44 research outputs found
Prostate cancer incidence across stage, NCCN risk groups, and age before and after USPSTF Grade D recommendations against prostateĂą specific antigen screening in 2012
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153721/1/cncr32604.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153721/2/cncr32604_am.pd
Infection of the brown alga Ectocarpus siliculosus by the oomycete Eurychasma dicksonii induces oxidative stress and halogen metabolism
Acknowledgments We would like to thank the Aberdeen Proteome Facility, especially Phil Cash, David Stead and Evelyn Argo for assistance with 2D electrophoresis and mass spectrometry. M.S. gratefully acknowledges a Marie Curie PhD fellowship from the European Commission (ECOSUMMER, MEST-CT-2005-20501), a joint FEMS/ESCMID Research Fellowship and the Genomia Fund. C.M.M.G. is supported by a Marie Curie postdoctoral fellowship (MEIF-CT-2006-022837), a Marie Curie Re-Integration Grant (PERG03-GA-2008-230865) and a New Investigator grant from the UK Natural Environment Research Council (NERC, grant NE/J00460X/1). F.C.K. would like to thank NERC for funding (grants NE/D521522/1, NE/F012705/1 and Oceans 2025 / WP 4.5). L.J.G.-B., C.M.M.G., F.C.K. and P.W. would like to acknowledge funding from NERC for a Strategic Ocean Funding Initiative award (NE/F012578/1). Funding from the MASTS pooling initiative (Marine Alliance for Science and Technology for Scotland, funded by the Scottish Funding Council and contributing institutions; grant reference HR09011) and from the TOTAL Foundation (Paris) to F.C.K. is gratefully acknowledged. Finally, we would like to thank the two anonymous referees for constructive suggestions to improve our manuscript.Peer reviewedPublisher PD
Conservative management of lowĂą risk prostate cancer among young versus older men in the United States: Trends and outcomes from a novel national database
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151903/1/cncr32332.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151903/2/cncr32332_am.pd
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Active surveillance and watchful waiting for low-risk prostate cancer in black patients: A population-based analysis
10 Background: Evidence from clinical trials supports conservative management as an acceptable alternative to definitive therapy for low-risk prostate cancer (LRPC). The optimal approach for Black men, however, remains unclear given trial underrepresentation and concern about racial differences in disease aggressiveness. We therefore sought to determine U.S. conservative management utilization rates for Black men with LRPC. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program Prostate with Active Surveillance/Watchful Waiting (AS/WW) Database queried 50,302 LRPC patients (N = 5218 Black), diagnosed from 2010-2015. Trends in AS/WW utilization over time were determined, stratified by race (Black versus non-Black) and number of positive biopsy cores (â€2 versus â„3). Results: From 2010 to 2015, AS/WW utilization increased from 12.6% to 36.4% among Black men (Ptrend< 0.001) and from 14.8% to 43.3% among non-Black men (Ptrend< 0.001). AS/WW rates reached 52.0% and 57.3% by 2015 for Black (Ptrend< 0.001) and non-Black (Ptrend< 0.001) men with â€2 positive biopsy cores, respectively. Rates continually increased for all subgroups except Black men with â„3 positive biopsy cores, where rates plateaued at 22.9% by 2013. Conclusions: In this report from the largest U.S. population of Black LRPC patients with quality assured AS/WW data, AS/WW rates have nearly tripled for Black men from 2010-2015, suggesting AS/WW is viewed as a safe management option in all races
Prevalence of chronic pain among cancer survivors in the United States, 2010â2017
Background
There are a growing number of cancer survivors in the United States who are at risk for chronic pain due to cancer disease and treatments. The prevalence of chronic pain among cancer survivors has not been comprehensively reported.
Methods
This study used data from the National Health Interview Survey (2010â2017) to compare the prevalence of chronic pain between participants with a cancer diagnosis and participants without one. Adjusted odds ratios (AORs) of having chronic pain were assessed by multivariable logistic regression, which included an age (less than the median age vs greater than or equal to the median age) Ă cancer diagnosis (yes vs no) interaction term. Among cancer survivors, multivariable logistic regression defined the odds of feeling depressed, feeling worried/nervous/anxious, being unable to work, and needing assistance for activities of daily living (ADLs) and instrumental activities of daily living (IADLs).
Results
Among 115,091 participants, a cancer diagnosis was associated with an increased AOR of chronic pain in comparison with the general population (30.8% vs 15.7%; AOR, 1.48; 95% confidence interval, 1.38â1.59). Older age was associated with higher odds of chronic pain (P < .001 across all increasing age categories); however, the positive association between older age and chronic pain was seen only in participants without cancer and was not seen in those with a cancer diagnosis (PageĂcancer < .001). Among patients reporting a cancer diagnosis, chronic pain was associated with greater odds of feeling depressed, feeling worried/nervous/anxious, being unable to work, and needing assistance with ADLs or IADLs (P < .001 for all).
