Navigation Links
Risk of death after cancer diagnosis; shift in stage of breast cancer diagnosis
Date:6/22/2008

EMBARGOED UNTIL 12:01 AM ET MONDAY JUNE 23, 2008

LOW SOCIOECONOMIC STATUS INCREASES RISK OF DEATH AFTER CANCER DIAGNOSIS

Cancer patients with low socioeconomic status (SES) have more advanced cancers at diagnosis, receive less aggressive treatment, and have a higher risk of dying in the five years following cancer diagnosis, according to a new study. The study, which will appear in the August 1, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society, supports the need to focus on SES as an underlying factor in cancer disparities by race and ethnicity.

Racial and ethnic disparities in the diagnosis and treatment of cancer and in risk of death after cancer have been documented by many studies. But the role that socioeconomic status might play, in addition to race and ethnicity, has been less well-studied

To explore the association between SES and mortality, Tim Byers, M.D. of the University of Colorado Denver and colleagues from seven states conducted the Breast, Colon, and Prostate Cancer Data Quality and Patterns of Care (POC) Study, a collaborative inquiry by seven state cancer registries within the National Program of Cancer Registries. The researchers documented compete information on cancer stage, treatment received, and 5-year mortality rates from multiple medical record sources for 13,598 cancer cases diagnosed in seven states in 1997, including 4,844 women with breast cancer, 4,332 men with prostate cancer, and 4,422 men and women with colorectal cancer. They also determined the socioeconomic status of the neighborhood of each patient by using the neighborhood-specific income and education data from the 2000 U.S. census.

Their analysis revealed that for all three types of cancers, individuals of low socioeconomic status had more advanced stages of cancer and received less aggressive treatment. For example, women of low socioeconomic status were less likely to receive radiation treatment after a lumpectomy or to receive anti-estrogen therapy when diagnosed with an estrogen receptor positive (ER+) tumor. Men with prostate cancer who were living in areas of low socioeconomic status were less likely to have been treated by prostatectomy or radiation compared to men from areas of high socioeconomic status. Chemotherapy was also less likely to be used for low socioeconomic status men and women with colorectal cancer.

For all three types of cancer, patients who lived in low SES neighborhoods were more likely to die in the five years following their cancer diagnosis than were patients in higher SES neighborhoods. A substantial proportion of this difference seemed to be due to the combined effects of this less intensive treatment and to a later stage of cancer at the time of diagnosis. While African Americans and Hispanics were more likely than non-Hispanic whites to have lived in areas of low socioeconomic status, the investigators say that the low SES factor was apparent for all racial and ethnic groups. Disparities related to socioeconomic status were not as apparent among patients aged 65 and older, perhaps because nearly everyone over age 65 is provided access to cancer screening and treatment via Medicare, regardless of their socioeconomic status.

"These findings support the need to focus on socioeconomic status as an important underlying factor in cancer disparities by race and ethnicity," the authors concluded. "We need better information on how access to health care contributes to differences in cancer outcomes by socioeconomic status in order to address the root causes of racial and ethnic cancer disparities in the United States," they added.

Article: "The impact of socioeconomic status on survival after cancer in the United States: Findings from the National Program of Cancer Registries Patterns of Care Study." Tim Byers, Holly J. Wolf, Katrina R. Bauer, Susan Bolick-Aldrich, Vivien W. Chen, Jack L. Finch, John P. Fulton, Maria J. Schymura, Tiefu Shen, Scott Van Heest, and Xiang Yin. CANCER; Published Online: June 23, 2008 (DOI: 10.002/cncr.23567); Print Issue Date: August 1, 2008.

Contact: Lynn Gorham, University of Colorado Comprehensive Cancer Center, 303-724-3160 or lynn.gorham@uchsc.edu.

EMBARGOED UNTIL 12:01 AM ET MONDAY, JUNE 23, 2008

OUTREACH INITIATIVES LEAD TO SHIFT IN STAGE OF BREAST CANCER DIAGNOSIS IN AFRICAN AMERICAN WOMEN

A new study indicates that community education outreach and internal navigation programs lead to a significant shift in stage at diagnosis of breast cancer among African American women, with a doubling in the proportion of cases caught at the earliest stage and a nearly reciprocal drop in the proportion of cancers at most advanced stage. The research suggests that initiatives aimed at raising awareness and utilization of breast cancer screening may improve breast cancer survival rates for African American women, who have a higher risk of death from the disease compared to whites. The study is published in the August 1, 2008 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

A disproportionate number of deaths from breast cancer occur in African American women, a disparity attributed to later stage of disease at diagnosis and diagnosis at an earlier age. Treatment differences may also contribute to the higher risk of mortality.

To assess the effectiveness of outreach programs on breast cancer stage among African American women, Sheryl Gabram, M.D., an Emory University surgical oncologist and director of the AVON Comprehensive Breast Center at the Georgia Cancer Center for Excellence at Grady Memorial Hospital in Atlanta, reported on a program implemented in 2001 with two components: Community Health Advocacy and Patient Navigation. The Community Health Advocacy component includes public educational programs that encourage mammography screening, teach the importance of breast self exams, and instruct individuals to see a trained healthcare provider. The Patient Navigation component involves breast cancer survivors who communicate directly with all patients who have been diagnosed with breast cancer in the AVON Breast Center. Patient Navigators (PNs) encourage patients to follow-up with recommended medical care and access needed resources such as finances, transportation, and support services.

