Cancer Causes & Control最新文献

{"title":"Disparities in lung cancer screening utilization at two health systems in the Southeastern USA.","authors":"Soumya J Niranjan, Desiree Rivers, Rekha Ramachandran, JEdward Murrell, Kayleigh C Curry, Mohammed Mubasher, Eric Flenaugh, Mark T Dransfield, Sejong Bae, Isabel C Scarinci","doi":"10.1007/s10552-024-01929-6","DOIUrl":"https://doi.org/10.1007/s10552-024-01929-6","url":null,"abstract":"<p><strong>Purpose: </strong>Low-dose computed tomography lung cancer screening is effective for reducing lung cancer mortality. It is critical to understand the lung cancer screening practices for screen-eligible individuals living in Alabama and Georgia where lung cancer is the leading cause of cancer death. High lung cancer incidence and mortality rates are attributed to high smoking rates among underserved, low income, and rural populations. Therefore, the purpose of this study is to define sociodemographic and clinical characteristics of patients who were screened for lung cancer at an Academic Medical Center (AMC) in Alabama and a Safety Net Hospital (SNH) in Georgia.</p><p><strong>Methods: </strong>A retrospective cohort study of screen-eligible patients was constructed using electronic health records between 2015 and 2020 seen at an Academic Medical Center (AMC) and a Safety Net Hospital (SNH) separately. Chi-square tests and Student t tests were used to compare screening uptake across patient demographic and clinical variables. Bivariate and multivariate logistic regressions determined significant predictors of lung cancer screening uptake.</p><p><strong>Results: </strong>At the AMC, 67,355 were identified as eligible for LCS and 1,129 were screened. In bivariate analyses, there were several differences between those who were screened and those who were not screened. Screening status in the site at Alabama-those with active tobacco use are significantly more likely to be screened than former smokers (OR: 3.208, p < 0.01). For every 10-unit increase in distance, the odds of screening decreased by about 15% (OR: 0.848, p < 0.01). For every 10-year increase in age, the odds of screening decrease by about 30% (OR: 0.704, p < 0.01). Each additional comorbidity increases the odds of screening by about 7.5% (OR: 1.075, p < 0.01). Those with both private and public insurance have much higher odds of screening compared to those with only private insurance (OR: 5.403, p < 0.01). However, those with only public insurance have lower odds of screening compared to those with private insurance (OR: 0.393, p < 0.01). At the SNH-each additional comorbidity increased the odds of screening by about 11.9% (OR: 1.119, p = 0.01). Notably, those with public insurance have significantly higher odds of being screened compared to those with private insurance (OR: 2.566, p < 0.01).</p><p><strong>Conclusion: </strong>The study provides evidence that LCS has not reached all subgroups and that additional targeted efforts are needed to increase lung cancer screening uptake. Furthermore, disparity was noticed between adults living closer to screening institutions and those who lived farther.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methylation-based immune deconvolution in prostate cancer patients before and after radical prostatectomy.","authors":"Lauren M Hurwitz, Maeve Bailey-Whyte, Michael A Daneshvar, Cathy D Vocke, Julian Custer, Bríd M Ryan, Stefan Ambs, Peter A Pinto, Emily L Rossi","doi":"10.1007/s10552-024-01924-x","DOIUrl":"https://doi.org/10.1007/s10552-024-01924-x","url":null,"abstract":"<p><strong>Purpose: </strong>Surgery, an established short-term immunosuppressive event, may spur dissemination of circulating tumor cells and promote the growth of micrometastases. Whether surgical treatment for prostate cancer (i.e., radical prostatectomy) leads to long-term immune changes is unknown.</p><p><strong>Methods: </strong>We characterized intra-individual changes in circulating immune cell subsets across a six-month period using serial blood samples from prostate cancer patients pre- and post-radical prostatectomy (n = 11), and from a comparison group managed with active surveillance (n = 8). Immune cell subsets for each patient at each time point were deconvoluted using genome-wide methylation data.</p><p><strong>Results: </strong>There were no statistically significant intra-individual changes in immune cell proportions from pre- to six months post-radical prostatectomy. There were also no intra-individual changes in immune cell proportions in the active surveillance group, and no differences between treatment groups in immune cell changes over time.