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Comparative study of HPV and Cervical Cancer Knowledge and Beliefs between Mexican Immigrant Women in the US and Peruvian Women
Full text linkCervical cancer remains one of the major cancers affecting women from developing countries, especially those from socioeconomically disadvantaged backgrounds. In the US, Hispanic immigrant women experience restricted access to health care and higher incidence rates of cervical cancer compared to the non-Hispanic white population. Knowledge of cervical cancer risk factors and symptoms is associated with greater interest in participating in regular cervical cancer screening. To explore knowledge and beliefs about cervical cancer, survey questionnaires were administered to Mexican immigrant women in southeast Georgia, US and to mestizo women - primarily Quechua language dominant speakers - in Cusco, Peru. As part of these survey studies, there was a list of 32 items asking participants to agree or disagree with whether certain symptoms or risk factors could cause cervical cancer and a pile sort of 15 of the most salient items. Cultural consensus analysis was used to calculate overall agreement with a cultural model of cervical cancer risk factor knowledge in each sample independently. For the Georgia sample, there was marginal consensus, but for the Peru sample, there was no consensus. Analysis of cultural competence values and residual agreement show significant differences across education in the Georgia study, with a positive correlation between education and cultural competence (r=0.50, p=0.001), but not in the Peru study. Likewise, the results of the pile sort data exhibited consensus for the Georgia sample for the cervical cancer risk factors, but not for the Peru sample. The lack of consensus among the Peru sample on either task suggests little widespread knowledge on risk factors of cervical cancer. Additional analyses related to factors associated with screening behaviors from the cultural cancer screening scale indicated more pronounced fatalistic beliefs and catastrophic disease expectations about cervical cancer among the Peruvian women compared to the Mexican immigrant women
Risk Factors for Prostate Cancer in West African Men: The Prostate Cancer Transatlantic Consortium (CaPTC) Cohort Study
No full textProstate cancer (CaP) has been identified as the most common cancer among men globally with higher prevalence, incidence and mortality rates in black men. This study aims to assess the risk factors for CaP among West African men residing in Nigeria, Cameroun and the United States. A validated CaPTC familial cohort study questionnaire was used to collect data on the respondents’ characteristics, alcohol consumption pattern, smoking pattern, knowledge of CaP, physical activity level and cancer status. Anthropometric measurements were taken using standard procedures. Data was summarised using descriptive statistics and penalized maximum likelihood logistic regression analysis via Firth method was used to determine association between CaP status and independent variables. The results show that 2.21% reported to have been diagnosed of CaP out of which 90.91% resides in Nigeria. Median age of the respondents is 47 years, 62.21% had poor knowledge of CaP, and 17.11% had central obesity. More than half (62.07%) of the study participants currently drink alcohol, 24.4% are current smokers and 51.5% engage in low physical activity. Number of daughters (OR=1.2435, 95%CI: 1.0045, 1.5393), consistent alcohol drinkers in years (OR=1.0484, 95%CI: 1.0151, 1.0829) and glasses of drink on a typical occasion (OR=1.2145, 95%CI: 1.0560, 1.3968) were associated with CaP status. In the multiple logistic regression, only number of daughters (OR=1.2531, 95%CI: 1.0055, 1.5617) is associated with CaP status. In conclusion, poor knowledge of CaP was observed among the respondents. Alcohol consumption, increased number of glasses of alcohol consumed on typical occasion and increasing number of daughters are associated with CaP status and increased risk of the disease
Regional Disparities in Ovarian Cancer in the United States
Full text linkThe aim of this study was to investigate the association between geographic regions and ovarian cancer disparities in the United States.Data from the Surveillance, Epidemiology, and End Results (SEER) Program was used to identify women diagnosed with ovarian cancer. 18 registries were divided into two groups: South region and US14 region. Chi-Square tests were used to compare proportions, the logistic regression model to evaluate the association between 5-year survival and other variables, and the Cox proportional hazards model to estimate hazard ratios.The South region had a lower incidence rate than the US14 region (12.0 vs. 13.4 per 100,000), and a lower 5-year observed survival rate (37.5% vs. 39.8%). White women living in the US14 region had the best overall survival, compared to white women living in the South region, and black women living in both regions. Women in the South region were less likely to have insurance (6.6% vs. 2.7%, p<0.0001) and surgery (73.4% vs. 76.2%, p<0.0001). Women living in the South were 1.4 times more likely to die after five years of diagnosis than women living in the US14 region. The data confirmed regional disparities in ovarian cancer in the United States, showing women living in the South region were disadvantaged in ovarian cancer survival regardless of race, black or white. Future research focusing on the identification of contributing factors to regional disparity in ovarian cancer is necessary to develop practical approaches to improve health outcomes related to this lethal disease
