80 research outputs found
Disparities in quality of cancer care
No full textEscalating costs and concerns about quality of cancer care have increased calls for quality measurement and performance accountability for providers and health plans. The purpose of the present cross-sectional study was to assess variability in the quality of cancer care by health insurance type in California.Persons with breast, ovary, endometrium, cervix, colon, lung, or gastric cancer during the period 2004 to 2014 were identified in the California Cancer Registry. Individuals were stratified into 5 health insurance categories: private insurance, Medicare, Medicaid, dual Medicare and Medicaid eligible, and uninsured. Quality of care was evaluated using Commission on Cancer quality measures. Logistic regression models were generated to assess the independent effect of health insurance type on stage at diagnosis, quality of care and survival after adjusting for age, sex, race/ethnicity, and socioeconomic status (SES).A total of 763,884 cancer cases were evaluated. Individuals with Medicaid or Medicare-Medicaid dual-eligible coverage and the uninsured had significantly lower odds of receiving recommended radiation and/or chemotherapy after diagnosis or surgery for breast, endometrial, and colon cancer, relative to those with private insurance. Dual eligible patients with gastric cancer had 21% lower odds of having the recommended number of lymph nodes removed and examined compared to privately insured patients.After adjusting for known demographic confounders, substantial and consistent disparities in quality of cancer care exist according to type of health insurance in California. Further study is needed to identify particular factors and mechanisms underlying the identified treatment disparities across sources of health insurance
Megacyllene melanaspis
No full textMegacyllene melanaspis (Chevrolat, 1862) (Fig. 22–26) Cyllene menalaspis Chevrolat, 1862: 378; Aurivillius 1912: 385 (cat.); Blackwelder 1946: 581 (checklist). Cyllene melanaspis; Lucas 1862: XCI; Lacordaire 1869: 62. Clytus melanaspis; Gemminger 1872: 2932 (cat.). Megacyllene melanaspis; Monné 1993: 8 (cat.); Martínez 2000: 86 (distr.); Monné et al. 2012: 10 (distr.); Monné and Chaboo 2015: 47 (distr.); Monné 2018: 131 (cat.). Megacyllene (Megacyllene) melanaspis; Monné and Giesbert 1994: 112 (checklist); Monné 2005: 91 (cat.); Monné and Hovore 2006: 43 (checklist). Megacyllene menalaspis; Martins and Galileo 2011: 72. Chevrolat (1862) described Cyllene menalaspis in his work named “Description de Clytides de l’ancienne Colombie [Description of Clytides from ancient Colombia].” According to him (translated): “I continue this work [Chevrolat 1860], occupying myself for the moment only those who come from the old Colombia, forming today, as we know, three distinct states: New Granada, Venezuela and Ecuador.” Cyllene menalaspis was described from New Granada, a country that has been reported to be Colombia (e.g. Monné 2018). However, at that time New Grenada encompassed part of Panama as well as Colombia (see discussion detailing this in Santos-Silva and Botero (2018: 5)) accordingly, the correct type locality for Cyllene menalaspis is New Granada. Lacordaire (1869) listed: “ Cyll. melanaspis, elongata, crinicornis, caracasensis, Chevrol. Ann. d. l. Soc. entom. 