Background: More than 100,000 individuals in the United States are survivors of advanced prostate cancer, defined as metastatic hormone sensitive (mHSPC) or castration resistant prostate cancer (CRPC). This growing, vulnerable population could be uniquely susceptible or responsive to factors that are associated with overall survival. We investigated the associations of marital status and living arrangements with overall survival among individuals with advanced prostate cancer in the International Registry for Men with Advanced Prostate Cancer (IRONMAN). Methods: We included 2,347 men (ages 40-96 years, median 70 years) with advanced prostate cancer recruited between 2017 and October 2022. Cox proportional hazards models estimated adjusted hazard ratios (adjusted HR) and 95% confidence intervals (CI) for the associations between marital status (married vs. not married), living arrangement (living alone vs. not living alone) and all-cause mortality, mutually adjusting for marital status and living arrangement and potential confounders (disease state [mHSPC vs. CRPC], country of enrollment, age at enrollment, race, education, employment status, smoking status, family history of prostate cancer, prostate specific antigen level at enrollment, and Gleason score). We conducted stratified analyses by disease state (mHSPC vs. CRPC), age (<70 vs. ≥70 years), and country of enrollment (North America vs. others). Results: This study included 1524 (65%) participants with mHSPC and 809 (35%) with CRPC. 1690 (77%) were married and 338 (16%) lived alone. Over the follow-up period (maximum: 52 months, median: 6 months, IQR: 13 months), we observed 451 deaths, with 313 deaths among married individuals and 59 deaths among those who lived alone. Overall, married individuals had better survival compared to those not married (adjusted HR: 0.52; 95% CI 0.35, 0.78), while those living alone had better survival compared to those not living alone (adjusted HR: 0.48; 95% CI: 0.29, 0.80). The protective association between being married and survival is stronger among those with mHSPC (adjusted HR: 0.42; 95% CI: 0.24, 0.71) compared to those with CRPC (adjusted HR: 0.72; 95% CI: 0.35, 1.49) and stronger among those with ages 70 or older (adjusted HR: 0.43; 95% CI: 0.25, 0.74) compared to those younger than 70 (adjusted HR: 0.71; 95% CI: 0.36, 1.43). Conclusion: Being married was associated with better survival among advanced prostate cancer survivors. While living alone was also associated with better survival, this finding should be interpreted with caution as there may be residual confounding by socioeconomic status or physical functioning. Citation Format: Naiyu Chen, Colleen B. McGrath, Caroline I. Ericsson, Jane B. Vaselkiv, Michelle O. Sodipo, Emily M. Rencsok, Konrad H. Stopsack, Daniel J. George, Karen A. Autio, Dana E. Rathkopf, Kathryn L. Penney, Lorelei A. Mucci. Marital status, living arrangement, and overall survival among individuals with advanced prostate cancer in the IRONMAN cohort. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6489.
Background:We studied women enrolled in the Boston Mammography Cohort Study to investigate whether subgroups defined by age, race, or family history of breast cancer experienced differences in trends of screening or diagnostic imaging rates during the COVID-19 lockdown and had slower rebound in trends of these rates during reopening.Methods:We compared trends of monthly breast cancer screening and diagnostic imaging rates over time between the pre-COVID-19, lockdown, and reopening periods and tested for differences in the monthly trend within the same period by age (<50 vs ≥50), race (White vs non-White), and first-degree family history of breast cancer (yes vs no).Results:Overall, we observed a decline in breast cancer screening and diagnostic imaging rates. The monthly trend of breast cancer screening rates for women age ≥50 was 5% higher (p=0.005) in the pre-COVID-19 period but was 19% lower in the reopening phase than that of women aged <50 (p<0.001). White participants had 36% higher monthly trend of breast cancer diagnostic imaging rates than non-White participants (p=0.018).Discussion:The rebound in screening was lower in women age ≥50 and lower in non-White women for diagnostic imaging. Careful attention must be paid as the COVID-19 recovery continues to ensure equitable resumption of care.Funding:The project was supported by the Breast Cancer Research Foundation (RT). Researchers were supported by the University of Louisville CIEHS P30 ES030283 (NCD), K01CA188075 (ETW), T32CA09001 (NCD, MOS, MEB) P30 ES000002 (JH, FL), and NIH/NCI K00 CA212222 (MEB). This manuscript is the responsibility of the authors and does not represent the official views of the National Institutes of Health.
