Despite the overall decreasing incidence, nasopharyngeal cancer (NPC) continues to cause a significant health burden among Asian Americans (AAs), who are a fastgrowing but understudied heterogeneous racial group in the United States. We aimed to examine the racial/ethnic disparities in NPC incidence, treatment, and mortality with a specific focus on AA subgroups. NPC patients aged ≥15 years were obtained from the Surveillance, Epidemiology, and End Results (SEER) 18 . AAs were divided into Chinese, Filipino, Vietnamese, Hawaiian, Japanese, Laotian, Korean, Cambodian, Indian/Pakistani and other Asian/Pacific Islanders (APIs). Age-adjusted incidence was calculated using the SEER*Stat software. Cox proportional and Fine-Gray subdistribution hazard models were used to calculate overall and cause-specific mortalities after adjusting for confounders. Among the total 11 964 NPC cases, 18.4% were Chinese,
Introduction: Prior research has revealed rural populations have lower rates of breast and colorectal cancer screening compared to their urban counterparts in the USA. An increasing number of rural hospitals have closed, with rural residents reporting skipping diagnosing imaging and preventative care due to a lack of access. Considering increasing rural hospital closures, this study investigated disparities in breast and colorectal cancer screening between urban and rural women in the USA. Methods: This cross-sectional study analyzed the Behavioral Risk Factor Surveillance System (BRFSS) data 2014-2019. Focusing on women aged 50-74 years, this study evaluated the prevalence of breast cancer and colorectal cancer (CRC) screening overall and by urban-rural location using multivariable logistic regressions. Results: During the study period, the adjusted prevalences of breast cancer screening were 80.0% and 77.1% (p<0.001) in urban and rural settings, respectively. The adjusted CRC screening prevalences were 72.8% and 68.4% (p<0.001) in urban and rural settings, respectively. By year, this study found that by 2019 there was no significant difference between urban and rural screening: 80.8% versus 79.6% in breast cancer and 78.9% versus 76.6% in CRC screening in urban and rural groups, respectively. Screening disparities existed between different racial groups. Conclusion: Breast cancer and CRC screening disparities between urban and rural women have narrowed; however, they continue to exist within these groups. The implementation of screening initiatives targeting underscreened rural regions and racial groups continues to be necessary.
Background. Despite the death rates of breast cancer declining in the last two decades, new breast cancer cases have disproportionately affected some marginalized populations such as African American women. Since mammography screening disparities by sexual orientation and gender identity are inconsistent, it is important to understand the patterns of mammography screening to inform public health interventions. Aims. This secondary data analysis study aimed to examine the disparities in mammography screening by sexual orientation and gender identity among females assigned at birth (FAAB) overall and stratified by race/ethnicity in the U.S. Methods. By using 2014, 2016, and 2018 Behavioral Risk Factor Surveillance Survey (BRFSS) data, we conducted adjusted multivariable logistic regression models to estimate the odds of receiving an up-to-date mammography screening in relation to sexual orientation, gender identity, and other correlates among FAAB aged 50-74 years (unweighted N=228,257). Results. Overall, the lifetime and up-to-date prevalence of mammography screening were 96.3% and 76.0% in U.S. FAAB, respectively. Non-Hispanic Black (NHB) participants reported a higher rate of up-to-date mammography screening (84.13%) whereas those who had an income less than $15,000 per year had the lowest (71.31%). Being insured, overweight/obese, and not a current smoker were positively associated with receiving an up-to-date mammography screening across racial and ethnic groups. Besides, being physically active was significant for an up-to-date mammography screening in non-Hispanic White (NHW) and Hispanic participants. Also, Hispanic transgender participants were more likely to have an up-to-date mammography screening than their same-ethnic cisgender counterparts. Contribution to Evidence-Based Care. The findings reveal that the disparities in receiving an up-to-date mammography screening varied by sexual identity, gender identity, and race/ethnicity in FAAB aged 50-74 years. The lower rate of an up-to-date mammography screening was found particularly in Hispanic, bisexual AFAB. Future tailored mammogram programs should integrate physical activity and cultural components for people with multiple minority identities.
Background: Many LGBTQ youth experience rejection and discrimination in their families and schools, and the range of interventions for improving their resilience and well-being is limited. We developed and piloted an LGBT-youth-focused intervention to build resilience, called Pride Camp. Methods: Using a mixed-method approach we examined the impact of Pride Camp on resilience and other measures of well-being among LGBTQ high school students who attended camp on a college campus in 2015, 2016, and 2017. Camp attendees and the research sample included a majority proportion of transgender and gender nonbinary (TGN) youth. Results: Pre- and post-test data from our quantitative surveys (n=28), indicated significant increases in resilience, self-esteem, and quality of life in LGBTQ youth who attended camp. Similar results were found among the TGN participants (n=19). Qualitative data from focus groups indicated that specifically for TGN youth, the affirming environment at the camp provided social opportunities that they had not found elsewhere. Conclusions: Findings suggest that the Pride Camp intervention provides a platform for LGBTQ youth to meet peers and engage in LGBTQ communities, improving their resilience and outlook on the future. A larger controlled study of the Pride Camp intervention is warranted.
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