1861, p. 378; Colombie.” He changed Cyllene menalaspis to C. melanaspis without explanation. Furthermore, C. menalaspis was not described from Colombia, C. elongata was described from Venezuela on page 379, C. crinicornis was listed on page 380 as a new record for Venezuela, and C. caracasensis was described from Venezuela on page 380. This name change was repeated by Gemminger (1872) who also listed the species as C. melanaspis without explanation. Subsequently, the species was also referred to as C. menalaspis by Aurivillius (1912) and Blackwelder (1946). In Monné (1993) and henceforth the species has been listed as C. melanaspis, except for Martins and Galileo (2011), who listed the species as C. menalaspis. We believe that Chevrolat (1862) really intended to name the species “ melanaspis ”, meaning dark shield, and C. menalaspis is simply a printer’s error. On page XCVII of the same volume of the “Annales de la Société Entomologique de France ” the name appears as “ melanaspis ”. Thus, this can be considered the first correction of the spelling of a name (ICZN 1999: 32.5.1), and not in Lacordaire (1869). Accordingly, the author of the justified emendation is H. Lucas (1862) (see “Annales de la Société Entomologique de France ”, 1862, page XCI): “Mr. H. Lucas, assistant secretary, has, as in previous years, since 1860, to be in charge of drawing up this table as well as that of the Authors.” Based on the material available to us, Megacyllene melanaspis and Megacyllene proxima are sympatric throughout their known distribution in Bolivia. Although, M. melanaspis is encountered more commonly in higher elevations than M. proxima while the opposite is true in mid to lower elevations. Both have been collected on blossoms of woody plants and taken beating or crawling on fresh cut wood in agricultural cuts. The two species can be readily separated by their yellow pubescent pattern of the elytra. Both species have a similar transverse basal fascia with M. melanaspis then having three paired subcircular fascia down the suture (Fig. 22, 25) while M. proxima has four (Fig. 27–28). Currently, M. melanaspis (Fig. 22–26) is known from Colombia, Venezuela, Ecuador, and Peru (Monné 2018). To this, Bolivia (Fig. 29) is added as a new country record. Material examined. Megacyllene melanaspis: PERU, Junín: Pampa Hermosa Lodge (22 km N San Ramon, 1220 m, 10°59.3′S / 75°25.5′W), 1 female, 24–27.XI.2007, D. Brzoska col. (ACMT); Chanchamayo, 1 male, 9-12.VIII.1963, Caballero col. (MZSP). Ucayali: Pucallpa, 1 female, VI.1974, no collector indicated (MZSP). COLOMBIA, Cundinamarca: Viotá, 1 female, no date indicated, H. Apol. col. (MZSP). BOLIVIA (Fig. 29) (New country record), Santa Cruz: Road to Amboró above Achira, 3 males, 2 females, 10-11.X.2006, Wappes, Nearns, and Eya col. (ACMT); 1 male, 14–15.X.2006, Wappes, Nearns, and Eya col. (MZSP); above Achira (Rd to Floripondio; 1900 m; 18°09′S / 63°47′W), 1 female, 10.XII.2011, Wappes, Bonaso, and Morris col. (ACMT); 1 male, 1 female, 19.XII.2011, Wappes, Lingafelter and Woodley col. (ACMT); 2 males, 29.XI.2013, Konstantinov col. (SLPC); 1 male, 2 females, 29.XI.2013, Woodley col. (SLPC): 1 female, 19.XII.2011, Lingafelter col. (SLPC); 2 males, 4 females, 19.XII.2011, Woodley col. (SLPC); 4–5 km N Achira (rd to Floripondio; 18°09′S / 63°47′W, 6350′), 1 female, 15.IX.2012, Wappes, Skelley, Bonaso, and Hamel col. (ACMT); 1 female, 10.XII.2011, Morris and Wappes col. (RFMC); 4–6 km N Achira (5400–5800′), 1 female, 20.XI.2003, Wappes, Morris, and Nearns col. (ACMT); Achira (ridge rd to Amboró; 18°07′S / 63°48′W, 2000 m), 1 female, 24–25.I.2007, Wappes and Lingafelter col. (ACMT); Achira area (N rd to Amboró, on Achira ridge; 18°19′S / 63°48′W), 1 female, 5–6.II.2013, Wappes, Bonaso, Lingafelter and Garzon col. (ACMT); Amboró (rd above Achira Campo, 5-5800′), 1 female, 9–11.X.2004, Morris and Wappes col. (RFMC); 1 male, 