Although Socioeconomic status (SES), race/ethnicity, and surgical type/delays are associated with breast cancer mortality outcomes, studies on these associations have been contrasting. This study examined the racial/ethnic and SES differences in surgical treatment types and delays. Also, we quanti ed the extent to which these differences explained the racial/ethnic disparities in breast cancer mortality. MethodsWe studied 290,066 women 40 + years old diagnosed with breast cancer between 2010 and 2017 identi ed from the Surveillance, Epidemiology, and End Results database. We performed logistic regression models to examine the association of SES and race/ethnicity with surgical treatment type and delays. We performed mediation analysis models to quantify the extent to which mortality differences were mediated by treatment, sociodemographic, and clinicopathologic factors. ResultsNon-Hispanic (NH) Black [Odds ratio (OR) = 1.16, 95% CI: 1.13-1.19] and Hispanic women [OR = 1.27, 95% CI: 1.24-1.31] were signi cantly more likely to undergo mastectomy compared to NH White women. Similarly, NH Black and Hispanic women had higher odds of delayed surgical treatment than NH Whites.Patients in the highest SES quintile, compared to those in lowest the lowest, were less likely to experience breast cancer-speci c mortality (BCSM). Variations in treatment, SES, and clinicopathological factors signi cantly explained 70% of the excess BCSM among NH Blacks compared to their NH White counterparts. ConclusionsBridging the gap of access to adequate healthcare services for all to diminish the disproportionate burden of breast cancer would require a multifactorial approach that addresses several biological and social factors that cause these differences.This retrospective cohort study used data from the Surveillance, Epidemiology, and End Results (SEER) research plus 18 registries' specialized census tractlevel SES and rurality dataset released in November 2020. SEER is a cancer surveillance program supported by the National Cancer Institutes (NCI) that serves as the primary source of reliable incidence and survival data in the US. [21]. A detailed database and data collection description can be found elsewhere [21].The study subjects were de-identi ed, and there was no patient contact; thus, the study was exempted from an Institutional Review Board's (IRB) approval.We use SEER*stat version 8.4.0 and identi ed 403,791 women, 40 years old or older, diagnosed with breast cancer as the rst primary cancer between January 2010 and December 2017. From the 403,791 women, our study only included patients who underwent surgery and excluded those who were not recommended for surgery, declined recommended surgery, or had unknown surgery status. In addition, we excluded patients with distant tumor stages, grade IV tumors, and those diagnosed during an autopsy. Lastly, we excluded patients with unknown breast cancer subtypes, tumor grade, tumor stage, tumor site, race, SES, marital status, or rurality. Hence, the sample size used in our analysis was ...
Although much emphasis has been placed on the impact of ambiguity on cognitive processes, the impact of mental health disorder symptoms and racial/ethnic disparities in cancer perception of fatalism and ambiguity remains less explored. This study explored the association between mental health disorder symptoms and negative cancer perceptions. Also, we assessed differences in these outcomes within mental health disorder symptoms and racial/ethnic subgroups. MethodsWe used the 2019-2020 Health Information National Trends Survey data to assess the perception of cancer fatalism and cancer communication ambiguity, and employed weighted multivariable logistic regression to determine the effects of mental health disorder symptoms on these negative cancer perceptions. ResultsPeople with moderate [Adjusted Odds Ratio (AOR)= 1.58, 95% Con dence Interval (CI)= 1.09, 2.31] and severe anxiety/depression (AOR= 1.88, 95% CI= 1.12, 3.14) symptoms were more likely to have cancer fatalism perceptions than people with no anxiety/depression symptoms. People with mild (AOR= 1.33, 95% CI= 1.06, 1.69) or severe (AOR= 1.80, 95% CI= 1.03, 3.16) anxiety/depression symptoms were more likely to perceive cancer communication as ambiguous compared to people who had no anxiety/depression symptoms. ConclusionsThe study showed that mental health status was associated with both cancer fatalism perception and perceived ambiguity in cancer recommendations. This suggests that interventions aimed at reducing mental health disorder symptoms may potentially reduce perceived cancer fatalism and communication ambiguity, thereby improving participation in cancer prevention programs. BackgroundCancer is recognized as the second leading cause of death in the United States (U.S.) [1]. It is projected that approximately 1.9 million new cancer diagnoses and 608,570 related deaths will occur in 2021 in the U.S. [2]. Additionally, nearly 1 in 3 Americans will be diagnosed with cancer at some point in their lifetime [3]. The prevalence of cancer in the U.S. has been increasing in the past few years due to reasons such as improvements in cancer treatment, population growth, increasing screening rates, and increasing life expectancy [4]. The rising cancer burden has contributed to an increase in the national cancer-related expenditure over the years. The estimated national expenditure for cancer care in the U.S. was $201 billion in 2020, up from $183 billion in 2015 [5]. This gure is projected to increase to 246 billion by 2030 (34% increase from 2015) [5]. The increasing cancer and associated nancial burden have not only impacted the physical and mental health of diagnosed people but also their families, communities, and society as a whole; making cancer a major public health concern [6].Several factors affect an individual's risk of morbidity and mortality from cancer. These include socioeconomic status (SES), race, gender, and lifestyle. Low SES, African American race, anxiety/depression, male gender, and smoking have been associated with increased morbidity and...
