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Tammemägi MC, Cina K, Kitts AKB, Koop D, Petereit MA, Sargent M, Petereit DG. Sensitivity of US Preventive Services Task Force and PLCOm2012 lung cancer screening eligibility criteria in individuals with lung cancer in South Dakota self-reporting as Indigenous and non-Indigenous. Cancer 2023; 129:3894-3904. [PMID: 37807694 DOI: 10.1002/cncr.34947] [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: 02/10/2023] [Revised: 05/01/2023] [Accepted: 05/24/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Lung cancer is the leading cause of cancer deaths. Screening individuals who are at elevated risk using low-dose computed tomography reduces lung cancer mortality by ≥20%. Individuals who have community-based factors that contribute to an increased risk of developing lung cancer have high lung cancer rates and are diagnosed at younger ages. In this study of lung cancer in South Dakota, the authors compared the sensitivity of screening eligibility criteria for self-reported Indigenous race and evaluated the need for screening at younger ages. METHODS US Preventive Services Task Force (USPSTF) 2013 and 2021 (USPSTF2013 and USPSTF2021) criteria and two versions of the PLCOm2012 risk-prediction model (based on the 2012 Prostate, Lung, Colorectal, and Ovarian [PLCO] Cancer Screening Trial), one with a predictor for race and one without, were applied at USPSTF-equivalent thresholds of ≥1.7% in 6 years and ≥1.0% in 6 years to 1565 individuals who were sequentially diagnosed with lung cancer (of whom 12.7% self-reported as Indigenous) at the Monument Health Cancer Care Institute in South Dakota (2010-2019). RESULTS Eligibility sensitivities of USPSTF criteria did not differ significantly between individuals who self-reported their race as Indigenous and those who did not (p > .05). Sensitivities of both PLCOm2012 models were significantly higher than comparable USPSTF criteria. The sensitivity of USPSTF2021 criteria was 66.1% and, for comparable PLCOm2012 models with and without race, sensitivity was 90.7% and 89.6%, respectively (both p < .001); 1.4% of individuals were younger than 50 years, and proportions did not differ by Indigenous classification (p = .518). CONCLUSIONS Disparities in screening eligibility were not observed for individuals who self-reported their race as Indigenous. USPSTF criteria had lower sensitivities for lung cancer eligibility. Both PLCOm2012 models had high sensitivities, with higher sensitivity for the model that included race. The PLCOm2012noRace model selected effectively in this population, and screening individuals younger than 50 years did not appear to be justified. PLAIN LANGUAGE SUMMARY Lung cancer is the leading cause of cancer deaths. Studies show that using low-dose computed tomography scans to screen people who smoke or who used to smoke and are at elevated risk for lung cancer reduces lung cancer deaths. This study of 1565 individuals with lung cancer in South Dakota compared screening eligibility using US Preventive Services Task Force (USPSTF) criteria and a lung cancer risk-prediction model (PLCOm2012; from the 2012 Prostate, Lung, Colorectal, and Ovarian [PLCO] Cancer Screening Trial). The model had higher sensitivity and picked more people with lung cancer to screen compared with USPSTF criteria. Eligibility sensitivities were similar for individuals who self-reported as Indigenous versus those who did not between USPSTF criteria and the model.
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Affiliation(s)
| | - Kristin Cina
- Avera Research Institute, Rapid City, South Dakota, USA
| | | | - David Koop
- Avera Research Institute, Rapid City, South Dakota, USA
| | - Mark A Petereit
- Sanford School of Medicine, University of South Dakota, Rapid City, South Dakota, USA
| | | | - Daniel G Petereit
- Monument Health Cancer Care Institute, Rapid City, South Dakota, USA
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Coleman CN, Wong R, Petereit DG, Maguire PD, Heron DE, Steinberg M, Bains Y, Vikram B, Angelis P, Livinski AA, Roach M, Govern FS. The National Cancer Institute's Cancer Disparities Research Partnership Program: a unique funding model 20 years later. J Natl Cancer Inst 2023; 115:1465-1474. [PMID: 37707545 PMCID: PMC10699796 DOI: 10.1093/jnci/djad173] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/29/2023] [Accepted: 08/22/2023] [Indexed: 09/15/2023] Open
Abstract
The burden of cancer and access to effective treatment are not experienced equally by all in the United States. For underserved populations that often access the health-care system when their cancers are in advanced disease stages, radiation oncology services are essential. In 2001, the National Cancer Institute's (NCI's) Radiation Research Program created and implemented the Cancer Disparities Research Partnership Program (CDRP). CDRP was a pioneering funding model whose goal was to increase participation of medically underserved populations in NCI clinical trials. CDRP's Cooperative Agreement funding supported for awardees the planning, development, and conduct of radiation oncology clinical research in institutions not traditionally involved in NCI-sponsored research and cared for a disproportionate number of medically underserved, health-disparities populations. The awardee secured and provided support for mentorship from 1 of 2 NCI comprehensive cancer centers named in its application. Six CDRP awards were made over two 5-year funding periods ending in 2013, with the end-of-program accomplishments previously reported. With the current focus on addressing equity, diversity, and inclusion, the 6 principal investigators were surveyed, 5 of whom responded about the impact of CDRP on their institutions, communities, and personal career paths. The survey that was emailed included 10 questions on a 5-point Likert scale. It was not possible to collect patient data this long after completion of the program. This article provides a 20-year retrospective of the experiences and observations from those principal investigators that can inform those now planning, building, and implementing equity, diversity, and inclusion programs.
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Affiliation(s)
- C Norman Coleman
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Rosemary Wong
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | | | - Patrick D Maguire
- Coastal Carolina Radiation Oncology (Novant-New Hanover Regional Medical Center Radiation Oncology), Wilmington, NC, USA
| | | | - Michael Steinberg
- Department of Radiation Oncology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA
| | | | - Bhadrasain Vikram
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Patricia Angelis
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Alicia A Livinski
- National Institutes of Health Library, Office of Research Services, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Mack Roach
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
- Departments of Radiation Oncology and Urology, University of California San Francisco, San Francisco, CA, USA
| | - Frank S Govern
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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Flores LE, Sargent M, Draeger B, Petereit DG, McClelland S. Validation of Navigator-Assisted Hypofractionation (NAVAH) Program Survey to Aid American Indian Breast Cancer Patients. Am J Clin Oncol 2023; 46:335-336. [PMID: 37291730 DOI: 10.1097/coc.0000000000001023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Laura E Flores
- University of Nebraska Medical Center, College of Allied Health Professions, Omaha, NE
| | | | - Beth Draeger
- Regional Health John T. Vucurevic Cancer Care Institute, Rapid City
| | - Daniel G Petereit
- Avera Walking Forward Program
- University of South Dakota Sanford School of Medicine, Sioux Falls, SD
| | - Shearwood McClelland
- Departments of Radiation Oncology
- Neurological Surgery, University Hospitals Cleveland Medical Center Case Western Reserve University, Cleveland, OH
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Roh S, Lee YS, Kenyon DB, Elliott AJ, Petereit DG, Gaba A, Lee HY. Mobile Web App Intervention to Promote Breast Cancer Screening Among American Indian Women in the Northern Plains: Feasibility and Efficacy Study. JMIR Form Res 2023; 7:e47851. [PMID: 37471115 PMCID: PMC10401399 DOI: 10.2196/47851] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Breast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This study used mobile health principles to develop a mobile web app-based mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains. OBJECTIVE This study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure. METHODS Using community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled trial design, we developed the wMammogram intervention. This study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as mammogram receipt, intention to receive breast cancer screening after the intervention, and participants' satisfaction with and acceptance of the intervention. RESULTS A significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences. CONCLUSIONS This study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations. TRIAL REGISTRATION ClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.
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Affiliation(s)
- Soonhee Roh
- Department of Social Work, University of South Dakota, Sioux Falls, SD, United States
| | - Yeon-Shim Lee
- School of Social Work, San Francisco State University, San Francisco, CA, United States
| | - DenYelle B Kenyon
- Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, United States
| | - Amy J Elliott
- Avera Research Institute, Avera Health, Sioux Falls, SD, United States
| | - Daniel G Petereit
- Monument Health Cancer Care Institute, Rapid City, SD, United States
| | - Anu Gaba
- Sanford Roger Maris Cancer Center, University of North Dakota, Fargo, ND, United States
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, AL, United States
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Brower JV, Rhodes SS, Remick JS, Russo AL, Dunn EF, Ayala-Peacock DN, Petereit DG, Bradley KA, Taunk NK. Effect of COVID-19 on Gynecologic Oncology Care: A Survey of Practicing Gynecologic Radiation Oncologists in the United States. Adv Radiat Oncol 2023; 8:101188. [PMID: 36974086 PMCID: PMC9968481 DOI: 10.1016/j.adro.2023.101188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/27/2023] [Indexed: 02/27/2023] Open
Abstract
Purpose The COVID-19 pandemic has placed demands and limitations on the delivery of health care. We sought to assess the effect of COVID-19 on the delivery of gynecologic oncologic care from the perspective of practicing radiation oncologists in the United States. Methods and Materials An anonymous online survey was created and distributed to preidentified radiation oncologists in the United States with clinical expertise in the management of gynecologic patients. The survey consisted of demographic questions followed by directed questions to assess specific patterns of care related to the COVID-19 pandemic. Results A total of 47 of 96 invited radiation oncologists responded to the survey for a response rate of 49%. Fifty-six percent of respondents reported an increase in locally advanced cervical cancer with no similar increase for endometrial, vulvar, or vaginal patients. Most respondents (66%) reported a pause in surgical management, with a duration of 1 to 3 months being most common (61%). There was a reported increased use of shorter brachytherapy regimens during the pandemic. Most providers (61%) reported caring for at least 1 patient with a positive COVID-19 test. A pause or delay in treatment due to COVID-19 positivity was reported by 45% of respondents, with 55% reporting that patients chose to delay their own care because of COVID-19-related concerns. Total treatment times >8 weeks for patients with cervical cancer were observed by 33% of respondents, but occurred in >25% of patients. Conclusions Data from this prospectively collected anonymous survey of practice patterns among radiation oncologists reveal that the COVID-19 pandemic resulted in delays initiating care, truncated brachytherapy treatment courses, and a reported increase in locally advanced cervical cancer cases at presentation. These data can be used as a means of self-assessment to ensure appropriate decision making for gynecologic patients during the endemic phase of COVID-19.
