Public Health Commons^™

Most Deprived Louisiana Census Tracts Have Higher Hepatocellular Carcinoma Incidence And Worse Survival, Kendra L. Ratnapradipa, Tingting Li, Mei Chin Hsieh, Laura Tenner, Edward S. Peters

School of Public Health Faculty Publications

Background: Liver cancer incidence increased in the US from 1975 through 2015 with heterogeneous rates across subpopulations. Upstream or distal area-level factors impact liver cancer risks. Objective: The aim of this study was to examine the association between area-level deprivation and hepatocellular carcinoma (HCC) incidence and survival. We also explored the association between area deprivation and treatment modalities. Methods: Louisiana Tumor Registry identified 4,151 adult patients diagnosed with malignant HCC from 2011 to 2020 and linked residential address to census tract (CT)-level Area Deprivation Index (ADI) categorized into quartiles (Q1 = least deprived). ANOVA examined the association between ADI quartile …

Childhood Cancer Survival In The Highly Vulnerable Population Of South Texas: Persistent Challenges For Adolescents And Hispanic Ethnicity, Shenghui Wu, Y. N. Liu, M. Williams, C. Aguilar, A. G. Ramirez, R. Mesa, G. E. Tomlinson

Research Symposium

Background: This study examines childhood cancer survival rates and prognostic factors related to survival in the majority Hispanic population of South Texas (STX), whereas most other population studies in childhood cancer survival focus on populations with relatively few Hispanics.

Methods: The population-based cohort study used Texas Cancer Registry data (1995-2017) to examine survival and prognostic factors.

Results: The 5-year relative survival rate for STX cancer patients diagnosed at 0–19 years was 80.3% for all races/ethnicity. Hispanics had statistically significant lower 5-year relative survival rates than non-Hispanic Whites (NHW) for male and female together diagnosed at age ≥ 5 years. When …

The Association Between Mediated Deprivation And Ovarian Cancer Survival Among African American Women, Andrew B. Lawson, Joanne Kim, Courtney Johnson, Kendra Ratnapradipa, Anthony J. Alberg, Maxwell Akonde, Theresa Hastert, Elisa V. Bandera, Paul Terry, Hannah Mandle, Michele L. Cote, Melissa Bondy, Jeffrey Marks, Lauren C. Peres, Joellen Schildkraut, Edward S. Peters

Journal Articles: Epidemiology

BACKGROUND: Deprivation indices are often used to adjust for socio-economic disparities in health studies. Their role has been partially evaluated for certain population-level cancer outcomes, but examination of their role in ovarian cancer is limited. In this study, we evaluated a range of well-recognized deprivation indices in relation to cancer survival in a cohort of self-identified Black women diagnosed with ovarian cancer. This study aimed to determine if clinical or diagnostic characteristics lie on a mediating pathway between socioeconomic status (SES) and deprivation and ovarian cancer survival in a minority population that experiences worse survival from ovarian cancer.

METHODS: We …

Rural-Urban Differences In Survival Among People With Early Onset Colorectal Cancer, Radhika Ranganathan

Theses and Dissertations

Colorectal cancer (CRC) is the third most common cancer and the second most among cancer deaths both in the US and globally. Early Onset Colorectal Cancer (EOCRC), occurring between the ages of 20 and 49, has continued to rise over the past decades. Several studies have reported a persistent increase in EOCRC incidence and mortality, especially in rural areas as compared to urban areas, despite decreases in rates for people over the age of 50 years. Increase in EOCRC may have played a role in lowering the age of screening recommendation to 45-49 age group. The objective of this study …

A Multilevel And Spatial Analysis Of Oral And Pharyngeal Cancer In South Carolina, Deborah M. Hurley

Theses and Dissertations

Objective: Disparities in the distribution of oral and pharyngeal cancer exist worldwide. This is also true in the United States and in South Carolina. Differences exist in oral and pharyngeal cancer stage and survival by race and sex, with higher incidence rates for Whites but higher proportions of late-stage cancer and lower survival for Blacks. This study was conducted to evaluate whether any differences exist in the spatial distribution of oral and pharyngeal cancer stage at diagnosis and survival, and to evaluate the association of income inequality, material deprivation and other measures of social determinants of health (contextual risk factors) …

The Determinants Of Endometrial Cancer Survival Disparities In The United States, Evelyn Anegbe

