JAMA Network Open最新文献

{"title":"AI-Augmented Electron Microscopy for Glomerular Disease Diagnosis.","authors":"Wisit Cheungpasitporn, Alton B Farris","doi":"10.1001/jamanetworkopen.2025.34997","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.34997","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2534997"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescents' Daily Race-Related Online Experiences and Mental Health Outcomes.","authors":"Brendesha M Tynes, Taylor McGee, Devin English","doi":"10.1001/jamanetworkopen.2025.36870","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.36870","url":null,"abstract":"<p><strong>Importance: </strong>Despite the rise in exposure to both positive and negative race-related experiences online, research on how these experiences are associated with mental health outcomes is limited.</p><p><strong>Objective: </strong>To examine the associations between negative online race-related experiences (online racial discrimination, traumatic events online, and algorithmic and filter bias), positive racial socialization messages, and mental health outcomes (depressive and anxiety symptoms).</p><p><strong>Design, setting, and participants: </strong>This survey study examined data from a nationally representative, intensive longitudinal 7-day daily dairy, collected as part of the National Survey of Critical Digital Literacy. Surveys were administered daily, with a 24-hour response window, in December 2020. Participants included Black or Black biracial or multiracial (parent-identified) adolescents. Participants were part of a larger nationally representative sample of 1138 adolescents, aged 11 to 19 years of various racial and ethnic backgrounds, recruited through Ipsos' KnowledgePanel. One eligible adolescent per household was randomly selected to participate. Analyses were conducted in August 2021 and revised in July 2025.</p><p><strong>Main outcomes and measures: </strong>To examine the daily associations between online race-related experiences and mental health outcomes, dynamic structural equation models were estimated for the longitudinal data.</p><p><strong>Results: </strong>Results were drawn from survey responses of 141 Black and Black biracial or multiracial adolescents (mean [SD] age, 14.74 [2.51] years; 80 [56.7%] female). Adolescents reported a total of 6 online race-related experiences per day, including 3.2 that are considered online racism and 2.8 that are positive. The study found experiences of online racial discrimination (γ = 0.12; 95% credible interval [CrI], 0.01-0.21), algorithmic bias (γ = 0.11; 95% CrI, 0.02-0.19), and traumatic events online (γ = 0.10; 95% CrI, 0.01-0.19) were positively associated with next day anxiety symptoms. Online racial discrimination (γ = 0.20; 95% CrI, 0.01-0.33]), traumatic events online (γ = 0.10; 95% CI, 0.04-0.15), and algorithmic bias (γ = 0.13; 95% CrI, 0.03-0.22) were positively associated with next-day depressive symptoms. Positive racial socialization experiences were not associated with mental health outcomes.</p><p><strong>Conclusions and relevance: </strong>In this survey study of online race-related experiences, Black adolescents, on average, reported experiencing 6 per day. Negative experiences were associated with poor mental health. Because young people can experience algorithms almost constantly, this study suggests more research is needed on related daily mental health outcomes.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2536870"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiles in Nonverbal Learning Disability, Academic Skills, and Psychiatric Diagnoses in Children.","authors":"Amy E Margolis, Jacob DeRosa, Minji Kang, Prudence W Fisher, Lauren Thomas, Caroline Southwick, Jessica Broitman, John M Davis, Aki Nikolaidis, Michael P Milham","doi":"10.1001/jamanetworkopen.2025.33848","DOIUrl":"10.1001/jamanetworkopen.2025.33848","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Nonverbal learning disability (NVLD) has been described since the 1960s, with varying subtypes proposed to address clinical heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify profiles of NVLD to improve clinical practice and increase rigor in research by parsing clinical heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This cross-sectional study used data from the Healthy Brain Network (HBN; release 8, years 2017 and 2021), a study of brain development and youth mental health that enrolls a community sample of New York, New York, children and adolescents (ages 5-21 years), to identify youths who met the research-defined criteria for NVLD. HBN recruits for desire to participate in research or perceived clinical concern, yielding a high proportion of youths with behavioral, learning, or emotional problems. An unsupervised clustering approach, Louvain community detection, was applied to the diagnostic parameters that defined NVLD. Profiles were described by patterns of strengths and weaknesses across diagnostic tests and by associations with clinical symptoms. Data were analyzed between April 22 and September 27, 2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Perceived clinical concern.