Objective Although Socioeconomic status (SES), race/ethnicity, and surgical type/delays are associated with breast cancer mortality outcomes, studies on these associations have been contrasting. This study examined the racial/ethnic and SES differences in surgical treatment types and delays. Also, we quantified the extent to which these differences explained the racial/ethnic disparities in breast cancer mortality. Methods We studied 290,066 women 40 + years old diagnosed with breast cancer between 2010 and 2017 identified from the Surveillance, Epidemiology, and End Results database. We performed logistic regression models to examine the association of SES and race/ethnicity with surgical treatment type and delays. We performed mediation analysis models to quantify the extent to which mortality differences were mediated by treatment, sociodemographic, and clinicopathologic factors. Results Non-Hispanic (NH) Black [Odds ratio (OR) = 1.16, 95% CI: 1.13–1.19] and Hispanic women [OR = 1.27, 95% CI: 1.24–1.31] were significantly more likely to undergo mastectomy compared to NH White women. Similarly, NH Black and Hispanic women had higher odds of delayed surgical treatment than NH Whites. Patients in the highest SES quintile, compared to those in lowest the lowest, were less likely to experience breast cancer-specific mortality (BCSM). Variations in treatment, SES, and clinicopathological factors significantly explained 70% of the excess BCSM among NH Blacks compared to their NH White counterparts. Conclusions Bridging the gap of access to adequate healthcare services for all to diminish the disproportionate burden of breast cancer would require a multifactorial approach that addresses several biological and social factors that cause these differences.
585 Background: Breast cancer is the most common malignancy affecting women of all racial and ethnic backgrounds in the United States (US). Although Socioeconomic status (SES), race/ethnicity, and surgical type/delays are associated with breast cancer mortality outcomes, studies on these associations have been contrasting. This study examined the racial/ethnic and SES differences in surgical treatment types and delays. Also, we quantified the extent to which these differences explained the racial/ethnic disparities in breast cancer mortality. Methods: We studied 290,066 women 40+ years old diagnosed with breast cancer between 2010 and 2017 identified from the Surveillance, Epidemiology, and End Results database. We performed logistic regression models to examine the association of SES and race/ethnicity with surgical treatment type and delays. We performed mediation analysis models to quantify the extent to which mortality differences were mediated by treatment, sociodemographic, and clinicopathologic factors. The study subjects were de-identified, and there was no patient contact; thus, the study was exempted from an Institutional Review Board's (IRB) approval. A p-value less than 0.05 indicated significant associations for the descriptive statistics, logistic and Cox proportional hazard regressions, and mediation analysis. We used Stata 17 to perform the analyses. Results: Non-Hispanic (NH) Black [Odds ratio (OR) = 1.16, 95% CI: 1.13-1.19] and Hispanic women [OR = 1.27, 95% CI: 1.24-1.31] were significantly more likely to undergo mastectomy compared to NH White women. Similarly, NH Black and Hispanic women had higher odds of delayed surgical treatment than NH Whites. Patients in the highest SES quintile, compared to those in lowest the lowest, were less likely to experience breast cancer-specific mortality (BCSM). Variations in treatment, SES, and clinicopathological factors significantly explained 70% of the excess BCSM among NH Blacks compared to their NH White counterparts. Conclusions: In conclusion, health disparity continues to be a major societal concern in the US. It affects people of all ages, socioeconomic classes, and ethnic/racial backgrounds. The findings of this study showed that racial and ethnic minorities, the majority of whom have a lower socioeconomic position, are significantly disadvantaged regarding the evaluation, quality, cost, and duration of medical care. Future studies can assess the multifactorial effects of sociodemographic factors like SES, access to health care assessment, and educational background amidst other variables as a multidimensional predictor of treatment delay and overall survival of breast cancer and other health issues among minoritized populations.
In Nigeria, the predictors of quality of life among children exposed to sexual abuse are unknown. Addressing this gap may strengthen the capacity of the health system to care for this population. Thus, this cross-sectional study selected 545 (mean age = 14.4 ± 1.4 years) Nigerian children exposed to sexual abuse. Results show that self-compassion, resilience, and meaning in life jointly predicted quality of life and explained 39% variance. The independent prediction of each predictor variable shows that self-compassion, resilience, and meaning in life have significant independent predictions, with self-compassion showing the greatest independent prediction, followed by resilience and meaning in life. Sex, age, and how long ago respondents were exposed to sexual abuse jointly predicted quality of life and explained 6% variance. However, how long ago respondents were exposed to sexual abuse shows a significant independent prediction. Results offer clinical implications that may strengthen the capacity of the health system to care for this population.
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