Walden Dissertations and Doctoral Studies

Endometrial cancer is the most common gynecologic cancer in the United States with recent trends showing a continued increase in incidence and mortality. Prognosis is influenced by cancer stage at diagnosis and differs by race/ethnicity. Researchers have documented poorer survival among Blacks than Whites diagnosed with endometrial cancer. The 5-year survival rates for women with endometrial cancer is 81%; while survival for White and Black women are 84% and 62%, respectively. There is a gap in literature examining the widening disparity in incidence and survival of women diagnosed with advanced stage disease among population subgroups across the United States. The …

Changing Dynamics Of Opioid Overdoses In West Virginia And Impact Of Medication For Opioid Use Disorder And Recurrence Of Overdose On Reducing Mortality Among West Virginia Medicaid Beneficiaries, Zheng Dai

Graduate Theses, Dissertations, and Problem Reports

Background

With increasing number of opioid overdoses in West Virginia (WV) in recent years and limited number of people receiving treatment, the dissertation study aims to better understand fatal overdose problems in WV and the impact of medication for opioid use disorder (MOUD) in preventing overdose deaths.

Method

WV drug-related deaths from 2005 to 2018 was used to describe the involvement of fentanyl and FAs. WV Medicaid claim data was analyzed to describe the recurrent opioid overdose and the changes in receipt of MOUD. Further, a Medicaid opioid overdose cohort was created to evaluate the effect of occurrence of recurrent …

Determinants Of Disparities In The Colorectal Cancer Burden, Karen Elizabeth Callahan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Colorectal cancer (CRC) is the third leading cause of cancer incidence and mortality in the United States, with an estimated 140,000 new cases and 51,000 deaths expected in 2018. Like most cancers, the burden of CRC is unequally distributed among population groups. The current dissertation included two studies filling gaps in knowledge about CRC disparities. Study 1 characterized the relationship between educational attainment and CRC mortality by race/ethnicity. Six years of CRC mortality data (2012-2017) from the diverse state of California, with 30,180 deaths were analyzed. Sex-specific mortality rate ratios (MRR) stratified by race/ethnicity as well as by educational level …

Care Of Acute Conditions And Chronic Diseases In Canada And The United States: Rapid Systematic Review And Meta-Analysis, Keren M. Escobar, Dorian Murariu, Sharon Munro, Kevin M. Gorey

Social Work Publications

This study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors …

The Effect Of Treatment Delay, Non-Adherence To Treatment Guidelines, And Never-Smoking Status On The Survival Of Lung Cancer Patients, Trisari Anggondowati

Theses & Dissertations

Despite many significant medical advances, lung cancer continues to cause more deaths than any of the other cancers in the United States (US), and worldwide. Timeliness of care and evidence-based guidelines are among the components of quality of care that are expected to improve patient outcomes. However, evidence on the effect of timeliness of care and adoption of evidence-based guidelines on patient survival remains lacking. In addition, there has been increasing concern on the fact that smokers are not the only group that suffers from lung cancer. Never-smokers comprise at least 10% of lung cancer patients in the US, or …

The Survival And Treatment Refusal Of Lung Cancer Patients: Analyses Of National Cancer Registries, Poppy Deviany

Theses & Dissertations

Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer mortality of both genders in the United States. A recent report suggests that the relative five-year survival rate of lung cancer is only 18%. Studies indicate many factors are associated with the survival of lung cancer patients, including age at diagnosis. It is widely known as a disease of older people, but the literature shows a substantial number of young people have been diagnosed with lung cancer. The literature also indicates that the refusal of recommended treatment contributes to cancer-related death and poorer survival. The …

Economic Burden Of Renal Cell Carcinoma (Rcc) And Treatment Patterns, Overall Survival And Healthcare Costs Among Older Metastatic Rcc Patients, Hrishikesh P. Kale

Theses and Dissertations

Background

Renal cell carcinoma (RCC) is the most common type of kidney cancer. Patients diagnosed with metastatic RCC (mRCC) have shorter overall survival compared to those diagnosed at earlier stages. Several targeted therapies, which cost from $7,000 - $16,000 per month have been approved since 2005 to treat mRCC. In addition, there is a growing interest in the use of cytoreductive nephrectomy (CN) with targeted therapies among mRCC patients. However, little is known regarding the economic burden of RCC and role of CN and prescribing patterns of targeted therapies among older mRCC patients.

