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School of Public Health Faculty Publications

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Travel Time To Treating Facility And Mortality In Men With Prostate Cancer, Stephan M. Korn, Filippo Dagnino, Danesha Daniels, Zhiyu Qian, Hanna Zurl, Klara K. Pohl, Mei Chin Hsieh, Brenda Y. Hernandez, Andrea Piccolini, Alexander P. Cole, Amanda J. Reich, Joel S. Weissman, Quoc Dien Trinh, Hari S. Iyer Dec 2025

Travel Time To Treating Facility And Mortality In Men With Prostate Cancer, Stephan M. Korn, Filippo Dagnino, Danesha Daniels, Zhiyu Qian, Hanna Zurl, Klara K. Pohl, Mei Chin Hsieh, Brenda Y. Hernandez, Andrea Piccolini, Alexander P. Cole, Amanda J. Reich, Joel S. Weissman, Quoc Dien Trinh, Hari S. Iyer

School of Public Health Faculty Publications

IMPORTANCE Geographic access to prostate cancer care may influence outcomes but is often measured using straight-line distance, which may not accurately capture the travel burden experienced by patients. OBJECTIVE To evaluate the association between estimated travel time from patients’ residence to treatment facilities and all-cause and prostate cancer–specific mortality. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the Multilevel Epidemiologic Tumor Registry for Oncology, a nationally representative, investigatorinitiated, population-based cancer registry that integrates geomasked residential and treatment facility information from multiple US state cancer registries. The study included patients aged 40 to 99 years from Hawaii, Louisiana, …

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Mediation Analysis To Investigate Differences In Prostate Cancer Diagnosis Stage Through Environmental Risk Factors In Louisiana, Nubaira Rizvi, Randy Hamilton, Xiao-Cheng Wu, Michael D. Celestin, Tung-Sung Tseng, Qingzhao Yu Jul 2025

Mediation Analysis To Investigate Differences In Prostate Cancer Diagnosis Stage Through Environmental Risk Factors In Louisiana, Nubaira Rizvi, Randy Hamilton, Xiao-Cheng Wu, Michael D. Celestin, Tung-Sung Tseng, Qingzhao Yu

School of Public Health Faculty Publications

Prostate Cancer (PCa) is the most commonly diagnosed cancer and the second leading cause of cancer death among men. In Louisiana (LA), Black men are disproportionately diagnosed at later stages compared to White men. This study explores environmental risk factors as potential intermediate variables linking race to cancer diagnosis stage. The Louisiana Tumor Registry data included 24,647 male patients diagnosed with PCa in LA between 2010 and 2018. Among them, 15,875 (64.40%) were Caucasian American (CA) and 8772 (35.59%) African American (AA). Mediation analysis using multiple additive regression trees (MART) identified possible intermediate variables that potentially explain the observed disparity. …

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Evaluating Algorithmic Bias On Biomarker Classification Of Breast Cancer Pathology Reports, Jordan Tschida, Mayanka Chandrashekar, Alina Peluso, Zachary Fox, Patrycja Krawczuk, Dakota Murdock, Xiao-Cheng Wu, John Gounley, Heidi A. Hanson May 2025

Evaluating Algorithmic Bias On Biomarker Classification Of Breast Cancer Pathology Reports, Jordan Tschida, Mayanka Chandrashekar, Alina Peluso, Zachary Fox, Patrycja Krawczuk, Dakota Murdock, Xiao-Cheng Wu, John Gounley, Heidi A. Hanson

School of Public Health Faculty Publications

OBJECTIVES: This work evaluated algorithmic bias in biomarkers classification using electronic pathology reports from female breast cancer cases. Bias was assessed across 5 subgroups: cancer registry, race, Hispanic ethnicity, age at diagnosis, and socioeconomic status. MATERIALS AND METHODS: We utilized 594 875 electronic pathology reports from 178 121 tumors diagnosed in Kentucky, Louisiana, New Jersey, New Mexico, Seattle, and Utah to train 2 deep-learning algorithms to classify breast cancer patients using their biomarkers test results. We used balanced error rate (BER), demographic parity (DP), equalized odds (EOD), and equal opportunity (EOP) to assess bias. RESULTS: We found differences in predictive …

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Fatigue Level Associated With Quality Of Life For Prostate Cancer Patients: Results From The All Of Us Research Program, Hui-Yi Lin, Masuma Mannan, Yu-Wen Chiu, Ya-Hsin Li, Rajasree P. Chowdry, Tung-Sung Tseng Apr 2025

