Prostate cancer incidence across stage, NCCN risk groups, and age before and after USPSTF Grade D recommendations against prostateâ 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

Self-reported Reasons and Patterns of Noninsurance Among Cancer Survivors Before and After Implementation of the Affordable Care Act, 2000-2017

This survey study analyzes NHIS data from nearly 18 000 patients with a cancer diagnosis before and after implementation of the Affordable Care Act (ACA) to evaluate patterns and patient-reported reasons for not having health insurance before and after the ACA

Prevalence of chronic pain among cancer survivors in the United States, 2010‐2017

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 (2010‐2017) 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) × 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, 1.38‐1.59). 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 (Page×cancer < .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 one‐third 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

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

Short‐term 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 short‐term 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%) HPV‐positive patients and 1370 HPV‐negative patients. Causes of death and cumulative incidence estimates for HNC‐specific mortality, competing mortality, second‐cancer 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 HPV‐negative patients, HPV‐positive patients had a lower risk of 2‐year cumulative incidence of all‐cause mortality (10.4% vs 33.3%; P < .0001) and a lower risk of both HNC‐specific mortality (4.8% vs 16.2%; P < .0001) and competing‐cause mortality (5.6% vs 16.8%; P < .0001). Second‐cancer mortality was the most common cause of non‐HNC mortality among HPV‐negative patients. Both second‐cancer mortality and noncancer mortality were significantly higher among patients who had HPV‐negative OPC (10.8% and 6.1%, respectively) compared with those who had HPV‐positive OPC (2.4% and 3.2%, respectively; both P < .0001). The median follow‐up was 11 months (range 1‐23 months) in this cohort with known HPV‐status. Conclusions Patients with HPV‐positive and HPV‐negative OPC have significantly different rates of both HNC mortality and competing mortality. HPV‐negative patients are at substantial risk of competing mortality, even within 2 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)‐positive and HPV‐negative oropharyngeal cancer have significantly different risks of both head and neck cancer–specific and competing mortality, and HPV‐negative patients are at a substantial risk of short‐term 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

Short‐term 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 short‐term 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%) HPV‐positive patients and 1370 HPV‐negative patients. Causes of death and cumulative incidence estimates for HNC‐specific mortality, competing mortality, second‐cancer 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 HPV‐negative patients, HPV‐positive patients had a lower risk of 2‐year cumulative incidence of all‐cause mortality (10.4% vs 33.3%; P < .0001) and a lower risk of both HNC‐specific mortality (4.8% vs 16.2%; P < .0001) and competing‐cause mortality (5.6% vs 16.8%; P < .0001). Second‐cancer mortality was the most common cause of non‐HNC mortality among HPV‐negative patients. Both second‐cancer mortality and noncancer mortality were significantly higher among patients who had HPV‐negative OPC (10.8% and 6.1%, respectively) compared with those who had HPV‐positive OPC (2.4% and 3.2%, respectively; both P < .0001). The median follow‐up was 11 months (range 1‐23 months) in this cohort with known HPV‐status. Conclusions Patients with HPV‐positive and HPV‐negative OPC have significantly different rates of both HNC mortality and competing mortality. HPV‐negative patients are at substantial risk of competing mortality, even within 2 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)‐positive and HPV‐negative oropharyngeal cancer have significantly different risks of both head and neck cancer–specific and competing mortality, and HPV‐negative patients are at a substantial risk of short‐term 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

General and Health-Related Internet Use Among Cancer Survivors in the United States: A 2013-2018 Cross-Sectional Analysis

A significant proportion of cancer survivors endorse ongoing health information needs and may use the internet to access information. We assessed patterns and predictors of general and health-specific internet use among cancer survivors. Using data from the National Health Interview Survey (NHIS), which was administered in 2013 through 2018, for adults reporting a cancer diagnosis, sample weight-adjusted estimates defined prevalence and multivariable logistic regressions defined adjusted odds ratios (aORs) of general and health-specific internet use, adjusting for relevant sociodemographic covariates, including healthcare satisfaction as the primary independent variable. The analysis for health-specific internet use was also repeated including a sex (female vs male)*healthcare satisfaction (very satisfied/somewhat satisfied vs somewhat dissatisfied/very dissatisfied) interaction term. Among 12,970 survivors of cancer, general and health-specific internet use increased from 2013 to 2018 (from 63.2% to 70.8% and from 46.8% to 52.2%, respectively; P<.05 for both). Survivors who were very dissatisfied with healthcare were more likely to use the internet for health information compared with those who were very satisfied (59.5% vs 48.0%; aOR, 1.78; 95% CI, 1.20-2.64; P=.004). Younger age, female sex, higher educational attainment, and higher socioeconomic status were all associated with increased reported use of the internet for both general and health-specific purposes (P<.001 for all). There was a significant sex*healthcare satisfaction interaction (P=.009) such that for female survivors, healthcare dissatisfaction was associated with higher odds of health-specific internet use (61.4% vs 52.5%; P<.001; men, P=.97). No association was found between healthcare satisfaction and general internet use (P=.42). The increasing proportion of survivors of cancer using the internet for health-specific information may be associated with self-reported dissatisfaction with healthcare. Efforts are needed to improve both access to the internet and the quality of cancer-relevant online health information, and to enhance patients' online health literacy