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The outcome of interest was NVLD profiles; hypotheses were generated prior to data analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 1640 children and adolescents with complete data in the HBN, 180 participants (110 [61%] male; 86 participants [48%] age 10-14 years; range, 6-17 years) met the research criteria for NVLD. Four profiles emerged: profile 1 (44 children) included deficits in both dimensions of visual-spatial processing (mean [SD] Wechsler Visual-Spatial Index [VSI], 96.11 [11.91]; Fluid Reasoning Index [FRI], 77.18 [7.94]), highest inattention (mean [SD], 1.23 [1.05]]; P = .001) and aggression scores (mean [SD], 65.03 [15.89]; P = .001), and lowest reading comprehension scores (mean [SD], 93.81 [10.31]; P = .001); profile 2 (37 children) included deficits in VSI (mean [SD], 78.27 [13.55]) but not FRI, the highest math scores (mean [SD], 101.16 [17.57]; P = .001) and rate of anxiety disorder (odds ratio, 2.19; 95% CI, 1.31-3.66; P = .02), and the lowest rate of specific learning disorder (odds ratio, 0.20; 95% CI, 0.05-0.84; P = .01); profile 3 (35 children) included deficits in FRI (mean [SD], 88.6 [12.63]) and highest reading comprehension scores (mean [SD], 101.8 [14.12]; P &lt; .001); profile 4 had no deficits in VSI or FRI, lowest verbal intelligence (mean [SD], 87.12 [13.07]; P = .001), and no functional impairments. In profiles with visual-spatial deficits (profiles 1, 2, and 3), VSI and FRI scores were positively associated with scores on measures of functional impairment, eg, FRI and math in profile 2 (Pearson r = .33; P &lt; .001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this cross-sectional study of heterogeneity in NVLD, 3 profiles ","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2533848"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errors in Abstract and Methods.","authors":"","doi":"10.1001/jamanetworkopen.2025.42056","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.42056","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2542056"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of HPV Self-Testing Options for Cervical Cancer Screening.","authors":"Richard T Meenan, Catherine Lacey, Diana S M Buist, Jasmin A Tiro, John Lin, Melissa L Anderson, Beverly B Green, Rachel L Winer","doi":"10.1001/jamanetworkopen.2025.34960","DOIUrl":"10.1001/jamanetworkopen.2025.34960","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Mailing human papillomavirus (HPV) self-sampling kits to underscreened individuals increases cervical cancer screening and can be cost-effective. However, cost-effectiveness has not been evaluated across other screening histories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To conduct an economic evaluation of mailed HPV self-sampling among members of a US health care system with adherent, overdue, or unknown screening histories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This economic evaluation was a cost-effectiveness analysis (CEA) and budget impact analysis (BIA) based on results of a randomized clinical trial (RCT) conducted between November 20, 2020, to July 29, 2022, in an integrated health care system in Washington State. Intervention delivery costs were calculated from Kaiser Permanente Washington and Medicare perspectives and used wellness-based or screening-only visit costs. Participants included female members aged 30 to 64 years identified through electronic medical records. Data were analyzed from August 1, 2022, to July 29, 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Members were randomized by screening history. Adherent participants were assigned to 4 groups: usual care (UC), patient reminders, clinician electronic health record [HER] alerts), education (UC and mailed educational materials), direct mail (UC, education, and mailed self-sampling kit), or opt-in (UC, education, and mailed invitation to request kit). Overdue participants were assigned to 3 groups: UC, education, or direct mail. Participants with unknown adherence were assigned to UC, education, or opt-in.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome and measures: &lt;/strong&gt;Primary RCT outcome was screening completion 6 months postrandomization. CEA outcome was incremental cost-effectiveness ratio for screening completion. BIA outcome was annual program implementation cost over 4 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Analyses included 31 355 individuals (mean [SD] age, 45.9 [10.4] years). Among screening adherent members, direct mail dominated all other strategies (more effective and cost-saving). Among overdue members, direct mail was also more effective than UC and generated an additional completed screen at a cost ranging from -$19 (95% CI, -$21 to -$16) (cost saving) to $63 (95% CI, $39 to $87) depending on cost basis and visit type. Among unknown members, opt-in generally dominated UC (more effective and cost-saving). The BIA indicated that although the screening adherent subgroup had the largest year 1 program budget, its budget declined fastest and, by year 4, was lowest among the 3 subgroups. Conversely, the smallest annual budget decreases were among eligible individuals with unknown history.