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Affiliation(s)
- Jeffrey V. Brower
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Radiation Oncology Associates–New England, Manchester, New Hampshire
| | - Sylvia S. Rhodes
- Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Jill S. Remick
- Department of Radiation Oncology, Winship Cancer Institute, Emory School of Medicine, Atlanta, Georgia
| | - Andrea L. Russo
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Emily F. Dunn
- Department of Radiation Oncology, Willamette Valley Cancer Institute and Research Center, Eugene, Oregon
| | | | - Daniel G. Petereit
- Department of Radiation Oncology, Monument Health Cancer Care Institute, Rapid City, South Dakota
| | - Kristin A. Bradley
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Neil K. Taunk
- Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Joyce DD, Tilburt JC, Pacyna JE, Cina K, Petereit DG, Koller KR, Flanagan CA, Stillwater B, Miller M, Kaur JS, Peil E, Zahrieh D, Dueck AC, Montori VM, Frosch DL, Volk RJ, Kim SP. The Impact of Within-Consultation and Preconsultation Decision Aids for Localized Prostate Cancer on Patient Knowledge: Results of a Patient-Level Randomized Trial. Urology 2023; 175:90-95. [PMID: 36898587 PMCID: PMC10239323 DOI: 10.1016/j.urology.2023.02.029] [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: 11/21/2022] [Revised: 02/09/2023] [Accepted: 02/19/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVE To evaluate the role of timing (either before or during initial consultation) on the effectiveness of decision aids (DAs) to support shared-decision-making in a minority-enriched sample of patients with localized prostate cancer using a patient-level randomized controlled trial design. METHODS We conducted a 3-arm, patient-level-randomized trial in urology and radiation oncology practices in Ohio, South Dakota, and Alaska, testing the effect of preconsultation and within-consultation DAs on patient knowledge elements deemed essential to make treatment decisions about localized prostate cancer, all measured immediately following the initial urology consultation using a 12-item Prostate Cancer Treatment Questionnaire (score range 0 [no questions correct] to 1 [all questions correct]), compared to usual care (no DAs). RESULTS Between 2017 and 2018, 103 patients-including 16 Black/African American and 17 American Indian or Alaska Native men-were enrolled and randomly assigned to receive usual care (n = 33) or usual care and a DA before (n = 37) or during (n = 33) the consultation. After adjusting for baseline characteristics, there were no statistically significant proportional score differences in patient knowledge between the preconsultation DA arm (0.06 knowledge change, 95% CI -0.02 to 0.12, P = .1) or the within-consultation DA arm (0.04 knowledge change, 95% CI -0.03 to 0.11, P = .3) and usual care. CONCLUSION In this trial oversampling minority men with localized prostate cancer, DAs presented at different times relative to the specialist consultation showed no improvement in patient knowledge above usual care.
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Affiliation(s)
| | - Jon C Tilburt
- Division of General Internal Medicine, Mayo Clinic, Scottsdale, AZ; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN; Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN.
| | - Joel E Pacyna
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN
| | - Kristin Cina
- Walking Forward Avera Health, Division of Research, Rapid City, SD
| | - Daniel G Petereit
- Cancer Care Institute at Monument Health, Rapid City, SD; Walking Forward Avera Health, Division of Research, Rapid City, SD
| | - Kathryn R Koller
- Alaska Native Tribal Health Consortium Research Services, Anchorage, AK
| | - Christie A Flanagan
- Alaska Native Tribal Health Consortium Research Services, Anchorage, AK; Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK
| | | | - Mariam Miller
- Department of Urology, Alaska Native Medical Center, Anchorage, AK
| | - Judith S Kaur
- Department of Hematology and Oncology, Mayo Clinic, Jacksonville, FL
| | - Elizabeth Peil
- Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN
| | - David Zahrieh
- Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN
| | - Amylou C Dueck
- Clinical Trials and Biostatistics, Mayo Clinic, Scottsdale, AZ
| | - Victor M Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN
| | | | - Robert J Volk
- Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Simon P Kim
- Division of Urology, University of Colorado Anschutz Medical Center, University of Colorado, Aurora, CO
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Isaacson MJ, Duran T, Johnson GR, Soltoff A, Jackson SM, Purvis SJ, Sargent M, LaPlante JR, Petereit DG, Armstrong K, Daubman BR. Great Plains American Indians' Perspectives on Patient and Family Needs Throughout the Cancer Journey. Oncol Nurs Forum 2023; 50:279-289. [PMID: 37155972 PMCID: PMC10233750 DOI: 10.1188/23.onf.279-289] [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] [Indexed: 05/10/2023]
Abstract
PURPOSE To explore the perspectives on patient and family needs during cancer treatment and survivorship of American Indian (AI) cancer survivors, caregivers, Tribal leaders, and healers. PARTICIPANTS & SETTING 36 AI cancer survivors from three reservations in the Great Plains region. METHODOLOGIC APPROACH A community-based participatory research design was employed. Postcolonial Indigenous research techniques of talking circles and semistructured interviews were used to gather qualitative data. Data were analyzed using content analysis to identify themes. FINDINGS The overarching theme of accompaniment was identified. The following themes were intertwined with this theme: (a) the need for home health care, with the subthemes of family support and symptom management; and (b) patient and family education. IMPLICATIONS FOR NURSING To provide high-quality cancer care to AI patients in their home communities, oncology clinicians should collaborate with local care providers, relevant organizations, and the Indian Health Service to identify and develop essential services. Future efforts must emphasize culturally responsive interventions in which Tribal community health workers serve as navigators to accompany patients and families during treatment and in survivorship.
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Petereit DG, Powers C, Frank SJ, Rossi P, Keyes M. Evidence Based Strategies in the Management of Localized Prostate Cancer and the Role of Brachytherapy. S D Med 2023; 76:16-23. [PMID: 36897785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Prostate cancer management is a critical component of men's health with ongoing controversies in screening and treatment. The purpose of this manuscript is to review contemporary evidence-based strategies in the management of localized prostate cancer to optimize patient outcomes, satisfaction, and shared decision making, to improve physician education and awareness, and to emphasize the importance of brachytherapy in the curative management of prostate cancer. The Bottom Line: 1. Selective screening and selective treatment reduces prostate cancer mortality rates. 2. Active surveillance is recommended for low risk prostate cancer. 3. Both radiation and surgery are appropriate options for patients with intermediate-risk and high-risk prostate cancer. 4. Quality of life and patient satisfaction favors brachytherapy for sexual function and urinary incontinence and surgery for urinary bother. 5. For patients with intermediate risk prostate cancer, brachytherapy achieves very high cure rates, acceptable sided effects, high patient satisfaction and is the most cost-effective treatment. 6. For patients with unfavorable intermediate-risk and high-risk prostate cancer, the combination of external beam radiation, brachytherapy, and ADT (Androgen Deprivation Therapy) achieves the highest rates of biochemical control and the lowest need for salvage therapies. 7. A collaborative shared decision making (SDM) process yields a well-informed, high-quality decision that is consistent with patients' preferences and value.
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Affiliation(s)
- Daniel G Petereit
- Cancer Care Institute, Monument Health, Rapid City, South Dakota.,University of South Dakota Sanford School of Medicine
| | - Colton Powers
- Internal Medicine Residency Program, University of South Dakota Sanford School of Medicine
| | - Steven J Frank
- MD Anderson Cancer Center, University of Texas, Houston, Texas
| | - Peter Rossi
- Calaway Young Cancer Center, Valley View Hospital, Glenwood Springs, Colorado
| | - Mira Keyes
- British Columbia Cancer Agency, Vancouver, Canada
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McClelland III S, Harris EE, Spratt DE, Cheatham C, Sun Y, Oliver AL, Jaboin JJ, Jagsi R, Petereit DG. Navigator-assisted hypofractionation (NAVAH) to address radiation therapy access disparities facing African-Americans with breast cancer. Rep Pract Oncol Radiother 2022; 27:583-588. [PMID: 36186700 PMCID: PMC9518767 DOI: 10.5603/rpor.a2022.0064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022] Open
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Tilburt JC, Zahrieh D, Pacyna JE, Petereit DG, Kaur JS, Rapkin BD, Grubb RL, Chang GJ, Morris MJ, Kovac EZ, Babaian KN, Sloan JA, Basch EM, Peil ES, Dueck AC, Novotny PJ, Paskett ED, Buckner JC, Joyce DD, Montori VM, Frosch DL, Volk RJ, Kim SP. Decision aids for localized prostate cancer in diverse minority men: Primary outcome results from a multicenter cancer care delivery trial (Alliance A191402CD). Cancer 2022; 128:1242-1251. [PMID: 34890060 PMCID: PMC8882149 DOI: 10.1002/cncr.34062] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 08/16/2021] [Revised: 10/14/2021] [Accepted: 11/03/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Decision aids (DAs) can improve knowledge for prostate cancer treatment. However, the relative effects of DAs delivered within the clinical encounter and in more diverse patient populations are unknown. A multicenter cluster randomized controlled trial with a 2×2 factorial design was performed to test the effectiveness of within-visit and previsit DAs for localized prostate cancer, and minority men were oversampled. METHODS The interventions were delivered in urology practices affiliated with the NCI Community Oncology Research Program Alliance Research Base. The primary outcome was prostate cancer knowledge (percent correct on a 12-item measure) assessed immediately after a urology consultation. RESULTS Four sites administered the previsit DA (39 patients), 4 sites administered the within-visit DA (44 patients), 3 sites administered both previsit and within-visit DAs (25 patients), and 4 sites provided usual care (50 patients). The median percent correct in prostate cancer knowledge, based on the postvisit knowledge assessment after the intervention delivery, was as follows: 75% for the pre+within-visit DA study arm, 67% for the previsit DA only arm, 58% for the within-visit DA only arm, and 58% for the usual-care arm. Neither the previsit DA nor the within-visit DA had a significant impact on patient knowledge of prostate cancer treatments at the prespecified 2.5% significance level (P = .132 and P = .977, respectively). CONCLUSIONS DAs for localized prostate cancer treatment provided at 2 different points in the care continuum in a trial that oversampled minority men did not confer measurable gains in prostate cancer knowledge.
