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Author: Leah Marcotte Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
Breast cancer screening disparities among Black women have been recognized for decades yet persist. Health systems interested in implementing tailored interventions to improve breast cancer screening disparities must first understand local determinants. Econometrics methods can be employed to evaluate the contribution of factors to the mean difference in outcomes between two groups. We conducted a cross-sectional analysis including 20,147 individuals who identified as white (n=18,749) or Black (n=1,398) race and were eligible for breast cancer screening within a large academic health system. We evaluated predisposing characteristics (age, previous screening, use of patient portal, number of office visits, smoking status, medical conditions) and enabling resources at insurance and provider (primary care provider (PCP) specialty and training, PCP clinical full time equivalent, clinic location) levels. We conducted logistic regression analyses and a Blinder-Oaxaca (BO) decomposition to evaluate determinants in breast cancer screening disparities. Black and white individuals differed on several factors; those who were Black were younger (mean age 61.5 ± 6.0 years vs. 63.2 ± 6.5 years, standardized mean difference (SMD)= -0.26), had less patient portal use (63.8% vs. 90.4%, SMD=0.67), higher rates of diabetes (29.8% vs. 11.8%, SMD= 0.45), higher rates of tobacco use (13.8% vs. 6.7%, SMD= 0.24), more Medicaid (19.0% vs. 6.2%, SMD= 0.39) insurance, and more often received primary care from a county hospital-based clinic (31.4% vs. 2.3%, SMD=0.82). Breast cancer screening was completed in 64.2% of Black individuals and 71.6% of white individuals (average marginal effect (AME) -0.07, 95% CI -0.10 to -0.05, p
Author: Leah Marcotte Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
Breast cancer screening disparities among Black women have been recognized for decades yet persist. Health systems interested in implementing tailored interventions to improve breast cancer screening disparities must first understand local determinants. Econometrics methods can be employed to evaluate the contribution of factors to the mean difference in outcomes between two groups. We conducted a cross-sectional analysis including 20,147 individuals who identified as white (n=18,749) or Black (n=1,398) race and were eligible for breast cancer screening within a large academic health system. We evaluated predisposing characteristics (age, previous screening, use of patient portal, number of office visits, smoking status, medical conditions) and enabling resources at insurance and provider (primary care provider (PCP) specialty and training, PCP clinical full time equivalent, clinic location) levels. We conducted logistic regression analyses and a Blinder-Oaxaca (BO) decomposition to evaluate determinants in breast cancer screening disparities. Black and white individuals differed on several factors; those who were Black were younger (mean age 61.5 ± 6.0 years vs. 63.2 ± 6.5 years, standardized mean difference (SMD)= -0.26), had less patient portal use (63.8% vs. 90.4%, SMD=0.67), higher rates of diabetes (29.8% vs. 11.8%, SMD= 0.45), higher rates of tobacco use (13.8% vs. 6.7%, SMD= 0.24), more Medicaid (19.0% vs. 6.2%, SMD= 0.39) insurance, and more often received primary care from a county hospital-based clinic (31.4% vs. 2.3%, SMD=0.82). Breast cancer screening was completed in 64.2% of Black individuals and 71.6% of white individuals (average marginal effect (AME) -0.07, 95% CI -0.10 to -0.05, p
Author: Publisher: ISBN: Category : Languages : en Pages : 138
Book Description
Breast cancer is one of the most common cancers among women in the United States (U.S. CSWG, 2009). Health care, screening behaviors (e.g., mammography) and late-stage disease detection account for significant differences in breast cancer morbidity and mortality among ethnically diverse women (ACS, 2007). The current study sought to identify variables that best predict women's breast cancer screening behaviors and to develop screening typologies for women in a large multiethnic sample (N = 15,130) from the California Health Interview Survey 2005 (CHIS, 2006). The study examined whether ethnicity (Hispanic, African American, Asian, and non-Hispanic white) moderated the relationship between emergent typologies and screening outcomes. Variables of interest addressed the following themes: health behaviors, women's