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  • 1
    In: European Journal of Epidemiology, Springer Science and Business Media LLC, Vol. 36, No. 1 ( 2021-01), p. 37-55
    Abstract: Associations between anthropometric factors and breast cancer (BC) risk have varied inconsistently by estrogen and/or progesterone receptor (ER/PR) status. Associations between prediagnostic anthropometric factors and risk of premenopausal and postmenopausal BC overall and ER/PR status subtypes were investigated in a pooled analysis of 20 prospective cohorts, including 36,297 BC cases among 1,061,915 women, using multivariable Cox regression analyses, controlling for reproductive factors, diet and other risk factors. We estimated dose–response relationships and tested for nonlinear associations using restricted cubic splines. Height showed positive, linear associations for premenopausal and postmenopausal BC risk (6–7% RR increase per 5 cm increment), with stronger associations for receptor-positive subtypes. Body mass index (BMI) at cohort baseline was strongly inversely associated with premenopausal BC risk, and strongly positively—and nonlinearly—associated with postmenopausal BC (especially among women who never used hormone replacement therapy). This was primarily observed for receptor-positive subtypes. Early adult BMI (at 18–20 years) showed inverse, linear associations for premenopausal and postmenopausal BC risk (21% and 11% RR decrease per 5 kg/m 2 , respectively) with stronger associations for receptor-negative subtypes. Adult weight gain since 18–20 years was positively associated with postmenopausal BC risk, stronger for receptor-positive subtypes, and among women who were leaner in early adulthood. Women heavier in early adulthood generally had reduced premenopausal BC risk, independent of later weight gain. Positive associations between height, baseline (adult) BMI, adult weight gain and postmenopausal BC risk were substantially stronger for hormone receptor-positive versus negative subtypes. Premenopausal BC risk was positively associated with height, but inversely with baseline BMI and weight gain (mostly in receptor-positive subtypes). Inverse associations with early adult BMI seemed stronger in receptor-negative subtypes of premenopausal and postmenopausal BC.
    Type of Medium: Online Resource
    ISSN: 0393-2990 , 1573-7284
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 2
    In: Systematic Reviews, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2021-12)
    Abstract: Disparities in the stage at diagnosis of endometrial cancer (EC) account for a significant proportion of the disparities in morbidity and mortality experienced by vulnerable groups in the USA. Evidence suggests that disparities in timeliness of care and treatment play a significant role in stage at diagnosis. Despite an increase in literature on EC disparities, the issue remains largely unchanged. The objectives of this review will be to synthesize the evidence to identify important remaining research questions and inform future interventions to reduce the disparity in stage at diagnosis of EC in the USA. Methods This scoping review protocol will use the five-step framework developed by Arksey and O’Malley. A literature search will be conducted from January 2000 onwards in PubMed, EMBASE, Scopus, and Cochrane CENTRAL databases. Studies on delays in care of EC will be included if they were published in English and reported findings for the US population. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality and bias will be appraised using appropriate tools. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods. The literature search, data extraction, and evidence synthesis will be informed by the Pathway to Treatment Model, which divides time to cancer care initiation into appraisal, help-seeking, diagnostic, and pre-treatment intervals. Results will be reported in accordance with the PRISMA statement. Discussion EC disparities research is currently benefitting form a growing expectation that studies have a real impact on disparities. Patient, healthcare, and disease factors impact the amount of time patients spend in different intervals of the Pathway to Treatment Model, so research and interventions aimed at reducing disparities in EC survival should be designed with cognizance to how these factors impact their target population. Reviews on disparities in stage at diagnosis of EC exist but do not provide a comprehensive picture of the pathway to treatment. This review will seek to provide an expanded bedrock of evidence for future studies to build on as they aim to more actively reduce EC disparities. Trial registration Open Science Framework ( osf.io/v2zxy ).
    Type of Medium: Online Resource
    ISSN: 2046-4053
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2662257-9
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  • 3
    In: SSRN Electronic Journal, Elsevier BV
    Type of Medium: Online Resource
    ISSN: 1556-5068
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
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  • 4
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2022
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 31, No. 2 ( 2022-02-01), p. 413-421
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 31, No. 2 ( 2022-02-01), p. 413-421
    Abstract: Our objective was to determine the association between racialized economic segregation and the hazard of breast cancer mortality in Maryland. Methods: Among 35,066 women (24,540 White; 10,526 Black) diagnosed with incident invasive breast cancer in Maryland during 2007 to 2017, exposure to racialized economic segregation was measured at the census tract level using Index of Concentration at the Extremes metrics. HRs and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression for the association between racialized economic segregation and the hazard of breast cancer mortality, accounting for clustering at the census tract level. Models were adjusted for age and stratified by race, median age ( & lt;60 years, ≥60 years), and clinical characteristics. Results: Overall, the hazard of breast cancer mortality was 1.84 times as high (95% CI, 1.64–2.06) for the least privileged quintile of racialized economic segregation compared with the most privileged quintile. This association differed significantly (Pinteraction & lt; 0.05) by race and age, with 1.20 (95% CI, 0.90–1.60) times the hazard of breast cancer mortality for Black women versus 1.66 (95% CI, 1.41–1.95) times the hazard for White women, and with greater hazards for younger women (HR, 2.17; 95% CI, 1.83–2.57) than older women (HR, 1.62; 95% CI, 1.40–1.88). Conclusions: Our results suggest that breast cancer survival disparities exist in Maryland among women residing in the least privileged census tracts with lower income households and higher proportions of Black residents. Impact: Our findings provide new insights into the breast cancer mortality disparities observed among women in Maryland.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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  • 5
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2023
    In:  Cancer Research Vol. 83, No. 7_Supplement ( 2023-04-04), p. 749-749
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 7_Supplement ( 2023-04-04), p. 749-749
    Abstract: Our study examined the associations between breast cancer tumor characteristics and self-reported survivorship care experiences stratified by multimorbidity among older female breast cancer survivors in the United States. Utilizing the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program and the Centers for Medicare and Medicaid Services’ Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data linkage from 2000-2019. Breast cancer (BC) survivors (N=19,017) were aged ≥65 years at CAHPS survey who completed a survey after diagnosis of primary site invasive BC. Adjusted multivariable linear regression models were used to estimate beta (β) and standard error (SE) coefficients of the relationships between tumor characteristics (extent of disease: localized, regional, distant; estrogen receptor [ER] status: ER+, ER-, missing/unknown) and several CAHPS composite and rating outcomes, overall and stratified by multimorbidity (BC only, 2-5 chronic conditions, ≥6 chronic conditions). Women were on average 76.3 years (SD=7.14) of age at survey and 4.65 years (SD=3.51) since BC diagnosis. Most survivors were non-Hispanic white (78.1%), had ≥6 chronic conditions (38.1%), were diagnosed with localized BC (80.5%) and/or ER+ tumors (56.9%). Survivors with regional BC at diagnosis reported significantly higher mean scores on Getting Needed Care (β=1.00, SE=0.46, p=0.03), and with distant BC reported significantly lower mean scores on Physician Communication (β=-1.92, SE=0.92, p=0.03) compared to those with localized BC. When stratified by multimorbidity, survivors with distant stage compared to localized, and with 2-5 chronic conditions reported significantly higher mean scores for Getting Needed Care (β=3.85, SE=1.96, p=0.04), while this association was inverse and not statistically significant (β=-2.72, SE=1.87, p=0.14) among survivors with BC only (p-interaction=0.01). While the overall associations between ER status and the CAHPS outcomes were not statistically significant, we observed significant statistical interactions by multimorbidity for the following association: among survivors with BC only, survivors with ER- tumors reported lower Health Plan Ratings (β=-1.89, SE=0.73, p=0.009) compared to survivors with ER+ tumors, while this association was positive however, marginally statistically significant (β=1.63, SE=0.86, p=0.05) among survivors with ≥6 conditions (p-interaction=0.002). BC survivors who are diagnosed with advanced stage and aggressive tumor phenotypes, such as ER- BC, experience different survivorship care experiences when they are also managing multiple chronic conditions. Remarkably, our results demonstrate that women with distant stage breast cancer and multimorbidity reported higher score on getting the care they need. Citation Format: Kate E. Dibble, Zhengyi Deng, Avonne E. Connor. The impact of multimorbidity on the relationship between breast cancer tumor characteristics and survivorship care experiences among older women: A SEER-CAHPS analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 749.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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    detail.hit.zdb_id: 410466-3