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Affiliation(s)
- Jon C Tilburt
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota.,Division of General Internal Medicine, Mayo Clinic, Scottsdale, Arizona.,Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - David Zahrieh
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Joel E Pacyna
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota
| | - Daniel G Petereit
- Rapid City Regional Cancer Care Institute, Monument Health, Rapid City, South Dakota
| | - Judith S Kaur
- Department of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida
| | - Bruce D Rapkin
- Department of Epidemiology and Population Health, Division of Community Collaboration and Implementation Science, Albert Einstein College of Medicine, Bronx, New York
| | - Robert L Grubb
- Department of Urology, Medical University of South Carolina, Charleston, South Carolina
| | - George J Chang
- Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael J Morris
- Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Evan Z Kovac
- Department of Urology, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Kara N Babaian
- Department of Surgery, Southern Illinois University, Springfield, Illinois
| | - Jeff A Sloan
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Ethan M Basch
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Elizabeth S Peil
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Amylou C Dueck
- Alliance Statistics and Data Center, Mayo Clinic, Scottsdale, Arizona
| | - Paul J Novotny
- Alliance Statistics and Data Center, Mayo Clinic, Rochester, Minnesota
| | - Electra D Paskett
- Ohio State University College of Medicine, The Ohio State University, Columbus, Ohio
| | - Jan C Buckner
- Department of Oncology, Mayo Clinic, Rochester, Minnesota
| | - Daniel D Joyce
- Department of Urology, Mayo Clinic, Rochester, Minnesota
| | - Victor M Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota
| | - Dominick L Frosch
- Palo Alto Medical Foundation Research Institute, Palo Alto, California
| | - Robert J Volk
- Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Simon P Kim
- Division of Urology, Anschutz Medical Center, University of Colorado, Aurora, Colorado
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Petereit DG. Increasing global access to brachytherapy: The ABS 300 in 10 initiative and ongoing international efforts. Brachytherapy 2021; 21:1-3. [PMID: 34893430 DOI: 10.1016/j.brachy.2021.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 12/30/2022]
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Mantz CA, Thaker NG, Pendyala P, Hubbard A, Eichler TJ, Shah C, Orio PF, Petereit DG. Disproportionate Negative Impact of the Radiation Oncology Alternative Payment Model on Rural Providers: A Cost Identification Analysis of Medicare Claims. JCO Oncol Pract 2021; 17:e1977-e1983. [PMID: 34529516 DOI: 10.1200/op.21.00330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The Radiation Oncology Alternative Payment Model (APM) is a Medicare demonstration project that will test whether prospective bundled payments to a randomly selected group of physician practices, hospital outpatient departments, and freestanding radiation therapy centers reduce overall expenditures while preserving or enhancing the quality of care for beneficiaries. The Model follows a complicated pricing methodology that blends historical reimbursements for a defined set of services made to professional and technical providers to create a weighted payment average for each of 16 cancer types. These averages are then adjusted by various factors to determine APM payments specific to each participating provider. METHODS This impact study segregates APM participants into rural and urban groups and analyzes the effect of the Radiation Oncology Alternative Payment Model on their fee-for-service reimbursements. RESULTS The main findings of this study are (1) the greater net-negative revenue impact on rural facilities versus urban facilities that would have participated in the Model this year and (2) the relative lack of high-value treatment services (ie, stereotactic radiotherapy and brachytherapy) delivered by rural facilities that exacerbates their negative impact. CONCLUSION As such, rural providers participating in the Model in its current form may face greater risk to their economic viability and greater difficulty in funding technology improvements necessary for the achievement of high-quality care compared with their urban counterparts.
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Affiliation(s)
| | | | | | - Anne Hubbard
- American Society for Radiation Oncology, Fairfax, VA
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Franco I, Petereit DG, Mourtada F, Singer L. Increasing Brachytherapy Mentorship and Representation Through #NextGenBrachy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.05.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Taunk NK, Li T, Petereit DG, Shah C, Mourtada F. In Regard to Dooley et al. Int J Radiat Oncol Biol Phys 2021; 109:834-835. [PMID: 33516444 DOI: 10.1016/j.ijrobp.2020.10.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/13/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Neil K Taunk
- Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania
| | - Taoran Li
- Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Chirag Shah
- Department of Radiation Oncology Taussig Cancer Center Cleveland Clinic, Cleveland, Ohio
| | - Firas Mourtada
- Helen F. Graham Cancer Center ChristianaCare Health System, Newark, Delaware
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15
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McClelland S, Petereit DG, Zeitlin R, Takita C, Suneja G, Miller RC, Deville C, Siker ML. Improving the Clinical Treatment of Vulnerable Populations in Radiation Oncology. Adv Radiat Oncol 2020; 5:1093-1098. [PMID: 33305069 PMCID: PMC7718519 DOI: 10.1016/j.adro.2020.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/11/2020] [Accepted: 07/17/2020] [Indexed: 11/29/2022] Open
Abstract
The increasing role of radiation oncology in optimal cancer care treatment brings to mind the adage that power is never a gift, but a responsibility. A significant part of the responsibility we in radiation oncology bear is how to ensure optimal access to our services. This article summarizes the discussion initiated at the 2019 American Society for Radiation Oncology Annual Meeting educational panel entitled “Improving the Clinical Treatment of Vulnerable Populations in Radiation Oncology: Latin, African American, Native American, and Gender/Sexual Minority Communities.” By bringing the discussion to the printed page, we hope to continue the conversation with a broader audience to better define the level of responsibility our field bears in optimizing cancer care to the most vulnerable patient populations within the United States.
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Affiliation(s)
- Shearwood McClelland
- Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Ross Zeitlin
- Departmment of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Cristiane Takita
- Department of Radiation Oncology, University of Miami Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Gita Suneja
- Department of Radiation Oncology, University of Utah, Salt Lake City, Utah
| | - Robert C. Miller
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Curtiland Deville
- Department of Radiation Oncology, Johns Hopkins Kimmel Cancer Center, Baltimore, Maryland
| | - Malika L. Siker
- Departmment of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Corresponding author: Malika L. Siker, MD
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16
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Frank SJ, Mourtada F, Crook J, Orio PF, Stock RG, Petereit DG, Rossi PJ, Cox BW, Tang C, Kudchadker RJ, Bruno T, Ma J, Sanders J, Keyes M. The American Brachytherapy Society prostate brachytherapy LDR/HDR simulation workshops: Hands-on, step-by-step training in the process of quality assurance. Brachytherapy 2020; 19:787-793. [PMID: 33132070 DOI: 10.1016/j.brachy.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/09/2020] [Revised: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Education and training on prostate brachytherapy for radiation oncology and medical physics residents in the United States is inadequate, resulting in fewer competent radiation oncology personnel to perform implants, and is a factor in the subsequent decline of an important, potentially curative cancer treatment modality for patients with cancer. The American Brachytherapy Society (ABS) leadership has recognized the need to establish a sustainable medical simulation low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy workshop program that includes physician-physicist teams to rapidly translate knowledge to establish high-quality brachytherapy programs. METHODS The ABS, in partnership with industry and academia, has held three radiation oncology team-based LDR/HDR workshops composed of physician-physicist teams in Chicago in 2017, in Houston in 2018, and in Denver in 2019. The predefined key metric of success is the number of attendees who returned to their respective institutions and were actively performing brachytherapy within 6 months of the prostate brachytherapy workshop. RESULTS Of the 111 physician/physicist teams participating in the Chicago, Houston, and Denver prostate brachytherapy workshops, 87 (78%) were actively performing prostate brachytherapy (51 [59%] HDR and 65 [75%] LDR). CONCLUSIONS The ABS prostate brachytherapy LDR/HDR simulation workshop has provided a successful education and training structure for medical simulation of the critical procedural steps in quality assurance to shorten the learning curve for delivering consistently high-quality brachytherapy implants for patients with prostate cancer. An ABS initiative, intended to bend the negative slope of the brachytherapy curve, is currently underway to train 300 new competent brachytherapy teams over the next 10 years.
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Affiliation(s)
- Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Firas Mourtada
- Department of Radiation Oncology, Christiana Care, Newark, DE
| | - Juanita Crook
- BC Cancer - Kelowa, University of British Columbia, Kelowa, Canada
| | - Peter F Orio
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA
| | | | | | | | - Brett W Cox
- Department of Radiation Oncology, Rush University Medical Center, Chicago, IL
| | - Chad Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rajat J Kudchadker
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Teresa Bruno
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jingfei Ma
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jeremiah Sanders
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Mira Keyes
- British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada
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17
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Tilburt JC, Pacyna JE, Cina K, Petereit DG, Kaur JS, Storrrick EM, Zahrieh D, Dueck AC, Kim SP. The impact of within-visit and pre-visit decision aids for localized prostate cancer on patient knowledge. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.29_suppl.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
151 Background: Decision aids (DAs) for prostate cancer treatment can improve knowledge and reduce decisional conflict, but the relative effect of pre-visit and within-visit DAs is not known, and effect sizes for minority populations has not been estimated. Methods: We conducted a 3-arm, patient-level-RCT in specialty urology and radiation oncology practices in Ohio, South Dakota, and Alaska, test the effect of pre-consultation and with-in consultation decision aids on patient knowledge immediately after specialty consultation compared to usual care. We used linear regression to estimate effects of each intervention arm, including the respective standard error, two-sided 95% confidence interval, and two-sided P value for testing the study’s hypotheses. Results: 103 patients were recruited and randomized to receive either the pre-visit decision aid, within-visit decision aid, or neither decision aids (usual care). In 2017 and 20018, we accrued similar numbers of men to pre-consultation aid (n = 37), during-consultation aid (n = 33) and usual care arms, respectively (n = 33). The median (range) age in years was 64 [49, 81]; 67.6% were White, 15.7% were Black or African American, 16.7% were American Indian or Alaska Native, and 1% were not reported. 47.6%, 45.6%, and 6.8% had a baseline clinical stage of T1, T2, and T3, respectively. The median [range] prostate specific antigen (PSA) was 8.0 [2.4, 53.7]. There were no clinically notable imbalances. We obtained usable data on 102 of the 103 patient-participants. The pre-visit decision aid arm showed a mean knowledge effect of 0.694 (0.636, 0.753). The within-visit decision arm showed a very similar mean knowledge effect of 0.686 (0.625, 0.748). The usual care arm showed a mean knowledge effect of 0.644 (0.582,0.705). The linear regression model showed, that, compared with usual care, neither intervention effect achieved statistical significance in the primary analysis (p = 0.24, 0.330, for pre-visit and within-visit, respectively). Conclusions: Modest knowledge gains of pre-visit and during-visit decision aids for prostate cancer treatment were not statistically significant. Clinical trial information: NCT03182998 .
