Comparison of cancer stage distribution in the immigrant and host populations of Norway, 1990-2014

e14129 Background: Cancer stage distribution offers an early window into the effect of the ACA’s 2014 Medicaid expansion. If Medicaid expansion enabled uninsured adults to access preventive care, then the proportion of cancers diagnosed at early stage should be higher in states that adopted it. Methods: Patient level data were retrieved from SEER-18, New York and Texas cancer registries from January 2010 to December 2015, for eight common tumor types; including N = 2,493,589 (breast, cervical, colorectal, prostate, lung) screen detectable and N = 369,203 (testis, kidney and uterine corpus) not detected by routine screening. Patients were categorized by residence in states that were: 1) Non-expanders; 2) Expanders - income eligibility thresholds increased from 0% to 138% of the federal poverty level (FPL) in 2014; and 3) Pre-Expanders, with pre-2014 eligibility thresholds > 70% of FPL. Stage distributions were compared before and after January 2014, categorized by AJCC stage and using ordinal stage equivalent (OSE) which assigns a numeric score based on AJCC stage. Difference in difference in difference (D3) methods compared patients ≥65 versus < 65, and screen-detectable versus not. Multivariable logistic regression was used to adjust for variation in age, sex, race, ethnicity and tumor site across states. Results: No differences in stage distribution were observed across the three categories of state. (Table). D3 analysis revealed no difference between trends in the over 65s, or for screen-detectable cancers. Adjustment for age, sex, race, ethnicity and tumor site made no significant difference to these results. Conclusions: States’ Medicaid expansion status in 2014 was not associated with a significant difference in early stage diagnoses for adults with cancer diagnosed before age 65. Obstacles to early cancer detection other than financial access must be addressed to improve population-level outcomes. [Table: see text]

Download Full-text

667 BLADDER CANCER STAGE DISTRIBUTION AT RADICAL CYSTECTOMY IN THE LAST TWO DECADES IN A POPULATION-BASED COHORT

European Urology Supplements ◽

10.1016/s1569-9056(09)60662-x ◽

2009 ◽

Vol 8 (4) ◽

pp. 287

Author(s):

C. Jeldres ◽

N. Bhojani ◽

S. Baillargeon-Gagné ◽

H. Isbarn ◽

U. Capitanio ◽

...

Keyword(s):

Bladder Cancer ◽

Radical Cystectomy ◽

Population Based ◽

Cancer Stage ◽

Stage Distribution

Download Full-text

Trends in breast cancer stage distribution before, during and after introduction of a screening programme in Norway

European Journal of Public Health ◽

10.1093/eurpub/cku015 ◽

2014 ◽

Vol 24 (6) ◽

pp. 1017-1022 ◽

Cited By ~ 16

Author(s):

Mette L. Lousdal ◽

Ivar S. Kristiansen ◽

Bjørn Møller ◽

Henrik Støvring

Keyword(s):

Breast Cancer ◽

Screening Programme ◽

Cancer Stage ◽

Stage Distribution

Download Full-text

553Stage at diagnosis for six major cancers in China with comparison to the United States

International Journal of Epidemiology ◽

10.1093/ije/dyab168.558 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Xianhui Ran ◽

Hongmei Zeng ◽

Siwei Zhang ◽

Lan An ◽

Rongshou Zheng ◽

...

Keyword(s):

