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Russell LA, Tinker SC, Rice CE, Ryerson AB, Gonzalez MG. Variation in identifying children and adolescents with disability and developmental disability in population-based public health surveys. Disabil Health J 2024; 17:101556. [PMID: 38001004 PMCID: PMC10999331 DOI: 10.1016/j.dhjo.2023.101556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The term "developmental disability" (DD) is inconsistently defined and applied depending on purpose and across sources, including in legislation. OBJECTIVE This project aimed to identify existing definitions of disability and DD and to determine the extent to which each definition could be operationalized to produce prevalence estimates using data from U.S. national surveys. METHODS Using data among children <18 years from the 2016-2018 National Health Interview Survey (NHIS) and National Survey of Children's Health (NSCH), we estimated the prevalence of two definitions of disability (Washington Group Short Set on Functioning, American Community Survey) and seven definitions of DD [Health and Human Services (ever/current), Developmental Disabilities Assistance and Bill of Rights Act of 2000 (1+, 2+, or 3+ components), and Diagnostic and Statistical Manual of Mental Disorders, 5th ed (ever/current)]. Complex sample design variables and weights were used to calculate nationally representative prevalence. RESULTS Disability (NHIS: 5.2-6.3%; NSCH: 9.2-11.9%) and DD prevalence (NHIS: 0.6-18.0% and NSCH: 0.2-22.2%) varied depending on the definition and data source. For the same definition, NSCH prevalence estimates tended to be higher than NHIS estimates. CONCLUSIONS The substantial variability in estimated prevalence of disability and DD among children in the United States may be in part due to the surveys not representing all components of each definition. Different or additional questions in national surveys may better capture existing definitions of disability and DD. Considering the data collection goals may help determine the optimal definition to provide useful information for public health action.
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Affiliation(s)
- Lauren A Russell
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA; Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs, Oak Ridge, TN, USA.
| | - Sarah C Tinker
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Catherine E Rice
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - A Blythe Ryerson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Maria G Gonzalez
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA
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Wiggins LD, Tian LH, Tinker SC, Yeargin-Allsopp M, DiGuiseppi CG, Nadler C, Powell PS, Moody EJ, Durkin MS, Fallin MD, Ryerson AB, Thierry JM, Robinson B, Pazol K. Remote Delivery of Allied and Behavioral Healthcare During COVID-19 for Children With Developmental Disabilities. JAACAP Open 2024; 2:36-44. [PMID: 38533351 PMCID: PMC10964929 DOI: 10.1016/j.jaacop.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Objective Many children with autism spectrum disorder (ASD) and other developmental disabilities (DD) transitioned to telehealth services due to the COVID-19 pandemic. Our objectives were to describe reductions in allied and behavioral healthcare services and receipt of caregiver training to deliver services at home because of COVID-19 for children with ASD and other DD, and factors associated with worse response to remote delivery of services for children with ASD. Method Prior to the pandemic, children 2 to 5 years of age were enrolled in a multi-site case-control study and completed a developmental assessment. Caregivers completed questionnaires on child behavior problems and ASD symptoms. Children were classified as having ASD vs another DD based on standardized diagnostic measures. Subsequently, caregivers completed a survey during January to June 2021 to assess how COVID-19 affected children and families. Results Caregivers reported that most children with ASD and other DD had a decrease in service hours (50.0%-76.9% by service type) during the COVID-19 pandemic. Children with ASD were significantly more likely to experience reduced speech/language therapy than children with other DD. Receipt of caregiver training to deliver services at home ranged from 38.1% to 57.4% by service type. Among children with ASD, pre-pandemic problems with internalizing behaviors and social communication/interaction were associated with worse response to behavioral telehealth but no other common therapies. Conclusion Our study demonstrates the caregiver-reported impacts of COVID-19 on remote delivery of allied and behavioral healthcare services for children with ASD and other DD. Considerations for caregiver support and remote delivery of services are provided.
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Affiliation(s)
- Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lin H Tian
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah C Tinker
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carolyn G DiGuiseppi
- School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado
| | - Cy Nadler
- Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, Missouri
| | - Patrick S Powell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric J Moody
- Institute for Disabilities, University of Wyoming, Laramie, Wyoming
| | - Maureen S Durkin
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - A Blythe Ryerson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - JoAnn M Thierry
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Britney Robinson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Pazol K, Tian LH, DiGuiseppi C, Durkin MS, Fallin MD, Moody EJ, Nadler C, Powell PS, Reyes N, Robinson B, Ryerson AB, Thierry JM, Tinker SC, Wiggins LD, Yeargin-Allsopp M. Health and Education Services During the COVID-19 Pandemic Among Young Children with Autism Spectrum Disorder and Other Developmental Disabilities. J Dev Behav Pediatr 2024; 45:e31-e38. [PMID: 38364085 PMCID: PMC10963045 DOI: 10.1097/dbp.0000000000001227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/29/2023] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Understanding how the COVID-19 pandemic affected children with disabilities is essential for future public health emergencies. We compared children with autism spectrum disorder (ASD) with those with another developmental disability (DD) and from the general population (POP) regarding (1) missed or delayed appointments for regular health/dental services, immunizations, and specialty services; (2) reasons for difficulty accessing care; and (3) use of remote learning and school supports. METHOD Caregivers of children previously enrolled in the Study to Explore Early Development, a case-control study of children with ASD implemented during 2017 to 2020, were recontacted during January-June 2021 to learn about services during March-December 2020. Children were classified as ASD, DD, or POP during the initial study and were aged 3.4 to 7.5 years when their caregivers were recontacted during the pandemic. RESULTS Over half of all children missed or delayed regular health/dental appointments (58.4%-65.2%). More children in the ASD versus DD and POP groups missed or delayed specialty services (75.7%, 58.3%, and 22.8%, respectively) and reported difficulties obtaining care of any type because of issues using telehealth and difficulty wearing a mask. During school closures, a smaller proportion of children with ASD versus another DD were offered live online classes (84.3% vs 91.1%), while a larger proportion had disrupted individualized education programs (50.0% vs 36.2%). CONCLUSION Minimizing service disruptions for all children and ensuring continuity of specialty care for children with ASD is essential for future public health emergencies. Children may need additional services to compensate for disruptions during the pandemic.
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Affiliation(s)
- Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lin H. Tian
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | | | - Eric J. Moody
- University of Wyoming Institute for Disabilities, Laramie, WY
| | - Cy Nadler
- Children’s Mercy Kansas City, Kansas City, MO
| | - Patrick S. Powell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Nuri Reyes
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Britney Robinson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - JoAnn M. Thierry
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sarah C. Tinker
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
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Hollis ND, Zhou T, Rice CE, Yeargin-Allsopp M, Cree RA, Singleton JA, Santibanez TA, Ryerson AB. Inequities in COVID-19 vaccination coverage for adolescents with and without disability, national immunization Survey-Child COVID module, July 22, 2021-February 26, 2022. Disabil Health J 2023; 16:101509. [PMID: 37558552 PMCID: PMC10961908 DOI: 10.1016/j.dhjo.2023.101509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/16/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Some people with disabilities are likely at increased risk of health impacts from coronavirus disease 2019 (COVID-19). OBJECTIVE To describe parent-reported COVID-19 vaccination status of adolescents (aged 13-17 years) and parental intent to get their child vaccinated, among adolescents with versus without disability. METHODS National Immunization Survey-Child COVID Module data from interviews conducted July 22, 2021-February 26, 2022, were analyzed to assess disability status and type and COVID-19 vaccination status for adolescents (n = 12,445). Prevalence estimates with 95% confidence intervals were calculated; T-tests were conducted. RESULTS A lower percentage of adolescents with disability received ≥1 dose of COVID-19 vaccine compared to adolescents without disability (52.5% vs. 58.6%), [those with cognition (50.8%) or not performing errands independently (49.5%) disabilities were significantly lower]; and a higher percentage of parents reported intent to definitely vaccinate (9.9% vs. 6.5%) and definitely not vaccinate (14.9% vs. 11.8%) their adolescent. Among the unvaccinated adolescents, parents of those with disability were more likely to report difficulty getting their child vaccinated (19.1% vs. 12.9%), inconvenient vaccination-site operating hours (7.6% vs. 3.9%), difficulty knowing where to get their child vaccinated (7.2% vs. 2.7%), and difficulty getting to vaccination sites (6.0% vs. 3.0%), than parents of those without disability. CONCLUSIONS Adolescents with disability had lower vaccination coverage compared to adolescents without disability. Parents of adolescents with disability reported higher intent to get their adolescents vaccinated, but among unvaccinated adolescents with disability, parents reported greater difficulty in accessing COVID-19 vaccines. Findings highlight the need for prioritized outreach to increase COVID-19 vaccination for this population.
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Affiliation(s)
- NaTasha D Hollis
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA; Commissioned Corps, U.S. Public Health Service, Atlanta, GA, USA.