Perceived Behavioral Control regarding Prostate Cancer Screening among Black Men in West Africa and the United States
Full text linkTo examine how perceived behavioral control (PBC) is affected by sociodemographic and behavioral factors, employing a socio-ecologic approach, and identify the relative importance of these factors. This was a cross-sectional, correlational study of 500 Black men from the Prostate Cancer Transatlantic Consortium (CaPTC) familial project. A survey using standardized CaPTC measures collected information on intrapersonal (e.g., age, knowledge), interpersonal (e.g., cues to action, social support), and institutional factors (e.g., informed decision) that are predictive of perceived behavioral control. Black male participants, aged between 35-70 years, were recruited from the US, Nigeria, and Cameroon. Descriptive statistics (mean, SD, and frequency) were calculated for all variables, and multiple regression was employed to determine significant (p<0.05) predictors of PBC. Data were analyzed using SPSS v24. Participants had an average age of 48±10 years, low level of knowledge (mean=10.31±3.66; range 0-20), encountered very low cues to action (mean=1.60±2.13; range 0-13), had usual levels of social support (2.41±1.24), and were mostly (96.4%) not counseled on the advantages and disadvantages of prostate cancer screening. Attitude, knowledge, informed decision, and prostate cancer information seeking behavior were significant predictors, and the overall model accounted for 49% (p < 0.01) of the variation in PBC. Using a socio-ecologic approach, multi-level factors were integrated to facilitate a fuller understanding of the several factors impacting PBC in Black men. The four significant factors (attitude, knowledge, informed decision, and prostate cancer information seeking behavior knowledge) could be considered when developing culturally-sensitive interventions aimed at engaging at-risk Black men regarding prostate cancer prevention and early detection practices
SPEECH: Synergistic Partnership for Enhancing Equity in Cancer Health
Full text linkMinority populations disproportionately bear the burden of cancers in the United States of America. The Synergistic Partnership for Enhancing Equity in Cancer Health (SPEECH) was established to focus on research, workforce development and community-based activities relevant to cancer health disparities in the Philadelphia-New Jersey-New York City (PNN) corridor. SPEECH\u27s overarching goal is to impact cancer health disparities through research and training, and by improving community health, cancer awareness, and access to good quality healthcare
Notch Signaling Pathway: An Emerging Therapeutic Target for African-American Triple Negative Breast Cancer Patients
Full text linkThe most fatal form of breast cancer, triple negative (TNBC), continues to challenge clinicians worldwide with its lack of reliable prognostic biomarkers and pharmacologically actionable treatment targets. In the US, this aggressive disease disproportionately afflicts African-American (AA) women at a rate 2-3 times higher than European-American (EA) women, thereby contributing to the observed higher mortality rates of AA BC patients. In order to address the unmet clinical need for new and effective treatments for AA TNBCs, we describe herein a potentially actionable pathway that appears to be in overdrive in TNBCs of AA patients compared to EA TNBCs: the Notch signaling pathway. Notch signaling is implicated in multiple aspects of carcinogenesis and tumor progression including in regulation of proliferation, apoptosis, the biology of cancer stem cells, tumor angiogenesis and epithelial-to-mesenchymal transition. Our gene expression analyses uncover significant upregulation of Notch signaling as well as gene ontologies reflecting dysregulation of key processes regulated by Notch signaling among AA compared to EA TNBC patients. Furthermore, we present evidence suggesting that upregulated Notch signaling may predict poor prognosis in TNBC. Our findings thus suggest differences in Notch signaling among racially-distinct TNBC patients that may contribute to the more aggressive clinical behavior of TNBC in AAs. These observations also suggest that Notch signaling may be an attractive therapeutic target for high-risk AA TNBC patients. 
