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Liver cancer incidence and mortality: Disparities based on age, ethnicity, health and nutrition, molecular factors, and geography
Full text linkLiver cancer (LCa) is the fifth and eighth leading cause of cancer death for men and women, respectively. However, despite improvements in treatment strategies and options, it has limited therapeutic options. Worldwide, the prevalence of LCa varies widely. Various factors are associated with the development of LCa, and its incidence, morbidity, and mortality rates differ due to disparities that are multifactorial and complex, including genetic and geographic factors. The frequency of LCa varies by race/ethnicity, age and sex and relates to viral infections, lifestyle, nutrition, obesity, and health. In addition, various molecular factors, including cytokines, hormones, apoptosis, and mutations, are involved in disparities in the progression and mortality of LCa. Here, we provide an overall perspective on LCa by presenting available information on these associated factors and discussing their importance in its disproportionate incidences and clinical outcomes
Relationship between the TP53 SNP rs1800371 and Lung Cancer in African Americans
Full text linkBackground: Germline and somatic mutations in TP53 have been investigated and intensely catalogued. One of these germline mutations, TP53 P47S SNP is only found in populations with African ancestry. The S47 variant was associated with an impaired ability to induce cell death following cisplatin treatment, and with a high rate of spontaneous cancer formation in mice engineered to carry S47. Lung cancer incidence is higher among men of African descent. We therefore tested the hypothesis that P47S was associated with increased risk of lung cancer. Methods: We included 926 controls and 425 cases, all of whom were African Americans. We genotyped rs1800371 using a predesigned Taqman assay. Results: No serine/serine genotypes were detected in the population. The proline/serine genotype was detected in 42 individuals (32/891 controls (3.5%) and 10/434 cases (2.3%). The serine allele was not associated with risk of lung cancer (OR: 0.65, 95% C.I. 0.28-1.48). Conclusions: rs1800371 is not associated with risk of lung cancer among African Americans
Predictors of Prostate Cancer Risk-Reduction Behaviours Among US BLACK Males Less Than 40 Years Old
No full textProstate cancer (CaP) is the leading cause of cancer deaths among Black men and modifications in lifestyle represent an important means of primary CaP prevention in young Black men. Thus, this study aimed to explore the cognitive-behavioral and demographic factors related to prostate cancer risk-reduction behaviors (CaPB) among young Black men in Texas, United States and to examine relationships between cognitive-behavioral and demographical factors. This was a cross-sectional study of 267 Black men aged 18 to 40 years. A survey collected information on demographics, exercise, knowledge of CaP and screening, cues to action, and current engagement in CaPB. Participants were young Black males of different ethnicities and education levels recruited from local universities, churches, organization, and fraternities. Descriptive statistics (mean, Standard Deviation, and frequency) were calculated for all variables, and multiple regression was employed to determine significant (p<0.05) predictors of CaPB. Participants had a low level of knowledge (mean=5.25±3.81; range 0-14), engaged in moderate levels, duration, and intensity of exercise (mean=6.44±3.147; range 0-10), mostly reported negative cues to action (79.4%) and engaged in low levels of CaPB (mean=13.7±5.62; range 0-40). Knowledge, academic classification, major field of study, and regular source of care were significant predictors of CaP risk-reduction behaviors, and the overall model accounted for 39% (p < 0.01) of the behaviors.Attention to the four significant factors found to predictor CaP risk-reduction behaviors, especially the modifiable ones, is important to young Black men’s engagement in CaPB. The modifiable factors should be considered in the development of strategies aimed toward increasing their engagement in CaPB
