Late-stage diagnosis of breast cancer in women of lower socioeconomic status: public health implications.

Farley, Tillman; Flannery, John

doi:10.2105/ajph.79.11.1508

Cited by 176 publications

(54 citation statements)

References 12 publications

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“…[1][2][3][4][5][6][7] Patients of low socioeconomic status and those who are uninsured or insured by Medicaid are also at greater risk of poor cancer outcomes. 4,6,[8][9][10][11][12][13][14] The reasons why these groups have less favorable cancer outcomes is not certain but has been attributed to lower rates of screening. [15][16][17][18][19][20][21][22][23][24] In an attempt to address these health disparities, we developed the Cancer Screening Offi ce System (Cancer SOS), a low-cost offi ce systems intervention to promote screening in primary care clinics serving disadvantaged populations.…”

Section: Introductionmentioning

confidence: 99%

Long-term Results From a Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers

Roetzheim¹

2005

The Annals of Family Medicine

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PURPOSEWe assessed whether increased cancer screening rates that were observed with Cancer Screening Offi ce Systems (Cancer SOS) could be maintained at 24 months' follow-up, a period in which clinics were expected to be largely self-suffi cient in maintaining the intervention. METHODSEight primary care clinics serving disadvantaged populations in Hillsborough County, Fla, agreed to take part in a cluster-randomized experimental trial. Charts of independent samples of established patients aged 50 to 75 years were abstracted, with data collected at baseline (n = 1,196) and at 24 months' follow-up (n = 1,296). Papanicolaou (Pap) smears, mammography, and fecal occult blood testing were assessed.RESULTS At 24 months of follow-up, intervention patients had received a greater number of cancer screening tests (mean 1.17 tests vs 0.94 tests, t test = 4.42, P <.0001). In multivariate analysis that controlled for baseline screening rates, secular trends, and other patient and clinic characteristics, the intervention increased the odds of mammograms slightly (odds ratio [OR]) = 1.26; 95% confi dence interval [CI], 1.02-1.55; P = .03) but had no effect on fecal occult blood tests (OR = 1.17; 95% CI, 0.92-1.48; P =0.19) or Pap smears (OR = 0.88; 95% CI, 0.0.68-1.15; P = .34).CONCLUSIONS The Cancer SOS intervention had persistent, although modest, effects on screening at 24 months' follow-up, an effect that had clearly diminished from results reported at 12 months' follow-up. Further study is needed to develop successful intervention strategies that are either self-sustaining or that are able to produce long-term changes in screening behavior.

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Section: Introductionmentioning

confidence: 99%

Long-term Results From a Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers

Roetzheim¹

2005

The Annals of Family Medicine

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“…Black women (Axtell & Meyers, 1978;Bain et al, 1986;Polednak, 1986) as compared to White women, and poorer women as compared to wealthier women (Farley & Flannery, 1989) (Baquet et al, 1986). There are relatively few studies that have compared Hispanic women with other ethnic groups, but Hispanic women also appear to be diagnosed with more advanced breast cancer than non-Hispanic Whites (Westbrook et al, 1975;Horm, 1987;Samet et al, 1988).…”

mentioning

confidence: 99%

Stage and delay in breast cancer diagnosis by race, socioeconomic status, age and year

Richardson

Langholz²,

Bernstein³

et al. 1992

Br J Cancer

168

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“…There are many factors that may contribute to these disparities, such as inequalities in access to healthcare and poverty (2-4), and lower education levels (5). These factors create barriers to health care access contributing to African-Americans being diagnosed at a later stage of disease (6)(7)(8)(9)(10)(11). Some studies have shown that socioeconomic factors are associated with a poorer outcome and may account for some of the difference between African-Americans and Whites (12)(13)(14)(15)(16)(17).…”

Section: Tasks (Objectives Of Project)mentioning

confidence: 99%

The Establishment of an Inflammatory Breast Cancer Registry and Biospecimen Repository

Levine¹

2004

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Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching exisOng data sources, gattienng and maintaining the data needed and compieUng and reviewing this collection of infonnation. Send comments regarding this burden estimate or any other aspect of this collecUon of infomiation, including suggestions for reducing this burden to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington. VA 22202-4302, and TITLE AND SUBTITLEThe Establishment of an Inflammatory Breast Cancer Registry and Biospecimen Repository AUTHOR(S)Paul H. Levine, M.D. PERFORMING ORGANIZATIONNAME(S) AND ADDRESS(ES)The George Washington University Body 2 Key Research Accomplishments 5Reportable Outcomes 6 Conclusions 6References.. Appendices. INTRODUCTIONStudying inflammatory breast cancer (IBC), the most aggressive form of breast cancer, may provide an understanding of aggressive breast cancer and the biology of breast cancer in general. Since IBC is relatively rare, we have developed a national registry of patients with IBC which contains standardized clinical, epidemiological and pathological information. Our registry includes both the clinical classification (redness, warmth, and edema) and the pathological classification (invasion of the dermal lymphatics). By standardizing clinical and pathologic information, we have an excellent opportunity to investigate the heterogeneity of IBC. We are characterizing the tumors of the IBC patients by using a panel of biomarkers through the implementation of a biospecimen repository. The specimens we collect include formalin fixed material (stained and unstained) and frozen tissue (normal and tumor). New technological advancements in molecular biology have made it possible to study biomarkers in these tumors. The specimens are needed more than ever to provide opportunities for critical translational research focusing on the pathogenesis of breast malignancies. We currently work with five laboratories. We will also make our specimens available to qualified investigators for new studies to facilitate their research. This registry will serve as a source of useful epidemiological data for investigators who are studying IBC and can be used to generate hypotheses that might be tested in subsequent epidemiological studies. BODYThe purposes of this project are: 1) to develop a well-documented Registry of patients with IBC, 2) to establish a bank of biospecimens and 3) improve the diagnostic criteria for IBC. The repository will be made available to researchers who are doing research on the etiology and pathogenesis of IBC. Tasks (objectives of project)1. To identify patients with IBC who are willing to provide relevant information.We have developed close communication with two Web-based IBC support groups that inform patients how to contact the IBC registry. As of Nov. 1, 2003,120 patients have asked to be enrolled in the IBC...

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Late-stage diagnosis of breast cancer in women of lower socioeconomic status: public health implications.

Cited by 176 publications

References 12 publications

Long-term Results From a Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers

Long-term Results From a Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers

Stage and delay in breast cancer diagnosis by race, socioeconomic status, age and year

The Establishment of an Inflammatory Breast Cancer Registry and Biospecimen Repository

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