The Effect of the 2009 USPSTF breast cancer screening recommendations on breast cancer in Michigan: A longitudinal study

Caughran, Jamie L.; Braun, Thomas; Breslin, Tara M.; Smith, Daniel R.; Kreinbrink, Jennifer L.; Parish, Grace K; Davis, Alan T.; Bacon-Baguley, Teresa A; Silver, Samuel; Henry, Norah Lynn

doi:10.1111/tbj.13034

Cited by 11 publications

(10 citation statements)

References 13 publications

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“…In accordance with previous literature [2,3,8,10,11], our study demonstrates that patients with symptomatic breast cancer tend to be significantly younger (49% of women with symptomatic cancer were 50 years compared to 13% of screen-detected patients). This observation is attributed, at least in part, to the widespread adoption of screening mammography in women over 50.…”

Section: Discussionsupporting

confidence: 92%

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The impact of tumor detection method on genomic and clinical risk and chemotherapy recommendation in early hormone receptor positive breast cancer

Bar¹,

Bar²,

Itzhak³

et al. 2021

The Breast

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Background: Symptomatic breast cancers share aggressive clinico-pathological characteristics compared to screen-detected breast cancers. We assessed the association between the method of cancer detection and genomic and clinical risk, and its effect on adjuvant chemotherapy recommendations. Patients and methods: Patients with early hormone receptor positive (HRþ) HER2neu-negative (HER2-) breast cancer, and known OncotypeDX Breast Recurrence Score test were included. A natural language processing (NLP) algorithm was used to identify the method of cancer detection. The clinical and genomic risks of symptomatic and screen-detected tumors were compared. Results: The NLP algorithm identified the method of detection of 401 patients, with 216 (54%) diagnosed by routine screening, and the remainder secondary to symptoms. The distribution of OncotypeDX recurrence score (RS) varied between the groups. In the symptomatic group there were lower proportions of low RS (13% vs 23%) and higher proportions of high RS (24% vs. 13%) compared to the screendetected group. Symptomatic tumors were significantly more likely to have a high clinical risk (59% vs 40%). Based on genomic and clinical risk and current guidelines, we found that women aged 50 and under, with a symptomatic cancer, had an increased probability of receiving adjuvant chemotherapy recommendation compared to women with screen-detected cancers (60% vs. 37%). Conclusions: We demonstrated an association between the method of cancer detection and both genomic and clinical risk. Symptomatic breast cancer, especially in young women, remains a poor prognostic factor that should be taken into account when evaluating patient prognosis and determining adjuvant treatment plans.

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Section: Discussionsupporting

confidence: 92%

“…Detection methods vary with age. Young women (<50 years) are more likely to present with palpable tumors, whereas identification of cancer by screening mammography increases with age [2,3].…”

Section: Introductionmentioning

confidence: 99%

The impact of tumor detection method on genomic and clinical risk and chemotherapy recommendation in early hormone receptor positive breast cancer

Bar¹,

Bar²,

Itzhak³

et al. 2021

The Breast

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“…Breast cancer also has a successful screening modality, namely mammography, and suffers from similar poor outcomes when associated with an ED visit, 11.9% mortality vs 3.4%, ED to non-ED associated. 21 Prostate cancer screening is controversial and recommendations vary by organization and country, regardless, a screening modality is available and those diagnosed with prostate cancer associated with an ED visit have higher mortality than those that don’t (13.2% vs 3.5%). 22 Lastly, cervical cancer also is frequently screened for as outpatients and 22% of those seen in the ED were dead, versus 7.4% of those not seen in the ED.…”

Section: Discussionmentioning

confidence: 99%

Disparities in outcomes among patients diagnosed with cancer associated with emergency department visits