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this economic analysis of a randomized clinical trial, directly mailing HPV kits to individuals who were screening adherent and overdue for screening was economically dominant over other strategies. P","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2534960"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing Medical Cannabis Competencies: A Consensus Statement.","authors":"Yuval Zolotov, Leslie Mendoza Temple, Richard Isralowitz, David A Gorelick, Rebecca Abraham, Donald I Abrams, Kyle Barich, Kevin F Boehnke, Stephen Dahmer, Joseph Friedman, Patricia Frye, Aviad Haramati, Jade Isaac, Mary Lynn Mathre, Marion E McNabb, Melinda Ring, Ethan B Russo, Deepika E Slawek, Brigham R Temple, Genester S Wilson-King, Julia H Arnsten, Mikhail Kogan","doi":"10.1001/jamanetworkopen.2025.35049","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.35049","url":null,"abstract":"<p><strong>Importance: </strong>The use of medical cannabis continues to expand rapidly across the US, yet most health care practitioners and trainees report feeling unprepared to counsel patients or integrate cannabis into care. Despite its clinical relevance, standardized education on medical cannabis remains absent from most medical school curricula.</p><p><strong>Objective: </strong>To develop a consensus-based set of core competencies for educating medical students about medical cannabis, including its clinical utility, risks, legal landscape, and evidence base.</p><p><strong>Evidence review: </strong>Between February and October 2023, a modified Delphi process was conducted with 23 experts representing a broad range of clinical and academic expertise. Through 2 rounds of anonymous, web-based surveys, panelists provided quantitative ratings and qualitative feedback on draft competencies. Competencies and subcompetencies were iteratively revised by the research team and re-evaluated by the panel. Final inclusion of competencies required a mean score of 4 or higher (on a 1 to 5 scale) on both importance and wording appropriateness. Subcompetencies were reviewed for comprehensiveness and educational value.</p><p><strong>Findings: </strong>The expert panel included 14 physicians across multiple specialties, along with nurses, a pharmacist, and individuals with leadership roles in academic medicine. An initial list of 9 competencies was refined and consolidated into 6 core competencies: (1) understand the basics of the endocannabinoid system; (2) describe the main components of the cannabis plant and their biological effects; (3) review the legal and regulatory landscape of cannabis in the US; (4) describe the evidence base for health conditions that are commonly managed with cannabis; (5) understand the potential risks of medical cannabis use; and (6) understand basic clinical management with medical cannabis. Each competency is supported by 2 to 7 subcompetencies, resulting in 26 subcompetencies reflecting granular topics, such as patient safety, vulnerable populations, structural inequities, and interdisciplinary care.</p><p><strong>Conclusions and relevance: </strong>These consensus-derived competencies provide a structured, evidence-informed foundation to guide the integration of medical cannabis into undergraduate medical education. Aligned with competency-based education principles, the implementation of the proposed framework can help ensure that future clinicians are equipped to provide informed, evidence-based, and patient-centered guidance on medical cannabis use.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2535049"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Early Motor Screening and Detection of Motor Difficulties.","authors":"Emily J Meachon","doi":"10.1001/jamanetworkopen.2025.36233","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.36233","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2536233"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncertain Risk of Parkinson Disease Among People With Restless Leg Syndrome.","authors":"Mark S Baron","doi":"10.1001/jamanetworkopen.2025.35766","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.35766","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2535766"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of AI in Identification of Sexually Transmitted Infections and Anogenital Dermatoses: A Systematic Review and Meta-Analysis.","authors":"Nyi Nyi Soe, Ingsun Isika Kusnandar, Phyu Mon Latt, Christopher K Fairley, Eric P F Chow, Ismael Maatouk, Cheryl C Johnson, Purvi Shah, Remco P H Peters, Lorenzo Subissi, Lei Zhang, Jason J Ong","doi":"10.1001/jamanetworkopen.2025.33512","DOIUrl":"10.1001/jamanetworkopen.2025.33512","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Artificial intelligence (AI) excels in dermatology. However, its applications to sexually transmitted infections (STIs) remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the performance of AI algorithms and their applications in detecting STIs and anogenital dermatoses from clinical images in sexual health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;Six databases (IEEE Xplore, Embase, Scopus, Medline, Web of Science, and CINAHL) were searched for studies published from January 1, 2010, to April 12, 2024, using 3 main concepts: artificial intelligence, diagnosis, and sexually transmitted infections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection: &lt;/strong&gt;Studies that used AI to identify anogenital skin conditions from clinical images were included. Studies that used non-AI approaches or nonanogenital conditions, as well as reviews and studies lacking performance metrics, were excluded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data extraction and synthesis: &lt;/strong&gt;Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2 reviewers independently assessed full-text articles and extracted data using a standardized spreadsheet. Another 2 reviewers