</p><p><strong>Conclusion: </strong>We observed no meaningful changes in circulating immune cell subsets six months after radical prostatectomy, suggesting that surgery-induced immune changes may not be long-lasting.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant endocrine therapy and risk of contralateral breast cancer: a systematic review and meta-analysis of observational studies.","authors":"Rajrupa Ghosh, Ruth M Pfeiffer, Sylvia Roberts, Gretchen L Gierach, Cher M Dallal","doi":"10.1007/s10552-024-01900-5","DOIUrl":"https://doi.org/10.1007/s10552-024-01900-5","url":null,"abstract":"<p><strong>Purpose: </strong>Randomized clinical trials support reductions in contralateral breast cancer (CBC) risk with use of adjuvant endocrine therapy, however, real-world treatment effects, particularly for subgroups of breast cancer survivors, remain inconclusive. To address this, population-based observational studies of adjuvant endocrine therapy and CBC were synthesized and meta-analyzed.</p><p><strong>Methods: </strong>PubMed and Embase databases were systematically searched for observational studies of endocrine therapy use and CBC risk. Random effects meta-analyses estimated summary relative risks (RRs) and 95% confidence intervals (CIs) for associations between endocrine therapy (ever use of tamoxifen and/or aromatase inhibitors (AIs)) and CBC risk. Heterogeneity across studies was assessed using the I² test. Subgroup analyses were conducted by study design, menopausal status, and CBC estrogen receptor (ER)-status.</p><p><strong>Results: </strong>Seventeen eligible observational studies (n = 287,576 breast cancer survivors) published between 1995 and 2019 were included. Endocrine therapy use was associated with reduced CBC risk (RR:0.62, 95% CI:0.53, 0.73, I² = 84.8%, p < 0.0001). No heterogeneity was observed by study design (p_het = 0.9). Similar reductions were observed in analyses restricted to tamoxifen use. As only two studies assessed AI use, estimates could not be meta-analyzed. In subgroup analyses, there were no differences in CBC risk reduction by menopausal status (p_het = 0.22). Endocrine therapy reduced risk of ER-positive (RR:0.55, 95% CI:0.43, 0.70) but not ER-negative CBC (RR:1.26, 95% CI:0.95, 1.66) (p_het < 0.001).</p><p><strong>Conclusion: </strong>This meta-analysis of observational studies supports a reduction in CBC risk with endocrine therapy among breast cancer survivors, in concert with evidence synthesized from randomized clinical trials, and highlights differences in endocrine therapy effectiveness by ER-status of CBC.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity before and after cancer diagnosis and mortality risk in three large prospective cohorts.","authors":"Cami N Christopher, Paulette D Chandler, Xuehong Zhang, Deirdre K Tobias, Aditi Hazra, J Michael Gaziano, Julie E Buring, I-Min Lee, Howard D Sesso","doi":"10.1007/s10552-024-01925-w","DOIUrl":"https://doi.org/10.1007/s10552-024-01925-w","url":null,"abstract":"<p><strong>Purpose: </strong>Physical activity (PA) can improve cancer survival; however, whether the timing of PA differentially affects mortality risk is unclear. We evaluated the association between PA levels pre- and post-diagnosis and mortality risk in the Women's Health Study (WHS), Physicians' Health Study (PHS)-I, and PHS-II prospective cohorts.</p><p><strong>Methods: </strong>We categorized PA pre- and post-diagnosis as active (WHS: ≥ 7.5 metabolic equivalent (MET)-h/week; PHS: vigorous PA ≥ 2-4 times/week) or inactive. We analyzed changes in pre- and post-diagnosis PA levels as four joint categories: (1) Inactive → Inactive, (2) Active → Inactive, (3) Inactive → Active, and (4) Active → Active, on mortality risk using multivariable Cox proportional hazards regression.</p><p><strong>Results: </strong>We identified 10,541 participants with incident cancer and 3,696 deaths during follow-up. Compared to maintaining inactivity in both periods, remaining active pre- and post-diagnosis observed lower all-cause (Hazard Ratio [95% confidence interval]: WHS: 0.55 [0.47-0.64]; PHS-I: 0.77 [0.67-0.88]), cancer (WHS: 0.55 [0.45-0.67]; PHS-I: 0.75; [0.61-0.92]) and non-cancer/cardiovascular disease (CVD) mortality risks (WHS: 0.49 [0.38-0.65]). Similarly, becoming active post-diagnosis was associated with lower all-cause (WHS: 0.60 (0.48-0.75]; PHS-I: 0.72 [0.61-0.88]), cancer (WHS: 0.65 [0.49-0.86]; PHS-I: 0.64 [0.49-0.84]), and non-cancer/CVD mortality risk (WHS: 0.49 [0.33-0.75]). Being active pre- and post-diagnosis was associated with lower mortality risks in separate analyses, although significance differed by cohort and outcome.