| | - Tianyi Zhou
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Leidos, Inc. Atlanta, GA, USA
| | - Catherine E Rice
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marshalyn Yeargin-Allsopp
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robyn A Cree
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tammy A Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Blythe Ryerson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ryerson AB, Lang D, Alazawi MA, Neyra M, Hill DT, St. George K, Fuschino M, Lutterloh E, Backenson B, Rulli S, Ruppert PS, Lawler J, McGraw N, Knecht A, Gelman I, Zucker JR, Omoregie E, Kidd S, Sugerman DE, Jorba J, Gerloff N, Ng TFF, Lopez A, Masters NB, Leung J, Burns CC, Routh J, Bialek SR, Oberste MS, Rosenberg ES. Wastewater Testing and Detection of Poliovirus Type 2 Genetically Linked to Virus Isolated from a Paralytic Polio Case - New York, March 9-October 11, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1418-1424. [PMID: 36327157 PMCID: PMC9639435 DOI: 10.15585/mmwr.mm7144e2] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
In July 2022, a case of paralytic poliomyelitis resulting from infection with vaccine-derived poliovirus (VDPV) type 2 (VDPV2)§ was confirmed in an unvaccinated adult resident of Rockland County, New York (1). As of August 10, 2022, poliovirus type 2 (PV2)¶ genetically linked to this VDPV2 had been detected in wastewater** in Rockland County and neighboring Orange County (1). This report describes the results of additional poliovirus testing of wastewater samples collected during March 9-October 11, 2022, and tested as of October 20, 2022, from 48 sewersheds (the community area served by a wastewater collection system) serving parts of Rockland County and 12 surrounding counties. Among 1,076 wastewater samples collected, 89 (8.3%) from 10 sewersheds tested positive for PV2. As part of a broad epidemiologic investigation, wastewater testing can provide information about where poliovirus might be circulating in a community in which a paralytic case has been identified; however, the most important public health actions for preventing paralytic poliomyelitis in the United States remain ongoing case detection through national acute flaccid myelitis (AFM) surveillance†† and improving vaccination coverage in undervaccinated communities. Although most persons in the United States are sufficiently immunized, unvaccinated or undervaccinated persons living or working in Kings, Orange, Queens, Rockland, or Sullivan counties, New York should complete the polio vaccination series as soon as possible.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - 2022 U.S. Poliovirus Response Team
- 2022 CDC Domestic Poliovirus Emergency Response Team; New York State Department of Health; Department of Public Health, Syracuse University, Syracuse, New York; Department of Biomedical Science, State University of New York at Albany, Albany, New York; Rockland County Department of Health, Pomona, New York; Orange County Department of Health, Goshen, New York; Sullivan County Department of Public Health, Liberty, New York; Nassau County Department of Health, Mineola, New York; New York City Department of Health and Mental Hygiene, New York, New York; Epidemic Intelligence Service, CDC; Department of Epidemiology and Biostatistics, State University of New York at Albany, Albany, New York
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Yuan Y, Thierry JM, Bull-Otterson L, Yeargin-Allsopp M, Clark KEN, Rice C, Ritchey M, Ryerson AB. COVID-19 Cases and Hospitalizations Among Medicare Beneficiaries With and Without Disabilities - United States, January 1, 2020-November 20, 2021. MMWR Morb Mortal Wkly Rep 2022; 71:791-796. [PMID: 35709015 DOI: 10.15585/mmwr.mm7124a3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Approximately 27% of adults in the United States live with a disability,* some of whom qualify for Medicare benefits. Persons with disabilities are at increased risk for severe COVID-19-associated outcomes compared with the general population (1); however, existing studies have limited generalizability† or only pertain to a specific disability (e.g., intellectual) (2). Older age is also associated with COVID-19-associated hospitalization and death, but the extent to which age might contribute to increased risk for severe COVID-19-associated outcomes among persons with disabilities is unknown (3). To describe the impact of COVID-19 on persons with disabilities and whether and how age contributes to disease rates, CDC assessed COVID-19 cases and hospitalizations during January 2020-November 2021, among Centers for Medicare & Medicaid Services (CMS) Medicare beneficiaries aged ≥18 years who were either eligible because of a disability (disability-eligible§) or only eligible because of age ≥65 years (age-eligible). COVID-19 incidence and hospitalization rates were higher in the disability-eligible group (10,978 and 3,148 per 100,000 population, respectively) throughout the study period compared with the age-eligible group (8,102 and 2,129 per 100,000 population, respectively). Both COVID-19 incidence and hospitalization rates increased with age in both disability- and age-eligible beneficiaries. American Indian or Alaska Native (AI/AN) persons had the highest disability-eligible (4,962 per 100,000) and age-eligible (5,024 per 100,000) hospitalization rates. Among all other racial and ethnic groups, hospitalization rates were higher among disability-eligible than among age-eligible patients. COVID-19 incidence and hospitalization rates among disability-eligible Medicare beneficiaries were disproportionally higher than rates among age-eligible beneficiaries. Collection of disability status as a core demographic variable in public health surveillance data and identification, as well as the addition of disability questions in other existing data sources can guide research and development of interventions for persons with disabilities. Efforts to increase access to and use of COVID-19 prevention and treatment strategies, including activities that support equitable vaccine access regardless of the substantial challenges that older adults and persons with disability face, are critical to reducing severe COVID-19-associated outcomes among these groups.
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Cogswell ME, Coil E, Tian LH, Tinker SC, Ryerson AB, Maenner MJ, Rice CE, Peacock G. Health Needs and Use of Services Among Children with Developmental Disabilities — United States, 2014–2018. MMWR Morb Mortal Wkly Rep 2022; 71:453-458. [PMID: 35324879 PMCID: PMC8956340 DOI: 10.15585/mmwr.mm7112a3] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tinker SC, Cogswell ME, Peacock G, Ryerson AB. Important Considerations for COVID-19 Vaccination of Children With Developmental Disabilities. Pediatrics 2021; 148:peds.2021-053190. [PMID: 34272340 PMCID: PMC8883287 DOI: 10.1542/peds.2021-053190] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sarah C. Tinker
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary E Cogswell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Georgina Peacock
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - A. Blythe Ryerson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Ryerson AB, Rice CE, Hung MC, Patel SA, Weeks JD, Kriss JL, Peacock G, Lu PJ, Asif AF, Jackson HL, Singleton JA. Disparities in COVID-19 Vaccination Status, Intent, and Perceived Access for Noninstitutionalized Adults, by Disability Status - National Immunization Survey Adult COVID Module, United States, May 30-June 26, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1365-1371. [PMID: 34591826 PMCID: PMC8486390 DOI: 10.15585/mmwr.mm7039a2] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Estimates from the 2019 American Community Survey (ACS) indicated that 15.2% of adults aged ≥18 years had at least one reported functional disability (1). Persons with disabilities are more likely than are those without disabilities to have chronic health conditions (2) and also face barriers to accessing health care (3). These and other health and social inequities have placed persons with disabilities at increased risk for COVID-19-related illness and death, yet they face unique barriers to receipt of vaccination (4,5). Although CDC encourages that considerations be made when expanding vaccine access to persons with disabilities,* few public health surveillance systems measure disability status. To describe COVID-19 vaccination status and intent, as well as perceived vaccine access among adults by disability status, data from the National Immunization Survey Adult COVID Module (NIS-ACM) were analyzed. Adults with a disability were less likely than were those without a disability to report having received ≥1 dose of COVID-19 vaccine (age-adjusted prevalence ratio [aPR] = 0.88; 95% confidence interval [CI] = 0.84-0.93) but more likely to report they would definitely get vaccinated (aPR = 1.86; 95% CI = 1.43-2.42). Among unvaccinated adults, those with a disability were more likely to report higher endorsement of vaccine as protection (aPR = 1.29; 95% CI = 1.16-1.44), yet more likely to report it would be or was difficult to get vaccinated than did adults without a disability (aPR = 2.69; 95% CI = 2.16-3.34). Reducing barriers to vaccine scheduling and making vaccination sites more accessible might improve vaccination rates among persons with disabilities.
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Ellington TD, Momin B, Wilson RJ, Henley SJ, Wu M, Ryerson AB. Incidence and Mortality of Cancers of the Biliary Tract, Gallbladder, and Liver by Sex, Age, Race/Ethnicity, and Stage at Diagnosis: United States, 2013 to 2017. Cancer Epidemiol Biomarkers Prev 2021; 30:1607-1614. [PMID: 34244156 DOI: 10.1158/1055-9965.epi-21-0265] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/09/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Few population-based studies have examined incidence and mortality of cancers of the biliary tract, including intrahepatic bile duct, extrahepatic bile duct, ampulla of Vater, and overlapping or other lesions of the biliary tract in one study. METHODS To further the understanding of recent rates of biliary tract cancers, we used population-based data, to examine incidence and mortality during 2013 to 2017. We examined how rates varied by sex, age, race/ethnicity, U.S. census region, and stage at diagnosis. RESULTS Intrahepatic bile duct was the most common biliary tract cancer, with an incidence rate of 1.49 per 100,000 persons. Cancer incidence rates per 100,000 persons were 0.96 for extrahepatic bile duct, 0.45 for ampulla of Vater, and 0.24 for overlapping or other lesions of the biliary tract. Cancer death rates per 100,000 persons were 1.66 for intrahepatic bile duct and 0.45 for other biliary tract. Intrahepatic bile duct incidence and death rates were higher among males than females, higher among Hispanic and Asian and Pacific Islander persons compared with non-Hispanic Whites, and higher in the Northeast and in urban counties. CONCLUSIONS This report provides national estimates of these rare biliary tract cancers. IMPACT Key interventions targeted to high-risk populations may help reduce incidence and mortality of cancers of the biliary tract by improving primary prevention through strategies to reduce tobacco and alcohol use, control overweight and obesity, and promote hepatitis B vaccination and use of syringe service programs meant to curb the transmission of infectious diseases such as viral hepatitis.
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Affiliation(s)
- Taylor D Ellington
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee. .,Division of Cancer Prevention and Control, NCCDPHP, CDC
| | | | - Reda J Wilson
- Division of Cancer Prevention and Control, NCCDPHP, CDC
| | - S Jane Henley
- Division of Cancer Prevention and Control, NCCDPHP, CDC
| | - Manxia Wu
- Division of Cancer Prevention and Control, NCCDPHP, CDC
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Torrone E, Lewis F, Kirkcaldy RD, Bernstein K, Ryerson AB, de Voux A, Oliver S, Quilter L, Weinstock H. Genital Mycoplasma, Shigellosis, Zika, Pubic Lice, and Other Sexually Transmitted Infections: Neither Gone Nor Forgotten. Sex Transm Dis 2021; 48:310-314. [PMID: 33492101 PMCID: PMC10111245 DOI: 10.1097/olq.0000000000001367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Most estimates of the combined burden and cost of sexually transmitted infections (STIs) in the United States have focused on 8 common STIs with established national surveillance strategies (chlamydia, gonorrhea, syphilis, trichomoniasis, genital herpes, human papillomavirus, and sexually transmitted human immunodeficiency virus and hepatitis B). However, over 30 STIs are primarily sexually transmitted or sexually transmissible. In this article, we review what is known about the burden of "other STIs" in the United States, including those where sexual transmission is not the primary transmission route of infection. Although the combined burden of these other STIs may be substantial, accurately estimating their burden due to sexual transmission is difficult due to diagnostic and surveillance challenges. Developing better estimates will require innovative strategies, such as leveraging existing surveillance systems, partnering with public health and academic researchers outside of the STI field, and developing methodology to estimate the frequency of sexual transmission, particularly for new and emerging STIs.
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Affiliation(s)
- Elizabeth Torrone
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Hepatitis, STD Prevention and TB Elimination. Division of STD Prevention
| | - Felicia Lewis
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Hepatitis, STD Prevention and TB Elimination. Division of STD Prevention
| | - Robert D. Kirkcaldy
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Hepatitis, STD Prevention and TB Elimination. Division of STD Prevention
| | - Kyle Bernstein
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Hepatitis, STD Prevention and TB Elimination. Division of STD Prevention
| | - A. Blythe Ryerson
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Hepatitis, STD Prevention and TB Elimination. Division of Viral Hepatitis
| | - Alex de Voux
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Hepatitis, STD Prevention and TB Elimination. Division of STD Prevention
| | - Sara Oliver
- Centers for Disease Control and Prevention. National Center for Immunization and Respiratory Diseases. Division of Bacterial Diseases
| | - Laura Quilter
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Hepatitis, STD Prevention and TB Elimination. Division of STD Prevention
| | - Hillard Weinstock
- Centers for Disease Control and Prevention. National Center for HIV/AIDS, Hepatitis, STD Prevention and TB Elimination. Division of STD Prevention
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Peacock G, Ryerson AB, Koppaka R, Tschida J. The importance of seasonal influenza vaccination for people with disabilities during the COVID-19 pandemic. Disabil Health J 2020; 14:101058. [PMID: 33384278 PMCID: PMC7997783 DOI: 10.1016/j.dhjo.2020.101058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/23/2022]
Abstract
A large proportion of Americans have at least one disability and yet people with disabilities face inequities in health and health care access. Factors associated with underlying disability and health, how they perceive and interact with the world, and where they live, or work may increase the risk people with disabilities face for illness or severe outcomes from seasonal influenza. Given the need to reduce the burden of respiratory illness on a healthcare system already overwhelmed by the COVID-19 pandemic, maximizing seasonal influenza vaccination coverage is particularly important in 2020–2021. It is critical this season to ensure equitable access to influenza vaccination for people with disabilities. Providing influenza vaccination services in the unique places where people with disabilities are living, working, or receiving care during the COVID-19 pandemic is crucial, as well as communicating effectively to people with different types of disabilities.
