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Luo Q, LaRocca CJ, Ankeny JS, Jensen EH, Marmor S, Brauer DG. Socioeconomic variables in the national cancer database: utilization and impact of income and education in survival models for patients with resected pancreas cancer. HPB (Oxford) 2024; 26:461-464. [PMID: 38168619 DOI: 10.1016/j.hpb.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Qianyun Luo
- Division of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, United States.
| | - Christopher J LaRocca
- Division of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, United States; Masonic Cancer Center, University of Minnesota, United States
| | - Jacob S Ankeny
- Division of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, United States; Masonic Cancer Center, University of Minnesota, United States
| | - Eric H Jensen
- Division of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, United States; Masonic Cancer Center, University of Minnesota, United States
| | - Schelomo Marmor
- Division of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, United States; Masonic Cancer Center, University of Minnesota, United States; Center for Outcomes, Delivery and Evaluation (C-QODE), University of Minnesota Medical School, United States
| | - David G Brauer
- Division of Surgical Oncology, Department of Surgery, University of Minnesota Medical School, United States; Masonic Cancer Center, University of Minnesota, United States
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Murthy SS, Ortiz A, DuBois T, Sorice KA, Nguyen M, Castellanos JA, Pinheiro P, Gonzalez ET, Lynch SM. The effect of social determinants of health on utilization of surgical treatment for hepatocellular carcinoma patients. Am J Surg 2023; 225:715-723. [PMID: 36344305 DOI: 10.1016/j.amjsurg.2022.10.011] [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: 06/28/2022] [Revised: 09/17/2022] [Accepted: 10/07/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND A paucity of data exists on how social determinants of health (SDOH) influence treatment for Hepatocellular carcinoma (HCC). We investigated associations between SDOH (healthcare access, education, social/community context, economic stability, and built/neighborhood environment) and receipt of surgery. METHODS The Pennsylvania Liver Cancer Registry was linked with neighborhood SDOH from the American Community Survey. Multilevel logistic regression models with patient and neighborhood SDOH variables were developed. RESULTS Of 9423 HCC patients, 2393 were stage I. Only 36.3% of stage I patients received surgery. Black patients had significantly lower odds of surgery vs Whites (OR = 0.73; p < 0.01), but not after adjustments for SDOH. All 5 SDOH domains were associated with odds of surgery overall; 2 domains were associated in Stage I patients, social context (e.g., racial concentration, p = 0.03) and insurance access (p < 0.01). CONCLUSIONS SDOH impact utilization of surgery for HCC. Findings can guide healthcare professionals to create programs for populations at risk for poor liver cancer outcomes.
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Affiliation(s)
| | - Angel Ortiz
- Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | | | | | | | - Paulo Pinheiro
- University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL, USA
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Hester CA, Ogobuiro IC, Merchant NB, Datta J. ASO Author Reflections: Racial Disparities in Chemoresponsivity in Localized Pancreatic Cancer: Nature or Nurture? Ann Surg Oncol 2023; 30:1495-1497. [PMID: 36402894 DOI: 10.1245/s10434-022-12843-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 11/21/2022]
Affiliation(s)
- Caitlin A Hester
- Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ifeanyichukwu C Ogobuiro
- Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nipun B Merchant
- Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jashodeep Datta
- Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
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Anbari K, Amiri MM, Heidari-Soureshjani S, Sherwin CM, Kasiri K. A Systematic Review and Meta-analysis on the Role of Statins in the Prevention of Mortality Following Pancreatic Cancer. Anticancer Agents Med Chem 2023; 23:2073-2082. [PMID: 37622694 DOI: 10.2174/1871520623666230824095226] [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: 04/08/2023] [Revised: 06/28/2023] [Accepted: 07/11/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Pancreatic cancer (PC) is a type of cancer with a high incidence and case-fatality rate. OBJECTIVE This study aimed to evaluate the role of statins in preventing mortality following PC based on scientific evidence with systematic review and meta-analysis method. METHODS This meta-analysis considered studies published from 1980 till the end of 2022 in ISI Web of Science, Scopus, PubMed, Cochrane, Science Direct, Google Scholar, and Embase databases. Funnel diagrams and Begg's and Egger's tests were used to assess the publication bias. RESULTS In general, this meta-analysis has included 19 studies (13 cohort studies, 4 case-control, and 2 randomized clinical trials (RCTs)) and a total of 100,888 patients with PC. The risk of mortality of PC in statin users in total was 0.86 (95% CI: 0.80 - 0.92, P-value <0.001); in the case-control studies, it was equal to 0.53 (0.34-0.83); in the cohort studies, it was equal to 0.87 (0.82-0.92, P-value <0.001); in RCTs, it was equal to 1.19 (0.99-1.42, P-value <0.001); in studies with good quality score category, it was equal to 0.92 (0.86-0.99, P-value <0.001), and in articles of the moderate quality score category, it was equal to 0.73 (0.64-0.84, P-value <0.001). The results of statistical tests indicated the existence of publication bias (Begg's test (P-value = 0.002) and Egger's test (P-value = 0.004)). CONCLUSION Statins reduce the risk of mortality in patients with PC. However, no significant relation has been observed in RCTs. Therefore, it is necessary to be cautious in interpreting the results.