27–28.X.2011, Skillman and Wappes Col. (FWSC); Pvc. Florida, Floripondio (west), 18°08’S, 63°45’W, 1880 m, 1 male, 25.XI.2004, on/flying to fresh cut trees, Clarke col. (RCSZ); Florida prov. (16 km NE Mairana; 6600′; 18°05′S / 63°54′W), 1 female, 11.XII.2011, Wappes, Bonaso, and L. Sekerka col. (ACMT); above Achira Campo (road to Amboró, Vicoquin area, 18°07′S / 63°48′W), 1 female, 11.XI.2012, Bonaso and Windsor col. (ACMT); Refugio los Volcanes, 18°06′24″S, 63°35′55″W, 1056 m, 20.XII.2016, R. Perger col. (CBFL); 1 female, 8.XI.2017, Lingafelter col. (SLPC). Megacyllene proxima: BOLIVIA (Fig. 29), Cochabamba, N. of Cristal Mayu, 19.X.2011, Skillman and Wappes col. (FWSC); 2 males, Wappes and Skillman col. (ACMT); Santa Cruz, Florida, 4 km N. Bermejo, Refugio Los Volcanes, 18°06′S, 63°36′W, 1000–1200 m, 7.XII.2013, Skillman and Wappes col. (FWSC); 10.XII.2015, Skillman and Wappes col. (FWSC); 12.XII.2011, Skillman and Wappes col. (FWSC); 1 male, 18–20.IX.2012, Wappes, Skelley, Bonaso and Hamel col. (ACMT); 1 male, 18–22.I.2006, Wappes and Lingafelter col. (ACMT); 1 male, 2 females, 3.XI.2017, Lingafelter col. (SLPC); 5 males, 1 female, 6–10. III.2011, Wappes and Thomas col. (ACMT); 1 female, 1350 m, 9–12.XII.2011, Morris and Wappes col. (RFMC); 1 male, 2 females, 1350 m, 18–24.X.2014, Morris and Wappes col. (RFMC); 1 female, Florida Prv., Vicoquin area above Achira, chaco, 1730 m, 22–25.I.2007, Wappes, Lingafelter and Prena col. (ACMT); 1 male, 1 female, 19.XII.2011, N. Woodley col. (SLPC); 2 males, 2 females, 22–25.I.2007, Lingafelter, Wappes and Prena col. (SLPC); 1 female, 19.XII.2011, Lingafelter col. (SLPC); Pvc. Florida, Floripondio (west), 18°08′S, 63°45′W, 1880 m, 1 male, 1 female, 1.XI.2009, on/flying to flowers of Sagüintillo, Clarke col. (RCSZ); 1 female, 1.XI.2009, flying to fresh cut trees, Clarke col. (RCSZ); 1 male, 25.XI.2004, Clarke col. (RCSZ); 18°08′S, 63°44′W, Floripondio (east), 1 female, on/flying to flowers of Sotillo, 16.XI.2009, Clarke col. (RCSZ); 1 female, 27.XI2009, Clarke col. (RCSZ); 1 female, 18°09′S, 63°47′W, 10.XII.2011, Morris and Wappes col. (RFMC); La Hoyado (above Agua Clara), 2 females, 19.XI.2003, Morris, Nearns and Wappes col. (RFMC). PERU, Madre de Dios, 1 female, 10-13.XI.2007, Amazonas Lodge (N-Atalaya), 480 m, 12°52.2′S, 71°22.6′W, D. Brzoska col. (ACMT).Published as part of Botero, Juan Pablo, Santos-Silva, Antonio & Wappes, James E., 2019, New species, a new combination, and a new country record in American Clytini (Coleoptera: Cerambycidae: Cerambycinae), pp. 1-19 in Insecta Mundi 697 on pages 6-8, DOI: 10.5281/zenodo.367054
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Increasing trends in the use of breast-conserving surgery in California
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Rethinking the Hispanic advantage in cancer outcomes: Influence of birthplace
No full textJ Registry Manag
No full textBackgroundSome guidelines advise adjuvant chemotherapy be considered after surgical resection for high-risk stage II colon cancer patients; however, high-risk criteria are poorly defined and the long-term benefits are still debated. This study documents patterns of care by selected patient and tumor characteristics using a US population-based cohort of stage II colon cancer patients diagnosed in 2011.MethodsData were collected from 10 specialized cancer registries participating in the Centers for Disease Control and Prevention\u2019s National Program of Cancer Registries\u2019 Enhancing Cancer Registry Data for Comparative Effectiveness Research project. The data were used to describe characteristics of stage II