The fatigue behaviour of a piezoelectric ceramic stack co-fired at low temperatures under the influence of a large cyclic dynamic load was studied. The piezoelectric ceramic stack is equivalent to a parallel plate capacitor with a charge source in parallel. The equations for the total current, output current and capacitor charging current of an equivalent device for an applied load were derived using Kirchhoff’s theoretical formula. A new type of fatigue test equipment was developed for continuous long-term M-shaped wave output. The piezoelectric ceramic stack is positioned between two concrete slabs, forming a pavement-subgrade piezoelectric structure. The fatigue behaviour of the piezoelectric ceramic stack was observed for 800,000 cycles of dynamic load. The results show that the dynamic load studied produced fatigue damage in the piezoelectric ceramic stack. As the number of dynamic loads increased, the electric output capacity of the piezoelectric ceramic stack decreased. Evident stage divisions were observed in the fatigue behaviour of the piezoelectric ceramic stack under cyclic dynamic loading. The electric output capacity of the stack decreased as the number of dynamic loads increased in the early and late stages, whereas it exhibited negligible change during the stable period.
The COVID-19 pandemic has placed an unprecedented burden on the healthcare system, disrupting routine care including breast cancer screening. We used data from 2392 women without a history of breast cancer enrolled in the Boston Mammography Cohort Study (BMCS) to investigate whether subgroups defined by age, race, or family history of breast cancer: 1) experienced greater declines in screening or diagnostic imaging during the lockdown; or 2) had slower rebound during reopening. In this interrupted time series analysis, we used Poisson regression with robust standard errors to model expected monthly rates of breast cancer screening and diagnostic imaging from January 2019 through December 2020. We defined the pre-COVID-19 period as January 1, 2019, to February 29, 2020; the lockdown period as March 1 to May 30, 2020; and the reopening period as June 1 to December 31, 2020. We examined changes in trends overall and tested for the difference in trends by age (<50 vs ≤50), race (white vs non-white), and first-degree family history of breast cancer (yes or no). The mean monthly rate of breast cancer screening in the BMCS cohort was 45 per 1000 people during the pre-COVID-19 period, 7 per 1000 people during the lockdown period, and 50 per 1000 people during the reopening period. The mean monthly rate of breast cancer diagnostic imaging was 6 per 1000 people during the pre-COVID-19 period, 3 per 1000 people during the lockdown period, and 6 per 1000 people during the reopening period. During the pre-COVID-19 period, those who are age 50 or older had 5.3% higher monthly trend in breast cancer screening rates (p=0.005) and 9.8% higher monthly trend in diagnostic imaging rates (p=0.0389). During the lockdown period, those who were age 50 or older had a lower monthly trend in breast cancer screening rates compared to those who were younger than 50 (p<0.0001), while those who were white and those with family history have higher monthly trends of breast cancer screening rates compared to their respective counterparts (p<0.0001). During the reopening phase, those who are age 50 or older have 18.5% lower monthly trend in breast cancer screening rates in comparison to those who are younger than 50 (p=0.0008) and those who were white have 36.2% higher monthly trend in breast cancer diagnostic procedure rates in comparison to those who are non-white (p=0.018). Overall, we observed a significant decline in breast cancer screening rates with the advent of the COVID-19 pandemic. For the most part, screening and diagnostic imaging rates during the reopening phase equaled or exceeded those of the pre-COVID-19 period. However, the rate of return to screening was lower in women age 50 or older and the rebound in diagnostic imaging was lower in non-white women. Careful attention must be paid as the COVID-19 recovery continues to ensure equitable resumption of care. Future work will examine other factors including insurance status, breast cancer risk scores, and geographic location. Citation Format: Naiyu Chen, David Cheng, Mollie Barnard, Natalie C. DuPre, Rulla M. Tamimi, Erica T. Warner. Impact of age, race, and family history on COVID-19 related changes in breast cancer screening among the Boston Mammography Cohort Study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-250.
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