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Affiliation(s)
| | | | | | | | | | | | | | | | - Simon P. Kim
- University Hospitals Cleveland Medical Center, Cleveland, OH
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18
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Erickson B, Crook J, Vicini F, Arthur D, Ouhib Z, Thomadsen B, Bice W, Butler WM, Petereit DG, Viswanathan AN. The ABS brachytherapy schools. Brachytherapy 2020; 19:820-826. [PMID: 32928682 DOI: 10.1016/j.brachy.2020.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/08/2020] [Indexed: 11/17/2022]
Abstract
The American Brachytherapy Society brachytherapy schools have been pivotal in teaching and evolving the art of brachytherapy over the past decades. Founded in 1995, the schools have consistently provided content for the major disease sites including gynecologic, prostate, and breast with ocular, vascular, head and neck, pediatric, intraluminal, systemic, and intraoperative approaches more selectively addressed. In addition, Physics schools, either coupled with clinical schools or as stand-alone venues, have provided an essential educational component for practicing physicists, a pivotal part of the brachytherapy team. Celebrating 25 years in existence, this historical overview of the American Brachytherapy Society brachytherapy schools is a tribute to the many teachers who have shared their expertise, to the many students who have been enthusiastic and interactive participants, and the staff who have made it all possible, with the reward of perpetuating the important and timely art of brachytherapy.
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Affiliation(s)
- Beth Erickson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI.
| | - Juanita Crook
- Department of Radiation Oncology, BC Cancer Kelowna and University of British Columbia
| | - Frank Vicini
- 21th Century Oncology, Michigan Healthcare Professionals, Farmington Hills, MI
| | - Douglas Arthur
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA
| | - Zoubir Ouhib
- Lynn Cancer Institute of Boca Raton Regional Hospital, Delray Beach, FL
| | - Bruce Thomadsen
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - William Bice
- Radiation Oncology Department, John Muir Health Systems, Walnut Creek, CA
| | - Wayne M Butler
- Schiffler Cancer Center, Wheeling Hospital, Wheeling, WV
| | | | - Akila N Viswanathan
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Medicine, Baltimore, MD
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19
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Petereit DG. COVID 19 crisis: Maintaining brachytherapy access and strategies for risk mitigation. Brachytherapy 2020; 19:389. [PMID: 32448746 PMCID: PMC7188651 DOI: 10.1016/j.brachy.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Daniel G Petereit
- President, American Brachytherapy Society, Department of Radiation Oncology, Monument Health Cancer Care Institute, Rapid City, SD.
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20
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Tilburt JC, Pacyna JE, Petereit DG, Kaur JS, Rapkin BD, Grubb R, Chang GJ, Morris MJ, Kovac E, Sloan JA, Basch EM, Storrrick EM, Zahrieh D, Dueck AC, Paskett ED, Buckner JC, Montori V, Frosch DL, Volk RJ, Kim SP. Decision aids for localized prostate cancer: Initial outcomes from NCI Community Oncology Research Program Alliance Research Base Cancer Care Delivery Research (CCDR) Protocol - A191402CD - A Cluster-Randomized Trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e24176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e24176 Background: Decision aids for prostate cancer treatment can improve knowledge, but the relative effect of pre-consultation and within-consultation DAs is not known. Methods: We conducted a parallel design, 2-by-2 factorial, 4-arm, cluster-RCT in urology practices affiliated with the NCI’s Alliance research base. We compared patient knowledge immediately after consultation (%12-item% correct) intervention arms compared to usual care. We used mixed effects regression modeling to assess effect of interventions on knowledge adjusting for site-clustering, race/ethnicity (non-Hispanic White; Other), age (years), clinical stage (T1-3), PSA, and Gleason score. Results: 15 of 21 randomized centers accrued 158 pts from Nov 2017 to June 2019. The arm delivering both DAs (n = 3 sites) recruited 25 pts. The pre-consultation DA arm (n = 4 sites) recruited 39 pts. The within-consultation DA arm (n = 4 sites) recruited 44 pts. The no DA arm (n = 4 sites) accrued 50 pts. Overall, mean age was 64; 54% were AA; 73% had T1 stage; median Gleason = 7; and median PSA = 7. The combined DAs group, followed by pre-consultation reported higher median knowledge (75% and 67%, respectively). The within-consultation and no DA arms both reported median knowledge scores (58%). Within arm, inter-site standard deviations in mean knowledge scores ranged from 0.164 in in the pre-consultation arm to 0.232 in the usual care arm. Neither pre-consultation nor within-consultation DAs had statistically significant effects (p = .15 and p = .99, respectively). Pre-specified adjusted difference [97.5% CIs], comparing the pre-consultation DA and the within-consultation DA with the control was 9.4% [-7.3%, 26.2%] and -0.4% [-16.9%, 16.1%], respectively. Intra-cluster correlation (ICC) coefficient was high (.24). No interaction effects were identified (p = .98). A post-hoc analysis comparing any DA vs usual care found a mean adjusted difference [95% CI] of 5.6% [-8.5%, 19.8%] (p = 0.40), 63.9% for any DA and 58.3% for usual care. Conclusions: Possible knowledge gains associated with some DAs for early prostate cancer were obscured by larger-than-expected intra-cluster correlation effects associated with the primary outcome. How interventions were used was not measured. Support:UG1CA189823; https://acknowledgments.alliancefound.org ; R01 MD008934-06. Clinical trial information: NCT03103321 .
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Affiliation(s)
| | | | | | | | - Bruce D. Rapkin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY
| | - Robert Grubb
- Medical University of South Carolina, Charleston, SC
| | - George J. Chang
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Ethan M. Basch
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | | | | | | | | | | | | | | | | | - Simon P. Kim
- University Hospitals Cleveland Medical Center, Cleveland, OH
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21
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McClelland S, Petereit DG. The Advanced Alternative Payment Model: Catalyst for Prostate Brachytherapy Adoption? Int J Radiat Oncol Biol Phys 2020; 106:1104-1105. [DOI: 10.1016/j.ijrobp.2019.12.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 12/21/2019] [Accepted: 12/24/2019] [Indexed: 11/25/2022]
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22
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Ritter MA, Kupelian PA, Petereit DG, Lawton CA, Anger N, Geye H, Chappell RJ, Forman JD. A Prospective Multi-Institutional Phase I/II Trial of Step-Wise Dose-per-Fraction Escalation in Low and Intermediate Risk Prostate Cancer. Pract Radiat Oncol 2020; 10:345-353. [PMID: 32169590 DOI: 10.1016/j.prro.2020.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/06/2020] [Accepted: 02/09/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE This phase I/II, multi-institutional trial explored the tolerance and efficacy of stepwise increasing hypofractionation (HPFX) radiation therapy regimens for fraction sizes up to 4.3 Gy in localized prostate cancer. METHODS AND MATERIALS Three escalating dose-per-fraction schedules were designed to yield similar predicted tumor control while maintaining equivalent predicted late toxicity. HPFX levels I, II, and III were carried out sequentially and delivered schedules of 64.7 Gy/22 fx/2.94 Gy, 58.08 Gy/16 fx/3.63 Gy, and 51.6 Gy/12 fx/4.3 Gy, respectively with next level escalations contingent upon acceptable gastrointestinal (GI) toxicity. The primary endpoints were biochemical control and toxicity. RESULTS A total of 347 patients were recruited by 5 institutions with 101, 111, and 135 patients treated on HPFX levels I, II, and III with median follow-ups of 100, 85.5, and 61.7 months, respectively (83.2 months combined). The National Comprehensive Cancer Network low- or intermediate-risk group distribution was 46% and 54%, respectively. Sixteen percent of patients, primarily intermediate risk, received 6 months of androgen deprivation therapy. The 8-year nadir + 2 actuarial biochemical control rates for HPFX levels I, II, and III were 91.1% ± 3.0%, 92.7% ± 2.7%, and 88.5% ± 4.6%, respectively (Kaplan-Meier log rank, 0.903). Among clinical covariates, only Gleason score reached near significance in multivariate analysis (P = .054). Twenty-six patients failed biochemically (crude incidence of 7.5%), and there were 5 cause-specific deaths. GI and genitourinary toxicities were acceptable and similar across the 3 HPFX levels. The combined actuarial cumulative incidence of grade 2+ GI and genitourinary toxicities at 7 years were 16.3% ± 2.1% and 22.1% ± 2.4%, respectively. CONCLUSIONS HPFX employing fraction sizes extending into the 3.6 to 4.3 Gy/fraction range can be delivered with excellent oncologic outcomes. Such schedules, positioned between moderate and ultra-HPFX, may provide additional options for patients wishing to avoid prolonged treatment schedules associated with conventionally fractionated radiation therapy for prostate cancer.
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Affiliation(s)
- Mark A Ritter
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin.