colon cancer patients treated by surgery to evaluate factors associated with receiving adjuvant chemotherapy.ResultsOf the 3,891 stage II colon cancer patients, 14.3% were treated with surgery and adjuvant chemotherapy compared to 82.9% by surgery alone. The patients treated with adjuvant chemotherapy were predominately non-Hispanic white (66.1%), of younger age, and had private insurance (39.9%). Compared to surgery alone, the 5 characteristics associated with adjuvant therapy were younger age (adjusted odds ratio [AOR] for 5-year decrease below 75 years, 1.25; P < .001); more advanced stage (IIB/IIC vs IIA) (AOR, 4.79; P < .001); lymphovascular invasion (AOR, 1.76, P < .001); higher grade (III/IV vs I/II) (AOR, 1.84; P < .001); and registry area.ConclusionsIn this population-based cohort, younger patients with more advanced stage II colon tumors, with lymphovascular invasion, and poor differentiation were more likely to receive adjuvant chemotherapy in addition to surgery. These characteristics align with high-risk profiles defined in guidelines. Ongoing data collection on outcomes, including recurrence and survival, will help clarify the benefits of adjuvant treatments for stage II colon patients.CC999999/Intramural CDC HHSUnited States
Cancer Epidemiol Biomarkers Prev
No full textBackground:Multiple studies have yielded important findings regarding the determinants of an advanced-stage diagnosis of breast cancer. We seek to advance this line of inquiry through a broadened conceptual framework and accompanying statistical modeling strategy that recognize the dual importance of access-to-care and biologic factors on stage.Methods:The Centers for Disease Control and Prevention\u2013sponsored Breast and Prostate Cancer Data Quality and Patterns of Care Study yielded a seven-state, cancer registry\u2013derived population-based sample of 9,142 women diagnosed with a first primary in situ or invasive breast cancer in 2004. The likelihood of advanced-stage cancer (American Joint Committee on Cancer IIIB, IIIC, or IV) was investigated through multivariable regression modeling, with base-case analyses using the method of instrumental variables (IV) to detect and correct for possible selection bias. The robustness of base-case findings was examined through extensive sensitivity analyses.Results:Advanced-stage disease was negatively associated with detection by mammography (P 40 (P = 0.001), a HER2 type tumor (P < 0.001), and tumor grade not well differentiated (P < 0.001). This IV model detected and adjusted for significant selection effects associated with method of detection (P = 0.02). Sensitivity analyses generally supported these base-case results.Conclusions:Through our comprehensive modeling strategy and sensitivity analyses, we provide new estimates of the magnitude and robustness of the determinants of advanced-stage breast cancer.Impact:Statistical approaches frequently used to address observational data biases in treatment-outcome studies can be applied similarly in analyses of the determinants of stage at diagnosis.U01 DP000261/DP/NCCDPHP CDC HHSUnited States/U01 DP000258/DP/NCCDPHP CDC HHSUnited States/U01 DP000251/DP/NCCDPHP CDC HHSUnited States/U01 DP000264/DP/NCCDPHP CDC HHSUnited States/U01 DP000259/DP/NCCDPHP CDC HHSUnited States/U01 DP000260/DP/NCCDPHP CDC HHSUnited States/P30 CA138292/CA/NCI NIH HHSUnited States/CC999999/ImCDC/Intramural CDC HHSUnited States/U01 DP000253/DP/NCCDPHP CDC HHSUnited States/2021-12-02T00:00:00Z26819266PMC863865610652vault:4049
Cancer Epidemiol Biomarkers Prev
No full textBackground:Through adequate screening and follow-up, cervical cancer can be prevented or detected at early-stage (stage I), which is related to excellent survival. Current guidelines recommend discontinuing screening for women 6565 with history of normal Pap and/or HPV tests, potentially leaving this age group vulnerable. This study examined late-stage disease in a population-based cohort.Methods:Using California Cancer Registry data, we identified 12,442 patients aged 6521 years with a first primary cervical cancer diagnosed during 2009\u20132018. Proportions of late-stage disease (stages II-IV) and early and late-stage 5-year relative survival are presented by age group. Among patients aged 6565 years, multivariable logistic regression estimated associations of sociodemographic and clinical characteristics with late-stage cervical cancer.Results:Nearly one-fifth of patients (n=2,171, 17.4%) were 6565 years. More women aged 6565 (71%) presented with late-stage disease than younger women (48% in patients aged <65). Late-stage 5-year relative survival was lower for women 6565 (23.2% 1236.8%) compared to patients <65 (41.5% 1251.5%). Characteristics associated with late-stage cervical cancer in women 6565 included older age (odds ratio (OR)=1.02, 95% confidence interval (CI) 1.01\u20131.04; each year), non-adenocarcinoma histologic subtypes, and comorbidities (OR=1.59, CI 1.21\u20132.08).Conclusions:There remains a significant burden of advanced cervical cancer in women 6565.Impact:Efforts should be made to better understand how the current screening paradigm is failing women 65 years and older. Future work should focus on determining past screening history, lapses in follow-up care, and non-invasive testing approaches.HHSN261201800009C/CA/NCI NIH HHSUnited States/NU58DP006344/DP/NCCDPHP CDC HHSUnited States/HHSN261201800015I/CA/NCI NIH HHSUnited States/HHSN261201800032I/CA/NCI NIH HHSUnited States/HHSN261201800015C/CA/NCI NIH HHSUnited States/HHSN261201800009I/CA/NCI NIH HHSUnited States/HHSN261201800032C/CA/NCI NIH HHSUnited States/P30 CA093373/CA/NCI NIH HHSUnited States
Cancer
No full textPurpose:Transplant recipients have an elevated risk of cancer because of organ rejection immunosuppressive medications, but no study has comprehensively examined associations between transplant status and mortality following a cancer diagnosis.Methods:For 16 different cancer types, we assessed cases in the US general population (N=7,147,476) ascertained from 11 cancer registries. Presence of a solid organ transplant prior to diagnosis (N=11,416 cancer cases) was identified through linkage with the national transplant registry (1987\u20132014). We used Cox models to examine the association between transplant status and cancer-specific mortality, adjusting for demographic characteristics and cancer stage.Results:For most cancers, cancer-specific mortality was higher in transplant recipients than for other cancer patients. The increase was particularly pronounced for melanoma (adjusted hazard ratio (aHR)=2.59, 95%CI 2.18\u20133.00) and cancers of the breast (1.88, 1.61\u20132.19), bladder (1.85, 1.58\u20132.17), and colorectum (1.77, 1.60\u20131.96), but it was also increased for cancers of the oral cavity/pharynx, stomach, pancreas, kidney, and lung, and diffuse large B-cell lymphoma (aHRs ranging from 1.21 to 1.47). Associations remained significant after adjustment for first-course cancer treatment and were generally stronger among local stage cancers for which potentially curative treatment was provided, e.g., for melanoma (aHR=3.82, 95%CI 2.94\u20134.97), and cancers of the colorectum (2.77, 2.07\u20133.70), breast (2.08, 1.50\u20132.88), and