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Fedewa SA, Jemal A. Prostate cancer disease severity and country of origin among black men in the United States. Prostate Cancer Prostatic Dis 2013; 16:176-80. [DOI: 10.1038/pcan.2012.53] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Virgo KS, Fedewa SA, Chen AY, Stewart AK, Flanders WD, Ward EM. Hospital characteristics associated with surgery for non-small cell lung cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6543] [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
6543 Background: Previous research suggests that black patients are less likely to undergo curative-intent surgery for early stage non-small cell lung cancer (NSCLC) compared to whites, holding all else constant. Among Medicare beneficiaries 65 and older, the likelihood of patients undergoing surgery is significantly reduced in hospitals with racial compositions of > 30% black patients after controlling for hospital and patient characteristics. This study analyzes whether hospital racial composition is associated with curative-intent surgery among early stage NSCLC patients of all ages. Methods: All adult patients ages 19–104 diagnosed with an invasive initial primary early stage (TNM I-II) NSCLC during 2003–2005 were selected from the National Cancer Data Base (NCDB). Facility characteristics were extracted from the NCDB and American College of Surgeons (ACoS) Commission on Cancer (CoC) Facility Information Profile System (FIPS). Hospital racial composition of lung cancer patients, operationalized as percent black, was initially divided into tertiles; sensitivity analyses used dichotomous definitions. Generalized estimating equations with a logistic model were used to control for clustering by facility. Results: Of 52,853 evaluable patients seen at CoC-approved hospitals, blacks were primarily (74%) seen at hospitals with a racial composition of > 11% black patients. Hispanics (72%), non-Hispanic whites (69%), and Asians or other (72%) were primarily seen at hospitals with < 11% black patients. In sensitivity analyses, irrespective of the cutpoint used to classify hospitals by racial composition of black patients (10, 20, or 30%), black patients seen at hospitals with a high black racial composition were significantly less likely to undergo curative-intent surgery than black patients seen at hospitals with a lower black racial composition. After controlling for patient characteristics in multivariate models, however, high black racial composition at the facility level was no longer significant. Conclusions: Hospital racial composition (% black) was not predictive of reduced likelihood of curative-intent surgery among patients > 18 years of age with NSCLC. Patient-level predictors accounted for the majority of the variation in likelihood of curative-intent surgery. No significant financial relationships to disclose.
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Affiliation(s)
- K. S. Virgo
- American Cancer Society & Emory University, Atlanta, GA; American College of Surgeons, Chicago, IL
| | - S. A. Fedewa
- American Cancer Society & Emory University, Atlanta, GA; American College of Surgeons, Chicago, IL
| | - A. Y. Chen
- American Cancer Society & Emory University, Atlanta, GA; American College of Surgeons, Chicago, IL
| | - A. K. Stewart
- American Cancer Society & Emory University, Atlanta, GA; American College of Surgeons, Chicago, IL
| | - W. D. Flanders
- American Cancer Society & Emory University, Atlanta, GA; American College of Surgeons, Chicago, IL
| | - E. M. Ward
- American Cancer Society & Emory University, Atlanta, GA; American College of Surgeons, Chicago, IL
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Meliker JR, Slotnick MJ, AvRuskin GA, Fedewa SA, Schottenfeld D, Nriagu JO. 056-S: Lifetime Exposure to Arsenic in Drinking Water and Bladder Cancer Risk in Michigan. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s14c] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J R Meliker
- The University of Michigan, Ann Arbor, MI 48109
| | | | | | - S A Fedewa
- The University of Michigan, Ann Arbor, MI 48109
| | | | - J O Nriagu
- The University of Michigan, Ann Arbor, MI 48109
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