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Affiliation(s)
- Georgina Peacock
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, 30033, USA.
| | - A Blythe Ryerson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, 30033, USA
| | - Ram Koppaka
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30033, USA
| | - John Tschida
- Association of University Centers on Disabilities, USA
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Abstract
Hepatitis C virus (HCV) infection is a major source of morbidity and mortality in the United States. HCV is transmitted primarily through parenteral exposures to infectious blood or body fluids that contain blood, most commonly through injection drug use. No vaccine against hepatitis C exists and no effective pre- or postexposure prophylaxis is available. More than half of persons who become infected with HCV will develop chronic infection. Direct-acting antiviral treatment can result in a virologic cure in most persons with 8-12 weeks of all-oral medication regimens. This report augments (i.e., updates and summarizes) previously published recommendations from CDC regarding testing for HCV infection in the United States (Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR Recomm Rec 2012;61[No. RR-4]). CDC is augmenting previous guidance with two new recommendations: 1) hepatitis C screening at least once in a lifetime for all adults aged ≥18 years, except in settings where the prevalence of HCV infection is <0.1% and 2) hepatitis C screening for all pregnant women during each pregnancy, except in settings where the prevalence of HCV infection is <0.1%. The recommendation for HCV testing that remains unchanged is regardless of age or setting prevalence, all persons with risk factors should be tested for hepatitis C, with periodic testing while risk factors persist. Any person who requests hepatitis C testing should receive it, regardless of disclosure of risk, because many persons might be reluctant to disclose stigmatizing risks.
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Affiliation(s)
- Sarah Schillie
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Carolyn Wester
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Melissa Osborne
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Laura Wesolowski
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - A. Blythe Ryerson
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
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Ryerson AB, Schillie S, Barker LK, Kupronis BA, Wester C. Vital Signs: Newly Reported Acute and Chronic Hepatitis C Cases - United States, 2009-2018. MMWR Morb Mortal Wkly Rep 2020; 69:399-404. [PMID: 32271725 PMCID: PMC7147907 DOI: 10.15585/mmwr.mm6914a2] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction Hepatitis C is a leading cause of death from liver disease in the United States. Acute hepatitis C infection is often asymptomatic, and >50% of cases will progress to chronic infection, which can be life-threatening. Hepatitis C can be diagnosed with a blood test and is curable, yet new cases of this preventable disease are increasing. Methods National Notifiable Diseases Surveillance System data were analyzed to determine the rate of acute hepatitis C cases reported to CDC by age group and year during 2009–2018 and the number and rate of newly reported chronic cases in 2018 by sex and age. The proportion of adults aged ≥20 years with hepatitis C who reported having ever been told that they had hepatitis C was estimated with 2015–2018 National Health and Nutrition Examination Survey data. Results During 2018, a total of 3,621 cases of acute hepatitis C were reported, representing an estimated 50,300 cases (95% confidence interval [CI] = 39,800–171,600). The annual rate of reported acute hepatitis C cases per 100,000 population increased threefold, from 0.3 in 2009 to 1.2 in 2018, and was highest among persons aged 20–29 (3.1) and 30–39 years (2.6) in 2018. A bimodal distribution of newly reported chronic hepatitis C cases in 2018 was observed, with the highest proportions among persons aged 20–39 years and 50–69 years. Only 60.6% (95% CI = 46.1%–73.9%) of adults with hepatitis C reported having been told that they were infected. Conclusions and Implications for Public Health Practice Increasing rates of acute hepatitis C among young adults, including reproductive-aged persons, have put multiple generations at risk for chronic hepatitis C. The number of newly reported chronic infections was approximately equal among younger and older adults in 2018. The new CDC hepatitis C testing recommendations advise screening all adults and pregnant women, not just persons born during 1945–1965, and those with risk factors.
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Affiliation(s)
- A Blythe Ryerson
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Sarah Schillie
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Laurie K Barker
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Benjamin A Kupronis
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Carolyn Wester
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
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Bradley H, Hall EW, Rosenthal EM, Sullivan PS, Ryerson AB, Rosenberg ES. Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013-2016. Hepatol Commun 2020; 4:355-370. [PMID: 32140654 PMCID: PMC7049678 DOI: 10.1002/hep4.1457] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/20/2019] [Indexed: 12/23/2022] Open
Abstract
Hepatitis C virus (HCV) infection is a leading cause of liver-related morbidity and mortality, and more than 2 million adults in the United States are estimated to be currently infected. Reducing HCV burden will require an understanding of demographic disparities and targeted efforts to reduce prevalence in populations with disproportionate disease rates. We modeled state-level estimates of hepatitis C prevalence among U.S. adults by sex, birth cohort, and race during 2013-2016. National Health and Nutrition Examination Survey data were used in combination with state-level HCV-related and narcotic overdose-related mortality data from the National Vital Statistics System and estimates from external literature review on populations not sampled in the National Health and Nutrition Examination Survey. Nationally, estimated hepatitis C prevalence was 1.3% among males and 0.6% among females (prevalence ratio [PR] = 2.3). Among persons born during 1945 to 1969, prevalence was 1.6% compared with 0.5% among persons born after 1969 (PR = 3.2). Among persons born during 1945 to 1969, prevalence ranged from 0.7% in North Dakota to 3.6% in Oklahoma and 6.8% in the District of Columbia. Among persons born after 1969, prevalence was more than twice as high in Kentucky, New Mexico, Oklahoma, and West Virginia compared with the national average. Hepatitis C prevalence was 1.8% among non-Hispanic black persons and 0.8% among persons of other races (PR = 2.2), and the magnitude of this disparity varied widely across jurisdictions (PR range: 1.3-7.8). Overall, 23% of prevalent HCV infections occurred among non-Hispanic black persons, whereas 12% of the population was represented by this racial group. These estimates provide information on prevalent HCV infections that jurisdictions can use for understanding and monitoring local disease patterns and racial disparities in burden of disease.
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Affiliation(s)
- Heather Bradley
- Department of Population Health SciencesGeorgia State University School of Public HealthAtlantaGA
| | - Eric W. Hall
- Department of EpidemiologyEmory University Rollins School of Public HealthAtlantaGA
| | - Elizabeth M. Rosenthal
- Department of Epidemiology and BiostatisticsUniversity at Albany School of Public HealthState University of New YorkRensselaerNY
| | - Patrick S. Sullivan
- Department of EpidemiologyEmory University Rollins School of Public HealthAtlantaGA
| | - A. Blythe Ryerson
- Division of Viral HepatitisNational Center for HIV/AIDS, Viral Hepatitis, STD, and TB PreventionCenters for Disease Control and PreventionAtlantaGA
| | - Eli S. Rosenberg
- Department of Epidemiology and BiostatisticsUniversity at Albany School of Public HealthState University of New YorkRensselaerNY
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Hofmeister MG, Edlin BR, Rosenberg ES, Rosenthal EM, Barker LK, Barranco MA, Hall EW, Mermin J, Ryerson AB. Reply. Hepatology 2019; 70:759-760. [PMID: 30945751 PMCID: PMC10993926 DOI: 10.1002/hep.30635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- Megan G Hofmeister
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Brian R Edlin
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Eli S Rosenberg
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, NY
| | - Elizabeth M Rosenthal
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, NY
| | - Laurie K Barker
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
| | - Meredith A Barranco
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, NY
| | - Eric W Hall
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jonathan Mermin
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - A Blythe Ryerson
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA
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Hofmeister MG, Rosenthal EM, Barker LK, Rosenberg ES, Barranco MA, Hall EW, Edlin BR, Mermin J, Ward JW, Ryerson AB. Estimating Prevalence of Hepatitis C Virus Infection in the United States, 2013-2016. Hepatology 2019; 69:1020-1031. [PMID: 30398671 PMCID: PMC6719781 DOI: 10.1002/hep.30297] [Citation(s) in RCA: 331] [Impact Index Per Article: 66.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/24/2018] [Indexed: 02/06/2023]
Abstract
Hepatitis C virus (HCV) infection is the most commonly reported bloodborne infection in the United States, causing substantial morbidity and mortality and costing billions of dollars annually. To update the estimated HCV prevalence among all adults aged ≥18 years in the United States, we analyzed 2013-2016 data from the National Health and Nutrition Examination Survey (NHANES) to estimate the prevalence of HCV in the noninstitutionalized civilian population and used a combination of literature reviews and population size estimation approaches to estimate the HCV prevalence and population sizes for four additional populations: incarcerated people, unsheltered homeless people, active-duty military personnel, and nursing home residents. We estimated that during 2013-2016 1.7% (95% confidence interval [CI], 1.4-2.0%) of all adults in the United States, approximately 4.1 (3.4-4.9) million persons, were HCV antibody-positive (indicating past or current infection) and that 1.0% (95% CI, 0.8-1.1%) of all adults, approximately 2.4 (2.0-2.8) million persons, were HCV RNA-positive (indicating current infection). This includes 3.7 million noninstitutionalized civilian adults in the United States with HCV antibodies and 2.1 million with HCV RNA and an estimated 0.38 million HCV antibody-positive persons and 0.25 million HCV RNA-positive persons not part of the 2013-2016 NHANES sampling frame. Conclusion: Over 2 million people in the United States had current HCV infection during 2013-2016; compared to past estimates based on similar methodology, HCV antibody prevalence may have increased, while RNA prevalence may have decreased, likely reflecting the combination of the opioid crisis, curative treatment for HCV infection, and mortality among the HCV-infected population; efforts on multiple fronts are needed to combat the evolving HCV epidemic, including increasing capacity for and access to HCV testing, linkage to care, and cure.