Objectives

1) To assess the economic burden …

Metabolic Dysregulation And Cancer Mortality In A National Cohort Of Blacks And Whites, Tomi Akinyemiju, Justin Xavier Moore, Suzanne Judd, Susan Lakoski, Michael Goodman, Monika M. Safford, Maria Pisu

Epidemiology and Environmental Health Faculty Publications

Background: We examined the association between metabolic dysregulation and cancer mortality in a prospective cohort of Black and White adults.

Methods: A total of 25,038 Black and White adults were included in the analysis. Metabolic dysregulation was defined in two ways: 1) using the joint harmonized criteria for metabolic syndrome (MetS) and 2) based on factor analysis of 15 variables characterizing metabolic dysregulation. We estimated hazards ratios (HRs) and 95% confidence intervals (CIs) for the association of MetS and metabolic dysregulation with cancer mortality during follow-up using Cox proportional hazards models.

Results: About 46% of Black and 39% of White …

The Role Of Pre-Existing Type 2 Diabetes Mellitus In Colorectal Cancer Stage And Survival In Elderly Americans: A Seer-Medicare Population-Based Study 2002-~2011, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a common comorbid condition among colorectal cancer (CRC) patients, yet its effects in CRC outcomes, particularly stage at diagnosis, risk of death and variations by diabetes severity (complications vs no complications) and Hispanic ethnicity have not been adequately studied. The purpose of this study was to investigate the association between pre-existing T2DM and advanced stage at diagnosis in elderly patients with CRC; to examine whether diabetes is an independent predictor of poor survival from all-cause and CRC-specific mortality; to assess whether variations exist by diabetes severity and to analyze the outcomes for the Hispanic group.

The Surveillance Epidemiology …

Ambient Ozone And Cadmium As Risk Factors For Congenital Diaphragmatic Hernia, Rema Ramakrishnan

USF Tampa Graduate Theses and Dissertations

Congenital diaphragmatic hernia (CDH) results from a defect in the diaphragm through which abdominal contents enter the thorax displacing the heart and the lungs. This causes lung hypoplasia and varying degrees of pulmonary hypertension resulting in high rates of morbidity and mortality. Though CDH has a prevalence rate of 2.61 per 10,000 live births it is an expensive birth defect with an estimated annual cost of nearly $250 million for all CDH survivors. Maternal exposure to air pollutants have not been studied as risk factors for CDH in humans. Ambient ozone has been found to be risk factors for certain …

Availability Of Healthcare Resources And Epithelial Ovarian Cancer Stage Of Diagnosis And Mortality Among Blacks And Whites, Swati Sakhuja, Huifeng Yun, Maria Pisu, Tomi Akinyemiju

Epidemiology and Environmental Health Faculty Publications

Background: The purpose of this study is to examine whether racial disparities in epithelial ovarian cancer stage at diagnosis and survival may be explained by geographic availability of healthcare resources among Blacks and Whites.

Methods: Data from the Surveillance, Epidemiology and End Results (SEER) database was used to identify White and Black women ages 40 years and above diagnosed with epithelial ovarian cancer between 2000 and 2010. Data on county-level availability of healthcare resources was obtained from the Area Resource File. Multi-level regression models, overall and stratified by race and age, were used to examine the associations of health care …

Children's Oncology Group Hospital Membership And Survival Of Pediatric Lymphoblastic Leukemia, Paul David Betts

Walden Dissertations and Doctoral Studies

Acute lymphoblastic leukemia (ALL) predominates in children ages 0-14 years and has an excellent prognosis for cure with 5-year survival exceeding 90% in the United States. However, not all children experience such positive outcomes. The purpose of this quantitative, retrospective cohort study was to evaluate differences in survival of ALL among children who reside in the 32-county Texas-Mexico border region. While factors such as poverty and health insurance have been strongly associated with poorer cancer outcomes, additional factors such as geographic isolation and treatment disparities are not as well-documented in children. This study examined the association between use of Texas …

Type 2 Diabetes Mellitus And Colorectal Cancer Risk And Survival In Oman, Rose Ngozi Mafiana