health, cancer history, health insurance, health care utilization, mental health, as well as acculturation, racial discrimination, education, and socioeconomic status. Latent profile analysis (LPA : Lanza, Flaherty, & Collins, 2003) was employed to empirically derive and subsequently predict screening using each variable simultaneously to develop typologies of women. Post-hoc analyses using logistic regression were utilized to explain significant ethnicity by class interactions. Results revealed three substantive risk domains, Health, Stress, and Demographic, were significantly related to breast cancer screening. LPA revealed two classes, deemed Healthy and Health Risk, emerged significant for the Health domain. Health Risk class women engaged in more mammography screening, relative to Healthy class counterparts across all ethnic groups (ps
Author: National Research Council Publisher: National Academies Press ISBN: 0309170133 Category : Medical Languages : en Pages : 564
Book Description
Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
Author: Giovanna Gatti Publisher: Springer ISBN: 3319163787 Category : Medical Languages : en Pages : 91
Book Description
This book explains how telemedicine can offer solutions capable of improving the care and survival rates of cancer patients and can also help patients to live a normal life in spite of their condition. Different fields of application – community, hospital and home based – are examined, and detailed attention is paid to the use of tele-oncology in rural/extreme rural settings and in developing countries. The impact of new technologies and the opportunities afforded by the social web are both discussed. The concluding chapters consider eLearning in relation to cancer care and assess the scope for education to improve prevention. No medical condition can shatter people’s lives as cancer does today and the need to develop strategies to reduce the disease burden and improve quality of life is paramount. Readers will find this new volume in Springer’s TELe Health series to be a rich source of information on the important contribution that can be made by telemedicine in achieving these goals.
Author: Andrew Chung Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
The COVID-19 pandemic has abruptly changed the healthcare system and disrupted health care services, especially in preventive care including breast cancer screening. In this study, our objective is to utilize real-world health records data from a large research network to evaluate how the pandemic has impacted the follow-up screenings for breast cancer. We used the data obtained from the TriNetX Research Network (covering over 95 million patients in the US) and included women who received at least one breast cancer screening between the index date, January 1, 2017, and March 30, 2022. The breast cancer screening utilization rate was calculated for each month among the screening-eligible women to examine the temporal trends. We compared the rate of having a follow-up screening within 24 months since the last screening during vs. before the pandemic. A logistic regression model with generalized estimating equation was applied to assess the COVID-19 impact on follow-up screening accounting for repeated measures, which also adjusted for individual-level factors including demographics, health service access, and comorbidities. A total of 1,891,034 women eligible for breast cancers screening at the index date were included in our analysis. We observed that the monthly screening utilization rate temporarily decreased since COVID-19 pandemic from 5.5%-6.5% prior to February to 1.4% in April 2020, and rebounded to pre-pandemic rates at 5.7%-6.8% after June 2020. However, the rate of follow-up screening within 24 months since the previous screening decreased from 77.88% (95% Confidence Interval: 77.78-77.98%) in the pre-COVID to 77.41% (77.29-77.52%) during the COVID-period, with variation between demographic subpopulations. Our logistic regression analysis showed that the COVID-period significantly impacted the follow-up screening rate with an estimated Odds Ratio 0.741 (0.736-0.747). Sensitivity analysis with different model specifications showed consistent findings. The study found that subpopulations at higher risk of COVID-19 complications were also at higher risk of being lost for a follow-up during the pandemic. Furthermore, the pandemic exacerbated disparities in screening practices across the race categories, even though overall screening practices were minimally affected.