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Affiliation(s)
- Megan G. Hofmeister
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth M. Rosenthal
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, New York
| | - Laurie K. Barker
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eli S. Rosenberg
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, New York
| | - Meredith A. Barranco
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, New York
| | - Eric W. Hall
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Brian R. Edlin
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jonathan Mermin
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John W. Ward
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia,Program for Viral Hepatitis Elimination, The Task Force for Global Health, Decatur, Georgia
| | - A. Blythe Ryerson
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
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Rosenberg ES, Rosenthal EM, Hall EW, Barker L, Hofmeister MG, Sullivan PS, Dietz P, Mermin J, Ryerson AB. Prevalence of Hepatitis C Virus Infection in US States and the District of Columbia, 2013 to 2016. JAMA Netw Open 2018; 1:e186371. [PMID: 30646319 PMCID: PMC6324373 DOI: 10.1001/jamanetworkopen.2018.6371] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Infection with hepatitis C virus (HCV) is a major cause of morbidity and mortality in the United States, and incidence has increased rapidly in recent years, likely owing to increased injection drug use. Current estimates of prevalence at the state level are needed to guide prevention and care efforts but are not available through existing disease surveillance systems. OBJECTIVE To estimate the prevalence of current HCV infection among adults in each US state and the District of Columbia during the years 2013 to 2016. DESIGN, SETTING, AND PARTICIPANTS This survey study used a statistical model to allocate nationally representative HCV prevalence from the National Health and Nutrition Examination Survey (NHANES) according to the spatial demographics and distributions of HCV mortality and narcotic overdose mortality in all National Vital Statistics System death records from 1999 to 2016. Additional literature review and analyses estimated state-level HCV infections among populations not included in the National Health and Nutrition Examination Survey sampling frame. EXPOSURES State, accounting for birth cohort, biological sex, race/ethnicity, federal poverty level, and year. MAIN OUTCOMES AND MEASURES State-level prevalence estimates of current HCV RNA. RESULTS In this study, the estimated national prevalence of HCV from 2013 to 2016 was 0.84% (95% CI, 0.75%-0.96%) among adults in the noninstitutionalized US population represented in the NHANES sampling frame, corresponding to 2 035 100 (95% CI, 1 803 600-2 318 000) persons with current infection; accounting for populations not included in NHANES, there were 231 600 additional persons with HCV, adjusting prevalence to 0.93%. Nine states contained 51.9% of all persons living with HCV infection (California [318 900], Texas [202 500], Florida [151 000], New York [116 000], Pennsylvania [93 900], Ohio [89 600], Michigan [69 100], Tennessee [69 100], and North Carolina [66 400]); 5 of these states were in Appalachia. Jurisdiction-level median (range) HCV RNA prevalence was 0.88% (0.45%-2.34%). Of 13 states in the western United States, 10 were above this median. Three of 10 states with the highest HCV prevalence were in Appalachia. CONCLUSIONS AND RELEVANCE Using extensive national survey and vital statistics data from an 18-year period, this study found higher prevalence of HCV in the West and Appalachian states for 2013 to 2016 compared with other areas. These estimates can guide state prevention and treatment efforts.
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Affiliation(s)
- Eli S. Rosenberg
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer
| | - Elizabeth M. Rosenthal
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer
| | - Eric W. Hall
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Laurie Barker
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Megan G. Hofmeister
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patrick S. Sullivan
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Patricia Dietz
- Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jonathan Mermin
- Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - A. Blythe Ryerson
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Glenn BA, Hamilton AS, Nonzee NJ, Maxwell AE, Crespi CM, Ryerson AB, Chang LC, Deapen D, Bastani R. Obesity, physical activity, and dietary behaviors in an ethnically-diverse sample of cancer survivors with early onset disease. J Psychosoc Oncol 2018; 36:418-436. [PMID: 29764334 PMCID: PMC6209096 DOI: 10.1080/07347332.2018.1448031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To assess weight status, physical activity, and dietary behaviors in an ethnically-diverse sample of breast and colorectal cancer survivors with early onset disease (≤ 50 years). METHODS Breast and colorectal cancer survivors, diagnosed between 1999 and 2009 with early-stage cancer diagnosed by 50 years of age, were identified through a population-based cancer registry and surveyed. Descriptive and regression analyses were conducted to characterize the sample and identify correlates of lifestyle behaviors. FINDINGS The majority of participants (n = 156) were female (83%), insured (84%), and racial/ethnic minorities (29% Asian, 24% Latino, 15% African American). Participants' mean age at response was 50 years and mean time since diagnosis was 9 years. Over half of survivors were overweight or obese. Few participants reported engaging in regular physical activity (31%) and adhering to minimum guidelines for fruit and vegetable consumption (32%). A substantial proportion of survivors consumed fast food in the past week (75%) and nearly half (48%) reported daily consumption of sugar-sweetened beverages. Lower income was associated with inadequate fruit and vegetable intake. Fast food and sugar-sweetened beverage consumption was significantly higher among racial/ethnic minority survivors compared to non-Latino whites. CONCLUSIONS High prevalence of overweight and suboptimal adherence to recommended nutrition and physical activity behaviors were observed among cancer survivors with early onset disease. Cancer survivors diagnosed at a young age may benefit from targeted interventions to address overweight and suboptimal nutrition and physical activity.
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Affiliation(s)
- Beth A Glenn
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - Ann S Hamilton
- b Department of Preventive Medicine, Los Angeles County Cancer Surveillance Program and Keck School of Medicine , University of Southern California , Los Angeles , California , USA
| | - Narissa J Nonzee
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - Annette E Maxwell
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - Catherine M Crespi
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - A Blythe Ryerson
- c Division of Cancer Prevention and Control, Centers for Disease Control and Prevention , Atlanta , Georgia , USA
| | - L Cindy Chang
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - Dennis Deapen
- b Department of Preventive Medicine, Los Angeles County Cancer Surveillance Program and Keck School of Medicine , University of Southern California , Los Angeles , California , USA
| | - Roshan Bastani
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
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Siegel DA, Henley SJ, Wike JM, Ryerson AB, Johnson CJ, Rees JR, Pollack LA. Capture of tobacco use among population-based registries: Findings from 10 National Program of Cancer Registries states. Cancer 2018; 124:2381-2389. [PMID: 29579317 DOI: 10.1002/cncr.31326] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/23/2018] [Accepted: 02/10/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Tobacco use data are important when the epidemiology and prognosis of tobacco-associated cancers are being defined. Central cancer registries in 10 National Program of Cancer Registries states pilot-tested the collection of standardized tobacco use variables. This study evaluated the capture of tobacco use data and examined smoking prevalence among cancer patients. METHODS Participating registries collected data about the use of tobacco-cigarettes, other smoked tobacco, and smokeless tobacco-for cases diagnosed during 2011-2013. The percentage of cases with known tobacco variable values was calculated, and the prevalence of tobacco use was analyzed by the primary cancer site and state. RESULTS Among 1,646,505 incident cancer cases, 51% had known cigarette use data: 18% were current users, 31% were former users, and 51% reported never using. The percentage of cases with a known status for both other smoked tobacco and smokeless tobacco was 43%, with 97% and 98% coded as never users, respectively. The percent known for cigarette use ranged from 27% to 81% by state and improved from 47% in 2011 to 59% in 2013 for all 10 states combined. The percent known for cigarette use and the prevalence of ever smoking cigarettes were highest for laryngeal cancer and tracheal, lung, and bronchus cancer. CONCLUSIONS Cancer registrars ascertained cigarette use for slightly more than half of all new cancer cases, but other tobacco-related fields were less complete. Studies to evaluate the validity of specific tobacco-related variables and the ability of cancer registries to capture this information from the medical record are needed to gauge the usefulness of collecting these variables through cancer surveillance systems. Cancer 2018;124:2381-9. © 2018 American Cancer Society.
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Affiliation(s)
- David A Siegel
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.,Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer M Wike
- DB Consulting Group, Inc, CDC-NPCR Contractor, Atlanta, Georgia
| | - A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Judy R Rees
- New Hampshire State Cancer Registry, Lebanon, New Hampshire.,Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Lori A Pollack
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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21
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Miller JW, Smith JL, Ryerson AB, Tucker TC, Allemani C. Disparities in breast cancer survival in the United States (2001-2009): Findings from the CONCORD-2 study. Cancer 2017; 123 Suppl 24:5100-5118. [PMID: 29205311 PMCID: PMC5826549 DOI: 10.1002/cncr.30988] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 08/05/2017] [Accepted: 08/17/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Reducing breast cancer incidence and achieving equity in breast cancer outcomes remains a priority for public health practitioners, health care providers, policy makers, and health advocates. Monitoring breast cancer survival can help evaluate the effectiveness of health services, quantify inequities in outcomes between states or population subgroups, and inform efforts to improve the effectiveness of cancer management and treatment. METHODS We analyzed breast cancer survival using individual patient records from 37 statewide registries that participated in the CONCORD-2 study, covering approximately 80% of the US population. Females were diagnosed between 2001 and 2009 and were followed through December 31, 2009. Age-standardized net survival at 1 year, 3 years, and 5 years after diagnosis was estimated by state, race (white, black), stage at diagnosis, and calendar period (2001-2003 and 2004-2009). RESULTS Overall, 5-year breast cancer net survival was very high (88.2%). Survival remained remarkably high from 2001 through 2009. Between 2001 and 2003, survival was 89.1% for white females and 76.9% for black females. Between 2004 and 2009, survival was 89.6% for white females and 78.4% for black females. CONCLUSIONS Breast cancer survival was more than 10 percentage points lower for black females than for white females, and this difference persisted over time. Reducing racial disparities in survival remains a challenge that requires broad, coordinated efforts at the federal, state, and local levels. Monitoring trends in breast cancer survival can highlight populations in need of improved cancer management and treatment. Cancer 2017;123:5100-18. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Jacqueline W Miller
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Judith Lee Smith
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Thomas C Tucker
- Kentucky Cancer Registry, University of Kentucky, Lexington, Kentucky
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Campbell CA, Canary L, Smith N, Teshale E, Blythe Ryerson A, Ward JW. State HCV Incidence and Policies Related to HCV Preventive and Treatment Services For Persons Who Inject Drugs - United States, 2015-2016. Am J Transplant 2017. [DOI: 10.1111/ajt.14364] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- C. A. Campbell
- Division of Viral Hepatitis; National Center for HIV/AIDS; Viral Hepatitis; STD and TB Prevention; CDC; Atlanta GA
| | - L. Canary
- Division of Viral Hepatitis; National Center for HIV/AIDS; Viral Hepatitis; STD and TB Prevention; CDC; Atlanta GA
| | - N. Smith
- Division of Viral Hepatitis; National Center for HIV/AIDS; Viral Hepatitis; STD and TB Prevention; CDC; Atlanta GA
| | - E. Teshale
- Division of Viral Hepatitis; National Center for HIV/AIDS; Viral Hepatitis; STD and TB Prevention; CDC; Atlanta GA
| | - A. Blythe Ryerson
- Division of Viral Hepatitis; National Center for HIV/AIDS; Viral Hepatitis; STD and TB Prevention; CDC; Atlanta GA
| | - J. W. Ward
- Division of Viral Hepatitis; National Center for HIV/AIDS; Viral Hepatitis; STD and TB Prevention; CDC; Atlanta GA
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Abstract
Routine data collection efforts are a necessary, often underappreciated, component of nearly all cancer research and prevention efforts. Public health cancer surveillance data are crucial for identifying needs, planning interventions, directing public health resources, and evaluating the overall effectiveness of initiatives aimed at preventing or treating cancer and its negative health consequences. As the nation’s health protection agency, the Centers for Disease Control and Prevention (CDC) provides resources for disease surveillance systems to help protect our nation against expensive and dangerous health threats, including cancer. Therefore, public health surveillance is a core function of CDC. In this article we briefly describe CDC’s approach to cancer surveillance in our public health programs and other federal initiatives to monitor cancer-related outcomes. We also describe our premier cancer incidence surveillance system, the National Program of Cancer Registries, and discuss uses and applications of the program’s critical cancer data.