resolved any disagreements. A modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) critical appraisal tool and the Checklist for Evaluation of Image-Based AI Reports in Dermatology (CLEAR Derm) were used for quality assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Pooled sensitivity and specificity of AI applications for detecting anogenital skin conditions. A bivariate random-effects meta-analysis was conducted for conditions with more than 3 studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 5381 studies screened and 258 full texts selected, 140 met the inclusion criteria. Most studies reported on mpox (110 [78.6%]), while other anogenital conditions, including genital herpes (7 [5.0%]), genital warts (8 [5.7%]), scabies (8 [5.7%]), and molluscum contagiosum (6 [4.3%]), received less attention. Meta-analyses showed high performance of AI for identification of mpox (pooled sensitivity: 0.96 [95% CI, 0.93-0.97]; pooled specificity: 0.98 [95% CI, 0.97-0.99]), herpes simplex (sensitivity: 0.91 [95% CI, 0.71-0.98]; specificity: 0.97 [95% CI, 0.94-0.98]), genital warts (sensitivity: 0.87 [95% CI, 0.67-0.96]; specificity: 0.98 [95% CI, 0.95-0.99]), psoriasis (sensitivity: 0.90 [95% CI, 0.78-0.95]; specificity: 0.98 [95% CI, 0.96-0.99]), and scabies (sensitivity: 0.89 [95% CI, 0.84-0.93]; specificity: 0.98 [95% CI, 0.95-0.99]). Study quality was variable, and the assessment identified high risk of bias across the population selection (76.1%), reference standards (76.1%), and index tests (20.0%). Most studies relied on open-source datasets (121 [86.4%]); only 17 (12.1%) used external validation. All but 1 study (0.7%) remained at the proof-of-concept stage, and models were not publicly available for external evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and re","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2533512"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Federal Housing Assistance and Stage at Cancer Diagnosis Among Older Adults in the US.","authors":"Craig Evan Pollack, Amanda L Blackford, Taylor K Craig, Qinjin Fan, S M Qasim Hussaini, Katherine L Chen, Daniel Polsky, Margaret Katana Ogongo, Joan L Warren, Cary P Gross, K Robin Yabroff","doi":"10.1001/jamanetworkopen.2025.36281","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.36281","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;A growing number of older adults live in unaffordable and unstable housing; however, whether programs designed to counter housing insecurity contribute to earlier-stage cancer diagnosis remains largely unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine the association between the receipt of federal housing assistance, which limits household spending on rent and utilities, and cancer stage at diagnosis among older adults in the US.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This comparative cohort study used the Surveillance, Epidemiology, and End Results cancer registry program and Medicare database linked with data from the US Department of Housing and Urban Development (HUD). Participants were individuals aged 66 to 95 years who received new diagnoses of breast cancer, colorectal cancer, non-small cell lung cancer (NSCLC), or prostate cancer between 2007 and 2019. Data were acquired in 2023, and the data analysis was performed from June 2023 through March 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Receipt of federal housing assistance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was stage at cancer diagnosis, defined as in situ (for breast cancer only), localized, regional, or distant. Odds ratios (ORs) for the association between having HUD assistance at diagnosis and cancer stage at diagnosis were estimated using multinomial (nonproportional odds) regression. Individuals with HUD assistance were propensity score matched to individuals without housing assistance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 52 532 individuals (mean [SD] age at diagnosis, 76.3 [6.8] years; 33 608 women [64.0%]) with housing assistance at diagnosis were included: 16 064 had breast cancer, 10 807 had colorectal cancer, 17 156 had NCSLC, and 8505 had prostate cancer; 38 183 (72.7%) were enrolled in Medicaid, and 38 539 (73.4%) had Part D low-income cost sharing. Compared with matched controls, fewer individuals with housing assistance received a diagnosis of distant breast cancer (1071 patients [6.7%] vs 3485 patients [7.2%]; adjusted OR [aOR], 0.85; 95% CI, 0.82- 0.90), distant colorectal cancer (2398 patients [22.2%] vs 7562 patients [23.3%]; aOR, 0.90; 95% CI, 0.83-0.98), and distant NSCLC (8810 patients [51.4%] vs 27 901 patients [54.2%]; aOR, 0.83; 95% CI, 0.79-0.86) compared with localized cancers. Housing assistance was not significantly associated with stage at diagnosis for individuals with prostate cancer. The association between housing assistance and stage at cancer diagnosis varied across the different types of housing assistance, including the Housing Choice voucher program, multifamily housing, and public housing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The findings of this cohort study of older adults with cancer suggest that federal housing assistance was associated with earlier-stage diagnosis of breast cancer, colorectal cancer, and NSCLC, highlighting its potential","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2536281"},"PeriodicalIF":9.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}