Health disparities between Black Hispanic and Black non-Hispanic cervical cancer cases in the USA

Background: Globally, cervical cancer is a major public health concern. Cervical cancer is the second most common cancer among women, resulting in approximately 500,000 cases per year. The purpose of this study is to compare disease characteristics between Black Hispanic (BH) and Black non-Hispanic (BNH) women in the US. Materials and Methods: We used stratified random sampling to select cervical cancer patient records from the SEER database (1973-2009). We used Chi-square and independent samples t-test to examine differences in proportions and means. Results: The sample included 2,000 cervical cancer cases of Black non-Hispanic and 91 Black Hispanic women. There were statistically significant differences between black Hispanic and black non- Hispanics in mean age at diagnosis (p\u3c0.001), mean survival time (p\u3c0.001), marital status (p\u3c0.001), primary site of cancer (p\u3c0.001); lymph node involvement (p\u3c0.001); grading and differentiation (p\u3c0.0001); and tumor behavior (p\u3c0.001). Black women were more likely to develop cervical cancer and to have the highest mortality rates from the disease. Conclusions: Findings from this study show clear racial and ethnic disparities in cervical cancer incidence and prognosis that should be addressed

Disparities in cervical cancer characteristics and survival between white Hispanics and white non-Hispanic women

Background:Cervical cancer is the second most common cancer among women resulting in nearly 500,000cases annually. Screening leads to better treatment and survival time. However, human papillomavirus (HPV)exposure, screening, and treatment vary among races and ethnicities in the United States. The purpose of thisstudy is to examine disparities in characteristics of cervical cancer and survival of cases between White Hispanic(WH) and White non-Hispanic (WNH) women in the United States.Methods:We used a stratified random sampling method to select cervical cancer patient records from ninestates; a simple random sampling method to extract the demographic and disease characteristics data withinstates from the Surveillance Epidemiology and End Results (SEER) database. We used statistical probabilitydistribution methods for discrete and continuous data. The chi-square test and independent samplest-testwere used to evaluate statistically significant differences. Furthermore, the Cox Proportional Regression andthe Kaplan–Meier survival estimators were used to compare WH and WNH population survival times in theUnited States.Results:The samples of WNH and WH women included 4,000 cervical cancer cases from 1973–2009. Therewere statistically significant differences between ethnicities: marital status (p\u3c0.001); primary site of cancer(p\u3c0.001); lymph node involvement (p\u3c0.001); grading and differentiation (p\u3c0.0001); and tumor behavior(p\u3c0.001). The mean age of diagnosis for both groups showed no statistical differences. However, the meansurvival time for WNH was 221.7 (standard deviation [SD]=118.1) months and for WH was 190.3 (SD=120.3),which differed significantly (p\u3c0.001).Conclusions:Clear disparities exist in risk factors, cervical cancer characteristics, and survival time betweenWH and WNH women

Cardiovascular and renal outcomes of initial combination therapy with glucose-lowering agents versus stepwise approach in newly diagnosed or treatment naïve type 2 diabetes: a systematic review and meta-analysis.

BackgroundIt is uncertain if initial combination therapy with glucose-lowering agents provides longer-term beneficial cardio-renal outcomes compared to stepwise therapy in patients with newly diagnosed type 2 diabetes (T2D). Using a systematic review and meta-analysis of observational cohort studies and randomised controlled trials (RCTs), we evaluated the efficacy and safety of the initial combination therapy vs a stepwise approach in newly diagnosed T2D.MethodsStudies were identified from MEDLINE, Embase, the Cochrane Library, and search of bibliographies to January 2022. Study-specific risk ratios (RRs) and mean differences with 95% confidence intervals (CIs) were pooled. Quality of the evidence was assessed using GRADE.ResultsEight articles comprising 4 unique RCTs (n = 5527 participants) and one observational cohort study (n = 200) that compared initial combination therapy vs stepwise therapy were included. The RR (95% CI) for myocardial infarction comparing initial combination therapy vs stepwise therapy was 1.21 (0.74-2.00). Initial combination therapy reduced levels of fasting plasma glucose and HbA1c: mean differences (95% CIs) of -0.97 mmoL/L (-1.41, -0.53) and -0.13 % (-0.20, -0.07), respectively. Initial combination therapy vs stepwise therapy reduced lipid levels, blood pressure and intima media thickness, with no differences in body composition parameters, neuropathy, retinopathy, and adverse events. Single study results showed initial combination therapy reduced creatinine levels and urine albumin excretion rate. The quality of the evidence ranged from moderate to very low.ConclusionsExcept for improving cardiometabolic and glycaemic parameters, a limited number of studies characterised by small sample sizes show that initial combination therapy for newly diagnosed T2D may be similar in efficacy and safety to stepwise therapy with respect to cardio-renal outcomes. There is a lack of sufficient evidence to recommend initial combination therapy with glucose-lowering agents in newly diagnosed T2D with the aim of preventing cardio-renal outcomes. Definitive RCTs are warranted. This article is protected by copyright. All rights reserved

Black hispanic and black nonhispanic breast cancer survival data analysis with half-normal model application

Background: Breast cancer is the second leading cause of cancer death for women in the United States. Differences in survival of breast cancer have been noted among racial and ethnic groups, but the reasons for these disparities remain unclear. This study presents the characteristics and the survival curve of two racial and ethnic groups and evaluates the effects of race on survival times by measuring the lifetime data-based half-normal model. Materials and Methods: The distributions among racial and ethnic groups are compared using female breast cancer patients from nine states in the country all taken from the National Cancer Institute’s Surveillance, Epidemiology, and End Results cancer registry. The main end points observed are: age at diagnosis, survival time in months, and marital status. The right skewed half-normal statistical probability model is used to show the differences in the survival times between black Hispanic (BH) and black non-Hispanic (BNH) female breast cancer patients. The Kaplan-Meier and Cox proportional hazard ratio are used to estimate and compare the relative risk of death in two minority groups, BH and BNH. Results: A probability random sample method was used to select representative samples from BNH and BH female breast cancer patients, who were diagnosed during the years of 1973-2009 in the United States. The sample contained 1,000 BNH and 298 BH female breast cancer patients. The median age at diagnosis was 57.75 years among BNH and 54.11 years among BH. The results of the half-normal model showed that the survival times formed positive skewed models with higher variability in BNH compared with BH. The Kaplan-Meir estimate was used to plot the survival curves for cancer patients; this test was positively skewed. The Kaplan-Meier and Cox proportional hazard ratio for survival analysis showed that BNH had a significantly longer survival time as compared to BH which is consistent with the results of the half-normal model. Conclusions: The findings with the proposed model strategy will assist in the healthcare field to measure future outcomes for BH and BNH, given their past history and conditions. These findings may provide an enhanced and improved outlook for the diagnosis and treatment of breast cancer patients in the United States