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Affiliation(s)
- A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, F-76, Atlanta, GA 30341-3717.
| | - Greta M Massetti
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Campbell CA, Canary L, Smith N, Teshale E, Ryerson AB, Ward JW. State HCV Incidence and Policies Related to HCV Preventive and Treatment Services for Persons Who Inject Drugs - United States, 2015-2016. MMWR Morb Mortal Wkly Rep 2017; 66:465-469. [PMID: 28493854 PMCID: PMC5657985 DOI: 10.15585/mmwr.mm6618a2] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Cecily A Campbell
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Lauren Canary
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Nicole Smith
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - Eyasu Teshale
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - A Blythe Ryerson
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
| | - John W Ward
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
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Affiliation(s)
- Simple D Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Henley SJ, Singh SD, King J, Wilson RJ, O'Neil ME, Ryerson AB. Invasive Cancer Incidence and Survival - United States, 2013. MMWR Morb Mortal Wkly Rep 2017; 66:69-75. [PMID: 28125576 PMCID: PMC5724910 DOI: 10.15585/mmwr.mm6603a1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although cancer represents many heterogeneous diseases, some cancer types share common risk factors. For example, conclusive evidence links cancer at multiple sites with tobacco use, alcohol use, human papillomavirus (HPV) infection, excess body weight, and physical inactivity (1,2). To monitor changes in cancer incidence and assess progress toward achieving Healthy People 2020 objectives,* CDC analyzed data from the U.S. Cancer Statistics (USCS) data set for 2013, the most recent year for which incidence and survival data are available. In 2013, a total of 1,559,130 invasive cancers were reported to cancer registries in the United States (excluding Nevada), for an annual age-adjusted incidence rate of 439 cases per 100,000 persons. Cancer incidence rates were higher among males (479) than females (413), highest among blacks (444), and ranged by state from 364 (New Mexico) to 512 (Kentucky) per 100,000 persons (359 in Puerto Rico). The proportion of persons with cancer who survived ≥5 years after diagnosis was 67%. This proportion was the same for males and females (67%), but lower among blacks (62%) than among whites (67%). Cancer surveillance data are key to cancer epidemiologic and clinical outcomes research, program planning and monitoring, resource allocation, and state and federal appropriations accountability.
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Affiliation(s)
- S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Simple D Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jessica King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Reda J Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Mary Elizabeth O'Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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27
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Freeman MB, Wilson RJ, Ryerson AB. Examination of Preliminary Cancer Surveillance Data from the National Program of Cancer Registries, Diagnosis Year 2012. J Registry Manag 2017; 44:62-68. [PMID: 29611676 PMCID: PMC6077983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND The United States Cancer Statistics (USCS) are the official federal cancer statistics and contain the most complete and accurate data. Yet, the data are typically older than 24 months by the time they are published. The National Program of Cancer Registries (NPCR) contributes 96% of the data in USCS and has been collecting preliminary data since 2000, though the quality of these data has not been published. The objective of this analysis is to determine how accurately preliminary cancer data submitted by NPCR grantees predict cancer rates eventually published in USCS. METHODS Cancer data were obtained for diagnosis year 2012 among all cancer sites combined and a subset of 20 cancer sites that were used to test completeness of case ascertainment. Age-adjusted incidence rates (IR), rate ratios (RR), and 95% CIs were calculated for data submitted in November 2013 (NPCR preliminary, or 12-month data)—794,413 cases—and compared to USCS, which uses data submitted in November 2014 (24-month data)—1,529,078 cases. RESULTS For all cancer sites and all races combined, the incidence rates for the NPCR preliminary data were slightly lower than the rate obtained through USCS (401.3 vs 440.3), but showed comparability (RR = 0.91). Regardless of race, 75% of the cancer sites had rate ratios of at least 0.90. For hospitals or clinics, the site-specific RRs were high, but RRs were more variable for other non-hospital centers and were lower for cases obtained from death certificates and autopsies. More than half (56%) of the US population and 87% of cancer cases diagnosed in 2012 were represented by the states included in the preliminary data set. DISCUSSION This is the first known study examining cancer incidence rates calculated using earlier cancer surveillance data than is traditionally used. The strengths of this analysis include the representativeness of the sample and comparability with the USCS data. Our results also show that, compared to other sources, early reporting from hospitals most accurately estimates cancer rates in USCS. CONCLUSION Preliminary cancer data may accurately estimate the official federal cancer incidence rates for the 2012 diagnosis year and supports the possibility of using these data as an early preview of cancer incidence rates.
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Affiliation(s)
- MaryBeth B. Freeman
- Cancer Surveillance Branch, Division of Cancer Prevention and
Control, National Center for Chronic Disease Prevention and Health Promotion,
Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Reda J. Wilson
- Cancer Surveillance Branch, Division of Cancer Prevention and
Control, National Center for Chronic Disease Prevention and Health Promotion,
Centers for Disease Control and Prevention, Atlanta, Georgia
| | - A. Blythe Ryerson
- Cancer Surveillance Branch, Division of Cancer Prevention and
Control, National Center for Chronic Disease Prevention and Health Promotion,
Centers for Disease Control and Prevention, Atlanta, Georgia
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Ryerson AB, Wasilewski-Masker K, Border WL, Goodman M, Meacham L, Austin H, Marchak JG, Mertens AC. Pediatric quality of life in long-term survivors of childhood cancer treated with anthracyclines. Pediatr Blood Cancer 2016; 63:2205-2211. [PMID: 27442487 DOI: 10.1002/pbc.26149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/31/2016] [Accepted: 06/16/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Anthracyclines are a common class of drugs used to treat pediatric cancer. While much attention is given to their cardiotoxicity, little is known about the relationship between the use of anthracyclines and health-related quality-of-life (HRQoL) outcomes. This study examines the association of anthracycline cardiotoxicity risk status and Pediatric Quality-of-Life (PedsQL) InventoryTM scores in childhood cancer METHODS: Pediatric cancer survivors aged 8-21 who were at least 5 years posttreatment were recruited from a Cancer Survivor Clinic. Participants completed the PedsQL 4.0 Generic Core Scales and a health behavior survey. Linear regression was used to evaluate the association between PedsQL scores and anthracycline cardiotoxicity risk status and to assess whether self-reported physical activity modified the association. RESULTS Eighty survivors participated and were characterized by cardiotoxicity risk status (high: 12; moderate: 23, low: 24, no risk: 21) as defined by the Children's Oncology Group (COG). Measures in all PedsQL domains tended to be slightly lower for survivors exposed to anthracyclines as compared to the unexposed. The largest difference in unadjusted mean scores was for social functioning (96.0% for unexposed vs. 91.3% for exposed, P = 0.0068). There was also an inverse dose-response relation between adjusted PedsQL scores and increasing anthracycline cardiotoxicity risk; this association was not modified by physical activity level. CONCLUSION These data indicate that regular psychosocial assessments, such as those currently recommended by the COG, may be especially important for survivors treated with anthracyclines.
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Affiliation(s)
- A Blythe Ryerson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
| | - Karen Wasilewski-Masker
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - William L Border
- Sibley Heart Center Cardiology, Atlanta, Georgia.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Lillian Meacham
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Harland Austin
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jordan Gilleland Marchak
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Ann C Mertens
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.,Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
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Abstract
This report provides, in tabular and graphic form, official federal statistics on the occurrence of cancer for 2012 and trends for 1999-2012 as reported by CDC and the National Cancer Institute (NCI) (1). Cancer incidence data are from population-based cancer registries that participate in CDC's National Program of Cancer Registries (NPCR) and NCI's Surveillance, Epidemiology, and End Results (SEER) program reported as of November 2014. Cancer mortality data are from death certificate information reported to state vital statistics offices through 2012 and compiled into a national file for the entire United States by CDC's National Center for Health Statistics' (NCHS) National Vital Statistics System (NVSS). This report is a part of the Summary of Notifiable Noninfectious Conditions and Disease Outbreaks - United States, which encompasses various surveillance years but is being published in 2016 (2). The Summary of Notifiable Noninfectious Conditions and Disease Outbreaks appears in the same volume of MMWR as the annual Summary of Notifiable Infectious Diseases (3).
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Affiliation(s)
- Simple D Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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30
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Puckett M, Neri A, Rohan E, Clerkin C, Underwood JM, Ryerson AB, Stewart SL. Evaluating Early Case Capture of Pediatric Cancers in Seven Central Cancer Registries in the United States, 2013. Public Health Rep 2016; 131:126-36. [PMID: 26843678 DOI: 10.1177/003335491613100119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Cancer is the second-leading cause of death in children, but incidence data are not available until two years after diagnosis, thereby delaying data dissemination and research. An early case capture (ECC) surveillance program was piloted in seven state cancer registries to register pediatric cancer cases within 30 days of diagnosis. We sought to determine the quality of ECC data and understand pilot implementation. METHODS We used quantitative and qualitative methods to evaluate ECC. We assessed data quality by comparing demographic and clinical characteristics from the initial ECC submission to a resubmission of ECC pilot data and to the most recent year of routinely collected cancer data for each state individually and in aggregate. We conducted telephone focus groups with registry staff to determine ECC practices and difficulties in August and September 2013. Interviews were recorded, transcribed, and coded to identify themes. RESULTS Comparing ECC initial submissions with submissions for all states, ECC data were nationally representative for age (9.7 vs. 9.9 years) and sex (673 of 1,324 [50.9%] vs. 42,609 of 80,547 [52.9%] male cases), but not for primary site (472 of 1,324 [35.7%] vs. 27,547 of 80,547 [34.2%] leukemia/lymphoma cases), behavior (1,219 of 1,324 [92.1%] vs. 71,525 of 80,547 [88.8%] malignant cases), race/ethnicity (781 of 1,324 [59.0%] vs. 64,518 of 80,547 [80.1%] white cases), or diagnostic confirmation (1,233 of 1,324 [93.2%] vs. 73,217 of 80,547 [90.9%] microscopically confirmed cases). When comparing initial ECC data with resubmission data, differences were seen in race/ethnicity (808 of 1,324 [61.1%] vs. 1,425 of 1,921 [74.2%] white cases), primary site (475 of 1,324 [35.9%] vs. 670 of 1,921 [34.9%] leukemia/lymphoma cases), and behavior (1,215 of 1,324 [91.8%] vs. 1,717 of 1,921 [89.4%] malignant cases). Common themes from focus group analysis included implementation challenges and facilitators, benefits of ECC, and utility of ECC data. CONCLUSIONS ECC provided data rapidly and reflected national data overall with differences in several data elements. ECC also expanded cancer reporting infrastructure and increased data completeness and timeliness. Although challenges related to timeliness and increased work burden remain, indications suggest that researchers may reliably use these data for pediatric cancer studies.