Fatigue Level Associated With Quality Of Life For Prostate Cancer Patients: Results From The All Of Us Research Program, Hui-Yi Lin, Masuma Mannan, Yu-Wen Chiu, Ya-Hsin Li, Rajasree P. Chowdry, Tung-Sung Tseng

School of Public Health Faculty Publications

BACKGROUND/OBJECTIVES: Prostate cancer (PCa) patients frequently experience extended survivorship, highlighting the importance of quality of life (QoL) in cancer care. QoL has been shown to influence survival and PCa progression. For PCa patients, fatigue is a common issue due to cancer itself or its treatments. However, many QoL studies on PCa patients are limited by small sample sizes in clinic settings and often overlook the impact of fatigue and health-related behaviors. To fill this gap, this study aims to evaluate fatigue associated with QoL and related health measures among PCa patients. METHODS: This study used the All of Us cohort …

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Multi-Level Factors Associated With Low Dose Computed Tomography Lung Cancer Screening In The United States, Tung Sung Tseng, Chien Ching Li, Hui Yi Lin, Kelsey N. Witmeier, Chaoyi Zeng, Yu Wen Chiu, Michael D. Celestin, Edward J. Trapido Jan 2025

Multi-Level Factors Associated With Low Dose Computed Tomography Lung Cancer Screening In The United States, Tung Sung Tseng, Chien Ching Li, Hui Yi Lin, Kelsey N. Witmeier, Chaoyi Zeng, Yu Wen Chiu, Michael D. Celestin, Edward J. Trapido

School of Public Health Faculty Publications

Low-dose computed tomography (LDCT) screening is recommended for high-risk smokers to decrease lung cancer-related mortality and increase prognosis. In the U.S., the uptake of LDCT screening among eligible smokers is suboptimal. The impacts of social-environmental and individual factors on LDCT screening uptake using nationally representative dataset recommendations are understudied. The current study investigated multi-level factors associated with LDCT screening using national data. Methods: The 2017-2021 Behavioral Risk Factor Surveillance System (BRFSS) data, social determinants of health (SDOH) and other state-level variables (Medicaid expansion status and the number of screening facilities using American Lung Association (ALA) 's State of Lung Cancer) …

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Patient-Reported Functional Outcomes And Treatment-Related Regret In Hispanic And Spanish-Speaking Men Following Prostate Cancer Treatment, Andrea A. Lopez, Bashir Al Awamlh, Li-Ching Huang, Zhiguo Zhao, Tatsuki Koyama, Karen E. Hoffman, Christopher J. Wallis, Kerri Cavanaugh, Ruchika Talwar, Alicia K. Morgans, Michael Goodman, Ann S. Hamilton, Xiao-Cheng Wu, Jie Li, Brock B. O'Neil, David F. Penson, Daniel A. Barocas Dec 2024

Patient-Reported Functional Outcomes And Treatment-Related Regret In Hispanic And Spanish-Speaking Men Following Prostate Cancer Treatment, Andrea A. Lopez, Bashir Al Awamlh, Li-Ching Huang, Zhiguo Zhao, Tatsuki Koyama, Karen E. Hoffman, Christopher J. Wallis, Kerri Cavanaugh, Ruchika Talwar, Alicia K. Morgans, Michael Goodman, Ann S. Hamilton, Xiao-Cheng Wu, Jie Li, Brock B. O'Neil, David F. Penson, Daniel A. Barocas

School of Public Health Faculty Publications

OBJECTIVES: Compare functional outcomes and treatment-related regret over 10 years in Spanish- and English-speaking Hispanic men compared to non-Hispanic men following treatment of localized prostate cancer. METHODS AND MATERIALS: Data from a prospective cohort study of men with localized prostate cancer treated with active surveillance, radical prostatectomy or radiotherapy were used to examine the effect of survey language (Spanish speaking vs. English speaking) and ethnicity (Hispanic vs. non-Hispanic) on functional outcomes and treatment-related regret over 10 years. Outcomes were measured using validated questionaries adjusting for baseline patient and disease characteristics. RESULTS: A total of 770 men were included, 12% were …

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Development Of Message Passing-Based Graph Convolutional Networks For Classifying Cancer Pathology Reports, Hong Jun Yoon, Hilda B. Klasky, Andrew E Blanchard, J. Blair Christian, Eric B Durbin, Xiao Cheng Wu, Antoinette Stroup, Jennifer Doherty, Linda Coyle, Lynne Penberthy, Georgia D Tourassi Sep 2024