Quality of Evidence on Prostate Cancer in Nigeria
Full text linkProstate cancer is the 2ndcommonest malignancy in men worldwide. It is, however, the commonest in Nigeria. While several disparities have been documented between Caucasian men and men of African descent, there is limited research on prostate cancer in Nigeria. Evidence-based medicine is a key tool in making clinical decisions and developing screening and treatment guidelines. This review was undertaken to assess the levels of evidence on prostate cancer research in Nigeria. A systematic review of all research published on prostate cancer from January 1975 to May 2018 in Nigeria was conducted. We reviewed all articles found on various databases by searching for “Prostate cancer in Nigeria”. We classified them based on their study designs into different levels of evidence as well as the year of publication. Meta-analyses were not considered in the review. A total of 171 articles were eligible for this review. Most publications were at the 4th(66%) and 5thlevels of evidence (17%) respectively. No clinical trials on prostate cancer in Nigeria was seen or registered on clinicaltrials.gov, hence no studies at level 1 (a, b or c) of evidence published in Nigeria. The commonest type of study design was cross-sectional studies accounting for 56% of all publications.Prostate cancer research is currently at low levels of evidence in Nigeria. It is pertinent to explore and increase funding channels for cancer-related research
Colorectal Adenoma Detection Rate in Northeast Texas – Outcome from Community Service Project Using the Fecal Immunochemical Test and Colonoscopy
Full text linkColorectal cancer (CRC) is the fourth most frequently diagnosed cancer in the United States. CRC incidence rates in Northeast Texas, a primarily rural region of the state, far exceed state and national averages. The current study sought to determine the proportion of polyps found in a sample of 5,391 individuals living in Northeast Texas using either colonoscopy or fecal immunochemical testing. In addition, the role of insurance to CRC screening was also investigated. An adenomatous polyp was detected in 44.7% participants in the colonoscopy group and in 2.6% of participants undergoing FIT testing. Additionally, participants in the colonoscopy group who were un- or under-insured were 30% more likely to have an adenomatous polyp detected. While a larger proportion of participants had an adenomatous polyp detected in the colonoscopy group, many including the un- or under-insured are not able to afford, at which point FIT testing may be a better option
Patterns of Cancer Related Health Disparities in Arizona
Full text linkCancer incidence rates vary regionally among American Indians (AIs) and Latinos. The goal of this was to identify areas of research necessary to reduce cancer health disparities in AIs and Latinos, the two major racial/ethnic minority groups in Arizona. In an effort to better understand cancer health disparities, cancer incidence rates in AIs and Latinos in Arizona were compared to non-Hispanic Whites (NHWs). Age-adjusted incidence rates (per 100,000) were obtained from the Arizona Cancer Registry and the North American Association of Central Cancer Registries. Spearman’s rank test was used to examine correlation between county-level cancer incidence rates and socio-demographic factors. AIs and Latinos had lower incidence rates of screening for detectable cancers than NHWs. Among older men (age ≥65), however, AIs and Latinos had similar prostate cancer incidence rates to NHWs. Some of less common cancers, such as kidney, stomach, liver, and gallbladder, were more frequently diagnosed in AIs and Latinos than NHWs. AIs and Latinos were more likely to be diagnosed with advanced cancer stage, except for cervical cancer. Correlations between prostate and breast cancer incidence rates and percent urban residents as well as population size were significantly positive. Poverty levels were inversely correlated with colorectal and lung cancer incidence rates. Our review of cancer incidence rates suggests that socio-demographic factors, such as population size (rural/urban) and poverty levels, have influenced cancer detection and incidence rates in Arizona. 