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Affiliation(s)
- Mary Puckett
- Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, GA; Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, GA
| | - Antonio Neri
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, GA
| | - Elizabeth Rohan
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, GA
| | - Castine Clerkin
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, GA
| | - J Michael Underwood
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, GA
| | - A Blythe Ryerson
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, GA
| | - Sherri L Stewart
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, GA
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Ryerson AB, Eheman CR, Altekruse SF, Ward JW, Jemal A, Sherman RL, Henley SJ, Holtzman D, Lake A, Noone AM, Anderson RN, Ma J, Ly KN, Cronin KA, Penberthy L, Kohler BA. Annual Report to the Nation on the Status of Cancer, 1975-2012, featuring the increasing incidence of liver cancer. Cancer 2016; 122:1312-37. [PMID: 26959385 PMCID: PMC4840031 DOI: 10.1002/cncr.29936] [Citation(s) in RCA: 654] [Impact Index Per Article: 81.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/21/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Annual updates on cancer occurrence and trends in the United States are provided through an ongoing collaboration among the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR). This annual report highlights the increasing burden of liver and intrahepatic bile duct (liver) cancers. METHODS Cancer incidence data were obtained from the CDC, NCI, and NAACCR; data about cancer deaths were obtained from the CDC's National Center for Health Statistics (NCHS). Annual percent changes in incidence and death rates (age-adjusted to the 2000 US Standard Population) for all cancers combined and for the leading cancers among men and women were estimated by joinpoint analysis of long-term trends (incidence for 1992-2012 and mortality for 1975-2012) and short-term trends (2008-2012). In-depth analysis of liver cancer incidence included an age-period-cohort analysis and an incidence-based estimation of person-years of life lost because of the disease. By using NCHS multiple causes of death data, hepatitis C virus (HCV) and liver cancer-associated death rates were examined from 1999 through 2013. RESULTS Among men and women of all major racial and ethnic groups, death rates continued to decline for all cancers combined and for most cancer sites; the overall cancer death rate (for both sexes combined) decreased by 1.5% per year from 2003 to 2012. Overall, incidence rates decreased among men and remained stable among women from 2003 to 2012. Among both men and women, deaths from liver cancer increased at the highest rate of all cancer sites, and liver cancer incidence rates increased sharply, second only to thyroid cancer. Men had more than twice the incidence rate of liver cancer than women, and rates increased with age for both sexes. Among non-Hispanic (NH) white, NH black, and Hispanic men and women, liver cancer incidence rates were higher for persons born after the 1938 to 1947 birth cohort. In contrast, there was a minimal birth cohort effect for NH Asian and Pacific Islanders (APIs). NH black men and Hispanic men had the lowest median age at death (60 and 62 years, respectively) and the highest average person-years of life lost per death (21 and 20 years, respectively) from liver cancer. HCV and liver cancer-associated death rates were highest among decedents who were born during 1945 through 1965. CONCLUSIONS Overall, cancer incidence and mortality declined among men; and, although cancer incidence was stable among women, mortality declined. The burden of liver cancer is growing and is not equally distributed throughout the population. Efforts to vaccinate populations that are vulnerable to hepatitis B virus (HBV) infection and to identify and treat those living with HCV or HBV infection, metabolic conditions, alcoholic liver disease, or other causes of cirrhosis can be effective in reducing the incidence and mortality of liver cancer. Cancer 2016;122:1312-1337. © 2016 American Cancer Society.
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Affiliation(s)
- A. Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christie R. Eheman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sean F. Altekruse
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - John W. Ward
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance Research Program, American Cancer Society, Atlanta, Georgia
| | - Recinda L. Sherman
- North American Association of Central Cancer Registries, Springfield, Illinois
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deborah Holtzman
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrew Lake
- Information Management Services, Inc., Rockville, Maryland
| | - Anne-Michelle Noone
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Robert N. Anderson
- Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Jiemin Ma
- Surveillance Research Program, American Cancer Society, Atlanta, Georgia
| | - Kathleen N. Ly
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen A. Cronin
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Lynne Penberthy
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Betsy A. Kohler
- North American Association of Central Cancer Registries, Springfield, Illinois
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Massetti GM, Ragan KR, Thomas CC, Ryerson AB. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations. LGBT Health 2016; 3:11-14. [DOI: 10.1089/lgbt.2015.0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Greta M. Massetti
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen R. Ragan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C. Thomas
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - A. Blythe Ryerson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Wilson RJ, Ryerson AB, Singh SD, King JB. Cancer Incidence in Appalachia, 2004-2011. Cancer Epidemiol Biomarkers Prev 2016; 25:250-8. [PMID: 26819264 DOI: 10.1158/1055-9965.epi-15-0946] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/14/2015] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Limited literature is available about cancer in the Appalachian Region. This is the only known analysis of all cancers for Appalachia and non-Appalachia covering 100% of the US population. Appalachian cancer incidence and trends were evaluated by state, sex, and race and compared with those found in non-Appalachian regions. METHODS US counties were identified as Appalachian or non-Appalachian. Age-adjusted cancer incidence rates, standard errors, and confidence intervals were calculated using the most recent data from the United States Cancer Statistics for 2004 to 2011. RESULTS Generally, Appalachia carries a higher cancer burden compared with non-Appalachia, particularly for tobacco-related cancers. For all cancer sites combined, Appalachia has higher rates regardless of sex, race, or region. The Appalachia and non-Appalachia cancer incidence gap has narrowed, with the exception of oral cavity and pharynx, larynx, lung and bronchus, and thyroid cancers. CONCLUSIONS Higher cancer incidence continues in Appalachia and appears at least in part to reflect high tobacco use and potential differences in socioeconomic status, other risk factors, patient health care utilization, or provider practices. It is important to continue to evaluate this population to monitor results from screening and early detection programs, understand behavioral risk factors related to cancer incidence, increase efforts to reduce tobacco use and increase cancer screening, and identify other areas where effective interventions may mediate disparities. IMPACT Surveillance and evaluation of special populations provide means to monitor screening and early detection programs, understand behavioral risk factors, and increase efforts to reduce tobacco use to mediate disparities.
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Affiliation(s)
- Reda J Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - A Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Simple D Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jessica B King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Henley SJ, Singh SD, King J, Wilson RJ, O’Neil ME, Ryerson AB. Invasive Cancer Incidence and Survival — United States, 2012. MMWR Morb Mortal Wkly Rep 2015; 64:1353-8. [DOI: 10.15585/mmwr.mm6449a1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Simple D. Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jessica King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Reda J. Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Mary Elizabeth O’Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - A. Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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35
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Ryerson AB, Eheman C, Styles T, Rycroft R, Snyder C. Connecting the Dots: Linking the National Program of Cancer Registries and the Needs of Survivors and Clinicians. Am J Prev Med 2015; 49:S528-35. [PMID: 26590648 PMCID: PMC4656128 DOI: 10.1016/j.amepre.2015.08.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 08/24/2015] [Accepted: 08/31/2015] [Indexed: 12/14/2022]
Abstract
Cancer survivors, the medical community, public health professionals, researchers, and policymakers all need information about newly diagnosed cancer cases and deaths to better understand and address the disease burden. CDC collects cancer data on 96% of the U.S. population through the National Program of Cancer Registries. The National Program of Cancer Registries routinely collects data on all cancer occurrences, deaths, and the types of initial treatment received by the patients, and recently CDC has made advances in its cancer surveillance activities that have direct applicability to cancer survivorship research and care. This article examines CDC's innovative uses of the National Program of Cancer Registries infrastructure and data as a recruitment source for survivorship research studies and behavioral interventions; comparative effectiveness and patient-centered outcomes research; and the collection, consolidation, and dissemination of treatment summaries for cancer survivors and their providers. This paper also discusses long-term, idealistic plans for additional data linkages and sharing among public health, providers, and the cancer survivor through innovative concepts such as patient portals and rapid-learning health care.
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Affiliation(s)
- A Blythe Ryerson
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia.
| | - Christie Eheman
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| | - Timothy Styles
- Division of Cancer Prevention and Control, CDC, Atlanta, Georgia
| | - Randi Rycroft
- Colorado Central Cancer Registry, Colorado Department of Public Health and Environment, Denver, Colorado
| | - Claire Snyder
- Division of General Internal Medicine, Johns Hopkins School of Medicine; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
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Singh SD, Henley SJ, Ryerson AB. Summary of Notifiable Noninfectious Conditions and Disease Outbreaks: Surveillance for Cancer Incidence and Mortality - United States, 2011. MMWR Morb Mortal Wkly Rep 2015; 62:11-51. [PMID: 26506286 DOI: 10.15585/mmwr.mm6254a3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Massetti GM, Ragan KR, Thomas CC, Ryerson AB. Public Health Opportunities for Promoting Health Equity in Cancer Prevention and Control in LGBT Populations. LGBT Health 2015; 0:doi:10.1089/lgbt.2015.0109. [PMID: 26566532 PMCID: PMC4639460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Advances in cancer prevention, detection, and treatment have led to reductions in morbidity and premature mortality and improvements in quality of life. However, not all Americans have benefitted equally from these advances, and certain populations experience continued disparities in cancer care. Although research and public health efforts have highlighted the experiences of some groups, other populations have been relatively understudied, such as lesbian, gay, bisexual, and transgender (LGBT) individuals. Public health efforts in surveillance, research, programs, and partnerships can provide opportunities to advance health equity for LGBT at the population level and lead to better health outcomes for LGBT individuals with cancer.
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Affiliation(s)
- Greta M. Massetti
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen R. Ragan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C. Thomas
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - A. Blythe Ryerson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Kohler BA, Sherman RL, Howlader N, Jemal A, Ryerson AB, Henry KA, Boscoe FP, Cronin KA, Lake A, Noone AM, Henley SJ, Eheman CR, Anderson RN, Penberthy L. Annual Report to the Nation on the Status of Cancer, 1975-2011, Featuring Incidence of Breast Cancer Subtypes by Race/Ethnicity, Poverty, and State. J Natl Cancer Inst 2015; 107:djv048. [PMID: 25825511 PMCID: PMC4603551 DOI: 10.1093/jnci/djv048] [Citation(s) in RCA: 608] [Impact Index Per Article: 67.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/21/2015] [Accepted: 02/10/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The American Cancer Society (ACS), Centers for Disease Control and Prevention (CDC), National Cancer Institute (NCI), and North American Association of Central Cancer Registries (NAACCR) collaborate annually to produce updated, national cancer statistics. This Annual Report includes a focus on breast cancer incidence by subtype using new, national-level data. METHODS Population-based cancer trends and breast cancer incidence by molecular subtype were calculated. Breast cancer subtypes were classified using tumor biomarkers for hormone receptor (HR) and human growth factor-neu receptor (HER2) expression. RESULTS Overall cancer incidence decreased for men by 1.8% annually from 2007 to 2011 [corrected]. Rates for women were stable from 1998 to 2011. Within these trends there was racial/ethnic variation, and some sites have increasing rates. Among children, incidence rates continued to increase by 0.8% per year over the past decade while, like adults, mortality declined. HR+/HER2- breast cancers, the subtype with the best prognosis, were the most common for all races/ethnicities with highest rates among non-Hispanic white women, local stage cases, and low poverty areas (92.7, 63.51, and 98.69 per 100000 non-Hispanic white women, respectively). HR+/HER2- breast cancer incidence rates were strongly, positively correlated with mammography use, particularly for non-Hispanic white women (Pearson 0.57, two-sided P < .001). Triple-negative breast cancers, the subtype with the worst prognosis, were highest among non-Hispanic black women (27.2 per 100000 non-Hispanic black women), which is reflected in high rates in southeastern states. CONCLUSIONS Progress continues in reducing the burden of cancer in the United States. There are unique racial/ethnic-specific incidence patterns for breast cancer subtypes; likely because of both biologic and social risk factors, including variation in mammography use. Breast cancer subtype analysis confirms the capacity of cancer registries to adjust national collection standards to produce clinically relevant data based on evolving medical knowledge.