Development Of Message Passing-Based Graph Convolutional Networks For Classifying Cancer Pathology Reports, Hong Jun Yoon, Hilda B. Klasky, Andrew E Blanchard, J. Blair Christian, Eric B Durbin, Xiao Cheng Wu, Antoinette Stroup, Jennifer Doherty, Linda Coyle, Lynne Penberthy, Georgia D Tourassi

School of Public Health Faculty Publications

Background: Applying graph convolutional networks (GCN) to the classification of free-form natural language texts leveraged by graph-of-words features (TextGCN) was studied and confirmed to be an effective means of describing complex natural language texts. However, the text classification models based on the TextGCN possess weaknesses in terms of memory consumption and model dissemination and distribution. In this paper, we present a fast message passing network (FastMPN), implementing a GCN with message passing architecture that provides versatility and flexibility by allowing trainable node embedding and edge weights, helping the GCN model find the better solution. We applied the FastMPN model to …

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Deep Learning Uncertainty Quantification For Clinical Text Classification, Alina Peluso, Ioana Danciu, Hong-Jun Yoon, Jamaludin Mohd Yusof, Tanmoy Bhattacharya, Adam Spannaus, Noah Schaefferkoetter, Eric B. Durbin, Xiao-Cheng Wu, Antoinette Stroup, Jennifer Doherty, Stephen Schwartz, Charles Wiggins, Linda Coyle, Lynne Penberthy, Georgia D. Tourassi, Shang Gao Dec 2023

Deep Learning Uncertainty Quantification For Clinical Text Classification, Alina Peluso, Ioana Danciu, Hong-Jun Yoon, Jamaludin Mohd Yusof, Tanmoy Bhattacharya, Adam Spannaus, Noah Schaefferkoetter, Eric B. Durbin, Xiao-Cheng Wu, Antoinette Stroup, Jennifer Doherty, Stephen Schwartz, Charles Wiggins, Linda Coyle, Lynne Penberthy, Georgia D. Tourassi, Shang Gao

School of Public Health Faculty Publications

INTRODUCTION: Machine learning algorithms are expected to work side-by-side with humans in decision-making pipelines. Thus, the ability of classifiers to make reliable decisions is of paramount importance. Deep neural networks (DNNs) represent the state-of-the-art models to address real-world classification. Although the strength of activation in DNNs is often correlated with the network's confidence, in-depth analyses are needed to establish whether they are well calibrated. METHOD: In this paper, we demonstrate the use of DNN-based classification tools to benefit cancer registries by automating information extraction of disease at diagnosis and at surgery from electronic text pathology reports from the US National …

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Impact On The Volume Of Pathology Reports Before And During The Covid-19 Pandemic In Seer Cancer Registries, Amina Chtourou, Pamela V. Sanchez, Todd Golden, Huann Sheng Chen, Stephen M. Schwartz, Xiao Cheng Wu, Brenda Y. Hernandez, Jovanka N. Harrison, Lynne Penberthy, Serban Negoita Nov 2023

Impact On The Volume Of Pathology Reports Before And During The Covid-19 Pandemic In Seer Cancer Registries, Amina Chtourou, Pamela V. Sanchez, Todd Golden, Huann Sheng Chen, Stephen M. Schwartz, Xiao Cheng Wu, Brenda Y. Hernandez, Jovanka N. Harrison, Lynne Penberthy, Serban Negoita

School of Public Health Faculty Publications

Introduction: Health care procedures including cancer screening and diagnosis were interrupted due to the COVID-19 pandemic. The extent of this impact on cancer care in the United States is not fully understood. We investigated pathology report volume as a reflection of trends in oncology services pre-pandemic and during the pandemic. Methods: Electronic pathology reports were obtained from 11 U.S. central cancer registries from NCI’s SEER Program. The reports were sorted by cancer site and document type using a validated algorithm. Joinpoint regression was used to model temporal trends from January 2018 to February 2020, project expected counts from March 2020 …

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Screening For Lung Cancer: 2023 Guideline Update From The American Cancer Society, Andrew M. D. Wolf, Kevin C. Oeffinger, Tina Ya-Chen Shih, Louise C. Walter, Timothy R. Church, Elizabeth T. H. Fontham, Elena B. Elkin, Ruth D. Etzioni, Carmen E. Guerra, Rebecca B. Perkins, Karli K. Kondo, Tyler B. Kratzer, Deanna Manassaram-Baptiste, William L. Dahut, Robert A. Smith Nov 2023

