancestry-associated gene expression signatures. Using SNVs identified from our RNA sequencing data, global ancestry was estimated. We identified 156 African ancestry-associated genes and found that, compared to SRR, quantitative genetic analysis was a more robust method to identify racial/ethnic-specific genes that were differentially expressed. A subset of African ancestry-specific genes that were upregulated in TNBCs of our AA patients were validated in TCGA data. In AA patients, there was a higher incidence of basal-like two tumors and altered TP53, NFB1, and AKT pathways. The distinct distribution of TNBC subtypes and altered oncologic pathways show that the ethnic variations in TNBCs are driven by shared genetic ancestry. Thus, to appreciate the molecular diversity of TNBCs, tumors from patients of various ancestral origins should be evaluated.
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Affiliation(s)
- Melissa Davis
- Department of Surgery, Weill Cornell Medicine, New York, NY 10065, USA; (M.D.); (R.M.); (L.N.)
| | - Rachel Martini
- Department of Surgery, Weill Cornell Medicine, New York, NY 10065, USA; (M.D.); (R.M.); (L.N.)
| | - Lisa Newman
- Department of Surgery, Weill Cornell Medicine, New York, NY 10065, USA; (M.D.); (R.M.); (L.N.)
| | - Olivier Elemento
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10065, USA;
- Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY 10065, USA;
- Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10065, USA
| | - Jason White
- Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, AL 36088, USA; (J.W.); (W.D.C.)
| | - Akanksha Verma
- Department of Computational Biology, Weill Cornell Medicine, New York, NY 10065, USA;
| | - Indrani Datta
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI 48202, USA; (I.D.); (I.A.); (Y.C.)
| | - Indra Adrianto
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI 48202, USA; (I.D.); (I.A.); (Y.C.)
| | - Yalei Chen
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI 48202, USA; (I.D.); (I.A.); (Y.C.)
| | - Kevin Gardner
- Department of Pathology and Cell Biology, Columbia University, New York, NY 10027, USA;
| | - Hyung-Gyoon Kim
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (H.-G.K.); (I.-E.E.); (A.R.F.); (W.E.G.)
| | - Windy D. Colomb
- Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, AL 36088, USA; (J.W.); (W.D.C.)
- Department of Hematology and Oncology, Our Lady of Lourdes JD Moncus Cancer Center, Lafayette, LA 70508, USA
| | - Isam-Eldin Eltoum
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (H.-G.K.); (I.-E.E.); (A.R.F.); (W.E.G.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Andra R. Frost
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (H.-G.K.); (I.-E.E.); (A.R.F.); (W.E.G.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - William E. Grizzle
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (H.-G.K.); (I.-E.E.); (A.R.F.); (W.E.G.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Andrea Sboner
- Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY 10065, USA;
- Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10062, USA
| | - Upender Manne
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (H.-G.K.); (I.-E.E.); (A.R.F.); (W.E.G.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Clayton Yates
- Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, AL 36088, USA; (J.W.); (W.D.C.)
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