Absolute and Relative Black-White Disparities in Cancer Incidence and Survival in the United States, 2000-2014
Full text linkProgress has been made in reducing the overall burden of cancer among US adults. However, racial differences persist across multiple cancer types. This report presents data on the absolute and relative inequalities in cancer incidence and survival among Blacks and Whites in the US. Data from the Surveillance Epidemiology and Ends Results database on cancer incidence and survival in 2000-2014 among patients ages 20 -85 years in the US were used to estimate absolute and relative Black-White differences in incidence and survival rates. In 2000-2008, the overall cancer incidence rate ratio (IRR) comparing Blacks versus Whites was 1.06 (95% CI: 1.06-1.06). In 2010-2014, the overall Black-White IRR was 1.03 (95% CI: 1.03-1.04). In 2000-2008, the overall 5-year relative survival rate ratio (SRR) comparing Blacks to Whites was 0.90 (95% CI: 0.90-0.90), corresponding to a survival rate of 67.8% (95% CI: 67.7-67.8) for Whites and 60.8% (95% CI: 60.7- 61.0) for Blacks. In the 2009-2014, the overall SRR comparing Blacks to Whites was 0.92 (95% CI: 0.92-0.92). In 2009-2014, the cancer site with the largest racial difference in incidence was Kaposi Sarcoma (Black vs. White RR: 3.20, 95% CI: 2.80-3.40), and for survival in 2009-2014, it was Mesothelioma (White vs. Black HR: 1.82, 95% CI: 1.38-2.20). Absolute and relative racial disparities in cancer incidence and survival persist in the US. Research is needed to understand and address the differential distribution of cancer-related risk factors and improve access to high-quality and timely cancer treatment across racial groups
Colorectal Cancer Education and Screening Program For The Un- or Under- Insured In A Primarily Rural Setting in Northeast Texas: Design and Methods
Full text linkBackground: Although early detection and screening for colorectal cancer saves lives, screening rates remain suboptimal, especially for minorities, underserved populations, older adults (>60), men, un/under insured, and those living in rural settings. The goal of the colorectal cancer education and screening program is to target the un- or under- insured in a 19-county primarily rural target area to provide: 1) education concerning CRC and CRC screening to 12,000 individuals, and 2) CRC screenings (colonoscopy and/or FIT) to 5,1613 un- or under- insured individuals. Methods: The education outreach team targets local health fairs, clinics, churches, etc. to educate individuals on CRC and the importance of screening. The program aims to then have those individuals electively undergo a colonoscopy and/or a FIT test. The number of those educated and screened is recorded. The results related to colonoscopy, FIT, and follow-up are collected. Results: Primary outcomes include number of individuals educated, number of FIT test/colonoscopies performed and results of screening procedures. Conclusions: This education and screening outreach program is designed to reach primarily rural and underserved populations eligible for colorectal screening. Results of efficacy of program will advance knowledge on how to conduct colorectal cancer outreach programs in rural settings.
 
Modifiable Risk Factors Implicated in Prostate Cancer Mortality and Morbidity Among West African Men
No full textProstate cancer is a significant public health problem affecting men globally. In 2012, it was the second most commonly diagnosed cancer among men world-wide and disproportionately impact men of African ancestry. Some of the modifiable risk factors for prostate cancer include knowledge and attitudes about the disease, the belief system of individuals and their diet. Moreover, physical activity, alcohol and tobacco consumption have also been suggested as behavioral factors that contribute to prostate cancer disparities. This study compares modifiable risk factors implicated in prostate cancer among men living in Africa and African immigrants living in the United States to identifying behavioral factors that can be targeted for intervention. A cross-sectional study design was employed among Black men in Nigeria, Cameroon and African immigrants in United States using the Global Prostate Cancer Measure for Black men. Findings indicate that Nigerian and Cameroonian men residing in the United States expressed a more positive attitude towards screening than their counterparts in Africa. Knowledge levels about prostate cancer was higher among African Immigrants in the United States compared to those living in Africa. Additionally, fatalism, attitude and knowledge of prostate cancer signs and symptoms were statistically significant in the prediction of prostate cancer screening. Cancer control and prevention efforts in Nigerian and Cameroon should focus on educating men about the signs and symptoms of this disease to increase knowledge levels and ensure awareness of screening methods. Prostate cancer survivors should be part of health promotion campaigns to reduce fatalistic beliefs
Epidemiology of Prostate Cancer in NIGERIA: Observations at Lagos State University Teaching Hospital
Full text linkProstate cancer is a leading cause of morbidity and mortality among men, especially of African descent. Over the years, there has been relative paucity of research work on the subject of prostate cancer in sub-Saharan Africa. The objective of the study is to examine records of prostate cancers diagnosed at Mayo Height laboratory, Lagos State University Teaching Hospital, Lagos, Nigeria between January 2015 and June 2018, with a view to studying the epidemiological variables and pattern seen. Histopathological slides were retrieved and reviewed; relevant data were extracted from the Laboratory Information Systems, Laboratory Requisition Forms and the Hospital records where necessary. The data were statistically analysed. A total of 333 cases of prostate cancer were diagnosed during the study period, representing 46.4% of all prostate specimens received. The median age of the patients at diagnosis was 70 years, with the lowest recorded age being 50 years, while the highest age was 90 years. Individuals in the 7th decade of life (61-70 years) were the most commonly affected. Overwhelming number of cases (97.3%) were diagnosed based on trucut biopsy specimens, compared to open prostatectomy specimen. Majority of the cancers were histologically adenocarcinomas (97.3%) and majority of the tumours were of high grade (Gleason grade 5) representing 37.5%. Prostate cancer is an obvious scourge in Nigeria. It is commonly seen in the 7th decade of life. Majority of the patients had high grade adenocarcinoma.