Pettit

Sarmiento

Kline

2021

Preprint

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Importance: Diagnosis of cancer in the emergency department (ED) may be associated with poor outcomes, related to socioeconomic (SES) disparities, however data are limited. Objective: To examine the morality and associated disparities for cancer diagnoses made less than six months after an ED visit. Design: This study is case-control analysis of the Indiana State Department of Health Cancer Registry, and the Indiana Network for Patient Care. First time diagnoses of ICD-cancer appearing in the registry between January 2013 and December 2017 were included. Cases were patients who had an ED visit in the 6 months before their cancer diagnosis; controls had no recent ED visits. Main Outcome(s) and Measure(s): Primary outcome was mortality, comparing ED-associated mortality to non-ED-associated. Secondary outcomes include SES and demographic disparities. Results: 134,761 first-time cancer patients were identified, including 15,432 (11.5%) cases. In cases and controls, the mean age was same at 65 and the Charlson Comorbidity Index (CCI) was the same at 2.0 in both groups. More of the ED cohort were Black than the non-ED cohort (12.4% vs 7.4%, P<.0001, Chi Square) and more were low income (36.4%. vs 29.3%). The top 3 ED-associated cancer diagnoses were lung (18.4%), breast (8.9%), and colorectal cancer (8.9%), vs. the non-ED cohort were breast (17%), lung (14.9%), and prostate cancer (10.1%). Regardless of type, all ED-associated cancers had an over three-fold higher mortality, with cumulative death rate of 32.9% for cases vs 9.0% for controls (P<.0001) over the entire study period. Regression analysis predicting mortality, clustering by city, controlling for age, gender, race, SES, drug/alcohol/tobacco use, and CCI score, produced an odds ratio of 4.12 (95% CI 3.72-4.56 for ED associated cancers). Conclusion and Relevance: This study found that an ED visit within 6 months prior to the first time of ICD-coded cancer is associated with Black race, low income and an overall three-fold increased risk of death. The mortality rates for ED-associated cancers are uniformly worse for all cancer types. These data suggest that additional work is needed in order to reduce disparities among ED-associated cancer diagnoses, including increased surveillance and improved transitions of care.

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“…It has been reported that a number of hormones such as E1, E2 and FSH. in females can promote the proliferation and invasion of cancer cells, and that their mechanism of actions may be related to the activation of proteins, enzymes or oncogenes involved in nucleic acid synthesis which promotes tumorigenesis [13][14].…”

Section: Discussionmentioning

confidence: 99%

The effects of chemotherapy with anthracyclines vs capecitabine on tumour size, survival rate and estradiol levels in patients with locally advanced breast cancer

2020

European Journal of Gynaecological Oncology

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Objectives: To investigate the therapeutic effect of anthracycline chemotherapy in advanced breast cancer and its impact on Estradiol and tumor size. Methods: A total of 136 breast cancer patients in our hospital were divided into NH group (anthracycline chemotherapy) and CG group (non-anthracycline chemotherapy). The clinical effects on patients in both groups were observed. The levels of estrone (E1), estradiol (E2) and follicle stimulating hormone (FSH) before and after treatment were measured. The tumor size, adverse reactions and 2-year survival rate of NH group and CG group were evaluated after 1-3 courses of treatment. Results: There was no significant difference in the serum E1, E2 and FSH levels before treatment between the NH group and the CG group (p > 0.05). After treatment, the levels of E1 and E2 in the NH group and the CG group were lower than those before treatment, and the FSH levels were higher than those before treatment (p < 0.05). Compared with the NH group, whilst the FSH levels were lower, the E1 and E2 levels in the CG group were significantly higher. There was no significant difference in the tumor size between the NH group and the CG group before treatment (p > 0.05). Compared with those of before treatment, the FSH levels in the NH group and the CG group after treatment were higher (p < 0.05). The tumor volume gradually decreased over the course of treatment, and the tumor size during treatment in the NH group was smaller than that of the CG group (p < 0.05). There was no significant difference between the two groups (p > 0.05). The 2-year survival rate of NG group and CG group was 82.3% and 71.3%, respectively with the NH group being significantly higher than that of the CG group. Conclusions: The effects of anthracycline on advanced breast cancer was better, showing lowered levels of serum E2, and decreased tumor volumes.

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The Effect of the 2009 USPSTF breast cancer screening recommendations on breast cancer in Michigan: A longitudinal study

Cited by 11 publications

References 13 publications

The impact of tumor detection method on genomic and clinical risk and chemotherapy recommendation in early hormone receptor positive breast cancer

The impact of tumor detection method on genomic and clinical risk and chemotherapy recommendation in early hormone receptor positive breast cancer

Disparities in outcomes among patients diagnosed with cancer associated with emergency department visits

The effects of chemotherapy with anthracyclines vs capecitabine on tumour size, survival rate and estradiol levels in patients with locally advanced breast cancer

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