Walden Dissertations and Doctoral Studies

Type 2 diabetes mellitus (T2DM) and colorectal cancer (CRC) are 2 chronic diseases with common risk factors related to physical inactivity, obesity, and diet. Literature on T2DM as a risk factor for CRC development and survival in Oman is scarce. Using de-identified archival data provided by Sultan Qaboos University Hospital (SQUH) Oman, a retrospective, case-control, and time-to-event study designs were used to compare odds of developing CRC, and survival rates among adults with and without T2DM. The ecosocial theory provided the theoretical base for this research. Logistic regression was used to examine the odds of developing CRC among 114 cases …

The Impact Of Autoimmune Disease On Breast Cancer Survival, Samantha Truman

Theses and Dissertations

Background Breast cancer is the second leading cause of cancer death for women in developed countries, while autoimmune disease effects approximately 10 million people in the United States, of which approximately 80% are female. Both diseases are associated with hormonal risk factors and are related to the divergent effects of the cellular and humoral immunity that is associated with the T-helper 1 and T-helper 2 immune response. To investigate the potential implications that autoimmune disease may have on breast cancer-specific mortality, we have conducted a population-based retrospective cohort study of women who were diagnosed with breast cancer between January 1, …

The Effects Of Personal And Family History Of Cancer On The Development Of Dementia In Japanese Americans: The Kame Project, Adam Lee Slotnick

USF Tampa Graduate Theses and Dissertations

An increasing number of studies have shown an inverse association between a personal history of cancer (PHC) and dementia/Alzheimer’s disease (AD), both in those using dementia/AD as the outcome or cancer as the outcome. This is the first study to examine this potential association in Japanese Americans; and to examine family history of cancer and its association with incident dementia. Also, the association between these two diseases in the parents of participants were analyzed.

The Kame Project, conducted from 1992 through 2001 in King County, Washington was a population-based, prospective cohort study of older Japanese Americans. Conversion to incident dementia …

Neighborhood-Level Determinants Of Delayed Hiv Diagnosis And Survival Among Hiv-Positive Latinos, Florida 2000-2011, Diana M. Sheehan

FIU Electronic Theses and Dissertations

The purpose of this study was to estimate disparities in late human immunodeficiency virus (HIV) diagnosis and all-cause mortality among varying populations of HIV-positive Latinos, and to identify neighborhood-level predictors. Florida HIV surveillance data for years 2000–2011 were merged with 2007–2011 American Community Survey (ACS) data. Multilevel logistic regressions were used to estimate adjusted odds ratios (aOR) for late HIV diagnosis (acquired immunodeficiency syndrome within 3 months of HIV diagnosis). Multilevel weighted Cox regressions were used to estimate adjusted hazard ratios (aHR) for mortality. Of 5522 Latinos diagnosed 2007–2011, males were at increased odds of late diagnosis compared with females …

Gender Differences On The Interacting Effects Of Marital Status And Health Insurance On Long-Term Colon Cancer Survival In California, 1995-2014, Derek Campbell, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Objectives. Long-term colon cancer survival is not well explained by main effects. We explored the interaction of age, gender, marital status, health insurance and poverty on 10-year colon cancer survival.

Methods. California registry data were analyzed for 5,776 people diagnosed from 1995 to 2000; followed until 2014. Census data classified neighborhood poverty. We tested interactions with regressions and described them with standardized rates and rate ratios (RR).

Results. The 5-way interaction was significant, suggesting larger 4-way disadvantages among non-Medicare-eligible people. A significant 4-way interaction was a 3-way interaction in non-high poverty neighborhoods only. Private insurance was protective for unmarried …

Determinants And Disparities Of Survival In Triple-Negative Breast Cancer Patients: A Population-Based Retrospective Longitudinal Cohort Design Utilizing The Cox Proportional Hazard Analytical Model, Michael C. Belcon

FIU Electronic Theses and Dissertations

A significant racial disparity in breast cancer mortality exists among women in the United States. Triple-negative breast cancer (TNBC) is a breast cancer phenotype that may explain, in part, this disparity between white and African American women. The objective of this study was to determine the predictors of survival in TNBC and non-triple-negative breast cancer (NTNBC) patients.

Data on 168,756 female patients with a diagnosis of invasive breast cancer in the Surveillance Epidemiology and End Results (SEER) program were stratified based on breast cancer receptor phenotypes in this retrospective longitudinal cohort study design. Multiple logistic regressions were used for exploring …

Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter

Social Work Publications

Background: Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California.

