Trends in the Utilization of Metabolic and Bariatric Surgery (MBS) Procedures by Race and Ethnicity in Florida (2006-2017)

Abstract Metabolic and bariatric surgery (MBS) is an increasingly common treatment option for individuals with severe obesity, but utilization disparities remain with race and ethnic minority groups completing the procedure less frequently than non-Hispanic Whites. We examined the trends in MBS procedure types and prevalence of utilization by race and ethnicity among Florida inpatients. Discharge records with any MBS using the International Classification of Diseases 9th or 10th edition Procedure Coding System (ICD-PCS), were extracted from the Florida Agency for Health Care Administration (AHCA) inpatients’ data (2006 to 2017). Those who completed either Laparoscopic Roux-en-Y Gastric Bypass (RYGB), Sleeve Gastrectomy (SG), Laparoscopic Adjustable Gastric Banding (LAGB), LAGB Revision and Repair (LAGBREV), or LAGB Removal (LAGBREM) were included in the analysis. Cochran-Mantel-Haenszel tests evaluated the trend over time for MBS procedure by race and ethnicity. The sample (n = 90,845) was predominantly non-Hispanic White (NHW, 61.7%), female (75.5%), had a commercial insurance carrier (50.0%), and severe obesity (92.3%). Significant trends (p \u3c 0.05) in three MBS procedures were observed: decreasing trends for LAGB (36.2% in 2008 to 0.3% in 2017) and for RYGB (52.2% in 2009 to 20.3% in 2017) and an increasing trend for SG (18.7% in 2010 to 75.3% in 2017). Regardless of procedure type, NHW had the highest proportion of MBS in all years. More non-Hispanic Blacks received LAGB compared to Hispanics in 2006 through 2016. From 2009 to 2017, more Hispanics received RYGB compared to the NHB inpatients. RYGB was the prevalent procedure from 2006 to 2012 but was later (2013-2017) replaced by SG in Florida hospitals. The diversity in MBS procedures among race-ethnic groups in Florida may indicate social-cultural drivers and should be further investigated

At risk alcohol consumption with smoking by national background: Results from the Hispanic community health study/study of Latinos

Introduction: Tobacco smoking and binge or excess drinking are unhealthy behaviors that frequently co-occur. Studies of Hispanics/Latinos have mostly been of Mexican Americans although there are substantial differences in smoking and drinking by heritage background. Associated with co-use by 5 subpopulations. Methods: Cross-sectional data of 16,412 Hispanics/Latinos from Miami, the Bronx, Chicago and San Diego collected between 2008 and 2011 as part of the HCHS/SOL were analyzed. Smoking and alcohol consumption and demographic data were measured by self-report. Prevalence of smoking and alcohol consumption and co-use were reported. Logistic regression models examined the odds of co-use of smoking and binge or excess alcohol use by Hispanic/Latino background group. Results: Men of Cuban (10.3%), Puerto Rican (8.9%), and Mexican (8.9%) background had the highest prevalence of co-use of smoking and binge drinking compared to men of Central American (6.1%) and Dominican (6.6%) background. Women of Dominican (16.4%) and Puerto Rican (19.7%) background had the highest prevalence of binge drinking compared to women of Central American (10%) and Cuban (8%) background and Puerto Rican (34.1%) and Cuban (21.8%) women were the most likely to report current smoking compared to women of Central American (8.3%) and Mexican (10.4%) background. Acculturation was not associated with couse among men and women. Elevated depressive symptoms were positively associated with smoking and binge drinking among men, OR=1.5 [1.2–2.0], and women, OR=1.5 [1.1–2.2]. Puerto Rican women had increased odds of co-use of smoking and binge or excess drinking compared to Mexican American women, OR=3.2 [1.5–6.6]. Conclusions: Puerto Rican and Dominican Latinas and Central American and South American men have a higher prevalence of co-use

Alcohol Consumption and Metabolic Syndrome Among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

Background: The association between alcohol consumption and metabolic syndrome (MetS) among Hispanic/Latino populations has not been studied in great detail. Our study examined the relationship between alcohol consumption and MetS among U.S. Hispanics/Latinos and explored whether this relationship varied by age, body mass index, gender, and Hispanic/Latino backgrounds