Between 2001 and 2004, the program conducted a total of 1,148 community interventions for more than 10,000 participants. During that same time period, a total of 487 patients were identified, diagnosed, and treated for breast cancer at the AVON Comprehensive Breast Center (89 percent African American, 5 percent Caucasian, 2 percent Hispanic, and 4 percent other race/ethnicity). Dr. Gabram and her team found that there was a doubling in the proportion of Stage 0 non-invasive breast cancers (from 12.4 percent to 25.8 percent) over the study period, while the proportion of women diagnosed with Stage IV invasive breast cancers dropped from 16.8 percent to 9.4 percent.

"This reciprocal deviation of Stage 0 versus Stage IV cancers has implications on prognosis, and ultimately outcome for these women if recommended treatment guidelines are followed," the authors wrote. They, along with leadership from Emory University's Rollins School of Public Health team, are currently conducting studies to see if the Patient Navigation program successfully influences patients to accept treatment recommendations and to adhere to appointments after they are diagnosed with breast cancer. (Research has revealed that many patients with breast cancer refuse or do not receive appropriate therapy.)

The authors concluded that programs with Community Health Advocates (CHAs) who encourage mammography screening and stress the importance of early diagnosis should be jointly emphasized with the efforts of the Patient Navigators (PNs) who encourage acceptance of and adherence to treatment standards.

Article: "Effects of an outreach and internal navigation program on breast cancer diagnosis in an urban cancer center with a large African-American population." Sheryl G.A. Gabram, Mary Jo B. Lund, Jessica Gardner, Nadjo Hatchett, Harvey L. Bumpers, Joel Okoli, Monica Rizzo, Barbara J Johnson, Gina B Kirkpatrick, and Otis W. Brawley. CANCER; Published Online: June 23, 2008 (DOI: 10.002/cncr.23568); Print Issue Date: August 1, 2008.

Contact: Vincent Dollard, Emory University Winship Cancer Institute, vdollar@emory.edu or 404-778-4580


'/>"/>

Contact: Claire Greenwell
claire.greenwell@cancer.org
404-417-5883
American Cancer Society
Source:Eurekalert

Related medicine news :

1. A Cluster of Veterans Deaths; By Fred A. Baughman Jr., MD
2. Worldwide War Deaths Underestimated
3. Crop Workers Have Highest Heat-Related Death Rate
4. Failure to Take Seizure Drugs Boosts Death Risk
5. People With Lower Incomes, Lower Education Levels Have Higher Death Rates After Experiencing Heart Attack
6. People with lower incomes, lower education levels have higher death rates
7. Tim Russerts Death Provides Important Opportunity for News Media to Increase Public Awareness of How to Prevent Sudden Cardiac Arrest
8. Tim Russerts Sudden Cardiac Death May Have Been Preventable
9. Abortion drugs off-label use may have led to deaths
10. Pharmaceutical study: Less hemorrhaging after stroke, but not fewer deaths
11. Researchers Update Risk-of-Death Charts
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2017)... Abilene, Texas (PRWEB) , ... May 26, 2017 , ... ... released a new publication this week that is focusing on the Peace Agreements being ... begun his Middle East sprint in a race to try to speed up peace ...
(Date:5/26/2017)... ... 26, 2017 , ... Silver Birch of Hammond, a new assisted lifestyle community, ... four acres of land at 5620 Sohl Avenue in Hammond, serves older adults who ... 125 studio and one-bedroom apartments. Each of the private apartments at Silver Birch features ...
(Date:5/26/2017)... (PRWEB) , ... May 26, 2017 , ... Rob Lowe ... An upcoming production of the series is on hiking in American. Viewers can reconnect ... of the great benefits of hiking. , Many consumers have looked for an inventive ...
(Date:5/26/2017)... , ... May 26, 2017 , ... Dr. Alex Rabinovich, ... to announce a new, informational blog post on insurance options. If a Bay Area ... plans may help save time and money. Visiting an in-network provider for a second ...
(Date:5/26/2017)... ... 2017 , ... “When the Stars Lead Home”: a poignant story of loss, ... Laura Weigel Douglas, an avid reader who lives in the Pacific Northwest with her ... Green Hills Adventure Camp. She couldn’t be more grateful. , Twelve-year old Tizzy could ...
Breaking Medicine News(10 mins):
(Date:5/26/2017)... , May 25, 2017  In response to ... , Direct Relief is working with Pfizer to ... available at no cost to community health centers, free ... providers nationwide. "Pfizer has a long-standing ... medicines and ensuring patient safety through educational activities," said ...
(Date:5/24/2017)... 24, 2017  ivWatch LLC today announced the ... Board to enable seamless integration of ivWatch,s groundbreaking ... infusion pumps and other devices. By integrating ivWatch ... to help health care customers deliver a higher ... to IV therapy. "The ivWatch OEM ...
(Date:5/23/2017)... PLEASANTON, Calif. , May 23, 2017 /PRNewswire/ ... world,s most innovative medical devices for pressure ulcer ... at the American Association of Critical Care Nurses, ... Houston May 22-25. The Leaf Patient ... designed specifically for the hospital environment.  The system ...
Breaking Medicine Technology: