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Shirima S, Brazinskaite R, Killackey M, Sieloff BI, Cisneros C, Pratt-Chapman ML. Advancing Patient-Centered Cancer Survivorship Care: Evaluation of a Dissemination Project. J Cancer Educ 2023; 38:448-454. [PMID: 35037231 PMCID: PMC9288553 DOI: 10.1007/s13187-022-02138-y] [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] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 05/20/2023]
Abstract
Care coordination among primary care providers and oncologists continues to be a challenge in cancer survivorship care. The Advancing Patient-Centered Cancer Survivorship Care Toolkit ("Toolkit") was developed to provide a "workshop in a box" for comprehensive cancer control (CCC) stakeholders to advance patient-centered cancer survivorship care in their region. The Toolkit was disseminated through an e-learning module, established webpages, an online forum, and social media. Toolkit dissemination was evaluated using the RE-AIM framework. For effectiveness, e-learning module and workshop participants were surveyed to assess changes in confidence in learning objectives. The Toolkit Web page received over 10,000 impressions. E-learning module participants (n = 212) reported statistically significant improvement (p < 0.001) between the pre- (M = 3.42, SD = 0.85) and post-test (M = 4.18, SD = 0.60) mean scores on self-confidence to describe patient-reported priorities for cancer survivorship care. Among virtual workshop trainees (n = 121), 28 participants completed paired pre- and post-workshop surveys. Among those with matched responses, there were statistically significant improvements from pre- to post-workshop self-reported knowledge on what patients want in cancer survivorship care (M = 2.5, SD = 1.0, vs. M = 3.3, SD = 1.0; p = 0.001); confidence in describing critical components of patient-centered cancer survivorship care (M = 3.1, SD = 1.2, vs. M = 4.2, SD = 0.5; p < 0.001); and confidence in describing patient priorities for cancer survivorship care (M = 3.0, SD = 1.1, vs. M = 4.1, SD = 0.6; p < 0.001). Provision of technical assistance resources in a variety of formats can successfully build capacity of healthcare providers and comprehensive cancer coalition stakeholders to feel more prepared to deliver patient-centered, coordinated cancer survivorship care.
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Affiliation(s)
- Sylvia Shirima
- School of Medicine and Health Sciences, George Washington University, 800 22nd Street NW, Suite 8000, Washington, D.C, 20052, USA
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Ruta Brazinskaite
- School of Medicine and Health Sciences, George Washington University, 800 22nd Street NW, Suite 8000, Washington, D.C, 20052, USA
| | - Maureen Killackey
- American College of Surgeons' Commission On Cancer, Chicago, IL, USA
- GW Cancer Center Community Advisory Board, Washington, DC, USA
| | - Beth I Sieloff
- GW Cancer Center Community Advisory Board, Washington, DC, USA
- Inter-Tribal Council of Michigan, Sault Ste. Marie, MI, USA
| | - Cindy Cisneros
- GW Cancer Center Community Advisory Board, Washington, DC, USA
| | - Mandi L Pratt-Chapman
- School of Medicine and Health Sciences, George Washington University, 800 22nd Street NW, Suite 8000, Washington, D.C, 20052, USA.
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Arem H, Moses J, Nekhlyudov L, Killackey M, Sieloff B, Cisneros C, Pratt-Chapman ML. Oncology provider experiences during the COVID-19 pandemic. PLoS One 2022; 17:e0270651. [PMID: 35881586 PMCID: PMC9321423 DOI: 10.1371/journal.pone.0270651] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/14/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose
The COVID-19 pandemic upended nearly all aspects of daily life and of medical care, placing a double burden of professional and personal concerns on those who provide medical care. We set out to assess the burden of the pandemic on provider outlook and understand how cancer survivorship providers experienced rapid changes to practice.
Methods
We distributed a survey through the American College of Surgeons Commission on Cancer (CoC) to its accredited organizations in mid-October 2020. We included questions on provider characteristics, changes in patient care practices resulting from the pandemic, worry about COVID-19, and concern about impact on cancer survivors.
Results
Of the n = 607 participants, three-quarters were female and three-quarters were White. Only 2.1% of participants reported having had COVID-19, but 43% reported anxiety about getting COVID-19 and over a quarter experienced sadness or depression, anxiety about the future, changes to sleep, difficulty concentrating, or social isolation. Approximately half of providers also expressed significant concern about progression of cancer in patients who experienced care delays or were afraid of accessing in-person care. In terms of changes to survivorship care, respondents reported changes to visitor policies, delays or cancellations, and efforts to reduce in-person visits.
Conclusions
COVID-19 has taken a significant toll on front-line healthcare professionals, including oncologists and cancer care allied health professionals. Findings support proactive mental health support of healthcare professionals as well as emergency preparedness to manage delays to care for cancer patients in the event of future unexpected pandemics.
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Affiliation(s)
- Hannah Arem
- Healthcare Delivery Research, Medstar Health Research Institute, Washington, DC, United States of America
| | - Jenna Moses
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Larissa Nekhlyudov
- George Washington University Cancer Center, Community Advisory Board, Washington, DC, United States of America
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Maureen Killackey
- George Washington University Cancer Center, Community Advisory Board, Washington, DC, United States of America
- American College of Surgeons’ Commission on Cancer Site Reviewer, NYS Cancer Advisory Council, NY, United States of America
| | - Beth Sieloff
- George Washington University Cancer Center, Community Advisory Board, Washington, DC, United States of America
- Inter-Tribal Council of Michigan, Sault Ste, MI, United States of America
| | - Cindy Cisneros
- George Washington University Cancer Center, Community Advisory Board, Washington, DC, United States of America
| | - Mandi L. Pratt-Chapman
- School of Medicine and Health Sciences, George Washington University, Washington, DC, United States of America
- * E-mail:
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Arem H, Moses J, Cisneros C, Blondeau B, Nekhlyudov L, Killackey M, Pratt-Chapman ML. Cancer Provider and Survivor Experiences With Telehealth During the COVID-19 Pandemic. JCO Oncol Pract 2021; 18:e452-e461. [PMID: 34714706 DOI: 10.1200/op.21.00401] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The COVID-19 pandemic led to rapid shifts in cancer survivorship care, including the widespread use of telehealth. Given the swift transition and limited data on preferences and experiences around telehealth, we surveyed oncology providers and post-treatment survivors to better understand experiences with the transition to telehealth. METHODS We distributed provider (MD, PA or NP, nurse, navigator, and social worker) and survivor surveys through the American College of Surgeons Commission on Cancer in mid-October 2020. Survivor surveys were also disseminated through patient advocacy organizations. We included questions on demographics, experiences with telehealth, and preferences for future telehealth utilization. RESULTS Among N = 607 providers and N = 539 cancer survivors, there was overwhelmingly more support from providers than from survivors for delivery of various types of survivorship care via telehealth and greater comfort with telehealth technologies. The only types of appointments deemed appropriate for survivorship care by both > 50% of providers and survivors were discussion of laboratory results or imaging, assessment and/or management of cancer treatment symptoms, nutrition counseling, and patient navigation support. Only a quarter of survivors reported increased access to health care services (25.5%), and 32.0% reported that they would use telehealth again. CONCLUSION Although there have been drastic changes in technological capabilities and billing reimbursement structures for telehealth, there are still concerns around delivery of a broad range of survivorship care services via telehealth, particularly from the patient perspective. Still, offering telehealth services, where endorsed by providers and if available and acceptable to cancer survivors, may provide more efficient and accessible care following the COVID-19 pandemic.
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Affiliation(s)
- Hannah Arem
- Medstar Health Research Institute, Healthcare Delivery Research, Washington, DC.,Department of Oncology, Georgetown University School of Medicine, Washington, DC
| | - Jenna Moses
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC
| | - Cindy Cisneros
- George Washington University Cancer Center, Community Advisory Board, Washington, DC
| | - Benoit Blondeau
- University of New Mexico, Albuquerque, NM.,Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Larissa Nekhlyudov
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC.,George Washington University Cancer Center, Community Advisory Board, Washington, DC.,Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Maureen Killackey
- George Washington University Cancer Center, Community Advisory Board, Washington, DC.,American College of Surgeons' Commission on Cancer Site Reviewer, NYS Cancer Advisory Council, New York, NY
| | - Mandi L Pratt-Chapman
- George Washington University, School of Medicine and Health Sciences, Washington, DC
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Smith A, Couvillion R, Zhang R, Killackey M, Buell J, Lee B, Saggi BH, Paramesh AS. Incidence and management of leukopenia/neutropenia in 233 kidney transplant patients following single dose alemtuzumab induction. Transplant Proc 2015; 46:3400-4. [PMID: 25498059 DOI: 10.1016/j.transproceed.2014.07.070] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 07/15/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND The purpose of this study was to determine the incidence and management strategies for post-transplant leukopenia/neutropenia in kidney recipients receiving alemtuzumab induction during the first year following transplantation. METHODS We prospectively identified 233 adult patients who underwent kidney transplantation with alemtuzumab induction at a single institution. The incidence and severity of leukopenia (white blood cell count [WBC] ≤2500/mm(3)) and neutropenia (absolute neutrophil count [ANC] ≤500/mm(3)) were evaluated at 1, 3, 6, and 12 months post-transplantation. We determined any association with cytomegalovirus (CMV) infection, graft rejection, and infections requiring hospitalization. We also reviewed interventions performed, including medication adjustments, treatment with granulocyte stimulating factor, and hospitalization. RESULTS The combined incidence of either leukopenia or neutropenia was 47.5% (n = 114/233) with an average WBC nadir of 1700 ± 50/mm(3) at 131.0 ± 8.5 days and an average ANC nadir of 1500 ± 100/mm(3) at 130.4 ± 9.6 days. No significant difference in graft rejection, CMV infection, or infections requiring hospitalization was found in the leukopenia/neutropenia group vs the normal WBC group (P = .3). The most common intervention performed for leukopenia/neutropenia group was prophylactic medication adjustment. Six patients (5.2%) required a change in >1 medication. The majority of these patients also required granulocyte stimulating factor (61.5%; 32/52), with an average of 2.5 doses given. A total of 25 patients (21.9%) required hospitalization due to leukopenia/neutropenia with an average length of stay of 6 days. CONCLUSIONS Kidney transplant patients receiving alemtuzumab induction required significant interventions due to leukopenia/neutropenia in the first year post-transplantation. These results suggest the need for additional studies aimed at defining the optimum management strategies of leukopenia/neutropenia in this population.
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Affiliation(s)
- A Smith
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - R Couvillion
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - R Zhang
- Tulane University School of Medicine, Tulane Abdominal Transplant Institute, New Orleans, Louisiana, United States
| | - M Killackey
- Tulane University School of Medicine, Tulane Abdominal Transplant Institute, New Orleans, Louisiana, United States
| | - J Buell
- Tulane University School of Medicine, Tulane Abdominal Transplant Institute, New Orleans, Louisiana, United States
| | - B Lee
- Tulane University School of Medicine, Tulane Abdominal Transplant Institute, New Orleans, Louisiana, United States
| | - B H Saggi
- Tulane University School of Medicine, Tulane Abdominal Transplant Institute, New Orleans, Louisiana, United States
| | - A S Paramesh
- Tulane University School of Medicine, Tulane Abdominal Transplant Institute, New Orleans, Louisiana, United States.
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Crookes DM, Wang C, DeMairo KR, Killackey M, LePere JC, McFarlane A, Somayaji D, Allen P, Bily L, Brundage BA, Canosa R, Crean D, Jandorf L. Perceptions about participation in cancer clinical trials in New York state. J Community Support Oncol 2015; 13:62-72. [PMID: 25866985 DOI: 10.12788/jcso.0110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/13/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Clinical trials are valuable in advancing cancer care through the investigation of ways in which to better prevent, detect and diagnose, and/or treat cancer. Recruitment of adults into clinical trials has historically been low. OBJECTIVE To survey adult cancer patients who reside in New York state to better understand their participation in and attitudes about clinical trials. METHODS From January 2012-April 2013, we conducted a one-time survey about clinical trials in 8 cancer-treatment or cancer-patient support organizations in the state. Surveys were offered in person and online to adults with a past or current cancer diagnosis. Analysis was limited to adults who resided in the state and provided a self-reported status of previous participation in clinical trials. RESULTS Of the 1,832 participants who completed the survey, 1,475 were included in the analysis. Our sample represented all regions of the state. Most of the respondents (68.1%) had never participated in a clinical trial. Almost 32% said they had never received information about research studies. Most (84%) felt that patients should be asked to participate in clinical trials, but fewer (70%) were willing to be approached about participation. LIMITATIONS The sample is predominantly white and female and overrepresents breast and hematologic cancers. CONCLUSIONS Increased outreach coupled with a team approach to educate and enroll patients in clinical trials may be the necessary first steps to increase participation in trials and ensure a diverse sample of participants.
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Affiliation(s)
- Danielle M Crookes
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Chang Wang
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Jean C LePere
- Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Anita McFarlane
- The Greater New York City Affiliate of Susan G Komen for the Cure, New York, New York, USA
| | | | - Patti Allen
- American Cancer Society, Manasquan, New Jersey, USA
| | - Linda Bily
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, New York, USA
| | | | | | - Diana Crean
- CR Wood Cancer Center at Glens Falls Hospital, Glens Falls, New York, USA
| | - Lina Jandorf
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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McGee J, Mave V, Yau CL, Killackey M, Paramesh A, Buell J, Slakey DP, Hamm LL, Zhang R. Cytomegalovirus disease in African-American kidney transplant patients. Transpl Infect Dis 2013; 14:604-10. [PMID: 23228184 DOI: 10.1111/j.1399-3062.2012.00759.x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 01/27/2012] [Accepted: 02/14/2012] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cytomegalovirus (CMV) disease is a serious infection after kidney transplantation. The risk factors and the impact of CMV disease in African-American (AA) kidney transplant patients have not been well characterized. METHODS We performed a retrospective analysis on 448 AA patients transplanted between 1996 and 2005. A 3-month universal chemoprophylaxis with ganciclovir or valganciclovir was administered to CMV donor-positive/recipient-negative (D+/R-) patients and to those treated with anti-thymocyte globulin for rejection, but not routinely to those with other D/R serostatus. RESULTS A total of 31 AA patients (7%) developed clinical CMV disease. Compared with other D/R serostatus groups, the D+/R- group had the highest 3-year cumulative incidence of CMV disease (16.9% vs. 6.3% in D+/R+, 4.9% in D-/R+, and 2.4% in D-/R-). The D+/R- group also had the worst 3-year death-censored allograft survival (75% vs. 92% in D+/R+, 94% in D-/R+, and 96% in D-/R-, log-rank P = 0.01). Multivariate analysis found that D+/R- serostatus (odds ratio [OR] 5.4, 95% confidence interval [CI] 0.6-48.2, P = 0.003) and donor age > 60 years (OR 9.1, 95% CI 1.3-65, P = 0.03) were independent risk factors for CMV disease. CONCLUSION The D+/R- group has the highest incidence of CMV disease and the worst 3-year renal allograft survival despite 3-month universal prophylaxis. Prolonged chemoprophylaxis may be needed to prevent the late development of CMV disease and to improve allograft survival in the high-risk group of AA kidney transplant recipients.
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Affiliation(s)
- J McGee
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
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Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain JM, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER, Chelmow D, Herzig A, Kim JJ, Kinney W, Herschel WL, Waldman J. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. J Low Genit Tract Dis 2012; 16:175-204. [PMID: 22418039 PMCID: PMC3915715 DOI: 10.1097/lgt.0b013e31824ca9d5] [Citation(s) in RCA: 237] [Impact Index Per Article: 19.8] [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: 01/29/2023]
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from six working groups, and a recent symposium co-sponsored by the ACS, American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP), which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (e.g., management of screen positives and screening interval for screen negatives) of women after screening, age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16/18 infections.
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Affiliation(s)
- Debbie Saslow
- Breast and Gynecologic Cancer, Cancer Control Science Department, American Cancer Society, Atlanta, GA 30303, USA.
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Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin 2012; 62:147-72. [PMID: 22422631 PMCID: PMC3801360 DOI: 10.3322/caac.21139] [Citation(s) in RCA: 781] [Impact Index Per Article: 65.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from 6 working groups, and a recent symposium cosponsored by the ACS, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology, which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (eg, the management of screen positives and screening intervals for screen negatives) of women after screening, the age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.
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Affiliation(s)
- Debbie Saslow
- Cancer Control Science Department, American Cancer Society, Atlanta, GA 30303, USA.
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Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FAR, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol 2012; 137:516-42. [PMID: 22431528 DOI: 10.1309/ajcptgd94evrsjcg] [Citation(s) in RCA: 526] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from 6 working groups, and a recent symposium cosponsored by the ACS, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology, which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (eg, the management of screen positives and screening intervals for screen negatives) of women after screening, the age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.
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Zhang R, Florman S, Devidoss S, Zarifian A, Yau CL, Paramesh A, Killackey M, Alper B, Fonseca V, Slakey D. A comparison of long-term survivals of simultaneous pancreas-kidney transplant between African American and Caucasian recipients with basiliximab induction therapy. Am J Transplant 2007; 7:1815-21. [PMID: 17524073 DOI: 10.1111/j.1600-6143.2007.01857.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
African Americans (AA) have traditionally been thought to have higher immunologic risk than Caucasians (CA) for rejection and allograft loss. The impact of ethnicity on the outcome of simultaneous pancreas-kidney (SPK) transplant with basiliximab induction has not been reported. In this study, we retrospectively analyze the long-term results of 36 AA and 55 CA recipients of primary SPK. The actual patient survival rates of AA and CA groups were 91.7% vs. 90.1% at 1 year, 93.3% vs. 88.1% at 3 years, and 94.4% vs. 83.3% at 5 years. The actual kidney survival of AA and CA were 91.7% vs. 89.1% at 1 year, 90% vs. 81% at 3 years, and 83.3% vs. 75% at 5 years. The actual pancreas survival of AA and CA were 88.9% vs. 85.5% at 1 year, 83.3% vs. 78.6% at 3 years and 72.2% vs. 70.8% at 5 years. Death-censored analyses also found no difference in pancreas and kidney graft survival rates over 5 years. Higher rejection rate, but the same low CMV infection, and comparable quality of graft function were noted in AA group. AA may not have worse long-term outcomes than CA recipients of SPK with basiliximab induction and tacrolimus (TAC), mycophenolate acid (MFA) and steroid maintenance immunotherapy.
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Affiliation(s)
- R Zhang
- Department of Medicine, Tulane University Health Sciences Center, New Orleans, LA, USA.
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