Cancer Patients ◽

The United States ◽

Stage I ◽

Cancer Site ◽

Cancer Stage ◽

Stage At Diagnosis ◽

Stage Distribution ◽

The Us ◽

Center Hospital ◽

Clinical Records

Abstract Background To explore the distribution and factors associated with cancer stage at diagnosis, we conducted a multi-center hospital-based study in China. Methods 38 hospitals were selected to set up the Chinese cancer clinical database. Detailed stage information was collected from clinical records and focus on cancers of the lung, stomach, colon-rectum, liver, female breast, and esophagus diagnosed during 2016-2017. We compared the stage distribution with the US by data from Surveillance, Epidemiology, and End Results database during the same period. Results Overall 69632 first diagnosed cancer cases were analyzed. The proportion of cancer patients in stage I varies by cancer site, with highest in breast (28%) and lowest in liver (13%). The proportion of cancer cases at stage I was generally higher in women (OR:1.7,95%CI:1.6-1.8), in young (<65 years) (OR:1.2,1.1-1.2) and in subjects having Chinese Urban Insurances (OR:1.9,1. 8-2.0). Except for esophageal cancer, the other five major cancers in China had more advanced stage than in the US. Conclusions Socio-demographic inequalities exist in stage at diagnosis for major cancer cases in China. Early detection interventions are especially needed to be targeted on patients with higher risk of advance disease diagnosis. Key messages Multi-center hospital-based study on cancer stage distribution in China shows that women, young, and those with Chinese Urban Insurance were more likely to be diagnosed with early stage. Stage distribution in China was generally more advanced compared with cancer patients in the US.

Download Full-text

Adverse consequences of the COVID-19 pandemic on breast cancer stage distribution and breast cancer disparities.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10555 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10555-10555

Author(s):

Genevieve A. Fasano ◽

Yalei Chen ◽

Solange Bayard ◽

Melissa Davis ◽

Vivian Bea ◽

...

Keyword(s):

Breast Cancer ◽

New York ◽

New York City ◽

Cancer Patients ◽

York City ◽

Cancer Stage ◽

Breast Cancer Patients ◽

Stage Distribution ◽

Race Ethnicity ◽

Racial Ethnic

10555 Background: The COVID-19 surge in March 2020 resulted in a hiatus placed on screening mammography programs in support of shelter-in-place mandates and diversion of medical resources to pandemic management. The COVID-related economic recession and ongoing social distancing policies continued to influence screening practices after the hiatus was lifted. We evaluated the effect of the hiatus on breast cancer stage distribution on the diverse patient population of a health care system in New York City, the first pandemic epicenter in the United States. Methods: Breast cancer patients diagnosed January 1, 2019 to December 31, 2020 were analyzed, with comparisons of stage distribution and mammography screen-detection for three intervals: Pre-Hiatus, During Hiatus (March 15, 2020 to June 15, 2020), and Post-Hiatus. Results were stratified by African American (AA), White American (WA), Asian (As) and Hispanic/Latina (Hisp) self-reported racial/ethnic identity. Results: A total of 894 patients were identified; of these, 549 WA, 100 AA, 104 As, and 93 Hisp comprised the final race/ethnicity-stratified study population. Overall, 588 patients were diagnosed Pre-Hiatus, 61 During-Hiatus, and 245 Post-Hiatus. Nearly two-thirds (65.5%) of the Pre-Hiatus cases were screen-detected versus 49.2% During-Hiatus and 54.7% Post-Hiatus (p = 0.002). Frequency of tumors diagnosed < 1 cm declined from 41.9% Pre-Hiatus to 31.7% Post-Hiatus (p = 0.035). WA patients were more likely to have screen-detected disease compared to AA in the Pre-Hiatus period (69.1% vs. 56.1%; p = 0.05) but non-significantly more likely to have screen-detected disease compared to As and Hisp patients (66.2% vs. 56.9%; p = 0.08). In the Post-Hiatus period, the frequency of screen-detected disease was highest among WA patients (63.0%) compared to all other racial/ethnic groups (AA; 48.1%, As-33.3%, and Hisp-40%; p = 0.007). Similar patterns were observed for frequency of tumors diagnosed ≤1cm Pre-Hiatus (WA-44.3% vs AA-26%, p = 0.02; and vs. As-41.3%, Hisp-48%; p = 0.09), and Post-Hiatus (WA-37.7% vs. AA-18.2%, As-30.8%, Hisp-23.5%; p = 0.25). Conclusions: The 3-month pandemic-related mammography screening hiatus resulted in a more advanced stage distribution for New York City breast cancer patients, and worsened pre-existing race/ethnicity-associated disparities, especially for AA pts.

Download Full-text