</p><p><strong>Conclusions: </strong>Remaining active pre- and post-diagnosis and becoming active post-diagnosis may be associated with improvements in cancer survival, however, research is needed across diverse cancer populations.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trial knowledge among cancer survivors in the United States: the role of health information technology.","authors":"Ted O Akhiwu, Comfort Adewunmi, Mariah Bilalaga, Joseph O Atarere, Greeshma Gaddipati, Onyema G Chido-Amajuoyi, Diamond K Eziuche, Henry Onyeaka, Hermioni L Amonoo","doi":"10.1007/s10552-024-01928-7","DOIUrl":"https://doi.org/10.1007/s10552-024-01928-7","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical trials are essential to the advancement of cancer care. However, clinical trial knowledge and participation remain critically low among adult patients with cancer. Health information technology (HIT) could play an important role in improving clinical trial knowledge and engagement among cancer survivors.</p><p><strong>Methods: </strong>We used data from 3,794 adults who completed the 2020 Health Information National Trends Survey, 626 (16.2%) of whom were cancer survivors. We examined the prevalence of HIT use in the study population and by cancer history using chi-squared tests. We used multivariable logistic regression models to examine the impact of HIT use on clinical trial knowledge for cancer survivors and respondents with no cancer history, respectively.</p><p><strong>Results: </strong>Approximately 63.8% of cancer survivors reported having some knowledge of clinical trials. Almost half of the cancer survivors used HIT to communicate with doctors (47.1%) and make health appointments (49.4%), 68.0% used HIT to look up health information online and 42.2% used it to check test results. In the adjusted models, the use of HIT in communicating with doctors [OR 2.79; 95% CI (1.41, 5.54)], looking up health information online [OR 2.84; 95% CI (1.04, 7.77)], and checking test results [OR 2.47; 95% CI (1.12, 5.43)] was associated with having some knowledge of clinical trials.</p><p><strong>Conclusion: </strong>HIT use for engaging with the healthcare team and health information gathering is associated with higher clinical trial knowledge in cancer survivors. Given the rapid increase in mobile technology access globally and the increased use of HIT, digital technology can be leveraged to improve clinical trial knowledge and engagement among cancer survivors.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of evidence on routine cervical cancer screening in South Asia: investigating factors affecting adoption and implementation.","authors":"Priyobrat Rajkhowa, Mebin Mathew, Razeena Fadra, Soumyajit Saha, K Rakshitha, Prakash Narayanan, Helmut Brand","doi":"10.1007/s10552-024-01923-y","DOIUrl":"https://doi.org/10.1007/s10552-024-01923-y","url":null,"abstract":"<p><p>NEED: Cervical cancer is a major global public health issue, particularly affecting low and middle-income countries, distinctly in the South Asian region. This geographical region lacks a well-organized routine cervical screening program. Consequently, this scoping review aimed to investigate the evidence on factors influencing the adoption and implementation of routine cervical cancer screening in South Asia.</p><p><strong>Methods: </strong>Adopting the \"Arksey and O'Malley and Levac et al.\" methodology, databases such as PubMed, CINAHL, Web of Science, and Scopus were scrutinized in the pursuit of relevant studies. Subsequently, the collected data were synthesized by adopting the Consolidated Framework for Implementation Research (CFIR) model.</p><p><strong>Results: </strong>A total of 837 records were initially identified and screened for eligibility, including 55 studies. The successful adoption and implementation of cervical cancer screening in South Asia encounter numerous obstacles within the health system, including the absence of a comprehensive program protocol for screening, inadequate health infrastructure, and the presence of multiple sociocultural factors, such as social stigma, low levels of education, and concerns related to modesty.</p><p><strong>Conclusion: </strong>To optimize adoption and implementation, it is imperative to construct a customized policy framework that incorporates a risk communication strategy tailored to the specific contexts of these nations. Drawing insights from the experiences of South Asian countries in executing cervical cancer screening programs can inform the formulation of policies for similar healthcare initiatives aimed at facilitating the expansion of HPV vaccination efforts.