Archives for the month of: July, 2013

These data covered 7,375 black women diagnosed from 1991 to 2005 at 16 SEER sites who were matched with three sets of 7,375 white women each, all with a mean age of about 76 at diagnosis. These control sets of white patients were matched to the black patients on the basis of demographics (age, year of diagnosis, and SEER site), characteristics at presentation (comorbidities, tumor size, tumor grade and stage, and estrogen receptor status), and treatment (case characteristics plus details of surgery, radiation treatment, and drug therapy). In the comparison of black patients with whites matched by demographics only, 5-year survival rates were 55.9% (95% CI 54.8%-57.0%) in the former versus 68.8% (95% CI 67.8%-69.9%) in the latter (P<0.001), Silber and colleagues found. But 5-year survival in the white set matched by characteristics at presentation was 60.3% (95% CI 59.2%-61.4%), reducing the racial disparity markedly. Treatments differed significantly between blacks and the presentation-matched white patients. For example, black patients were less likely to receive breast-conserving surgery plus radiation (14.5% versus 16.5%) or chemotherapy with a taxane (3.7% versus 5%), and were more likely to receive no treatment at all (12.6% versus 8.2%) — all with P-values of less than 0.001. However, these differences appeared to have less influence on survival rates than differences at presentation. One factor that may have contributed to that finding was that care received in the 6 to 18 months prior to diagnosis was clearly inferior in the black patients. Rates of specific types of primary and preventive care during this interval were as follows (all P<0.001 for whites versus blacks): Any primary care: 80.5% blacks, 87.0% in presentation-matched whites, 88.5% in demographic-matched whites Any breast cancer screening: 23.5% in blacks, 31% in presentation-matched whites, 35.7% in demographic-matched whites Any cholesterol screening: 33.7% in blacks, 38.0% in presentation-matched whites, 38.2% in demographic-matched whites Any colon cancer screening: 16.5% in blacks, 21.3% in presentation-matched whites, 23.7% in demographic-matched whites On the other hand, many more of the black patients than the demographic-matched whites had important comorbidities at presentation including diabetes (26% versus 15.3%) and congestive heart failure (9.6% versus 5.9%, P<0.001 for both comparisons). Black patients also were less likely to have estrogen receptor-positive tumors (53% versus 64.5%, P<0.001). Another analysis suggested that socioeconomic status was the chief driver of the survival disparity, Silber and colleagues indicated. In a model using data from the black patients and the whites matched by presentation plus treatment characteristics, and then adjusted for dual eligibility status in Medicaid and Medicare, the hazard ratio for death was a nonsignificant 1.02 (95% CI 0.97-1.09). A similar analysis adjusting the mortality data for poverty rates and educational attainment in patients' census tracts also found similar survival rates in black and white patients after matching for presentation and treatment. Overall, Silber and colleagues wrote, "Most of the [survival] difference is explained by poorer health of black patients at diagnosis, with more advanced disease, worse biological features of the disease , and more comorbid conditions." 'Synergy Between Presentation and Treatment' In the accompanying editorial, Mandelblatt and colleagues cautioned against reading too much into the study findings.

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CDC-Funded Effort Educates Hispanics on Breast, Colorectal Cancer

“Poor health outcomes, unfortunately, are a common reality in the Hispanic community,” said Maite Arce, president of HAF. “Whether it’s the lack of having a primary doctor or access to health care in general, through education we can empower Latinos to become advocates for their health.” Titled “Together We Can Defeat Cancer” and funded by the Centers for Disease Control and Prevention (CDC), the effort will include dozens of free educational workshops, a PSA campaign and toll-free helpline to connect Hispanics to the resources they need. The campaign focuses on Latinos in New York, Rio Grande Valley, Houston, and Miami. The main purpose is to emphasize that women over 40 years of age should be screened for breast cancer regularly, while both men and women over the age of 50 should be screened for colorectal cancer. Not all screenings are cost prohibitive and in some cases even the uninsured can receive screenings, but early detection leads to improved survival rates for most everyone. “With the Hispanic population projected to nearly double by 2050, the immediate need to address the knowledge and behaviors within this community is paramount,” said AnitaMcFarlane, MPH,Director of Grants and Public Policy at the Greater New York City Affiliate of Susan G. Komen. “This project will help us increase the understanding of preventive health care within the Hispanic community and put them on the path to greater health outcomes.” HAF prides itself on its ability as a connector that helps remove barriers and link Hispanics to existing resources. Throughout this project, HAF will be collaborating with several local partners that offer expertise and services, which helps avoid a duplication of efforts and strengthen the overall outreach. Key partners in this initiative include the Greater New York City Affiliate of Susan G. Komen for the Cure, the New York Hospital Queens, University of Texas School of Public Health, Miami-Dade Area Health Education Center, lay health educators and other nonprofit organizations. For a list of dates and locations of workshops or for more information regarding early detection and this campaign, visit . About Hispanic Access Foundation Hispanic Access Foundation is a 501(c)(3) non-profit organization that works topromote responsible citizenship, educational attainment, and active engagement in the improvement of the health, environment, and financial well-being of Hispanic families throughout the United States. Working with and through strategic partnerships with faith and community organizations, HAF is dedicated to providing greater access to vital information and community resources to the U.S. Hispanic population to improve health and quality of life.

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Early screenings can help prevent colon cancer

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“Colorectal cancer is a disease of wealthy societies. When Hong Kong was less developed, the incidence rate was much lower. But as Hong Kong has become more prosperous, the incidence rate has increased,” says An honorary clinical professor in the department of pathology at University of Hong Kong, Yuen says as many of 85 per cent of cases were sporadic and believed to environmentally linked to diet and lifestyle. “With lung cancer on the decline, it is only a matter of time before colorectal cancer overtakes it to become the number one killer cancer in Hong Kong,” says Yuen. Ironically, colorectal cancer is one of the most easily preventable. Screening can detect abnormalities before they become cancerous. Building public awareness of the disease has become a priority of the Hong Kong Cancer Fund. A spokesman for the fund says the message is that lifestyle changes can help reduce the risk of developing the disease, and early detection saves lives. Two types of screening are available: a non-invasive method called faecal occult blood test and a colonoscopy. The blood test involves examining stool samples for blood produced by growths in the colon. But it needs to be done regularly and is not capable of detecting abnormal growths at a precancerous stage. According to Professor Law Wai-lun, a clinical professor in the department of surgery at University of Hong Kong’s Li Ka Shing Faculty of Medicine, this is why the colonoscopy is considered the gold standard for investigations of the colon. Like most experts, Law recommends people consider screening with this method at the age of 50, and then every 10 years afterwards. With a colonoscopy, the colon is screened using a flexible tube fitted with an endoscopic high-definition camera passed through the whole colon via the rectum.

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