Youth and Caregiver Physical Activity and Sedentary Time: HCHS/SOL Youth

We examined associations between youth and caregiver moderate/vigorous physical activity (MVPA) and sedentary (SED) time, using accelerometery, in the Hispanic Community Health Study/Study of Latino Youth (HCHS/SOL) Youth

Cannabis Use, Medication Management and Adherence Among Persons Living with HIV

Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV

Abstract S07-01: Examining COVID-19 preventive behaviors among cancer survivors in the United States: An analysis of the COVID-19 Impact Survey

Abstract Background: Cancer survivors are at high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infection that leads to COVID-19, as they are generally older and cancer therapies frequently lead to immunosuppression. Recently, to mitigate exposure the CDC recommended avoiding nonessential doctor appointments, which may lead to barriers in effective continuity of care and surveillance of cancer survivors during the COVID-19 pandemic. The patterns of COVID-19 preventive behaviors practiced by cancer survivors are unknown, including practices related to canceling doctors’ appointments. Objective: Our objective was to evaluate COVID-19-related preventive behaviors among cancer survivors in the United States (US). We further examined behaviors related to canceling or postponing activities, specifically doctors’ appointments. Methods: We utilized nationally representative weighted data from a sample of 4,428 US adults from the COVID-19 Impact Survey collected during Week 1 (April 20-26, 2020) and Week (May 4-10, 2020). We defined cancer survivors as those with a self-reported prior diagnosis of cancer. We presented frequencies and used χ2 tests to compare COVID-19-related preventive behaviors among cancer survivors to other adults. We calculated prevalence ratios with 95% confidence intervals using Poisson regression and robust estimation of standard errors to estimate determinants of canceling doctors’ appointments among cancer survivors. Results: Cancer survivors were mostly over the age of 60 years (62%), female (53%), non-Hispanic White (62%), and resided in urban areas (72%). Cancer survivors adhered to most recommended COVID-19-related preventive behaviors and were more likely to maintain social distancing (92%, χ2 p-value=0.005), wear a face mask (89%, χ2 p-value=0.001), and avoid crowded areas (84%, χ2 p-value=0.048) compared to other adults. Additionally, we found that cancer survivors are more likely to cancel their doctors’ appointments (44%, χ2 p-value=0.001) whereas they were less likely to cancel other social activities such as work (20%, χ2 p-value=0.001) and school-related (12%, χ2 p-value=0.002) activities, even among those below the age of 60. However, cancer survivors were more likely to report symptoms in the last 7 days, including muscle or body aches (χ2 p-value=0.003). The proportion of cancer patients who have canceled doctors’ appointments due to COVID-19 rose from the month of April (35%) to May (52%). Younger adults aged 18-29 years, females, and rural cancer survivors were more likely to cancel their doctors’ appointments, whereas NH-Blacks are less likely to cancel a doctor's appointment when compared to NH-Whites. Conclusion: Cancer survivors are adhering to recommended preventive behaviors. Cancer survivors’ continuity of care may be impacted by COVID-19, specifically young adults, females, and rural residents. Citation Format: Jessica Y. Islam, Marlene Camacho-Rivera, Denise C. Vidot. Examining COVID-19 preventive behaviors among cancer survivors in the United States: An analysis of the COVID-19 Impact Survey [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr S07-01

Abstract S10-04: Disparities in food insecurity among cancer survivors during the U.S. COVID-19 pandemic

