No abstract

BACKGROUND The current study examined the relationship between socioeconomic and demographic factors and type of treatment for carcinomas of the colon and rectum. The National Institutes of Health and the National Cancer Institute recommend surgery followed by adjuvant chemo‐ and/or radiotherapy for Stage III colon and Stages II and III rectal carcinomas. METHODS The authors linked Washington State's cancer registry and hospital discharge records and U.S. census data to assess socioeconomic and demographic factors related to treatment, controlling for clinical factors. RESULTS Compared to colon carcinoma patients under age 65 years, patients aged 75–84 years and 85 years or older were at higher risk for a treatment plan of surgery without adjuvant therapy (adjusted odds ratio [OR] = 2.5, 95% confidence interval [CI] = 1.3–4.7; OR = 14.1, CI = 6.3–31.4, respectively). Risk of no adjuvant therapy was more than doubled for patients in zip codes in the lowest quartile of per capita income compared to the top three quartiles (OR = 2.3, CI = 1.5–3.4) and for those with Medicare compared to private insurance (OR = 2.2, CI = 1.3–3.8). Older patients with rectal carcinoma were also at higher risk of a treatment plan that did not include adjuvant therapy. CONCLUSIONS The current findings suggest disparities in the provision of recommended medical procedures related to socioeconomic and demographic factors. Cancer 2002;95:39–46. © 2002 American Cancer Society. DOI 10.1002/cncr.10645

Lead screening questionnaires showed a wide range of sensitivity and specificity and performed little better than chance at predicting lead poisoning risk among children.

Death certificate data are often used to study the epidemiology of poisoning deaths, but the International Classification of Diseases (ICD) codes used to tabulate death data do not convey all of the available information about the drugs and other substances named on death certificates. In the United States and some other countries, the SuperMICAR computer system is used to assign ICD codes to deaths. The SuperMICAR system also stores a verbatim record of the text entered for the cause of death. We used the SuperMICAR text entries to study the 7,817 poisoning deaths that occurred among Washington State residents between 2003 and 2010. We tabulated the drugs named on death certificates and computed age-adjusted and age-specific death rates for the top-named drugs and for prescription and illicit drugs. Methadone was named on 2,149 death certificates and was the most frequently named substance, followed by alcohol, opiate, cocaine, oxycodone, and methamphetamine. For both men and women and at all ages, prescription drugs were involved in more deaths than were illicit drugs. Among the 25 drugs named most frequently, only 4 have unique ICD codes; the other 21 can be identified only by using the SuperMICAR data.

We examined the role of a history of sexual abuse as a predictor of child maltreatment by adolescent mothers in a prospective study of 104 mother-child dyads. Mothers were interviewed about any experienced abuse, and the mother-child dyads were observed in a teaching interaction and in the Strange Situation when the children were 1 year old. Three and a half years later, the mothers were interviewed about their Child Protective Service (CPS) contacts since the birth of their children. The percentage of mothers reporting CPS contacts for their own children was 15.4%, 38.5%, and 83.3%, respectively, for those mothers with no history of sexual abuse, a history of a single incident or brief duration of sexual abuse, and those mothers with a history of chronic sexual abuse (median 24 months duration; test of increasing trend significant atp< .000009). Mothers who reported having been chronically sexually abused as children were significantly more likely to have CPS contacts for their own children, after controlling for history of physical abuse, quality of early teaching interactions, and infant attachment security (both of which also predicted CPS contacts), race, IQ, welfare status at 1 year postpartum, and history of foster care.