| | | | - Daniel G Petereit
- John T. Vucurevich Cancer Center Institute, Rapid City, South Dakota
| | | | - Nick Anger
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | - Heather Geye
- Department of Human Oncology, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | - Richard J Chappell
- Department of Biostatistics and Medical Informatics and Department of Statistics, University of Wisconsin, Madison, Wisconsin
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23
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Vapiwala N, Thomas CR, Grover S, Yap ML, Mitin T, Shulman LN, Gospodarowicz MK, Longo J, Petereit DG, Ennis RD, Hayman JA, Rodin D, Buchsbaum JC, Vikram B, Abdel-Wahab M, Epstein AH, Okunieff P, Goldwein J, Kupelian P, Weidhaas JB, Tucker MA, Boice JD, Fuller CD, Thompson RF, Trister AD, Formenti SC, Barcellos-Hoff MH, Jones J, Dharmarajan KV, Zietman AL, Coleman CN. Enhancing Career Paths for Tomorrow's Radiation Oncologists. Int J Radiat Oncol Biol Phys 2019; 105:52-63. [PMID: 31128144 PMCID: PMC7084166 DOI: 10.1016/j.ijrobp.2019.05.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 05/03/2019] [Accepted: 05/08/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Neha Vapiwala
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Charles R Thomas
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
| | - Surbhi Grover
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania; University of Botswana, Gaborone, Botswana
| | - Mei Ling Yap
- Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute, University of New South Wales, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centre, Western Sydney University, Campbelltown, Australia; School of Public Health, University of Sydney, Camperdown, Australia
| | - Timur Mitin
- Department of Radiation Medicine Director, Program in Global Radiation Medicine, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Lawrence N Shulman
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary K Gospodarowicz
- Department of Radiation Oncology, University of Toronto, Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - John Longo
- Department of Radiation Oncology Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Daniel G Petereit
- Department of Radiation Oncology, Rapid City Regional Cancer Care Institute, Rapid City, South Dakota
| | - Ronald D Ennis
- Clinical Network for Radiation Oncology, Rutgers and Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - James A Hayman
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Danielle Rodin
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jeffrey C Buchsbaum
- Radiation Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Bhadrasain Vikram
- Clinical Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - May Abdel-Wahab
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Alan H Epstein
- Uniformed Service University of the Health Sciences, Bethesda, Maryland
| | - Paul Okunieff
- Department of Radiation Oncology, University of Florida Health Cancer Center, Gainesville, Florida
| | - Joel Goldwein
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania; Elekta AB, Stockholm, Sweden
| | - Patrick Kupelian
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California; Varian Medical Systems, Palo Alto, California
| | - Joanne B Weidhaas
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California; MiraDx, Los Angeles, California
| | - Margaret A Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, Maryland; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Clifton David Fuller
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Reid F Thompson
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon; VA Portland Health Care System, Portland, Oregon
| | - Andrew D Trister
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
| | - Silvia C Formenti
- Department of Radiation Oncology, Weill Cornell Medicine, New York City, New York
| | | | - Joshua Jones
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kavita V Dharmarajan
- Department of Radiation Oncology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Anthony L Zietman
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - C Norman Coleman
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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24
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Albuquerque K, Hrycushko BA, Harkenrider MM, Mayadev J, Klopp A, Beriwal S, Petereit DG, Scanderbeg DJ, Yashar C. Compendium of fractionation choices for gynecologic HDR brachytherapy—An American Brachytherapy Society Task Group Report. Brachytherapy 2019; 18:429-436. [DOI: 10.1016/j.brachy.2019.02.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/07/2019] [Accepted: 02/28/2019] [Indexed: 10/27/2022]
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Roh S, Burnette CE, Lee YS, Giger JT, Goins RT, Petereit DG, Lawler MJ, Lee KH. Identifying risk and protective factors related to depressive symptoms among Northern Plains American Indian women cancer survivors. Women Health 2019; 59:646-659. [PMID: 30481139 PMCID: PMC6591106 DOI: 10.1080/03630242.2018.1544965] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 07/21/2017] [Revised: 09/12/2018] [Accepted: 09/17/2018] [Indexed: 10/27/2022]
Abstract
Cancer is the leading cause of death among American Indian and Alaska Native (AIAN) women, and depressive symptoms have been linked to higher mortality, but research on depressive symptoms among AIAN cancer patients has been scant. The purpose of this exploratory study was, using the Framework of Historical Oppression, Resilience, and Transcendence, to examine risk and protective factors related to depressive symptoms in American Indian (AI) women cancer survivors. We examined the relationships of adverse childhood experiences (ACE), perceived health status, resilience, and social support with depressive symptoms in Northern Plains AI women cancer survivors. We used a cross-sectional design with purposive sampling of 73 female cancer survivors (aged 18 years or older) between June 2014 and February 2015. Hierarchical multiple regression was used to test three sets of variables in relation to depressive symptoms: (1) sociodemographics, (2) risk factors (ACE and perceived health), and (3) protective factors (psychological resilience and social support). Approximately 47 percent of participants had probable depressive symptoms. Depressive symptoms were inversely associated with perceived health, psychological resilience, and social support. These results support bolstering existing social support among AI cancer patients and survivors as well as prevention and intervention efforts that strengthen resilience.
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Affiliation(s)
- Soonhee Roh
- a Department of Social Work , University of South Dakota, 365 Health Science Center , Sioux Falls , South Dakota , USA
| | | | - Yeon-Shim Lee
- c School of Social Work , San Francisco State University , San Francisco , California , USA
| | - Jarod T Giger
- d College of Social Work, University of Kentucky , Lexington , Kentucky , USA
| | - R Turner Goins
- e College of Health and Human Sciences , Western Carolina University , Cullowhee , North Carolina , USA
| | - Daniel G Petereit
- f John T. Vucurevich Cancer Care Institute, Rapid City Regional Hospital , Rapid City , South Dakota , USA
| | - Michael J Lawler
- g Pacific Northwest University of Health Sciences , Yakima , Washington , USA
| | - Kyoung Hag Lee
- h School of Social Work , Wichita State University , Wichita , Kansas , USA
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Holschneider CH, Petereit DG, Chu C, Hsu IC, Ioffe YJ, Klopp AH, Pothuri B, Chen LM, Yashar C. Brachytherapy: A critical component of primary radiation therapy for cervical cancer. Gynecol Oncol 2019; 152:540-547. [DOI: 10.1016/j.ygyno.2018.10.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/11/2018] [Accepted: 10/15/2018] [Indexed: 11/15/2022]
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Holschneider CH, Petereit DG, Chu C, Hsu IC, Ioffe YJ, Klopp AH, Pothuri B, Chen LM, Yashar C. Brachytherapy: A critical component of primary radiation therapy for cervical cancer: From the Society of Gynecologic Oncology (SGO) and the American Brachytherapy Society (ABS). Brachytherapy 2019; 18:123-132. [PMID: 30665713 DOI: 10.1016/j.brachy.2018.11.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Brachytherapy is well-established as an integral component in the standard of care for treatment of patients receiving primary radiotherapy for cervical cancer. A decline in brachytherapy has been associated with negative impacts on survival in the era of modern EBRT techniques. Conformal external beam therapies such intensity modulated radiation therapy (IMRT) or stereotactic body radiation therapy (SBRT) should not be used as alternatives to brachytherapy in patients undergoing primary curative-intent radiation therapy for cervical cancer. Computed tomography or magnetic resonance image-guided adaptive brachytherapy is evolving as the preferred brachytherapy method. With careful care coordination EBRT and brachytherapy can be successfully delivered at different treatment centers without compromising treatment time and outcome in areas where access to brachytherapy maybe limited.
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Affiliation(s)
- Christine H Holschneider
- Gynecologic Oncology, Olive View-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA.
| | - Daniel G Petereit
- Radiation Oncology, Regional Health - John T. Vucurevich Cancer Care Institute, Rapid City, SD
| | - Christina Chu
- Gynecologic Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | - I-Chow Hsu
- Radiation Oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | | | - Ann H Klopp
- Radiation Oncology, MD Anderson Cancer Center, Houston, TX
| | - Bhavana Pothuri
- Gynecologic Oncology, NYU Langone Laura and Isaac Perlmutter Cancer Center, New York, NY
| | - Lee-May Chen
- Gynecologic Oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - Catheryn Yashar
- Radiation Oncology, UC San Diego School of Medicine, San Diego, CA
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McClelland S, Leberknight J, Guadagnolo BA, Coleman CN, Petereit DG. (P47) The Pervasive Crisis of Diminishing Radiotherapy Access for American Indians in the United States. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.02.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Odegaard K, White D, Petereit DG. Progressive Multifocal Leukoencephalopathy versus Brain Metastasis in a Patient with Locally-Advanced Non-Small Cell Lung Cancer. S D Med 2018; 71:102-106. [PMID: 29991095] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease affecting the white matter of the brain. This condition is caused by the John Cunningham virus and leads to progressive neuropsychological deficits. Though the infection is typically seen in association with HIV or AIDS, other immune-compromised states may predispose patients as well. This report discusses a patient who developed PML following standard chemo-radiotherapy for non-small cell lung cancer in whom presentation was initially more convincing for brain metastasis; thus, highlighting the importance of accurate diagnosis of new brain lesions in this setting.
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Affiliation(s)
| | | | - Daniel G Petereit
- John T. Vucurevich Regional Cancer Care Institute, Rapid City, South Dakota
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McClelland S, Leberknight J, Guadagnolo BA, Coleman CN, Petereit DG. The pervasive crisis of diminishing radiation therapy access for vulnerable populations in the United States, part 2: American Indian patients. Adv Radiat Oncol 2018; 3:3-7. [PMID: 29556572 PMCID: PMC5856975 DOI: 10.1016/j.adro.2017.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/14/2017] [Accepted: 08/15/2017] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION American Indian/Alaska Native (AI/AN) patients with cancer disproportionally present with more advanced stages of disease and have the worst cancer-specific survival rates of any racial/ethnic group in the United States. The presence of disparities in radiation therapy (RT) access for AI/AN patients has rarely been examined. METHODS AND MATERIALS National Cancer Institute (NCI) initiatives toward addressing AI/AN disparities were examined. Additionally, an extensive PubMed literature search for studies investigating RT access disparities in AI/AN patients was performed. RESULTS Literature describing RT access disparities for the AI/AN patient population is sparse, revealing only 3 studies, each of which described initiatives from the Walking Forward program, the NCI Cancer Disparity Research Partnership initiative to address barriers to cancer screening among AI populations in the Northern Plains region (eg, geographic remoteness and mistrust of health care providers). This program has used patient navigation, community education, and access to clinical trials for more than 4000 AI/AN patients to combat high cancer mortality rates. Over the course of its 15-year existence, the program has resulted in patients presenting with earlier stages of disease and experiencing higher cure rates. Lung cancer, the most common cause of cancer-related mortality in AI/AN patients, is the most recent and ongoing focus of the program. CONCLUSION The amount of information regarding RT access in AI/AN patients is limited, with nearly all peer-reviewed published progress in this area being associated with the Walking Forward program. Further initiatives from this program will hopefully inspire similar initiatives throughout the country to reduce the barriers to optimized cancer care that these patients face. Given the similarities with cancer disparities of populations worldwide, the AI/AN experience should be included within the broad issue of a global shortage of cancer care among underserved populations.
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Affiliation(s)
- Shearwood McClelland
- Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon
| | | | - B. Ashleigh Guadagnolo
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Daniel G. Petereit
- Walking Forward Program, Rapid City, South Dakota
- International Cancer Expert Corps, Washington, DC
- Rapid City Regional Cancer Care Institute, Rapid City, South Dakota
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Petereit DG. Walking Forward: A narrative from South Dakota. Pract Radiat Oncol 2017; 8:351-353. [PMID: 29042119 DOI: 10.1016/j.prro.2017.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Daniel G Petereit
- Avera Cancer Care Institute, Sioux Falls, South Dakota; Rapid City Regional Cancer Care Institute, Rapid City, South Dakota.
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Cina KR, Omidpanah AA, Petereit DG. Assessing HPV and Cervical Knowledge, Preference and HPV Status Among Urban American Indian Women. S D Med 2017; 70:439-443. [PMID: 28957617] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION To evaluate whether or not an educational intervention would lead to a change in knowledge and attitudes about human papillomavirus (HPV), HPV vaccines, and cervical cancer. The HPV status was also investigated for interested participants. METHODS We provided HPV and cervical cancer education to urban American Indian (AI) women 18 and older using a pre and post-knowledge exam to assess knowledge and attitudes. Women were also given the option to perform vaginal self-tests for high risk HPV (hrHPV) analysis immediately after the education. RESULTS Ninety-six women participated in our educational sessions. Improvement in performance on a knowledge exam increased from 61.6 to 84.3 percent. Ninety-three women performed the vaginal self-test with 63.1 percent of women preferring vaginal self-testing over conventional screening methods. Thirty-five out of 91 women (38.5 percent) had hrHPV types with 12 of the 35 harboring multiple hrHPV types (13 percent overall). CONCLUSION HPV and cervical cancer education was beneficial for urban AI women with the majority of women preferring vaginal self-testing. HPV self-testing may be a strategy to improve screening rates for cervical cancer. Urban AI women had high rates of hrHPV compared to rural AI populations as reported in previous studies.