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Affiliation(s)
- Khatereh Anbari
- Department of Community Medicine, School of Medicine, Social Determinant of Health Research Center, Lorestan University of Medical Science, Khorramabad, Iran
| | - Mehdi Mohammadian Amiri
- Department of Emergency Medicine, School of Medicine, Babol University of Medical Sciences, Mazandaran, Iran
| | | | - Catherine Mt Sherwin
- Pediatric Clinical Pharmacology and Toxicology, Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton Children's Hospital, One Children's Plaza, Dayton, Ohio, USA
| | - Karamali Kasiri
- Department of Pediatrics, Shahrekord University of Medical Sciences, Shahrekord, Iran
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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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Eskander MF, Hamad A, Li Y, Fisher JL, Oppong B, Obeng-Gyasi S, Tsung A. From street address to survival: Neighborhood socioeconomic status and pancreatic cancer outcomes. Surgery 2021; 171:770-776. [PMID: 34876291 DOI: 10.1016/j.surg.2021.10.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/10/2021] [Accepted: 10/07/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Neighborhood factors may influence cancer care through physical, economic, and social means. This study assesses the impact of neighborhood socioeconomic status on diagnosis, treatment, and survival in pancreatic cancer. METHODS Patients with pancreatic adenocarcinoma were identified in the 2010-2016 Surveillance Epidemiology and End Results database. Neighborhood socioeconomic status (divided into tertiles) was based on an National Cancer Institute census tract-level composite score, including income, education, housing, and employment. Multivariate models predicted metastasis at time of diagnosis and receipt of surgery for early-stage disease. Overall survival compared via Kaplan-Meier and Cox proportional hazards. RESULTS Fifteen thousand four hundred and thirty-six patients (29.7%) lived in low neighborhood socioeconomic status, 17,509 (33.7%) in middle neighborhood socioeconomic status, and 19,010 (36.6%) in high neighborhood socioeconomic status areas. On multivariate analysis, neighborhood socioeconomic status was not associated with metastatic disease at diagnosis (low neighborhood socioeconomic status odds ratio 1.02, 95% confidence interval 0.97-1.07; ref: high neighborhood socioeconomic status). However, low neighborhood socioeconomic status was associated with decreased likelihood of surgery for localized/regional disease (odds ratio 0.60, 95% confidence interval 0.54-0.68; ref: high neighborhood socioeconomic status) and worse overall survival (low neighborhood socioeconomic status hazard ratio 1.18, 95% confidence interval 1.15-1.21; ref: high neighborhood socioeconomic status). CONCLUSION Patients from resource-poor neighborhoods are less likely to receive stage-appropriate therapy for pancreatic cancer and have an 18% higher risk of death.
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Affiliation(s)
- Mariam F Eskander
- The Arthur G. James Cancer Hospital and Solove Research Institute at the Ohio State University Wexner Medical Center, Columbus, OH; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Ahmad Hamad
- The Arthur G. James Cancer Hospital and Solove Research Institute at the Ohio State University Wexner Medical Center, Columbus, OH
| | - Yaming Li
- The Arthur G. James Cancer Hospital and Solove Research Institute at the Ohio State University Wexner Medical Center, Columbus, OH
| | - James L Fisher
- The Arthur G. James Cancer Hospital and Solove Research Institute at the Ohio State University Wexner Medical Center, Columbus, OH
| | - Bridget Oppong
- The Arthur G. James Cancer Hospital and Solove Research Institute at the Ohio State University Wexner Medical Center, Columbus, OH
| | - Samilia Obeng-Gyasi
- The Arthur G. James Cancer Hospital and Solove Research Institute at the Ohio State University Wexner Medical Center, Columbus, OH
| | - Allan Tsung
- The Arthur G. James Cancer Hospital and Solove Research Institute at the Ohio State University Wexner Medical Center, Columbus, OH.
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