Exploring the Employment Challenges and Concerns of Minority Women Cancer Survivors
Full text linkEmployment plays an essential role in cancer survivorship. The study emerged from needs identified by community partners who voiced concerns about employment-related issues encountered by cancer survivors. Thus, the purpose of this exploratory study is to understand the experiences of minority women cancer survivors after cancer. We explore how type of occupation shapes the work-related outcomes of minority women cancer survivors. A community-based purposive sample of diverse cancer survivors (n=57) who reported working shortly before being diagnosed with cancer were administered a semi-structured questionnaire. Close-ended responses were analyzed using descriptive statistics. Open-ended responses were analyzed using applied thematic analysis techniques as well a Crisp Set Qualitative Comparative Analysis (QCA). Work-related concerns were similar across occupation types, while disparities were observed in reported job loss rates after diagnosis and employment rates after treatment. Women’s concerns related to productivity losses at work due to treatment side effects, disease management issues, fear of job loss, and economic concerns. The QCA pathway that appeared to best explain the outcome of working after treatment completion included the following components: working during treatment, having employer-based health insurance and being eligible for medical leave (perception of). This study provides relevant insights on the work experience and concerns of minority women cancer survivors, a population segment that has been frequently underrepresented in the literature on survivors’ work outcomes after cancer diagnosis and treatment
Standardized Global Behavioral and Epidemiological Measures for Prostate Cancer Studies in Black Men
Full text linkMulticenter trans-national studies may be required to understand the complex causes of and solutions to prostate cancer disparities in Black men. In 2014, two cancer epidemiology consortia supported by the US National Cancer Institute (NCI) - the Prostate Cancer Transatlantic Consortium (CaPTC), and African-Caribbean Cancer Consortium (AC3) - formed a consortia alliance to address the disproportionate burden of prostate cancer in Black men. As part of the alliance, this global study focused on developing standardized and culturally tailored data elements and measures for prostate cancer research in these populations. The study objective was achieved by a Consensus Working Group using the NCI–Grid-Enable Measures (GEM) platform. The Consensus Working Group members were assigned to three Special Interest Groups to focus on behavioral, epidemiology and clinical topics. Based on crowd-sourcing methodology, the initial standardization decisions were made by each group using GEM. This was followed using nominal group technique to build consensus. Finally, a one-day consensus development conference was held to facilitate the input of the scientific community. The use of the GEM platform, nominal group technique and a consensus development conference resulted in agreement among stakeholders for a recommended set of measures that included 25 behavioral scales and 24 epidemiological scales. The measures developed in this process will facilitate data harmonization and data sharing for multiethnic studies of Black men globally and these measures can be used by other researchers in this are
Five Years Record on Cancer Incidence from a Diagnostic Centre in Mizoram, Northeast India: Cancer trend in Mizoram
No full textCancer has become leading cause of death in Northeast Indian population. The main reason being poor knowledge of prevention and diagnosis combined with modern lifestyle of the Mizo population. All cancers have been reported in Mizo population including the cancers of stomach, cervix, lungs, breast, oesophagus, rectum, prostate, liver, bladder, oral etc. The cause of such high incidence rates of these cancers may be inherited or genetic and environmental factors such as life style and food habits, especially high consumption of tobacco and alcohol. A peculiar habit of tobacco smoke-infused water (Tuibur) is also in practice in this population. In view of these facts, the present article describes the status of various types of cancers in Mizo population. Besides, attempts have been made to describe the main causes of cancer in this population with their frequency and grading. In this study, increasing number of cancer patients in different age group was observed from 2011 – 2015. The highest incidence of cancer was observed in the patients with age group 50 - 60, followed by age groups above 60. In age group 20-30 years, the breast and cervix cancers were more prevalent, throughout all the years. In middle age group (30-40 and 40-50 years), the cervix, stomach and oesophagus cancers were more prevalent. The common type of cancer in female includes cervical cancer, followed by breast cancer which is shown to be increasing with age of the patients and also increasing each year within this 5 year period from 2011 – 2015. In 2014 and 2015, adenocarcinoma (AC) and squamous cell carcinoma (SCC) are both commonly seen. This study will help in understanding the etiology of cancer and also in developing preventive measures in future
Mammography Utilization Trends at a Safety-Net Center
Full text linkAmong uninsured and resource-poor populations, community safety net clinics are important providers of breast cancer screening services however there is little data on screening utilization patterns. Using data from a safety net screening center in Washington DC, we assessed time trends in mammography utilization by selected sociodemographic factors. Prospectively collected demographic data were abstracted from the electronic medical records of the Capital Breast Care Center (CBCC) during 2010 – 2015. Time trends of mammography utilization over the 6 years were calculated and statistical significance of the differences between trends by the selected sociodemographic factors was analyzed using the Cochran-Armitage test. 8448 Black/ African-American and Hispanic women were screened at CBCC with 106 diagnoses of breast cancer. The proportion of women <50 years of age declined over the 6- year study period. Trends in the racial/ethnic composition of the women screened shifted, with African-American women decreasing, while the proportion of Latina patients increased (p-value <0.0001). In this analysis of women presenting for breast cancer screening, over a 6- year period there were significant trends towards an older age at screening, an increase in Hispanic women being screened, and an increasing proportion residing outside the District of Columbia