Abstract Background: Food insecurity can negatively impact adherence to and receipt of high-quality cancer care. The purpose of the study was to (1) compare the prevalence of COVID-19 associated food insecurity among cancer survivors to adults without a history of cancer and (2) examine determinants associated with COVID-19 related food insecurity among cancer survivors. Methods: We used nationally-representative data from the COVID-19 Household Impact Survey (n = 10,760), collected at three time points: April 20-26, May 4-10, and May 30-June 8 of 2020. Our primary exposure was cancer survivor status, based on participant’s self-report of a cancer diagnosis (n=854, 7.1%). Primary outcomes of food insecurity were categorized on how often (response options: often true, sometimes true, never true) participants reported the following: “We worried our food would run out before we got money to buy more” or “The food that we bought just didn't last, and we didn't have money to get more”; respondents were categorized as food insecure if they chose often true or sometimes true. We also examined use of food pantry assistance or Supplemental Nutrition Assistance Program benefits during the pandemic period; respondents were also categorized as food insecure if they received or applied for these benefits. We compared reported food insecurity among cancer survivors to other U.S. adults using Chi-square tests. Multivariable Poisson regression was used to identify demographic determinants of food insecurity among cancer survivors. Results: Thirty-two percent of cancer survivors were food insecure. Cancer survivors aged 30-44 years and those aged ≥60 were more likely to report being food insecure compared to respondents without a history of cancer in the same age categories (30-44 years, 59.9% versus 41.2% p = 0.01, ≥60 years 27.2% versus 20.2%, p = 0.01). Cancer survivors without a high school diploma were more likely to report food insecurity compared to adults without a high school diploma and no history of cancer (87.0% versus 64.1%, p = 0.001). In examining determinants of food insecurity among cancer survivors, adults aged 45-49 years when compared to those ages ≥60 (aPR = 1.54, 95% CI 1.16-2.03), adults with no high school diploma (aPR = 2.63, 95% CI 1.53-4.50) or a high school degree (aPR = 1.94, 95% CI 1.08-3.49) compared to those with a baccalaureate or above, adults with an annual household income <$30,000 (aPR: 2.16, 95$100,000, and cancer survivors in rural areas (aPR = 1.51, 95% CI 1.07-2.12) compared those living in urban areas were more likely to report being food insecure. Uninsured cancer survivors (aPR: 2.39, 95% CI: 1.46-3.92) and those on Medicaid (aPR: 2.10, 95% CI: 1.40-3.17) were more likely to report being food insecure than their counterparts. Conclusions: Food insecurity during the COVID-19 pandemic is vast but varies considerably among cancer survivors and adults without a history of cancer. Among cancer survivors, differences in food insecurity were observed by age, SES, and area of residence. Citation Format: Marlene Camacho-Rivera, Jessica Y. Islam, Denise C. Vidot. Disparities in food insecurity among cancer survivors during the U.S. COVID-19 pandemic [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S10-04

Evaluating Mental Health–Related Symptoms Among Cancer Survivors During the COVID-19 Pandemic: An Analysis of the COVID Impact Survey

PURPOSE: The COVID-19 pandemic has affected the mental health of adults in the United States because of recommended preventive behaviors such as physical distancing. Our objective was to evaluate mental health symptoms and identify associated determinants among cancer survivors during the COVID-19 pandemic in the United States. METHODS: We used nationally representative data of 10,760 US adults from the COVID-19 Impact Survey. We defined cancer survivors as adults with a self-reported diagnosis of cancer (n = 854, 7.6%). We estimated associations of mental health symptoms among cancer survivors using multinomial logistic regression. We estimated determinants of reporting at least one mental health symptom 3-7 times in the 7 days before survey administration among cancer survivors using multivariable Poisson regression. RESULTS: Cancer survivors were more likely to report feeling nervous, anxious, or on edge (adjusted odds ratio [aOR], 1.42; 95% CI, 1.07 to 1.90); depressed (aOR, 1.57; 95% CI, 1.18 to 2.09); lonely (aOR, 1.42; 95% CI, 1.05 to 1.91); and hopeless (aOR, 1.51; 95% CI, 1.11 to 2.06) 3-7 days per week in the last 7 days when compared with adults without cancer. Among cancer survivors, adults of age 30-44 years (adjusted prevalence ratio [aPR], 1.87; 95% CI, 1.18 to 2.95), females (aPR, 1.55, 95% CI, 1.12 to 2.13), adults without a high school degree (aPR, 1.79; 95% CI, 1.05 to 3.04), and adults with limited social interaction (aPR, 1.40, 95% CI, 1.01 to 1.95) were more likely to report at least one mental health–related symptom in the last 7 days (3-7 days/week). CONCLUSION: Cancer survivors are reporting mental health symptoms during the COVID-19 pandemic, particularly young adults, adults without a high school degree, women, and survivors with limited social support