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Affiliation(s)
- Betsy A Kohler
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA).
| | - Recinda L Sherman
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Nadia Howlader
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Ahmedin Jemal
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - A Blythe Ryerson
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Kevin A Henry
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Francis P Boscoe
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Kathleen A Cronin
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Andrew Lake
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Anne-Michelle Noone
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - S Jane Henley
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Christie R Eheman
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Robert N Anderson
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
| | - Lynne Penberthy
- North American Association of Central Cancer Registries, Springfield, IL (BAK, RLS, KAH, FPB); National Cancer Institute, Bethesda, MD (NH, KAC, AMN, LP); American Cancer Society, Atlanta, GA (AJ); Centers for Disease Control and Prevention, Atlanta, GA (ABR, SJH, CRE); Temple University Department of Geography, Philadelphia, PA (KAH); New York State Cancer Registry, NY (FPB); Information Management Services, Inc., Rockville, MD (AL); National Center for Health Statistics, Hyattsville, MD (RNA)
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O’Neil ME, Henley SJ, Singh SD, Wilson RJ, Ortiz-Ortiz KJ, Ríos NP, Torres Cintrón CR, Luna GT, Zavala Zegarra DE, Ryerson AB. Invasive cancer incidence - Puerto Rico, 2007-2011. MMWR Morb Mortal Wkly Rep 2015; 64:389-93. [PMID: 25879898 PMCID: PMC5779544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
UNLABELLED Cancer is a leading cause of morbidity and death in Puerto Rico. To set a baseline for identifying new trends and patterns of cancer incidence, Puerto Rico Central Cancer Registry staff and CDC analyzed data from Puerto Rico included in U.S. Cancer Statistics (USCS) for 2007-2011, the most recent data available. This is the first report of invasive cancer incidence rates for 2007-2011 among Puerto Rican residents by sex, age, cancer site, and municipality. Cancer incidence rates in Puerto Rico were compared with those in the U.S. population for 2011. A total of 68,312 invasive cancers were diagnosed and reported in Puerto Rico during 2007-2011. The average annual incidence rate was 330 cases per 100,000 persons. The cancer sites with the highest cancer incidence rates included prostate (152), female breast (84), and colon and rectum (43). Cancer incidence rates varied by municipality, particularly for prostate, lung and bronchus, and colon and rectum cancers. In 2011, cancer incidence rates in Puerto Rico were lower for all cancer sites and lung and bronchus, but higher for prostate and thyroid cancers, compared with rates within the U.S. POPULATION Identifying these variations can aid evaluation of factors associated with high incidence, such as cancer screening practices, and development of targeted cancer prevention and control efforts. Public health professionals can monitor cancer incidence trends and use these findings to evaluate the impact of prevention efforts, such as legislation prohibiting tobacco use in the workplace and public places and the Puerto Rico Cessation Quitline in decreasing lung and other tobacco-related cancers.
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Affiliation(s)
- Mary Elizabeth O’Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Simple D. Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Reda J. Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | | | | | | | | | | | - A. Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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White A, Miller J, Royalty J, Ryerson AB, Benard V, Helsel W, Kammerer W. Clinical outcomes of mammography in the National Breast and Cervical Cancer Early Detection Program, 2009-2012. Cancer Causes Control 2015; 26:723-32. [PMID: 25809209 DOI: 10.1007/s10552-015-0567-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 03/18/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) enrolls asymptomatic women for cancer screening and symptomatic women for diagnostic services. This study describes the results of mammograms provided by the NBCCEDP, by examination indication (screening or diagnostic), and by age group. METHODS For the first NBCCEDP-funded mammogram received during 2009-2012, we calculated age-specific percentages of abnormal findings, rates of follow-up testing, and invasive and in situ breast cancer diagnoses per 1,000 mammograms. Logistic regression was used to estimate the odds for each of these outcomes by examination indication. RESULTS The NBCCEDP provided 941,649 screening, 175,310 diagnostic, and 30,434 unknown indication mammograms to 1,147,393 women. The percentage with abnormal mammograms was higher for diagnostic mammograms (40.1 %) than for screening mammograms (15.5 %). Compared with women aged 40-49 years, fewer women aged 50-64 years had abnormal results for screening (13.7 vs. 19.7 %) and diagnostic mammograms (37.7 vs. 42.7 %). Follow-up rates per 1,000 mammograms were lower among women aged 50-64 compared to those aged 40-49 (screening: 143.9 vs. 207.5; diagnostic: 645.3 vs. 760.9); biopsy rates exhibited a similar pattern (screening: 24.1 vs. 32.9; diagnostic: 167.7 vs. 169.7). For screening mammograms, older women had more cancers detected than younger women (invasive: 3.6 vs. 2.2; in situ: 2.3 vs. 2.0). Similarly, for diagnostic mammograms, cancer detection was higher for older women (invasive: 67.8 vs. 36.6; in situ: 17.4 vs. 11.1). CONCLUSIONS Abnormal mammograms and diagnostic follow-up procedures were less frequent in women aged 50-64 years compared to women aged 40-49 years, while breast cancer detection was higher, regardless of indication for the mammogram. Some of these differences between age groups were greater for screening mammograms than for diagnostic mammograms. Cancer detection rates were higher for diagnostic mammograms compared with screening mammograms. These findings support the NBCCEDP's priority of serving women aged 50-64 years and providing both screening and diagnostic mammograms.
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Affiliation(s)
- Arica White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway Northeast, Mailstop F76, Atlanta, GA, 30341-3717, USA,
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Henley SJ, Singh SD, King J, Wilson R, O’Neil ME, Ryerson AB. Invasive cancer incidence and survival--United States, 2011. MMWR Morb Mortal Wkly Rep 2015; 64:237-42. [PMID: 25763875 PMCID: PMC5779605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Because of improvements in early detection and treatment of cancer, the proportion of persons with cancer who survive ≥5 years after diagnosis has increased. To assess progress toward achieving Healthy People 2020 objectives,* CDC analyzed data from U.S. Cancer Statistics (USCS) for 2011, the most recent data available. USCS includes incidence and survival data from CDC's National Program of Cancer Registries (NPCR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and mortality data from the National Vital Statistics System. In 2011, a total of 1,532,066 invasive cancers were reported to cancer registries in the United States (excluding Nevada), for an annual incidence rate of 451 cases per 100,000 persons. Cancer incidence rates were higher among males (508) than females (410), highest among black persons (458), and ranged by state, from 374 to 509 per 100,000 persons (339 in Puerto Rico). The proportion of persons with cancer who survived ≥5 years after diagnosis was 65% and was similar among males (65%) and females (65%) but lower among black persons (60%) compared with white persons (65%). Surveillance of cancer incidence and survival are essential for identifying population groups with high cancer incidence rates and low cancer survival rates as well as for estimating the number of cancer survivors, which was 13.7 million in 2012. These data are being used by states to effectively develop comprehensive cancer control programs, including supporting the needs of cancer survivors.
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Affiliation(s)
- S. Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Simple D. Singh
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jessica King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Reda Wilson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Mary Elizabeth O’Neil
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - A. Blythe Ryerson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Wu M, Austin H, Eheman CR, Myles Z, Miller J, Royalty J, Ryerson AB. A comparative analysis of breast cancer stage between women enrolled in the National Breast and Cervical Cancer Early Detection Program and women not participating in the program. Cancer Causes Control 2015; 26:751-8. [PMID: 25761406 DOI: 10.1007/s10552-015-0548-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 02/28/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the proportional distribution of early- and late-stage breast cancers diagnosed in years 2004-2009 among women enrolled in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and to compare this distribution to that of geographically comparable non-enrolled women diagnosed with breast cancer. METHODS Using data from the National Program of Cancer Registries, we compared the demographic characteristics and cancer stage distribution of women enrollees and non-enrollees by use of conditional logistic regression using the odds ratio as a measure of association. RESULTS NBCCEDP enrollees were slightly younger and more likely to identify as African-American, API and AIAN than were non-enrollees. The proportion of late-stage breast cancer (regional and distant) decreased slightly over the study period. NBCCEDP enrollees generally were diagnosed at a later stage of breast cancer than were those not enrolled in the NBCCEDP. CONCLUSIONS The NBCCEDP has been effective in achieving its goal of enrolling racial and ethnic populations; however, enrollees had a poorer stage distribution of breast cancer than did non-enrollees underscoring the need to expand breast cancer control efforts among low-income, underserved populations.
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Affiliation(s)
- Manxia Wu
- Centers for Disease Control and Prevention, Atlanta, GA, USA,
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Ryerson AB, Miller J, Eheman CR. Reported breast symptoms in the National Breast and Cervical Cancer Early Detection Program. Cancer Causes Control 2015; 26:733-40. [PMID: 25754109 DOI: 10.1007/s10552-015-0544-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 02/24/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE The frequency and types of breast symptoms reported by women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) have never been characterized. This study aims to establish the frequency of reported symptoms and the diagnostic outcomes associated with reported symptoms. METHODS We examined the frequency of symptoms reported prior to mammography using medical record abstraction data from women in the NBCCEDP. We also calculated adjusted odds ratios (aOR) of having an abnormal mammogram, an abnormal clinical breast examination, or a final diagnosis of breast cancer by symptoms, compared to asymptomatic women. RESULTS In our sample of women, 10.3 % reported at least one symptom. Women with symptoms were younger and more likely to be non-Hispanic white. Among those reporting symptoms, breast lump (31.7 %) and pain or tenderness (49.3 %) was most common. A relatively low proportion of women with symptoms were diagnosed with in situ (0.9 %) or invasive breast cancer (4.3 %). However, a self-reported breast lump [aOR 13.7; 95 % confidence interval (CI) 7.8-24.1], inflammation or changes to the skin/nipple (aOR 27.8; 95 % CI 8.7-88.8), and other or unspecified symptoms (aOR 3.4; 95 % CI 2.1-7.5) were associated with an increased risk of invasive breast cancer. CONCLUSIONS Although the prevalence of breast cancer among women reporting symptoms is relatively low, knowing which symptoms carry the highest breast cancer risk is important to assist in appropriate diagnostic workup.
