scholarly journals PC3 - 164 Urban-Rural Residence and Brain Cancer Survival in Canada (1996-2008)

2016 ◽  
Vol 43 (S4) ◽  
pp. S18-S19
Author(s):  
J. Ross ◽  
Q. Shi ◽  
Y. Yuan ◽  
F.G. Davis
Keyword(s):  
Access To Care ◽  
Brain Cancer ◽  
Anaplastic Astrocytoma ◽  
Cancer Survival ◽  
The United States ◽  
Rural Residence ◽  
Diffuse Astrocytoma ◽  
Rural Residents ◽  
Significant Difference ◽  
Urban Rural

Disparities in cancer survival rates have been identified for rural patients in Canada and are thought to be due to inequities in access to care. The objective was to perform the first examination of urban and rural brain cancer survival in Canada. Methods: A population-based retrospective cohort study was performed using Canadian Cancer Registry data for patients diagnosed with a primary brain cancer from 1996-2008. Seven major brain cancer histology groups used were glioblastoma, diffuse astrocytoma, glioma (not otherwise specified), oligodendroglioma, anaplastic astrocytoma, oligoastrocytic tumours, and anaplastic oligodendroglioma as categorized by the Central Brain Tumor Registry of the United States (CBTRUS). Kaplan-Meier (KM) survival estimates and Cox Proportional Hazards Regression were performed, adjusting for sex, histology, age group, region, and urban-rural residence. Rural residence was defined using Statistics Canada’s “Rural and Small Town” definition of living in a region with a population of less than 10,000 people. Results: No significant difference between urban and rural residence was identified in crude KM survival estimates. Though not significant, 5-year survival was generally better among rural residents than urban residents, except for rural residents with anaplastic astrocytoma. There remained no significant difference for Cox hazard ratios after adjustment for age, sex, or region. Conclusions: This is the first study to examine the effect of urban-rural residence on brain cancer survival. No significant differences for any histology were found, indicating equitable access to care for brain cancer patients in Canada, regardless of their location of residence.

The impact of rural residence on adult brain cancer survival in the United States

2019 ◽  
Vol 144 (3) ◽  
pp. 535-543 ◽  
Author(s):  
Arash Delavar ◽  
Omar M. Al Jammal ◽  
Kathleen R. Maguire ◽  
Arvin R. Wali ◽  
Martin H. Pham
Keyword(s):  
United States ◽  
Brain Cancer ◽  
Cancer Survival ◽  
The United States ◽  
Adult Brain ◽  
Rural Residence ◽  
The Impact

Disparities in cancer survival among adolescents and young adults: a population-based study of 88,000 patients

2021 ◽  
Author(s):  
Caitlin C Murphy ◽  
Philip J Lupo ◽  
Michael E Roth ◽  
Naomi J Winick ◽  
Sandi L Pruitt
Keyword(s):  
Young Adults ◽  
Cancer Survival ◽  
Relative Survival ◽  
Population Based ◽  
Rural Residence ◽  
Neighborhood Poverty ◽  
Insurance Type ◽  
All Cause Mortality ◽  
Urban Rural ◽  
Race Ethnicity

Abstract Background Adolescent and young adults (AYA, ages 15-39 years) diagnosed with cancer comprise a growing, yet understudied, population. Few studies have examined disparities in cancer survival in underserved and diverse populations of AYAs. Methods Using population-based data from the Texas Cancer Registry, we estimated five-year relative survival of common AYA cancers and examined disparities in survival by race/ethnicity, neighborhood poverty, urban/rural residence, and insurance type. We also used multivariable Cox proportional hazards regression models to examine associations of race/ethnicity, neighborhood poverty, urban/rural residence, and insurance type with all-cause mortality. Results We identified 55,316 women and 32,740 men diagnosed with invasive cancer at age 15-39 years between January 1, 1995, and December 31, 2016. There were disparities in relative survival by race/ethnicity, poverty, and insurance for many cancer types. Racial/ethnic disparities in survival for men with non-Hodgkin Lymphoma (74.5% [95% confidence interval (CI) = 72.1% to 76.7%] White vs. 57.0% [95% CI = 51.9% to 61.8%] Black) and acute lymphocytic leukemia (66.5% [95% CI = 61.4% to 71.0%] White vs. 44.4% [95% CI = 39.9% to 48.8%] Hispanic) were striking, and disparities remained even for cancers with excellent prognosis, such as testicular cancer (96.6% [95% CI = 95.9% to 97.2%] White vs. 88.7% [95% CI = 82.4% to 92.8%] Black). In adjusted analysis, being Black or Hispanic, living in high poverty neighborhoods, and having Medicaid, other government insurance, or no insurance at diagnosis were associated with all-cause mortality in both women and men (all two-sided p < 0.01). Conclusion Our study adds urgency to well-documented disparities in cancer survival in older adults by demonstrating persistent differences in relative survival and all-cause mortality in AYAs. Findings point to several areas of future research to address disparities in this unique population of cancer patients.