Screening For Lung Cancer: 2023 Guideline Update From The American Cancer Society, Andrew M. D. Wolf, Kevin C. Oeffinger, Tina Ya-Chen Shih, Louise C. Walter, Timothy R. Church, Elizabeth T. H. Fontham, Elena B. Elkin, Ruth D. Etzioni, Carmen E. Guerra, Rebecca B. Perkins, Karli K. Kondo, Tyler B. Kratzer, Deanna Manassaram-Baptiste, William L. Dahut, Robert A. Smith

School of Public Health Faculty Publications

Lung cancer is the leading cause of mortality and person-years of life lost from cancer among US men and women. Early detection has been shown to be associated with reduced lung cancer mortality. Our objective was to update the American Cancer Society (ACS) 2013 lung cancer screening (LCS) guideline for adults at high risk for lung cancer. The guideline is intended to provide guidance for screening to health care providers and their patients who are at high risk for lung cancer due to a history of smoking. The ACS Guideline Development Group (GDG) utilized a systematic review of the LCS …

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Interactions Of Snps In Folate Metabolism Related Genes On Prostate Cancer Aggressiveness In European Americans And African Americans, Hui Yi Lin, Susan E. Steck, Indrani Sarkar, Elizabeth T.H. Fontham, Alan Diekman, Lora J. Rogers, Calvin T. Ratliff, Jeannette T. Bensen, James L. Mohler, L. Joseph Su Mar 2023

Interactions Of Snps In Folate Metabolism Related Genes On Prostate Cancer Aggressiveness In European Americans And African Americans, Hui Yi Lin, Susan E. Steck, Indrani Sarkar, Elizabeth T.H. Fontham, Alan Diekman, Lora J. Rogers, Calvin T. Ratliff, Jeannette T. Bensen, James L. Mohler, L. Joseph Su

School of Public Health Faculty Publications

Background: Studies showed that folate and related single nucleotide polymorphisms (SNPs) could predict prostate cancer (PCa) risk. However, little is known about the interactions of folate-related SNPs associated with PCa aggressiveness. The study’s objective is to evaluate SNP–SNP interactions among the DHFR 19-bp polymorphism and 10 SNPs in folate metabolism and the one-carbon metabolism pathway associated with PCa aggressiveness. Methods: We evaluated 1294 PCa patients, including 690 European Americans (EAs) and 604 African Americans (AAs). Both individual SNP effects and pairwise SNP–SNP interactions were analyzed. Results: None of the 11 individual polymorphisms were significant for EAs and AAs. Three SNP–SNP …

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Quitting Smoking After A Cancer Diagnosis Is Associated With High-Risk Neutrophil-To-Lymphocyte Ratio Among Tobacco Use-Related Cancer Survivors, You Lu, Katherine Kwong, James Wells, Andrea Edwards, Zhong Chen, Tung-Sung Tseng, Kun Zhang Feb 2023

Quitting Smoking After A Cancer Diagnosis Is Associated With High-Risk Neutrophil-To-Lymphocyte Ratio Among Tobacco Use-Related Cancer Survivors, You Lu, Katherine Kwong, James Wells, Andrea Edwards, Zhong Chen, Tung-Sung Tseng, Kun Zhang

School of Public Health Faculty Publications

Quitting smoking could potentially minimize the risk of a high neutrophil-to-lymphocyte ratio (NLR) among tobacco use-related (TUR) cancer survivors. A total of 1263 TUR cancer survivors aged 20 to 85 years old were investigated using data from the National Health and Nutritional Examination Survey 1999-2018. The primary outcome was the NLR, which was defined as having two levels: high-risk (≥ 3) and low-risk (< 3). The association between smoking cessation time and a high-risk NLR level was analyzed using weighted logistic regression models. Overall, the current smoking rate of TUR cancer survivors was found to be 21.7%. Older age (75 years above), gender and respiratory-related cancers are covariables associated with high risk of NLR levels for individual who identified as Non-Hispanic White (NHW). Non-Hispanic Black (NHB) (n = 27) who quit smoking after a cancer diagnosis were associated with the highest risk of a high NLR (OR 4.83, 95% CI 1.40-16.61, p = 0.01) compared to NHB nonsmokers (n = 139). These findings suggest that the risk of a high NLR level is strongly associated with the time of smoking cessation in NHB TUR cancer survivors. As a result, NHB TUR cancer survivors should quit smoking as soon as possible because the benefits of quitting smoking were observed over the 5 year period following smoking cessation.

