Impact of NCI Socioeconomic Index on the Outcomes of Nonmetastatic Breast Cancer Patients: Analysis of SEER Census Tract–Level Socioeconomic Database

Abdel‐Rahman, Omar

doi:10.1016/j.clbc.2019.06.013

Cited by 41 publications

(46 citation statements)

References 11 publications

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“…These findings complement previously published literature that highlighted the deleterious impact of low socioeconomic status on the outcomes of various cancers in North America. [16][17][18] Likewise, the current study suggests that people who self-identify as a visible minority are less likely to have timely screening tests. This is consistent with older studies suggesting a lower uptake of cancer screening among self-identified visible minorities in North America and highlights the need to address this disparity.…”

Section: Discussionmentioning

confidence: 62%

Patterns and Trends of Cancer Screening in Canada: Results From a Contemporary National Survey

Abdel‐Rahman

2021

Journal of the National Comprehensive Cancer Network

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Background: The aim of this study was to assess the patterns and trends of colorectal, breast, and cervical cancer screening within a contemporary cohort of Canadian adults. Methods: Canadian Community Health Survey datasets (2007–2016) were accessed and 3 cohorts were defined: (1) a colorectal cancer (CRC) screening cohort, defined as men and women aged 50 to 74 years with complete information about CRC screening tests and their timing; (2) a breast cancer screening cohort, defined as women aged 40 to 74 years with complete information about mammography and its timing; and (3) a cervical cancer screening cohort, defined as women aged 25 to 69 years with complete information about the Papanicolaou (Pap) test and its timing. Multivariable logistic regression analysis was then performed to evaluate factors associated with not having timely screening tests at the time of survey completion. Results: A total of 99,820 participants were considered eligible for the CRC screening cohort, 59,724 for the breast cancer screening cohort, and 46,767 for the cervical cancer screening cohort. Among eligible participants, 43% did not have timely recommended screening tests for CRC, 35% did not have timely mammography (this number decreased to 26% when limiting the eligible group to ages 50–74 years), and 25% did not have a timely Pap test. Lower income was associated with not having a timely recommended screening tests for all 3 cohorts (odds ratios [95% CI]: 1.86 [1.76–1.97], 1.89 [1.76–2.04], and 1.96 [1.79–2.14], respectively). Likewise, persons self-identifying as a visible minority were less likely to have timely recommended screening tests in all 3 cohorts (odds ratios for White race vs visible minority [95% CI]: 0.87 [0.83–0.92], 0.85 [0.80–0.91], and 0.66 [0.61–0.70], respectively). Conclusions: More than one-third of eligible individuals are missing timely screening tests for CRC. Moreover, at least one-quarter of eligible women are missing their recommended breast and cervical cancer screening tests. More efforts from federal and provincial health authorities are needed to deal with socioeconomic disparities in access to cancer screening.

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Section: Discussionmentioning

confidence: 62%

Patterns and Trends of Cancer Screening in Canada: Results From a Contemporary National Survey

Abdel‐Rahman

2021

Journal of the National Comprehensive Cancer Network

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“… 78 , 79 These studies assessed the following cancers: female breast, 8 , 9 , 13 , 17 , 18 , 26 , 29 , 30 , 32 , 36 , 44 , 49 , 53 , 59 - 61 , 65 , 67 , 77 male breast, 58 cervix, 24 , 50 ovary, 23 , 42 , 45 endometrium, 33 prostate, 7 , 34 , 43 , 64 penis, 47 colorectum, 12 , 15 , 22 , 28 , 40 , 48 , 55 , 57 , 66 , 73 lung, 10 , 11 , 16 , 20 , 25 , 41 , 56 head and neck, 31 ...…”

Section: Resultsmentioning

confidence: 99%

Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review

2021

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Background: There is strong and well-documented evidence that socio-economic inequality in cancer survival exists within and between countries, but the underlying causes of these differences are not well understood. Methods: We systematically searched the Ovid Medline, EMBASE, and CINAHL databases up to 31 May 2020. Observational studies exploring pathways by which socio-economic position (SEP) might causally influence cancer survival were included. Results: We found 74 eligible articles published between 2005 and 2020. Cancer stage, other tumor characteristics, health-related lifestyle behaviors, co-morbidities and treatment were reported as key contributing factors, although the potential mediating effect of these factors varied across cancer sites. For common cancers such as breast and prostate cancer, stage of disease was generally cited as the primary explanatory factor, while co-morbid conditions and treatment were also reported to contribute to lower survival for more disadvantaged cases. In contrast, for colorectal cancer, most studies found that stage did not explain the observed differences in survival by SEP. For lung cancer, inequalities in survival appear to be partly explained by receipt of treatment and co-morbidities. Conclusions: Most studies compared regression models with and without adjusting for potential mediators; this method has several limitations in the presence of multiple mediators that could result in biased estimates of mediating effects and invalid conclusions. It is therefore essential that future studies apply modern methods of causal mediation analysis to accurately estimate the contribution of potential explanatory factors for these inequalities, which may translate into effective interventions to improve survival for disadvantaged cancer patients.

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“…Socioeconomic and health insurance status have strong associations with cancer survival (21,22). Such differences between transplanted and untransplanted cancer patients may partly explain the inverse associations that we observed for some cancers, e.g., breast cancer (22,23).…”

Section: Discussionmentioning

confidence: 73%

Solid Organ Transplantation and Survival among Individuals with a History of Cancer

Engels

Haber

Hart

et al. 2021

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: The success of immunotherapy highlights a possible role for immunity in controlling cancer during remission for cancer patients in the general population. A prior cancer diagnosis is common among solid organ transplant candidates, and immunosuppressive medications administered to transplant recipients may increase recurrence risk.Methods: Using linked data from the United States solid organ transplant registry and 13 cancer registries, we compared overall and cancer-specific survival among cancer patients who did vs. did not receive subsequent transplantation. We used Cox regression in cohort and matched analyses, controlling for demographic factors, cancer stage, and time since cancer diagnosis.Results: The study included 10,524,326 cancer patients with 17 cancer types; 5425 (0.05%) subsequently underwent solid organ transplantation. The median time from cancer diagnosis to transplantation was 4.17 years. Transplantation was associated with reduced overall survival for most cancers, especially cervical, testicular, and thyroid cancers (adjusted hazard ratios [aHRs] for overall mortality: 3.43-4.88). In contrast, transplantation was not associated with decreased cancer-specific survival for any cancer site, and we observed inverse associations for patients with breast cancer (aHRs for cancer-specific mortality: 0.65-0.67), non-Hodgkin lymphoma (0.50-0.51), and myeloma (0.39-0.42).Conclusions: Among US cancer patients, subsequent organ transplantation was associated with reduced overall survival, likely due to end-stage organ disease and transplant-related complications. However, we did not observe adverse associations with cancer-specific survival, partly reflecting careful candidate selection. Impact: These results do not demonstrate a detrimental effect of immunosuppression on cancer-specific survival and support current management strategies for transplant candidates with previous cancer diagnoses.

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Impact of NCI Socioeconomic Index on the Outcomes of Nonmetastatic Breast Cancer Patients: Analysis of SEER Census Tract–Level Socioeconomic Database

Cited by 41 publications

References 11 publications

Patterns and Trends of Cancer Screening in Canada: Results From a Contemporary National Survey

Patterns and Trends of Cancer Screening in Canada: Results From a Contemporary National Survey

Factors Explaining Socio-Economic Inequalities in Cancer Survival: A Systematic Review

Solid Organ Transplantation and Survival among Individuals with a History of Cancer

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