Conclusions
Cancer survivors appear to have a high prevalence of chronic pain, which is associated with worse mental, functional, and employment outcomes. Screening and management of chronic pain should be addressed by policymakers to improve cancer survivorship care.
In this nationally representative study, approximately oneâthird of cancer survivors report having chronic pain; this is nearly double the prevalence in the general population. Among cancer survivors, the presence of chronic pain is associated with worse mental, functional, and employment outcomes
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Rates and patterns of uninsured cancer survivors before and after implementation of the Affordable Care Act, 2000-2017
e18105 Background: Cancer survivors experience difficulties in maintaining healthcare coverage, however the reasons and risk factors for lack of insurance are poorly defined. We sought to assess self-reported reasons for not having insurance and to assess demographic and socioeconomic factors associated with non-insurance among cancer survivors, before and after implementation of the Affordable Care Act (ACA) in 2014. Methods: We used the National Health Interview Survey to identify adult participants (18-64 years) reporting a cancer diagnosis between 2000-2017. Multivariable logistic regression was used to define the association between demographic and socioeconomic variables and odds being uninsured. The prevalence of the most common self-reported reasons for not having insurance (unemployment, employment-related reason, family-related) were estimated, with AORs for each of the reasons defined by multivariable logistic regression. Results: Among 17,806 survey participants, 10.3% reported not having health insurance. Individuals surveyed in 2000-2013 had higher odds of not having insurance as compared to those surveyed in 2014-2017 (10.6% vs. 6.2%, AOR 1.75, 95% CI 1.49-2.08). Variables associated with higher odds of non-insurance throughout the entire study interval included younger age, annual family income below the poverty threshold, black race, Hispanic ethnicity, non-citizen status and current smoking (p < 0.001 for all). After implementation of the ACA, increasing interval from cancer diagnosis and black race were no longer associated with not having insurance. The most commonly cited reason for not having insurance were cost followed by unemployment, both of which decreased after ACA implementation (cost: 49.6% vs. 37.6%, AOR 0.62, 95% CI 0.46-0.85; unemployment: 37.1% vs. 28.5%, AOR 0.62, 95% CI 0.45-0.87). Conclusions: The proportion of uninsured cancer survivors decreased after implementation of the ACA, however certain subgroups remain at greater risk of being uninsured. Cost remains the primary barrier to obtaining insurance, although more than half of cancer survivors reported other barriers to coverage. Given the growing number of cancer survivors in conjunction with rising health costs, efforts addressing barriers to insurance coverage are needed for this population
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Racial Disparities in Patient-Reported Measures of Physician Cultural Competency Among Cancer Survivors in the United States
This survey study assesses the role that physician cultural competency plays in racial disparities in cancer incidence and outcomes
Shortâterm mortality risks among patients with oropharynx cancer by human papillomavirus status
Background
There is substantial variation in head and neck cancer (HNC) mortality and competing mortality among patients with HNC. In this study, the authors characterize the causes and risks of shortâterm mortality among patients with oropharynx cancer (OPC) and how these risks differ by human papillomavirus (HPV) status.
Methods
A custom Surveillance, Epidemiology, and End Results (SEER) data set with HPV status was used to identify 4930 patients with OPC who were diagnosed with nonmetastatic (M0) disease from 2013 to 2014, including 3560 (72.2%) HPVâpositive patients and 1370 HPVânegative patients. Causes of death and cumulative incidence estimates for HNCâspecific mortality, competing mortality, secondâcancer mortality, and noncancer mortality were analyzed by HPV status. Risk factors for mortality events were determined using multivariable competing risk regression models.
Results
Compared with HPVânegative patients, HPVâpositive patients had a lower risk of 2âyear cumulative incidence of allâcause mortality (10.4% vs 33.3%; PÂ <Â .0001) and a lower risk of both HNCâspecific mortality (4.8% vs 16.2%; PÂ <Â .0001) and competingâcause mortality (5.6% vs 16.8%; PÂ <Â .0001). Secondâcancer mortality was the most common cause of nonâHNC mortality among HPVânegative patients. Both secondâcancer mortality and noncancer mortality were significantly higher among patients who had HPVânegative OPC (10.8% and 6.1%, respectively) compared with those who had HPVâpositive OPC (2.4% and 3.2%, respectively; both PÂ <Â .0001). The median followâup was 11Â months (range 1â23Â months) in this cohort with known HPVâstatus.
Conclusions
Patients with HPVâpositive and HPVânegative OPC have significantly different rates of both HNC mortality and competing mortality. HPVânegative patients are at substantial risk of competing mortality, even within 2Â years of cancer diagnosis. These differences can inform power calculations for clinical trials and patient management in the acute and survivorship settings.
Patients with human papillomavirus (HPV)âpositive and HPVânegative oropharyngeal cancer have significantly different risks of both head and neck cancerâspecific and competing mortality, and HPVânegative patients are at a substantial risk of shortâterm competing risks of mortality after diagnosis and treatment of head and neck cancer. These differences can inform power calculations for clinical trials and patient management in the acute and survivorship settings