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Affiliation(s)
- A Blythe Ryerson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, F-76, Atlanta, GA, 30341, USA,
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Ryerson AB, Border WL, Wasilewski-Masker K, Goodman M, Meacham L, Austin H, Mertens AC. Assessing anthracycline-treated childhood cancer survivors with advanced stress echocardiography. Pediatr Blood Cancer 2015; 62:502-8. [PMID: 25393686 DOI: 10.1002/pbc.25328] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 10/01/2014] [Indexed: 01/01/2023]
Abstract
BACKGROUND Surveillance for anthracycline cardiotoxicity in cancer survivors typically utilizes resting M-mode and two-dimensional echocardiography, which are insensitive to detection of subtle myocardial changes. We examined childhood cancer survivors treated with anthracyclines during exercise using various echocardiography techniques to investigate if these tools can better detect subclinical cardiac dysfunction. PROCEDURE We recruited asymptomatic survivors at least five years post treatment. Echocardiography was performed at rest and at termination of exercise utilizing tissue Doppler techniques and strain rate imaging. RESULTS Eighty participants were characterized by cardiotoxicity risk status (high [12], moderate [23], low [24], no risk [21]) as defined by the Children's Oncology Group Long Term Follow-Up Guidelines v3.0. The high-risk group had a higher resting heart rate than controls (100 vs. 88 bpm [P for trend = 0.049]). Peak aerobic capacity in all groups was similar. Compared to controls at rest, the high-risk group had evidence of diastolic dysfunction with lower E/A ratios (1.4 vs. 2.0, P = 0.008) and higher septal early diastolic velocities (E/E') of 11.7 versus 9.9 (P = 0.165). With exercise, this difference resolved and myocardial contractile reserve was preserved. CONCLUSIONS Asymptomatic, pediatric cancer survivors at high-risk for anthracycline cardiotoxicity have some evidence of diastolic filling abnormalities at rest. With exercise, they augment their systolic and diastolic function to achieve normal maximal aerobic capacity suggesting they are able to compensate for mild cardiac dysfunction in the early years after exposure. Additionally, findings suggest that routine exercise echocardiography may not be a useful surveillance tool to assess anthracycline cardiotoxicity.
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Affiliation(s)
- A Blythe Ryerson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Eheman CR, Leadbetter S, Benard VB, Blythe Ryerson A, Royalty JE, Blackman D, Pollack LA, Adams PW, Babcock F. National Breast and Cervical Cancer Early Detection Program data validation project. Cancer 2014; 120 Suppl 16:2597-603. [PMID: 25099903 DOI: 10.1002/cncr.28825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/15/2014] [Accepted: 04/16/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND The objectives of this study were to evaluate the quality of national data generated by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP); to assess variables collected through the program that are appropriate to use for program management, evaluation, and data analysis; and to identify potential data-quality issues. METHODS Information was abstracted randomly from 5603 medical records selected from 6 NBCCEDP-funded state programs, and 76 categorical variables and 11 text-based breast and cervical cancer screening and diagnostic variables were collected. Concordance was estimated between abstracted data and the data collected by the NBCCEDP. Overall and outcome-specific concordance was calculated for each of the key variables. Four screening performance measures also were estimated by comparing the program data with the abstracted data. RESULTS Basic measures of program outcomes, such as the percentage of women with cancer or with abnormal screening tests, had a high concordance rate. Variables with poor or inconsistent concordance included reported breast symptoms, receipt of fine-needle aspiration, and receipt of colposcopy with biopsy. CONCLUSIONS The overall conclusion from this comprehensive validation project of the NBCCEDP is that, with few exceptions, the data collected from individual program sites and reported to the CDC are valid and consistent with sociodemographic and clinical data within medical records.
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Affiliation(s)
- Christie R Eheman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Singh SD, Ryerson AB, Wu M, Kaur JS. Ovarian and uterine cancer incidence and mortality in American Indian and Alaska Native women, United States, 1999-2009. Am J Public Health 2014; 104 Suppl 3:S423-31. [PMID: 24754663 DOI: 10.2105/ajph.2013.301781] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES We examined geographic differences and trends in incidence and mortality of ovarian and uterine cancer in American Indian/Alaska Native (AI/AN) women. METHODS We linked mortality data (1990-2009) and incidence data (1999-2009) to Indian Health Service (IHS) records. Death (and incidence) rates for ovarian and uterine cancer were examined for AI/AN and White women; Hispanics were excluded. Analyses focused on Contract Health Service Delivery Area (CHSDA) counties. RESULTS AI/AN and White women had similar ovarian and uterine cancer death rates. Ovarian and uterine cancer incidence and death rates were higher for AI/ANs residing in CHSDA counties than for all US counties. We also observed geographic differences, regardless of CHSDA residence, in ovarian and uterine cancer incidence and death rates in AI/AN women by IHS region; Pacific Coast and Southern Plains women had higher ovarian cancer death rates and Northern Plains women had higher uterine cancer death rates. CONCLUSIONS Regional differences in the incidence and mortality of ovarian and uterine cancers among AI/AN women in the United States were significant. More research among correctly classified AI/AN women is needed to understand these differences.
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Affiliation(s)
- Simple D Singh
- Simple D. Singh, A. Blythe Ryerson, and Manxia Wu are with the Cancer Surveillance Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. Judith S. Kaur is with the Department of Oncology, Mayo Clinic, Rochester, MN
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Yeoman K, Ryerson AB, Koziol N, Buss B, Safranek T. Breast cancer incidence among Nebraska women: early- and late-stage trends, 1995-2009. J Registry Manag 2014; 41:154-157. [PMID: 25419611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Differences in breast cancer incidence and stage at diagnosis have been observed among women of different socioeconomic status. We evaluated trends in invasive breast cancer incidence by stage and poverty among Nebraska women using cancer registry data. We demonstrated increasing incidence of early- and late-stage cancer among women living in the lowest poverty level tracts. Determining the underlying reasons for increases in early- and late-stage breast cancers among this population warrants further investigation.
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Wilson RJ, Ryerson AB, Zhang K, Dong X. Relative survival analysis using the Centers for Disease Control and Prevention's National Program of Cancer Registries Surveillance System Data, 2000-2007. J Registry Manag 2014; 41:72-76. [PMID: 25153012 PMCID: PMC4361070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Cancer survival rates are important in evaluating cancer care, identifying disease patterns, and estimating the probability of death due to cancer. To date, survival rates have been calculated using other data sets with limited population coverage that may not be able to fully identify differences by treatment, geographic region, and racial or ethnic group. Data from the Centers for Disease Control and Prevention's (CDC's) National Program of Cancer Registries (NPCR) have not been used previously to calculate relative survival rates within the United States. METHODS Data from CDC's November 2011 submission for 21 state population-based central cancer registries, representing 50 percent of the US population, were included in this analysis. This paper presents relative survival rates for diagnosis years 2000-2007 with follow-up through 2008. RESULTS The relative survival rate for all cancers and races combined was 65.0 percent (65.3 percent for male and 64.8 percent for female patients). Black patients had a lower relative survival rate than white patients, except for lung and bronchus. For all cancers, the under 45 age groups had the highest relative survival rates, except for black males. DISCUSSION For all cancer primary sites combined for 2000-2007, the CDC NPCR 5-year relative survival rate is comparable to that reported by the National Cancer Institute and the Canadian Cancer Registry. This analysis presents, for the first time, relative survival rates for half of the total US population and demonstrates that reliable survival rates can be calculated using CDC's NPCR data now and in the future.
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Seeff LC, Royalty J, Helsel WE, Kammerer WG, Boehm JE, Dwyer DM, Howe WR, Joseph D, Lane DS, Laughlin M, Leypoldt M, Marroulis SC, Mattingly CA, Nadel MR, Phillips-Angeles E, Rockwell TJ, Ryerson AB, Tangka FKL. Clinical outcomes from the CDC's Colorectal Cancer Screening Demonstration Program. Cancer 2013; 119 Suppl 15:2820-33. [DOI: 10.1002/cncr.28163] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 10/05/2012] [Accepted: 11/06/2012] [Indexed: 12/13/2022]
Affiliation(s)
- Laura C. Seeff
- Division of Cancer Prevention and Control; Centers for Disease Control and Prevention; Atlanta Georgia
| | - Janet Royalty
- Division of Cancer Prevention and Control; Centers for Disease Control and Prevention; Atlanta Georgia
| | | | | | - Jennifer E. Boehm
- Division of Cancer Prevention and Control; Centers for Disease Control and Prevention; Atlanta Georgia
| | - Diane M. Dwyer
- Maryland Department of Health and Mental Hygiene; Baltimore Maryland
| | - William R. Howe
- Information Management Services, Inc; Silver Spring Maryland
| | - Djenaba Joseph
- Division of Cancer Prevention and Control; Centers for Disease Control and Prevention; Atlanta Georgia
| | | | - Melinda Laughlin
- Missouri Department of Health and Senior Services; Jefferson City Missouri
| | - Melissa Leypoldt
- Nebraska Department of Health and Human Services; Lincoln Nebraska
| | | | | | - Marion R. Nadel
- Division of Cancer Prevention and Control; Centers for Disease Control and Prevention; Atlanta Georgia
| | | | | | - A. Blythe Ryerson
- Division of Cancer Prevention and Control; Centers for Disease Control and Prevention; Atlanta Georgia
| | - Florence K. L. Tangka
- Division of Cancer Prevention and Control; Centers for Disease Control and Prevention; Atlanta Georgia
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Forsythe LP, Kent EE, Weaver KE, Buchanan N, Hawkins NA, Rodriguez JL, Ryerson AB, Rowland JH. Receipt of psychosocial care among cancer survivors in the United States. J Clin Oncol 2013; 31:1961-9. [PMID: 23610114 PMCID: PMC3661934 DOI: 10.1200/jco.2012.46.2101] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Given the importance of psychosocial care for cancer survivors, this study used population-based data to characterize survivors who reported a discussion with health care provider(s) about the psychosocial effects of cancer and who reported using professional counseling or support groups (PCSG) and tested associations between receipt of psychosocial care and satisfaction with care. PATIENTS AND METHODS We examined survivors of adult cancers from the 2010 National Health Interview Survey (N = 1,777). Multivariable logistic regression models examined factors associated with receipt of and satisfaction with psychosocial care. RESULTS Most survivors (55.1%) reported neither provider discussions nor use of PCSG; 31.4% reported provider discussion only, 4.4% reported use of PCSG only, and 8.9% reported both. Non-Hispanic blacks (v non-Hispanic whites), married survivors, survivors of breast cancer (v prostate or less prevalent cancers), those treated with chemotherapy, and survivors reporting past research study/clinical trial participation were more likely to report provider discussion(s) (P < .01). Hispanics (v non-Hispanic whites), survivors age 40 to 49 years (v ≤ 39 years), survivors of breast cancer (v melanoma or less prevalent cancers), those diagnosed ≤ 1 year ago (v > 5 years ago), survivors treated with radiation, and past research participants were more likely to report use of PCSG (P < .05). Survivors reporting any psychosocial care were more likely to be "very satisfied" with how their needs were met (P < .001). CONCLUSION Many survivors do not report a discussion with providers about the psychosocial effects of cancer, which reflects a missed opportunity to connect survivors to psychosocial services. These data can benchmark the success of efforts to improve access to cancer-related psychosocial care.
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Affiliation(s)
- Laura P Forsythe
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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