Methods: We analyzed registry data for people with non-metastasized colon cancer from Ontario (n = 2,060) and California (n = 4,574) diagnosed between 1996 and 2000 and followed to 2010. We obtained census tract-based socioeconomic data from population …

Examination Of Racial/Ethnic Disparities In Ovarian Cancer Stage Of Diagnosis, Surgery Treatment And Survival: Multilevel Analysis Of 2001-2012 Seer Data, Chen Chen

Electronic Theses and Dissertations

Context. Racial/ethnic disparities in cancer outcomes are major public health concerns. Ovarian cancer is the tenth most common cancer and the fifth leading cause of cancer-related deaths among women. Identifying individual- and contextual-level factors contributing to racial/ethnic disparities in ovarian cancer stage of diagnosis, surgery treatment and survival is necessary for reducing and eliminating these disparities.

Objective. The study aims to examine racial/ethnic disparities in ovarian cancer diagnosis, surgery treatment and survival outcomes; to explore individual- and contextual-level factors contributing to these disparities, and to examine the trend of ovarian cancer racial/ethnic disparities from 2001 to 2012.

Methods. The …

Determinants Of Head And Neck Cancer Survival In Nevada For 1995-2008, Xiao Q. Li

UNLV Theses, Dissertations, Professional Papers, and Capstones

Head and neck cancer (HNC), also known as oral cavity and pharyngeal cancer, comprises a group of cancers that arise in the head or neck region, such as the nasal cavity, sinuses, lips, mouth, salivary glands, and pharynx. Use of tobacco, alcohol, or a combination of the two, are major risk factors for head and neck cancer. Approximately 75% of oral cancers are attributable to smoking and/or alcohol consumption. More recently, the human papilloma virus (HPV) has also been associated with the development of head and neck cancer.

The objective of the present study is to investigate head and neck …

Examining Stage At Diagnosis And Survival In Three Cancers With Definitive Screening Guidelines For Average-Risk Adults: The Role Of Marital Status, David J. Blackley

Electronic Theses and Dissertations

Each year there are more than 350 000 new cases and nearly 100 000 deaths attributed to colorectal, female breast, and cervical cancer in the United States. Screening tests can reduce morbidity and mortality associated with these cancers. Patient marital status has been associated with health outcomes, but no study has focused on the relationship of marriage with disease stage and survival for the 3 cancers with established screening guidance. It is critical to identify special populations that may be at risk for poor cancer outcomes.

The objective of this study was to examine the relationship of marital status with …

Breast Cancer Care In Canada And The United States: Ecological Comparisons Of Extremely Impoverished And Affluent Urban Neighborhoods, Kevin M. Gorey

Social Work Publications

This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian …

Meta-Analysis: Racial Disparities In Prostate Cancer Survival And Case-Control Study: Association Between Family History Of Cancers, Obesity And Prostate Cancer, Gayathri Sridhar

Theses and Dissertations

This is a compilation of 3 abstracts for the three manuscripts included in this dissertation. I. Meta-Analysis: Racial Disparities in Prostate Cancer Survival: Prostate cancer is the second leading cause of cancer-related mortality in men. Previous studies have drawn inconsistent conclusions on racial differences in prostate cancer survival. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of published articles from 1968 to 2007 assessing survival from prostate cancer among African American and White men was conducted. The search yielded 20 eligible published manuscripts. Analysis of unadjusted studies showed African American …

Life Expectancy And Years Of Life Lost In Chronic Obstructive Pulmonary Disease: Findings From The Nhanes Iii Follow-Up Study, Robert M. Shavelle, David R. Paculdo, Scott J. Kush, David M. Mannino, David J. Strauss

David M. Mannino

Rationale

Previous studies have demonstrated that chronic obstructive pulmonary disease (COPD) causes increased mortality in the general population. But life expectancy and the years of life lost have not been reported.

Objectives

To quantify mortality, examine how it varies with age, sex, and other risk factors, and determine how life expectancy is affected.

Methods

We constructed mortality models using the Third National Health and Nutrition Examination Survey, adjusting for age, sex, race, and major medical conditions. We used these to compute life expectancy and the years of life lost.

Measurements and main results

Pulmonary function testing classified patients as having …