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Guadagnolo BA, Petereit DG, Coleman CN. Cancer Care Access and Outcomes for American Indian Populations in the United States: Challenges and Models for Progress. Semin Radiat Oncol 2017; 27:143-149. [PMID: 28325240 PMCID: PMC5363281 DOI: 10.1016/j.semradonc.2016.11.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 11/27/2022]
Abstract
Low socioeconomic and health care access realities of being American Indian/Alaskan Native (AI/AN) in the United States combined with decades of data documenting poor cancer outcomes for this population provide a population nested within the United States that is analogous to the cancer care landscape of low- and middle-income countries internationally. We reviewed the medical literature with respect to cancer prevention, access to cancer treatment, and access to effective supportive and palliative care for AI/AN populations in the United States. Research confirms poorer cancer outcomes, suboptimal cancer screening, and high-risk cancer behaviors among AI/AN communities. AI/AN cancer patients are less likely to undergo recommended cancer surgeries, adjuvant chemotherapy, and radiation therapy than their White counterparts. Studies including both rural and urban survivors with AI cancer revealed barriers to receipt of optimal cancer symptom management and proportionally lower hospice use among AI/AN populations. Culturally tailored programs in targeted communities have been shown to mitigate the observed cancer-related health disparities among AI/AN communities. There is still much work to be done to improve cancer-related health outcomes in AI/AN communities, and the goals of the providers serving them corresponds with those propelling the growing interest in global oncology equity. Policy work and more funding are needed to continue to build upon the work that the Indian Health Service and established cancer-related health programs have begun in AI/AN communities.
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Affiliation(s)
- B Ashleigh Guadagnolo
- Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX.
| | | | - C Norman Coleman
- International Cancer Expert Corps, New York, NY; Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, MD
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Miller RC, Petereit DG, Sloan JA, Liu H, Martenson JA, Bearden JD, Sapiente R, Seeger GR, Mowat RB, Liem B, Iott MJ, Loprinzi CL. N08C9 (Alliance): A Phase 3 Randomized Study of Sulfasalazine Versus Placebo in the Prevention of Acute Diarrhea in Patients Receiving Pelvic Radiation Therapy. Int J Radiat Oncol Biol Phys 2016; 95:1168-74. [PMID: 27354129 DOI: 10.1016/j.ijrobp.2016.01.063] [Citation(s) in RCA: 9] [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: 07/08/2015] [Revised: 12/30/2015] [Accepted: 01/05/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE To provide confirmatory evidence on the use of sulfasalazine to reduce enteritis during pelvic radiation therapy (RT), following 2 prior single-institution trials suggestive that benefit existed. METHODS AND MATERIALS A multi-institution, randomized, double-blind, placebo-controlled phase 3 trial was designed to assess the efficacy of sulfasalazine versus placebo in the treatment of RT-related enteritis during RT including the posterior pelvis (45.0-53.5 Gy) and conducted through a multicenter national cooperative research alliance. Patients received 1000 mg of sulfasalazine or placebo orally twice daily during and for 4 weeks after RT. The primary endpoint was maximum severity of diarrhea (Common Terminology Criteria for Adverse Events version 4.0). Toxicity and bowel function were assessed by providers through a self-administered bowel function questionnaire taken weekly during RT and for 6 weeks afterward. RESULTS Eighty-seven patients were enrolled in the trial between April 29, 2011, and May 13, 2013, with evenly distributed baseline factors. At the time of a planned interim toxicity analysis, more patients with grade ≥3 diarrhea received sulfasalazine than received placebo (29% vs 11%, P=.04). A futility analysis showed that trial continuation would be unlikely to yield a positive result, and a research board recommended halting study treatment. Final analysis of the primary endpoint showed no significant difference in maximum diarrhea severity between the sulfasalazine and placebo arms (P=.41). CONCLUSIONS Sulfasalazine does not reduce enteritis during pelvic RT and may be associated with a higher risk of adverse events than placebo. This trial illustrates the importance of confirmatory phase 3 trials in the evaluation of symptom-control agents.
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Affiliation(s)
- Robert C Miller
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
| | | | - Jeff A Sloan
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Heshan Liu
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | | | - James D Bearden
- Upstate Carolina Community Clinical Oncology Program, Spartanburg, South Carolina
| | | | | | - Rex B Mowat
- Toledo Community Hospital Oncology Program CCOP, Toledo, Ohio
| | - Ben Liem
- University of New Mexico, Albuquerque, New Mexico
| | - Matthew J Iott
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
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Coleman CN, Formenti SC, Chao N, Grover S, Rodin D, Petereit DG, Vikram B, Pistenmaa DA, Mohiuddin M, Williams TR, Wendling N, Roth L, Gospodarowicz M, Jaffray D. Establishing global health cancer care partnerships across common ground: bridging nuclear security, equitable access, education, outreach, and mentorship. The Lancet Global Health 2016. [DOI: 10.1016/s2214-109x(16)30019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Petereit DG. Abstract IA11: Understanding the complex factors that contribute to the persistence of disparities among American Indian/Alaska Native populations: The Walking Forward experience. Cancer Epidemiol Biomarkers Prev 2015. [DOI: 10.1158/1538-7755.disp14-ia11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
Abstract
Purpose/Objective(s): American Indians (AIs) present with more advanced stages of cancer and, therefore, suffer from higher cancer mortality rates compared to non-AIs. Under the National Cancer Institute Cancer Disparities Research Partnership Program (CDRP), we have been researching methods of improving cancer treatment and outcomes since 2002, for AIs in Western South Dakota, through the Walking Forward (WF) Program.
Materials/Methods: This program consists of 1) a culturally-tailored patient navigation program that facilitated access to innovative clinical trials in conjunction with a comprehensive educational program encouraging screening and early detection, b) surveys to evaluate barriers to access, c) clinical trials focusing on reducing treatment length as AIs live a median of 140 miles from the cancer center, d) a molecular study (ATM - Ataxia telangectasia mutation) to address whether there is a molecular profile that increases toxicity risks, and e) recently funded projects using mHealth (mobile) technology to address smoking cessation in the general population and cancer survivors, as well as a survivorship program to increase physical activity. A breast patient navigation (BPN) program was developed for all patients in 2007 to address the high mastectomy rates in our area. An analysis of this program was undertaken to determine if the breast conservation rates (BC) have improved over time: 849 non-navigated patients from 2000-2006 were compared to 617 navigated patients from 2007-2012.
Results: To date, over 3,800 AIs have participated in various WF research studies. Critical outcomes include the establishment of trust within tribal communities, identification of barriers to cancer screening, creation of research infrastructure, higher completion rates and patient satisfaction for patients undergoing cancer treatment, enrollment of patients on Phase II trials with excellent clinical outcomes, and the establishment of new research partners. The BC rates have improved from 37% to 56% over time. To date, 158 AIs have been enrolled in our smoking cessation study with an anticipated accrual of 256. Recent analysis suggests that AI cancer patients with screen-detectable cancers are now presenting with earlier stages of disease and higher cure rates.
Conclusions: This NCI funded pilot program has achieved some initial measures of success. A research infrastructure has been created in a community setting to address new research questions and interventions. One critical objective of the CDRP program was to create sustainable, community research programs that has been achieved at our site and is ongoing with new grants and a new partnership with the Avera Health in Sioux Falls, SD, where a genomics program will be implemented. Lessons learned will also be presented.
This study was funded by NIH grant 5 U56 CA099010.
Contributors: Sheikh Iqbal Ahamed2, Amy Boylan1, Simone Bordeaux1, Linda Burhansstipanov3, Kristin Cina1, Kim Crawford1, Mark Dignan6, Ashleigh Guadagnolo5, Linda Krebs3, Patricia Kussman1, Adam Omidpanah4, Daniel Petereit1, Michele Sargent1, Mary Stein1, Doris Thibeault1. 1Rapid City Regional Hospital, Rapid City, SD; 2Marquette University, Milwaukee, WI; 3Native American Cancer Research Corporation, Pine, CO; 4University of Washington, Seattle, WA; 5The University of Texas MD Anderson Cancer Center, Houston, TX; 6University of Kentucky, Lexington, KY.
Citation Format: Daniel G. Petereit. Understanding the complex factors that contribute to the persistence of disparities among American Indian/Alaska Native populations: The Walking Forward experience. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr IA11.
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Affiliation(s)
| | - Steven J Frank
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Akila N Viswanathan
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | - Patricia Eifel
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Paul L Nguyen
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - David E Wazer
- Tufts Medical Center, Tufts University School of Medicine, Boston, MA, and Rhode Island Hospital, The Alpert Medical School of Brown University, Providence, RI
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Magnuson WJ, Petereit DG, Anderson BM, Geye HM, Bradley KA. Impact of adjuvant pelvic radiotherapy in stage I uterine sarcoma. Anticancer Res 2015; 35:365-370. [PMID: 25550573] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIM The optimal adjuvant therapy for stage I uterine sarcoma remains unresolved and may consist of radiotherapy (RT), chemotherapy, hormonal therapy or observation. We analyzed the impact of adjuvant pelvic RT on overall survival (OS), cause-specific survival (CSS), disease-free survival (DFS), pelvic control (PC) and patterns of failure. PATIENTS AND METHODS A retrospective analysis of 157 patients with International Federation of Gynecology and Obstetrics FIGO stage I uterine sarcoma was performed. RT was given postoperatively to a dose of 45-51 Gy in 28-30 fractions. RESULTS The 5-year OS, CSS, DFS and PC was 58%, 62%, 47% and 72%, respectively. Adjuvant RT significantly improved PC (85% for RT group vs. 64% for non-RT group; p=0.02) but did not impact OS, CSS or DFS. CONCLUSION The addition of adjuvant pelvic RT significantly improved PC for patients with stage I uterine sarcoma. As systemic therapies continue to improve, optimal locoregional control may result in improved patient outcomes.
