Cancer survivorship research & care最新文献

{"title":"Urban greenspace and cardiovascular disease comorbidity at breast cancer diagnosis in the US: Regional, racial/ethnic, and socioeconomic variations among older women.","authors":"Jean C Bikomeye, Emily L McGinley, Yuhong Zhou, Sergey Tarima, Jamila L Kwarteng, Andreas M Beyer, Tina W F Yen, Aaron N Winn, Kirsten M M Beyer","doi":"10.1080/28352610.2025.2494564","DOIUrl":"10.1080/28352610.2025.2494564","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between urban residential greenspace and cardiovascular disease (CVD) comorbidity at breast cancer (BC) diagnosis among older women, and explore regional, racial/ethnic, and socioeconomic differences.</p><p><strong>Study design: </strong>This is a cross-sectional analysis of a population-based registry data.</p><p><strong>Methods: </strong>Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, data on women aged 66-90 diagnosed with BC (2010-2017) were analyzed. A tract-level measure of tree canopy cover was derived from the National Landcover Database (2011) and linked to SEER-Medicare records. Logistic regression models assessed the probability of CVD comorbidity based on state-specific percent tree canopy quartiles, adjusting for census tract clustering and covariates.</p><p><strong>Results: </strong>Out of 116,660 women, 74.7% (n=87,152) had CVD comorbidity at BC diagnosis. Overall, women residing in areas with higher percent tree canopy cover had a lower likelihood of CVD comorbidity compared to those in the lowest canopy areas, with an Adjusted Odds Ratio (AOR) and 95% confidence interval (CI) of 0.78 (0.71-0.85). Racial/ethnic, socioeconomic status (SES), and regional variations were noted. Adjusted effects of greenspace were significant only for NHW women; AOR (95%CI) = 0.78 (0.71-0.86). Women in the highest tree canopy quartile in California, New Jersey, and New Mexico had lower odds of comorbid CVD, with AORs (95% CI) of 0.80 (0.72-0.88), 0.77 (0.71-0.84), and 0.46 (0.34-0.63) respectively. Adjusted results for New York, Massachusetts, and Kentucky showed adverse harmful effects, while adjusted results for all other SEER states were not statistically significant. Both dual enrollment eligible and non-eligible women had benefits from greenspace, but greater benefits were observed in dual enrollment eligible women; AOR (95% CI)= 0.64 (0.48-0.86) versus 0.76 (0.69-0.84) for non-eligible women.</p><p><strong>Conclusions: </strong>Overall, urban greenspace is associated with a lower risk of CVD comorbidity among older women with BC, and variations exist by region, race/ethnicity, and SES. Our findings underscore the role of greenspace in mitigating Cardio-Oncology disparities. Further research is needed to better understand factors contributing to observed differences across SEER regions and racial/ethnic subgroups. A better understanding of interactions among greenspace, other environmental factors, and individual lifestyle factors will help improve CVD outcomes among women with BC.</p>","PeriodicalId":510903,"journal":{"name":"Cancer survivorship research & care","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Delaying and Forgoing Care Due to Cost among Long-term, Appalachian Cancer Survivors in Rural North Carolina.","authors":"Derek S Falk, Janet A Tooze, Karen M Winkfield, Ronny A Bell, Sarah A Birken, Bonny B Morris, Carla Strom, Emily Copus, Kelsey Shore, Kathryn E Weaver","doi":"10.1080/28352610.2023.2270401","DOIUrl":"10.1080/28352610.2023.2270401","url":null,"abstract":"<p><strong>Background: </strong>Little research exists on delayed and forgone health and mental health care due to cost among rural cancer survivors.</p><p><strong>Methods: </strong>We surveyed survivors in 7 primarily rural, Appalachian counties February to May 2020. Univariable analyses examined the distribution and prevalence of delayed/forgone care due to cost in the past year by independent variables. Chi-square or Fisher's tests examined bivariable differences. Logistic regressions assessed the odds of delayed/forgone care due to cost.</p><p><strong>Results: </strong>Respondents (n=428), aged 68.6 years on average (SD: 12.0), were 96.3% non-Hispanic white and 49.8% female; 25.0% reported delayed/forgone care due to cost. The response rate was 18.5%. The proportion of delayed/forgone care for those aged 18-64 years was 46.7% and 15.0% for those aged 65+ years (P<0.0001). Females aged 65+ years (OR: 2.00; CI: 1.02-3.93) had double the odds of delayed/forgone care due to cost compared to males aged 65+ years.</p><p><strong>Conclusion: </strong>About one in four rural cancer survivors reported delayed/forgone care due to cost, with rates approaching 50% in survivors aged <65 years.</p><p><strong>Impact: </strong>Clinical implications indicate the need to: 1) ask about the impact of care costs, and 2) provide supportive services to mitigate effects of treatment costs, particularly for younger and female survivors.</p>","PeriodicalId":510903,"journal":{"name":"Cancer survivorship research & care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10766413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}