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Prostate Cancer Aggressiveness And Financial Toxicity Among Prostate Cancer Patients, Madhav Kc, Evrim Oral, Ariane L. Rung, Edward Trapido, Laura S. Rozek, Elizabeth T.H. Fontham, Jeannette T. Bensen, Laura Farnan, Susan E. Steck, Lixin Song, James L. Mohler, Saira Khan, Sanah Vohra, Edward S. Peters Jan 2023

Prostate Cancer Aggressiveness And Financial Toxicity Among Prostate Cancer Patients, Madhav Kc, Evrim Oral, Ariane L. Rung, Edward Trapido, Laura S. Rozek, Elizabeth T.H. Fontham, Jeannette T. Bensen, Laura Farnan, Susan E. Steck, Lixin Song, James L. Mohler, Saira Khan, Sanah Vohra, Edward S. Peters

School of Public Health Faculty Publications

Introduction: Financial toxicity (FT) is a growing concern among cancer survivors that adversely affects the quality of life and survival. Individuals diagnosed with aggressive cancers are often at a greater risk of experiencing FT. The objectives of this study were to estimate FT among prostate cancer (PCa) survivors after 10−15 years of diagnosis, assess the relationship between PCa aggressiveness at diagnosis and FT, and examine whether current cancer treatment status mediates the relationship between PCa aggressiveness and FT. Methods: PCa patients enrolled in the North Carolina-Louisiana Prostate Cancer Project (PCaP) were recontacted for long-term follow-up. The prevalence of FT in …

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Distance To Radiation Therapy Facility Influences Surgery Type Among Older Women With Early-Stage Breast Cancer, Pratibha Shrestha, Quyen D. Chu, Mei Chin Hsieh, Yong Yi, Edward S. Peters, Edward Trapido, Qingzhao Yu, Tekeda Ferguson, Xiao-Cheng Wu Dec 2022

Distance To Radiation Therapy Facility Influences Surgery Type Among Older Women With Early-Stage Breast Cancer, Pratibha Shrestha, Quyen D. Chu, Mei Chin Hsieh, Yong Yi, Edward S. Peters, Edward Trapido, Qingzhao Yu, Tekeda Ferguson, Xiao-Cheng Wu

School of Public Health Faculty Publications

Background: Breast-conserving surgery plus radiation (BCT) yields equivalent or better survival than mastectomy for early-stage breast cancer (ESBC) women. However, nationwide mastectomy trends increased in recent decades, attracting studies on underlying causes. Prior research identified that long distance to the radiation treatment facility (RTF) was associated with mastectomy. Still, it is unclear whether such association applies to young and old ESBC women comparably. We sought to delineate such impacts by age. Methods: Women diagnosed with stages 0–II breast cancer in 2013–2017 receiving either BCT or mastectomy were identified from the Louisiana Tumor Registry. We assessed the association of surgery (mastectomy …

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Trends In The Incidence Of Early-Onset Colorectal Adenocarcinoma Among Black And White Us Residents Aged 40 To 49 Years, 2000-2017., Eric M Montminy, Meijiao Zhou, Lauren Maniscalco, Harrison Penrose, Timothy Yen, Swati G Patel, Xiao-Cheng Wu, Jordan J Karlitz Nov 2021

Trends In The Incidence Of Early-Onset Colorectal Adenocarcinoma Among Black And White Us Residents Aged 40 To 49 Years, 2000-2017., Eric M Montminy, Meijiao Zhou, Lauren Maniscalco, Harrison Penrose, Timothy Yen, Swati G Patel, Xiao-Cheng Wu, Jordan J Karlitz

School of Public Health Faculty Publications

Key Points: Question: What are the trends in early-onset colorectal cancer incidence rates when people aged 40 to 49 years are assessed specifically and stratification by race, sex, and adenocarcinoma histology (the target of screening and prevention) is performed? Findings: In this cross-sectional study of 45 429 individuals aged 40 to 49 years with colorectal adenocarcinoma from 2000 to 2017, beginning in 2014, overall colorectal adenocarcinoma incidence rates were the same in Black and White populations, and rectal adenocarcinoma rates were 39.3% lower in Black individuals compared with White individuals with a widening disparity in rectal cancer between Black women …

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