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Affiliation(s)
- William J Magnuson
- University of Wisconsin Department of Radiation Oncology, Madison, WI, U.S.A.
| | | | - Bethany M Anderson
- University of Wisconsin Department of Radiation Oncology, Madison, WI, U.S.A
| | - Heather M Geye
- University of Wisconsin Department of Radiation Oncology, Madison, WI, U.S.A
| | - Kristin A Bradley
- University of Wisconsin Department of Radiation Oncology, Madison, WI, U.S.A
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Coleman CN, Formenti SC, Williams TR, Petereit DG, Soo KC, Wong J, Chao N, Shulman LN, Grover S, Magrath I, Hahn S, Liu FF, DeWeese T, Khleif SN, Steinberg M, Roth L, Pistenmaa DA, Love RR, Mohiuddin M, Vikram B. The international cancer expert corps: a unique approach for sustainable cancer care in low and lower-middle income countries. Front Oncol 2014; 4:333. [PMID: 25478326 PMCID: PMC4237042 DOI: 10.3389/fonc.2014.00333] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 11/01/2014] [Indexed: 11/13/2022] Open
Abstract
The growing burden of non-communicable diseases including cancer in low- and lower-middle income countries (LMICs) and in geographic-access limited settings within resource-rich countries requires effective and sustainable solutions. The International Cancer Expert Corps (ICEC) is pioneering a novel global mentorship-partnership model to address workforce capability and capacity within cancer disparities regions built on the requirement for local investment in personnel and infrastructure. Radiation oncology will be a key component given its efficacy for cure even for the advanced stages of disease often encountered and for palliation. The goal for an ICEC Center within these health disparities settings is to develop and retain a high-quality sustainable workforce who can provide the best possible cancer care, conduct research, and become a regional center of excellence. The ICEC Center can also serve as a focal point for economic, social, and healthcare system improvement. ICEC is establishing teams of Experts with expertise to mentor in the broad range of subjects required to establish and sustain cancer care programs. The Hubs are cancer centers or other groups and professional societies in resource-rich settings that will comprise the global infrastructure coordinated by ICEC Central. A transformational tenet of ICEC is that altruistic, human-service activity should be an integral part of a healthcare career. To achieve a critical mass of mentors ICEC is working with three groups: academia, private practice, and senior mentors/retirees. While in-kind support will be important, ICEC seeks support for the career time dedicated to this activity through grants, government support, industry, and philanthropy. Providing care for people with cancer in LMICs has been a recalcitrant problem. The alarming increase in the global burden of cancer in LMICs underscores the urgency and makes this an opportune time fornovel and sustainable solutions to transform cancer care globally.
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Affiliation(s)
| | | | - Tim R Williams
- Lynn Cancer Institute at Boca Raton Regional Hospital , Boca Raton, FL , USA
| | | | - Khee C Soo
- National Cancer Center , Singapore , Singapore
| | - John Wong
- National University Cancer Institute, National University of Singapore , Singapore , Singapore
| | - Nelson Chao
- Division of Hematologic Malignancies and Cellular Therapy, BMT and Global Cancer, Duke Cancer Institute, Duke University , Durham, NC , USA
| | | | - Surbhi Grover
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania , Philadelphia, PA , USA
| | - Ian Magrath
- International Network for Cancer Treatment and Research , Brussels , Belgium
| | - Stephen Hahn
- Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania , Philadelphia, PA , USA
| | - Fei-Fei Liu
- Department of Radiation Oncology, Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto , Toronto, ON , Canada
| | - Theodore DeWeese
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University , Baltimore, MD , USA
| | - Samir N Khleif
- Cancer Center, Georgia Regents University , Augusta, GA , USA
| | - Michael Steinberg
- Department of Radiation Oncology, University of California Los Angeles , Los Angeles, CA , USA
| | - Lawrence Roth
- International Cancer Expert Corps , Chevy Chase, MD , USA
| | | | - Richard R Love
- International Cancer Expert Corps , Chevy Chase, MD , USA ; International Breast Cancer Research Foundation , Madison, WI , USA
| | | | - Bhadrasain Vikram
- Radiation Research Program, National Cancer Institute , Bethesda, MD , USA
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Wong RSL, Vikram B, Govern FS, Petereit DG, Maguire PD, Clarkson MR, Heron DE, Coleman CN. National Cancer Institute's Cancer Disparities Research Partnership Program: Experience and Lessons Learned. Front Oncol 2014; 4:303. [PMID: 25405101 PMCID: PMC4217306 DOI: 10.3389/fonc.2014.00303] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/14/2014] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To increase access of underserved/health disparities communities to National Cancer Institute (NCI) clinical trials, the Radiation Research Program piloted a unique model - the Cancer Disparities Research Partnership (CDRP) program. CDRP targeted community hospitals with a limited past NCI funding history and provided funding to establish the infrastructure for their clinical research program. METHODS Initially, 5-year planning phase funding was awarded to six CDRP institutions through a cooperative agreement (U56). Five were subsequently eligible to compete for 5-year implementation phase (U54) funding and three received a second award. Additionally, the NCI Center to Reduce Cancer Health Disparities supported their U56 patient navigation programs. RESULTS Community-based hospitals with little or no clinical trials experience required at least a year to develop the infrastructure and establish community outreach/education and patient navigation programs before accrual to clinical trials could begin. Once established, CDRP sites increased their yearly patient accrual mainly to NCI-sponsored cooperative group trials (~60%) and Principal Investigator/mentor-initiated trials (~30%). The total number of patients accrued on all types of trials was 2,371, while 5,147 patients received navigation services. CONCLUSION Despite a historical gap in participation in clinical cancer research, underserved communities are willing/eager to participate. Since a limited number of cooperative group trials address locally advanced diseases seen in health disparities populations; this shortcoming needs to be rectified. Sustainability for these programs remains a challenge. Addressing these gaps through research and public health mechanisms may have an important impact on their health, scientific progress, and efforts to increase diversity in NCI clinical trials.
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Affiliation(s)
- Rosemary S L Wong
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute , Rockville, MD , USA
| | - Bhadrasain Vikram
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute , Rockville, MD , USA
| | - Frank S Govern
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute , Rockville, MD , USA
| | - Daniel G Petereit
- Walking Forward Program, Rapid City Regional Hospital , Rapid City, SD , USA
| | | | | | - Dwight E Heron
- University of Pittsburgh Medical Center McKeesport , McKeesport, PA , USA
| | - C Norman Coleman
- Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute , Rockville, MD , USA
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Petereit DG, Kanekar S, Guadagnolo A, Boylan A, Cina K, Burhansstipanov L. Abstract PL02-02: Lessons learned from the Walking Forward Program in recruiting American Indians on clinical trials. Cancer Epidemiol Biomarkers Prev 2014. [DOI: 10.1158/1538-7755.disp13-pl02-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
Abstract
Purpose/Objective(s): American Indians (AIs) present with more advanced stages of cancer and, therefore, suffer from higher cancer mortality rates compared to non-AIs. Under the National Cancer Institute Cancer Disparities Research Partnership Program (CDRP), we have been researching methods of improving cancer treatment and outcomes since 2002, for AIs in Western South Dakota, through the Walking Forward (WF) Program.
Materials/Methods: This program consists of a) a culturally-tailored patient navigation program that facilitated access to innovative clinical trials in conjunction with a comprehensive educational program encouraging screening and early detection, b) surveys to evaluate barriers to access, c) clinical trials focusing on reducing treatment length as AIs live a median of 140 miles from the cancer center, d) a molecular study (ATM - Ataxia telangectasia mutation) to address whether there is a molecular profile that increases toxicity risks, and e) a recently funded project using mHealth (mobile) technology to address the high smoking rates in this population.
Results: To date, over 3,700 AIs have participated in various WF research studies. Critical outcomes include the establishment of trust within tribal communities, identification of barriers to cancer screening, creation of research infrastructure, higher completion rates and patient satisfaction for patients undergoing cancer treatment, enrollment of patients on phase II trials with excellent clinical outcomes, and the establishment of new research partners. Recent analysis suggests that AI cancer patients with screen detectable cancers are now presenting with earlier stages of disease and higher cure rates. Lessons learned will also be presented.
Conclusions: This NCI funded pilot program has achieved some initial measures of success. A research infrastructure has been created in a community setting to address new research questions and interventions. One critical objective of the CDRP program was to create sustainable, community research programs that has been achieved at our site.
Citation Format: Daniel G. Petereit, Shalini Kanekar, Ashleigh Guadagnolo, Amy Boylan, Kristin Cina, Linda Burhansstipanov. Lessons learned from the Walking Forward Program in recruiting American Indians on clinical trials. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr PL02-02. doi:10.1158/1538-7755.DISP13-PL02-02
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Affiliation(s)
| | | | | | - Amy Boylan
- 1Rapid City Regional Hospital, Rapid City, SD,
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Burhansstipanov L, Krebs LU, Dignan MB, Jones K, Harjo LD, Watanabe-Galloway S, Petereit DG, Pingatore NL, Isham D. Findings from the native navigators and the Cancer Continuum (NNACC) study. J Cancer Educ 2014; 29:420-427. [PMID: 25053462 PMCID: PMC4144404 DOI: 10.1007/s13187-014-0694-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Native Navigators and the Cancer Continuum (NNACC) was a community based participatory research study among Native American Cancer Research Corporation, CO; Inter-Tribal Council of Michigan, MI; Rapid City Regional Hospital's Walking Forward, SD; Great Plains Tribal Chairman's' Health Board, SD; and Muscogee (Creek) Nation, OK. The project goal was to collaborate, refine, expand, and adapt navigator/community education programs to address American Indian communities' and patients' needs across the continuum of cancer care (prevention through end-of-life). The intervention consisted of four to six site-specific education workshop series at all five sites. Each series encompassed 24 h of community education. The Social Ecology Theory guided intervention development; community members from each site helped refine education materials. Following extensive education, Native Patient Navigators (NPNs) implemented the workshops, referred participants to cancer screenings, helped participants access local programs and resources, and assisted those with cancer to access quality cancer care in a timely manner. The intervention was highly successful; 1,964 community participants took part. Participants were primarily American Indians (83 %), female (70 %) and between 18 and 95 years of age. The education programs increased community knowledge by 28 %, facilitated referral to local services, and, through site-specific navigation services, improved access to care for 77 participants diagnosed with cancer during the intervention. Approximately, 90 % of participants evaluated workshop content as useful and 92.3 % said they would recommend the workshop to others. The intervention successfully increased community members' knowledge and raised the visibility of the NPNs in all five sites.