Author: National Research Council Publisher: National Academies Press ISBN: 0309264146 Category : Social Science Languages : en Pages : 421
Book Description
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
Author: Christoph I. Lee Publisher: Oxford University Press ISBN: 0190270268 Category : Medical Languages : en Pages : 545
Book Description
Breast Imaging presents a comprehensive review of the subject matter commonly encountered by practicing radiologists and radiology residents in training. This volume includes succinct overviews of breast cancer epidemiology, screening, staging, and treatment; overviews of all imaging modalities including mammography, tomosynthesis, ultrasound, and MRI; step-by-step approaches for image-guided breast interventions; and high-yield chapters organized by specific imaging finding seen on mammography, tomosynthesis, ultrasound, and MRI. Part of the Rotations in Radiology series, this book offers a guided approach to breast imaging interpretation and techniques, highlighting the nuances necessary to arrive at the best diagnosis and management. Each chapter contains a targeted discussion of an imaging finding which reviews the anatomy and physiology, distinguishing features, imaging techniques, differential diagnosis, clinical issues, key points, and further reading. Breast Imaging is a must-read for residents and practicing radiologists seeking a foundation for the essential knowledge base in breast imaging.
Author: Peter Gotzsche Publisher: CRC Press ISBN: 1000477096 Category : Medical Languages : en Pages : 271
Book Description
'This book gives plenty of examples of ad hominem attacks, intimidation, slander, threats of litigation, deception, dishonesty, lies and other violations of good scientific practice. For some years I kept a folder labeled Dishonesty in breast cancer screening on top of my filing cabinet, storing articles and letters to the editor that contained statements I knew were dishonest. Eventually I gave up on the idea of writing a paper about this collection, as the number of examples quickly exceeded what could be contained in a single article.' From the Introduction The most effective way to decrease women's risk of becoming a breast cancer patient is to avoid attending screening. Mammography screening is one of the greatest controversies in healthcare, and the extent to which some scientists have sacrificed sound scientific principles in order to arrive at politically acceptable results in their research is extraordinary. In contrast, neutral observers increasingly find that the benefit has been much oversold and that the harms are much greater than previously believed. This groundbreaking book takes an evidence-based, critical look at the scientific disputes and the information provided to women by governments and cancer charities. It also explains why mammography screening is unlikely to be effective today. All health professionals and members of the public will find these revelations disturbingly illuminating. It will radically transform the way healthcare policy makers view mammography screening in the future. 'If Peter Gotzsche did not exist, there would be a need to invent him ...It may still take time for the limitations and harms of screening to be properly acknowledged and for women to be enabled to make adequately informed decisions. When this happens, it will be almost entirely due to the intellectual rigour and determination of Peter Gotzsche.' From the Foreword by Iona Heath, President, RCGP 'If you care about breast cancer, and we all should, you must read this book. Breast cancer is complex and we cannot afford to rely on the popular media, or on information from marketing campaigns from those who are invested in screening. We need to question and to understand. The story that Peter tells matters very much.' From the Foreword by Fran Visco, President, National Breast Cancer Coalition.
Author: Aamir Ahmad Publisher: Springer Nature ISBN: 3030203018 Category : Medical Languages : en Pages : 427
Book Description
Resistance to therapies, both targeted and systemic, and metastases to distant organs are the underlying causes of breast cancer-associated mortality. The second edition of Breast Cancer Metastasis and Drug Resistance brings together some of the leading experts to comprehensively understand breast cancer: the factors that make it lethal, and current research and clinical progress. This volume covers the following core topics: basic understanding of breast cancer (statistics, epidemiology, racial disparity and heterogeneity), metastasis and drug resistance (bone metastasis, trastuzumab resistance, tamoxifen resistance and novel therapeutic targets, including non-coding RNAs, inflammatory cytokines, cancer stem cells, ubiquitin ligases, tumor microenvironment and signaling pathways such as TRAIL, JAK-STAT and mTOR) and recent developments in the field (epigenetic regulation, microRNAs-mediated regulation, novel therapies and the clinically relevant 3D models). Experts also discuss the advances in laboratory research along with their translational and clinical implications with an overarching goal to improve the diagnosis and prognosis, particularly that of breast cancer patients with advanced disease.
Author: Leah Marcotte
Author: Leah Marcotte
Author: 
Author: National Research Council
Author: Giovanna Gatti
Author: Andrew Chung
Author: 
Author: National Research Council
Author: Christoph I. Lee
Author: Peter Gotzsche
Author: Aamir Ahmad