prostate (1.60, 1.12\u20132.29), despite lack of association for prostate cancer overall.Conclusion:For multiple cancer types, transplant recipients with cancer have an elevated risk of dying from their cancer, even after adjustment for stage and treatment, which may be due to impaired immunity.20192020-03-15T00:00:00ZU58 DP003931/DP/NCCDPHP CDC HHS/United StatesHHSN261201000037C/CA/NCI NIH HHS/United StatesN01PC35143/CA/NCI NIH HHS/United StatesU58 DP003875/DP/NCCDPHP CDC HHS/United StatesN01PC35137/CA/NCI NIH HHS/United StatesHHSN261201300071C/CA/NCI NIH HHS/United StatesU58 DP003920/DP/NCCDPHP CDC HHS/United StatesU58 DP003933/DP/NCCDPHP CDC HHS/United StatesU58 DP000848/DP/NCCDPHP CDC HHS/United StatesHHSN261201300011I/CA/NCI NIH HHS/United StatesN01PC35139/CA/NCI NIH HHS/United StatesU58 DP000824/DP/NCCDPHP CDC HHS/United StatesHHSN261201300019C/CA/NCI NIH HHS/United StatesU58 DP003883/DP/NCCDPHP CDC HHS/United StatesHHSN261201000035C/CA/NCI NIH HHS/United StatesP30 CA086862/CA/NCI NIH HHS/United StatesHHSN261201000036C/CA/NCI NIH HHS/United StatesU58 DP003879/DP/NCCDPHP CDC HHS/United StatesHHSN261201300011C/RC/CCR NIH HHS/United StatesU58 DP000807/DP/NCCDPHP CDC HHS/United StatesN01PC35142/CA/NCI NIH HHS/United StatesZ99 CA999999/ImNIH/Intramural NIH HHS/United StatesHHSN261201300021C/CA/NCI NIH HHS/United StatesHHSN261201000035I/CA/NCI NIH HHS/United StatesHHSN261201000034C/CA/NCI NIH HHS/United StatesU58 DP003921/DP/NCCDPHP CDC HHS/United States30624768PMC64030051060
Int J Cancer
No full textAdolescents and young adults (AYAs, 15-39\u2009years) are the largest uninsured population in the Unites\u2009States, increasing the likelihood of late-stage cancer diagnosis and poor survival. We evaluated the associations between the Affordable Care Act (ACA), insurance coverage, stage at diagnosis and survival among AYAs with lymphoma. We used data from the California Cancer Registry linked to Medicaid enrollment files on AYAs diagnosed with a primary non-Hodgkin (NHL; n\ua0=\ua05959) or Hodgkin (n\ua0=\ua05378) lymphoma pre-ACA and in the early and full ACA eras. Health insurance was categorized as continuous Medicaid, discontinuous Medicaid, Medicaid enrollment at diagnosis/uninsurance, other public and private. We used multivariable regression models for statistical analyses. The proportion of AYAs uninsured/Medicaid enrolled at diagnosis decreased from 13.4% pre-ACA to 9.7% with full ACA implementation, while continuous Medicaid increased from 9.3% to 29.6% during this time (P\u2009<\u2009.001). After full ACA, AYAs with NHL were less likely to be diagnosed with Stage\u2009IV disease (adjusted odds ratio [aOR]\ua0=\ua00.84, 95% confidence interval [CI]\ua0=\ua00.73-0.97). AYAs with lymphoma were more likely to receive care at National Cancer Institute-Designated Cancer Centers (aOR\ua0=\ua01.42, 95%\ua0CI\ua0=\ua01.28-1.57) and had lower likelihood of death (adjusted hazard ratio\ua0=\ua00.54, 95%\ua0CI\ua0=\ua00.46-0.63) after full ACA. However, AYAs from the lowest socioeconomic neighborhoods, racial/ethnic minority groups and those with Medicaid continued to experience worse survival. In summary, AYAs with lymphomas experienced increased access to healthcare and better clinical outcomes following Medicaid expansion under the ACA. Yet, socioeconomic and racial/ethnic disparities remain, calling for additional efforts to decrease health inequities among underserved AYAs with lymphoma.NU58DP006344/DP/NCCDPHP CDC HHSUnited States/P30 CA093373/CA/NCI NIH HHSUnited States/UL1 TR001860/TR/NCATS NIH HHSUnited States
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