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and concordance of penile, anal, and oral human papillomavirus infections among sexually active heterosexual men in Ibadan, Nigeria.","authors":"Imran O Morhason-Bello, Kathy Baisley, Miquel Angel Pavon, Isaac F Adewole, Rasheed Bakare, Sikiru A Adebayo, Silvia de Sanjosé, Suzanna C Francis, Deborah Watson-Jones","doi":"10.1007/s10552-024-01920-1","DOIUrl":"10.1007/s10552-024-01920-1","url":null,"abstract":"<p><strong>Background: </strong>The data on epidemiology of Human papillomavirus (HPV) infections in men are scarce relative to women generally, particularly among men engaging in heterosexual relationships. This study investigated the prevalence and risk factors for penile, anal, and oral HPV in men in two communities in Ibadan, Nigeria.</p><p><strong>Methods: </strong>This was a cross-sectional survey involving a face-to-face interview, a clinical examination, and sample collection from participants. HPV genotyping was performed with Anyplex II 28 HPV assay. The prevalences and factors associated with HPV infections using multivariable models and concordance between sites.</p><p><strong>Results: </strong>Of 316 men, the proportion of any HPV infection in the penile, anal, and oral sites was 40.5%, 9.7%, and 7.8%, respectively. The proportion of any high-risk HPV, low-risk HPV, and multiple HPV infections was highest in the penis followed by the anal and oral sites. Only 5/316 (1.6%) men had concordant HPV in all three sites, with the highest concordance in penile-anal sites relative to penile-oral and anal-oral sites. The odds of penile HPV were higher in men aged 25 years and above. Having penile HPV was associated with higher odds of detecting anal HPV and vice versa. Oral HPV was less likely in men not living with their sexual partners.</p><p><strong>Conclusion: </strong>Penile HPV is the most common infection followed by anal HPV and oral HPV infections among heterosexual Nigerian men. Concordant HPV infections was highest in penile-anal sites. Nigerian men, as in other settings, are a reservoir of HPV and it is important to conduct more robust studies to appreciate their role in HPV transmission, epidemiology, and prevention.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-varying associations of patient and tumor characteristics with cancer survival: an analysis of SEER data across 14 cancer sites, 2004-2017.","authors":"Emily K Roberts, Lingfeng Luo, Alison M Mondul, Mousumi Banerjee, Christine M Veenstra, Angela B Mariotto, Matthew J Schipper, Kevin He, Jeremy M G Taylor, Andrew F Brouwer","doi":"10.1007/s10552-024-01888-y","DOIUrl":"10.1007/s10552-024-01888-y","url":null,"abstract":"<p><strong>Purpose: </strong>Surveillance, Epidemiology, and End Results (SEER) cancer registries provides information about survival duration and cause of death for cancer patients. Baseline demographic and tumor characteristics such as age, sex, race, year of diagnosis, and tumor stage can inform the expected survival time of patients, but their associations with survival may not be constant over the post-diagnosis period.</p><p><strong>Methods: </strong>Using SEER data, we examined if there were time-varying associations of patient and tumor characteristics on survival, and we assessed how these relationships differed across 14 cancer sites. Standard Cox proportional hazards models were extended to allow for time-varying associations and incorporated into a competing-risks framework, separately modeling cancer-specific and other-cause deaths. For each cancer site and for each of the five factors, we estimated the relative hazard ratio and absolute hazard over time in the presence of competing risks.</p><p><strong>Results: </strong>Our comprehensive consideration of patient and tumor characteristics when estimating time-varying hazards showed that the associations of age, tumor stage at diagnosis, and race/ethnicity with risk of death (cancer-specific and other-cause) change over time for many cancers; characteristics of sex and year of diagnosis exhibit some time-varying patterns as well. Stage at diagnosis had the largest associations with survival.</p><p><strong>Conclusion: </strong>These findings suggest that proportional hazards assumptions are often violated when examining patient characteristics on cancer survival post-diagnosis. We discuss several interesting results where the relative hazards are time-varying and suggest possible interpretations. Based on the time-varying associations of several important covariates on survival after cancer diagnosis using a pan-cancer approach, the likelihood of the proportional hazards assumption being met or corresponding interpretation should be considered in survival analyses, as flawed inference may have implications for cancer care and policy.