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  • 6
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2023
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 32, No. 1_Supplement ( 2023-01-01), p. C116-C116
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 32, No. 1_Supplement ( 2023-01-01), p. C116-C116
    Abstract: Purpose: We aimed to outline the extent of racial/ethnic disparities in perceived quality of cancer survivorship care among older breast cancer survivors in the United States. Methods: We utilized the National Cancer Institute’s Surveillance, Epidemiology, and End Results program (SEER) and the Center for Medicare and Medicaid Services Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data linkage from 2000-2019. 19,017 female breast cancer survivors aged ≥65 years at survey with a prior diagnosis of primary invasive breast cancer were included. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression to determine the relationship between race/ethnicity (non-Hispanic white [NHW; referent], non-Hispanic Black [NHB] , non-Hispanic Asian [NHA], Hispanic) and perceived quality of survivorship care (excellent in Getting Care Quickly, Getting Needed Care, Physician Communication, Getting Needed Prescription Drugs, and Overall Care, Health Plan, and Physician ratings), and usually/always having Enough Time with Physician, overall and by perceived general health status (excellent/very good, good, fair/poor). Results: Most survivors were NHW (78.1%) while the minority were NHB (8.1%), NHA (6.5%), or Hispanic (6.2%). Survivors reported an average of 76.3 years at survey (SD=7.14) and 4.65 years (SD=3.51) since diagnosis. Overall, NHB survivors were significantly less likely to report excellent for Overall Care (aOR, 0.80, 95% CI, 0.71-0.91) and usually/always having Enough Time with Physician (aOR, 0.74, 95% CI, 0.58-0.93) compared to NHW survivors. NHA survivors were significantly less likely to report excellent Getting Care Quickly (aOR, 0.75, 95% CI, 0.63-0.88), Getting Needed Care (aOR, 0.79, 95% CI, 0.63-0.99), Physician Communication (aOR, 0.84, 95% CI, 0.73-0.97), and Overall Care rating (aOR, 0.76, 95% CI, 0.67-0.87) compared to NHW survivors. The aORs for Hispanic survivors varied depending on outcome. When stratified by general health status, NHB compared to NHW survivors were significantly more likely (aOR, 1.30, 95% CI, 1.05-1.62) to report excellent in Getting Needed Care among those who reported good general health, but this disparity was not observed among those who reported excellent/very good general health (p-interaction=0.04). Compared to NHW survivors, NHB were significantly more likely (aOR, 1.54, 95% CI, 1.14-2.08) to report excellent Health Plan ratings among those who reported excellent/very good general health but not among those who reported good (p-interaction=0.03) or fair/poor general health (p-interaction=0.01). There were no significant interactions between general health status and NHA or Hispanic group for any outcome. Conclusion: These findings can be used to inform future interventions, care, and physician education throughout breast cancer survivorship. Citation Format: Kate E. Dibble, Zhengyi Deng, Avonne E. Connor. Racial/ethnic disparities in perceived quality of breast cancer survivorship care among older women by general health status: A SEER-CAHPS study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C116.
    Type of Medium: Online Resource
    ISSN: 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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  • 7
    Online Resource
    Online Resource
    Elsevier BV ; 2023
    In:  Journal of Geriatric Oncology Vol. 14, No. 8 ( 2023-11), p. 101633-
    In: Journal of Geriatric Oncology, Elsevier BV, Vol. 14, No. 8 ( 2023-11), p. 101633-
    Type of Medium: Online Resource
    ISSN: 1879-4068
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2556813-9
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  • 8
    In: Women's Health Issues, Elsevier BV, Vol. 34, No. 1 ( 2024-01), p. 3-6
    Type of Medium: Online Resource
    ISSN: 1049-3867
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2024
    detail.hit.zdb_id: 2011979-3
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  • 9
    In: International Journal of Cancer, Wiley, Vol. 147, No. 5 ( 2020-09), p. 1306-1314
    Abstract: What's new? Body weight in childhood and early adulthood plays a key role in determining premenopausal breast cancer risk but little is conclusively known about how subsequent weight changes affect this risk. Here the authors pooled results from existing studies on weight changes and breast cancer risk including more than 600,000 premenopausal women. The results show that weight gain 〉 10–15 kg from early adulthood on lowers the risk of developing premenopausal breast cancer, providing further evidence of body weight as an important determinant of breast cancer risk.
    Type of Medium: Online Resource
    ISSN: 0020-7136 , 1097-0215
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 218257-9
    detail.hit.zdb_id: 1474822-8
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  • 10
    In: JAMA Oncology, American Medical Association (AMA), Vol. 4, No. 11 ( 2018-11-08), p. e181771-
    Type of Medium: Online Resource
    ISSN: 2374-2437
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2018
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