Rectal cancer survival in the United States by race and stage, 2001 to 2009: Findings from the CONCORD-2 study.

BACKGROUND: In the first CONCORD study, 5-year survival for patients with diagnosed with rectal cancer between 1990 and 1994 was <60%, with large racial disparities noted in the majority of participating states. We have updated these findings to 2009 by examining population-based survival by stage of disease at the time of diagnosis, race, and calendar period. METHODS: Data from the CONCORD-2 study were used to compare survival among individuals aged 15 to 99 years who were diagnosed in 37 states encompassing up to 80% of the US population. We estimated net survival up to 5 years after diagnosis correcting for background mortality with state-specific and race-specific life table. Survival estimates were age-standardized with the International Cancer Survival Standard weights. We present survival estimates by race (all, black, and white) for 2001 through 2003 and 2004 through 2009 to account for changes in collecting the data for Surveillance, Epidemiology, and End Results Summary Stage 2000. RESULTS: There was a small increase in 1-year, 3-year, and 5-year net survival between 2001-2003 (84.6%, 70.7%, and 63.2%, respectively), and 2004-2009 (85.1%, 71.5%, and 64.1%, respectively). Black individuals were found to have lower 1-year, 3-year, and 5-year survival than white individuals in both periods; the absolute difference in survival between black and white individuals declined only for 5-year survival. Black patients had lower 5-year survival than whites at each stage at the time of diagnosis in both time periods. CONCLUSIONS: There was little improvement noted in net survival for patients with rectal cancer, with persistent disparities noted between black and white individuals. Additional investigation is needed to identify and implement effective interventions to ensure the consistent and equitable use of high-quality screening, diagnosis, and treatment to improve survival for patients with rectal cancer. Cancer 2017;123:5037-58. Published 2017. This article is a U.S. Government work and is in the public domain in the USA

A Multidisciplinary Investigation of a Polycythemia Vera Cancer Cluster of Unknown Origin

Cancer cluster investigations rarely receive significant public health resource allocations due to numerous inherent challenges and the limited success of past efforts. In 2008, a cluster of polycythemia vera, a rare blood cancer with unknown etiology, was identified in northeast Pennsylvania. A multidisciplinary group of federal and state agencies, academic institutions, and local healthcare providers subsequently developed a multifaceted research portfolio designed to better understand the cause of the cluster. This research agenda represents a unique and important opportunity to demonstrate that cancer cluster investigations can produce desirable public health and scientific outcomes when necessary resources are available

Model framework.

<p>The microscopic model includes two layers, i.e., a tactical layer and an operational layer. The desired direction of movement is determined in the tactical layer. The operational layer determines the microscopic behavior when pedestrians interact with other agents.</p

A microscopic simulation model for pedestrian-pedestrian and pedestrian-vehicle interactions at crosswalks

<div><p>This study aims to develop a microscopic pedestrian behavior model considering various interactions on pedestrian dynamics at crosswalks. Particularly, we take into account the evasion behavior with counter-flow pedestrians, the following behavior with leader pedestrians, and the collision avoidance behavior with vehicles. Aerial video data at one intersection in Beijing, China are extracted for model calibration. A microscopic calibration approach based on maximum likelihood estimation is applied to estimate the parameters of a modified social force model. Finally, we validate step-wise speed, step-wise acceleration, step-wise direction change, crossing time and lane formation phenomenon by comparing the real data and simulation outputs.</p></div

Desired exit position and desired direction.

<p>The desired direction is assumed to be determined by the desired exit position of the crosswalk. The desired exit position is defined as the intersecting point of the curve of crosswalk edge and the desired walking trajectory.</p

Pedestrian-vehicle conflict.

<p>There are two types of pedestrian giving-way maneuvers when the pedestrian-vehicle conflict occurs: waiting until the vehicle passes by and crossing before the vehicle passes by.</p

Trajectory comparison.

<p>(a) shows the pedestrian trajectories from real data and (b) shows simulation outputs.</p

Simulation performance on speed, acceleration, direction change and crossing time.

<p>(a) shows the average absolute error of walking speed. (b) shows the comparison of step-wise acceleration distributions. (c) shows the distribution of the step-wise direction change between current and previous directions. (d) shows the distribution of the crossing time at crosswalk.</p

Fundamental diagrams of pedestrian flow.

<p>The simulated fundamental diagrams are in good agreement with the observed ones.</p

Collision avoidance with counter-flow pedestrians.

<p>(a) It is usually assumed that the magnitude of the repulsive force increases monotonically as the relative distance decreases. (b) It shows the case of valid and invalid conflicts.</p