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Affiliation(s)
- Linda Burhansstipanov
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO 880470-7830, and 3110 S. Wadsworth Blvd, Suite 103, Denver, CO, 80227, USA,
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Watanabe-Galloway S, Burhansstipanov L, Krebs LU, Harjo LD, Petereit DG, Pingatore NL, Isham D. Partnering for success through community-based participatory research in Indian country. J Cancer Educ 2014; 29:588-595. [PMID: 25030416 PMCID: PMC4142145 DOI: 10.1007/s13187-014-0683-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Shinobu Watanabe-Galloway
- Epidemiology Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-4395, USA
| | - Linda Burhansstipanov
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO 880470-7830 USA
| | - Linda U. Krebs
- College of Nursing, University of Colorado Denver, ED2N Room 4209, 13120 East 19 Avenue, P.O. Box 6511, Aurora, CO 80045, USA
| | - Lisa D. Harjo
- Native American Cancer Research Corporation (NACR), 3110 S. Wadsworth Blvd. Suite 103, Denver, CO 80227, USA
| | - Daniel G. Petereit
- Department of Radiology Oncology, Rapid City Regional Hospital, John T. Vucureivich Cancer 353 Fairmount Blvd, Rapid City, SD 57701, USA
| | - Noel L. Pingatore
- Inter-Tribal Council of Michigan, Inc., 2956 Ashmun St., Sault Ste. Marie, MI 49783, USA
| | - Debra Isham
- Oklahoma City Area Indian Health Service, 701 Market Drive, Oklahoma City, OK 73114. (Formerly Tobacco Prevention Program, Muscogee (Creek) Nation Division of Health, Okemah, OK)
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Dwojak SM, Finkelstein DM, Emerick KS, Lee JH, Petereit DG, Deschler DG. Poor Survival for American Indians with Head and Neck Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2014; 151:265-71. [PMID: 24781656 DOI: 10.1177/0194599814533083] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 01/08/2014] [Accepted: 04/04/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To examine patient characteristics, treatment modalities, and human papillomavirus (HPV) prevalence to identify potential mediators of disparities that may lead to differences in outcomes for American Indians with head and neck squamous cell carcinoma (HNSCC). STUDY DESIGN Historical cohort study. SETTING Community cancer centers. PATIENTS AND METHODS We reviewed all patients older than 18 years with a new diagnosis of HNSCC in South Dakota from 1999 to 2009. We assessed tissue samples from cases of oropharyngeal cancer for the presence of HPV DNA. RESULTS In total, 474 white patients were compared with 32 American Indians. American Indians experienced significantly worse survival compared with whites (hazard ratio [HR], 0.59; P = .05), even after controlling for other factors such as age, sex, distance, Charlson comorbidity index, alcohol abuse, smoking, insurance, and disease stage. American Indians had a greater risk of alcohol abuse (68% vs 42%; P = .008), current smoking (67% vs 49%; P = .03), living more than 1 hour from a cancer center (81% vs 30%; P < .001), lacking private insurance (24% vs 68%; P < .001), and late-stage disease presentation (stages III and IV) (74% vs 55%; P = .04). There were no detected differences in age, sex, medical comorbidities, tumor site, tumor grade, HPV status, time to treatment, or type of treatment received. CONCLUSION American Indians in South Dakota with HNSCC have poorer survival compared with white patients. Once presented to a cancer center, American Indians received nearly identical treatment to white patients. Disparities in outcomes arise primarily due to sociodemographic factors and later stage at presentation.
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Affiliation(s)
- Sunshine M Dwojak
- Department of Otolaryngology Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts, USA
| | - Dianne M Finkelstein
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kevin S Emerick
- Department of Otolaryngology Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts, USA
| | - John H Lee
- Sanford Cancer Research Center, Sioux Falls, South Dakota, USA
| | - Daniel G Petereit
- Rapid City Regional Hospital, John T. Vucurevich Cancer Care Institute, Rapid City, South Dakota, USA
| | - Daniel G Deschler
- Department of Otolaryngology Massachusetts Eye and Ear Infirmary, and Harvard Medical School, Boston, Massachusetts, USA
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Thomadsen BR, Erickson BA, Eifel PJ, Hsu IC, Patel RR, Petereit DG, Fraass BA, Rivard MJ. A review of safety, quality management, and practice guidelines for high-dose-rate brachytherapy: executive summary. Pract Radiat Oncol 2014; 4:65-70. [PMID: 24890345 DOI: 10.1016/j.prro.2013.12.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 12/23/2013] [Indexed: 12/26/2022]
Abstract
This white paper was commissioned by the American Society for Radiation Oncology (ASTRO) Board of Directors to evaluate the status of safety and practice guidance for high-dose-rate (HDR) brachytherapy. Given the maturity of HDR brachytherapy technology, this white paper considers, from a safety point of view, the adequacy of general physics and quality assurance guidance, as well as clinical guidance documents available for the most common treatment sites. The rate of medical events in HDR brachytherapy procedures in the United States in 2009 and 2010 was 0.02%, corresponding to 5-sigma performance. The events were not due to lack of guidance documents but failures to follow those recommendations or human failures in the performance of tasks. The white paper summarized by this Executive Summary reviews current guidance documents and offers recommendations regarding their application to delivery of HDR brachytherapy. It also suggests topics where additional research and guidance is needed.
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Affiliation(s)
- Bruce R Thomadsen
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin.
| | - Beth A Erickson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Patricia J Eifel
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - I-Chow Hsu
- Department of Radiation Oncology, University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | | | - Daniel G Petereit
- Department of Radiation Oncology, John T. Vucurevich Cancer Care Institute, Rapid City Regional Hospital, Rapid City, South Dakota
| | - Benedick A Fraass
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Mark J Rivard
- Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts
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Krebs LU, Burhansstipanov L, Watanabe-Galloway S, Pingatore NL, Petereit DG, Isham D. Navigation as an intervention to eliminate disparities in American Indian communities. Semin Oncol Nurs 2014; 29:118-27. [PMID: 23651681 DOI: 10.1016/j.soncn.2013.02.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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]
Abstract
OBJECTIVES To identify the role of patient navigation in decreasing health care disparities through an exemplar of a successful patient navigation program for American Indian populations living in the Northern and Southern Plains of the United States. DATA SOURCES Published literature and data from the Native Navigators and the Cancer Continuum study. CONCLUSION Native Patient Navigators successfully collaborated with local American Indian organizations to provide cancer education through a series of 24-hour workshops. These workshops increased community knowledge about cancer, influenced cancer screening behaviors, and increased the visibility and availability of the navigators to provide navigation services. IMPLICATIONS FOR NURSING PRACTICE Reaching those with health care disparities requires multiple strategies. Collaborating with patient navigators who are embedded within and trusted by their communities helps to bridge the gap between patients and providers, increases adherence to care recommendations, and improves quality of life and survival.
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Affiliation(s)
- Linda U Krebs
- University of Colorado, College of Nursing, Aurora, CO 80045, USA.
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Guadagnolo BA, Huo J, Buchholz TA, Petereit DG. Disparities in hospice utilization among American Indian Medicare beneficiaries dying of cancer. Ethn Dis 2014; 24:393-398. [PMID: 25417419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVE We sought to compare hospice utilization for American Indian and White Medicare beneficiaries dying of cancer. METHODS We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases to analyze claims for 181,316 White and 690 American Indian patients dying of breast, cervix, colorectal, kidney, lung, pancreas, prostate cancer, or stomach cancer from 2003 to 2009. RESULTS A lower proportion of American Indians enrolled in hospice compared to White patients (54% vs 65%, respectively; P < .0001). While the proportion of White patients who used hospice services in the last 6 months of life increased from 61% in 2003 to 68% in 2009 (P < .0001), the proportion of American Indian patients using hospice care remained unchanged (P = .57) and remained below that of their White counterparts throughout the years of study. CONCLUSION Continued efforts should be made to improve access to culturally relevant hospice care for American Indian patients with terminal cancer.
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Petereit DG, Hahn LJ, Kanekar S, Boylan A, Bentzen SM, Ritter M, Moser AR. Prevalence of ATM Sequence Variants in Northern Plains American Indian Cancer Patients. Front Oncol 2013; 3:318. [PMID: 24416720 PMCID: PMC3874556 DOI: 10.3389/fonc.2013.00318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/04/2013] [Accepted: 12/13/2013] [Indexed: 11/13/2022] Open
Abstract
Purpose: To identify sequence variants of the ataxia telangiectasia mutated (ATM) gene and establish their prevalence rate among American Indian (AI) as compared with non-AI cancer patients. Materials and Methods: DNA was isolated from blood samples collected from 100 AI and 100 non-AI cancer patients undergoing radiation therapy, and a blinded assessment of the ATM sequence was conducted. Quantitative PCR assessment of copy number for each exon was also performed. The main outcome measure was the prevalence of ATM variants in the two patient populations. Results: No statistically significant differences for total prevalence of ATM variants among AI and non-AI patients were found. Of the 25 variants identified, 5 variants had a prevalence of >2%, of which 4 occurred at a rate of >5% in one or both groups. The prevalence of these four variants could meaningfully be compared between the two groups. The only statistically significant difference among the groups was the c.4138C > T variant which is predicted not to affect protein function, seen in 8% of AI versus 0% of non-AI patients (P = 0.007). No exonic copy number changes were found in these patients. Conclusion: This study is the first to determine the prevalence of ATM variants in AIs.
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Affiliation(s)
- Daniel G Petereit
- Rapid City Regional Hospital, John T. Vucurevich Cancer Care Institute , Rapid City, SD , USA ; Department of Human Oncology, University of Wisconsin School of Medicine and Public Health , Madison, WI , USA
| | - L Jennifer Hahn
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health , Madison, WI , USA
| | - Shalini Kanekar
- Rapid City Regional Hospital, John T. Vucurevich Cancer Care Institute , Rapid City, SD , USA
| | - Amy Boylan
- Rapid City Regional Hospital, John T. Vucurevich Cancer Care Institute , Rapid City, SD , USA
| | - Søren M Bentzen
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health , Madison, WI , USA
| | - Mark Ritter
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health , Madison, WI , USA
| | - Amy R Moser
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health , Madison, WI , USA
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Shaverdian N, Gondi V, Sklenar KL, Dunn EF, Petereit DG, Straub MR, Bradley KA. Effects of Treatment Duration During Concomitant Chemoradiation Therapy for Cervical Cancer. Int J Radiat Oncol Biol Phys 2013; 86:562-8. [DOI: 10.1016/j.ijrobp.2013.01.037] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/15/2013] [Accepted: 01/29/2013] [Indexed: 01/08/2023]
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Love RR, Coleman CN, Vikram B, Petereit DG. Better cancer control for worldwide populations at the margins of healthcare: Direct big-issues talk and due diligence. J Cancer Policy 2013. [DOI: 10.1016/j.jcpo.2013.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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