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"1393-1405"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between inflammatory factors and melanoma: a bidirectional Mendelian randomization study.","authors":"Jiamin Lu, Yuqian Feng, Kaibo Guo, Leitao Sun, Kai Zhang","doi":"10.1007/s10552-024-01890-4","DOIUrl":"10.1007/s10552-024-01890-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study performed a bidirectional Mendelian randomization (MR) analysis to elucidate the causal relationships of C-reactive protein and 41 inflammatory regulators with melanoma, including data from UK Biobank, Cardiovascular Risk in Young Finns Study, and Cohorts for Inflammation Work Group.</p><p><strong>Methods: </strong>We selected the inverse variance weighting (IVW) to merge the estimated causal effects of multiple SNPs into a weighted average. To evaluate the heterogeneities of IVW, the Cochran Q statistic, and I² index were used. What's more, several sensitivity analyses were employed, including IVW, MR-Egger, weighted median, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO).</p><p><strong>Results: </strong>With SNPs reaching P < 5 × 10^-8, the analyses findings revealed that IL-16 had a significant positively association with genetically risk of melanoma (OR_IVW: 1.05; 95% CI: 1.03-1.07; P < 0.001), and high levels of MCP1 (OR_IVW: 1.13; 95% CI: 1.03-1.23; P = 0.01) were suggestively associated with melanoma susceptibility. What's more, TNF-β (OR_IVW: 1.07; 95% CI: 1.01-1.13; P = 0.02) and IL-8 (OR_IVW: 1.08, 95% CI: 1.01-1.16; P = 0.03) were demonstrated a positive association with the risk of melanoma under a less stringent cut-off (P < 5 × 10^-6). Conversely, we found a facilitative effect of melanoma susceptibility on IP-10 and inhibitory effects on IL-6, IL-1b, and GRO-α.</p><p><strong>Conclusion: </strong>The genetic evidence that we have uncovered indicates a potential association between the levels of specific inflammatory markers (IL-16, IL-8, MCP-1, and TNF-β) and the risk of melanoma. Further research is imperative to translate these findings into clinical applications.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"1333-1342"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicaid expansion in California and breast cancer incidence across neighborhoods with varying social vulnerabilities.","authors":"Lihua Li, Chen Yang, Yuanhui Huang, Serena Zhan, Liangyuan Hu, Joe Zou, Mandi Yu, Madhu Mazumdar, Bian Liu","doi":"10.1007/s10552-024-01893-1","DOIUrl":"10.1007/s10552-024-01893-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate changes in breast cancer incidence rates associated with Medicaid expansion in California.</p><p><strong>Methods: </strong>We extracted yearly census tract-level population counts and cases of breast cancer diagnosed among women aged between 20 and 64 years in California during years 2010-2017. Census tracts were classified into low, medium and high groups according to their social vulnerability index (SVI). Using a difference-in-difference (DID) approach with Poisson regression models, we estimated the incidence rate, incidence rate ratio (IRR) during the pre- (2010-2013) and post-expansion periods (2014-2017), and the relative IRR (DID estimates) across three groups of neighborhoods.</p><p><strong>Results: </strong>Prior to the Medicaid expansion, the overall incidence rate was 93.61, 122.03, and 151.12 cases per 100,000 persons among tracts with high, medium, and low-SVI, respectively; and was 96.49, 122.07, and 151.66 cases per 100,000 persons during the post-expansion period, respectively. The IRR between high and low vulnerability neighborhoods was 0.62 and 0.64 in the pre- and post-expansion period, respectively, and the relative IRR was 1.03 (95% CI 1.00 to 1.06, p = 0.026). In addition, significant DID estimate was only found for localized breast cancer (relative IRR = 1.05; 95% CI, 1.01 to 1.09, p = 0.049) between high and low-SVI neighborhoods, not for regional and distant cancer stage.</p><p><strong>Conclusions: </strong>The Medicaid expansion had differential impact on breast cancer incidence across neighborhoods in California, with the most pronounced increase found for localized cancer stage in high-SVI neighborhoods. Significant pre-post change was only found for localized breast cancer between high and low-SVI neighborhoods.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":" ","pages":"1343-1353"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}