scholarly journals Self-reported vs RUCA rural-urban classification among North Carolina pharmacists

2021 ◽  
Vol 19 (3) ◽  
pp. 2406
Author(s):  
Micah E. Castle ◽  
Casey R. Tak
Keyword(s):  
North Carolina ◽  
Rural Areas ◽  
Large Scale ◽  
Statistical Significance ◽  
Healthcare Services ◽  
The United States ◽  
Pharmacy Services ◽  
Significant Difference ◽  
Urban Rural ◽  
The Relationship

Background: The various ways in which rurality is defined can have large-scale implications on the provision of healthcare services. Objective: The purpose of this study was to identify the relationship between self-perceived urban-rural distinction and the United States (US) Census tract-based Rural-Urban Commuting Area (RUCA) scheme that defines rurality among pharmacists. Methods: This was a secondary analysis of data collected through a web-based survey of licensed pharmacists in North Carolina. Respondents self-reported their workplace settings, zip codes, and the pharmacy services offered in their place of work. Zip codes were replaced with the corresponding RUCA codes. The relationship between self-reported classification and RUCA codes was analyzed and a chi square test was performed to measure statistical significance. Results: Of the original survey, 584 participants reported their workplace zip code and 579 reported their workplace setting (urban, rural). A significant difference was found between pharmacists who self-reported working in rural areas and the RUCA classifications – 94 (56.6%) of the 166 participants who reported working in “rural” areas were considered “urban” according to RUCA. Conclusions: A significant discordance between pharmacists’ self-reported classification and the RUCA codes was found, with more respondents self-reporting their workplace area as “rural” as compared to the RUCA classification. Decision-makers examining the pharmacy workforce and pharmacy services should be aware of this discordance and its implications for resource allocation. We recommend the use of standardized metrics, when possible.

scholarly journals RTHP-05. CONTRIBUTION OF ATM MUTATION TO THE IMPROVED RADIO-SENSITIVITY: RETROSPECTIVE ANALYSIS USING NEXT-GENERATION SEQUENCING DATA

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi210-vi211
Author(s):  
Hong In Yoon ◽  
Nalee Kim ◽  
Se Hoon Kim ◽  
Ju Hyung Moon ◽  
Seok-Gu Kang ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Anaplastic Astrocytoma ◽  
High Grade Glioma ◽  
Next Generation Sequencing Data ◽  
Diffuse Astrocytoma ◽  
High Grade ◽  
Next Generation ◽  
Significant Difference ◽  
Radio Sensitivity ◽  
Generation Sequencing

Abstract PURPOSE/OBJECTIVES To identify the association of somatic ATM mutation (mATM) with improved radiotherapy sensitivity, we retrospectively reviewed the next-generation sequencing (NGS) data from high grade glioma patients. MATERIALS/METHODS This analysis includes 48 consecutive individuals diagnosed with high grade glioma (diffuse astrocytoma IDH-wild type n=2, anaplastic astrocytoma n=18, and glioblastoma n=28) between June 2017 and October 2018. Patients who underwent subtotal (n=30, 62.5%), partial (n=17, 35.4%) removal or biopsy (n=1, 2.1%) were included in this analysis for interpreting radio-sensitivity of residual tumor. We investigated mATM by NGS of FFPE specimens with a TruSight Tumor 170 (TST-170) cancer panel. RESULTS Among 48 samples, mATM was detected in 17% of cases (n=8). There was no significant difference in patient or tumor characteristics. Among mATM patients, there were 5 patients with glioblastoma and 3 patients with anaplastic astrocytoma IDH-wildtype. Most mutation was missense mutation (n=7, 88%). Median variant allele frequency was 44.7% (Interquartile range, IQR, 10.5–59.9%). Median follow-up duration after radiotherapy was 11.4 (IQR, 8.0–15.8) months. Radiation-related change was observed in 34 patients (71%). Tumors with mATM were related to higher frequency of radiation-related change at 6 months than tumors without mATM, respectively (88% and 64%, p = 0.016). Cases with mATM exhibited significantly 1-year progression free survival (PFS, 100% vs. 54%, p = 0.036). On subgroup of IDH WT (n=39) known as poor prognostic molecular marker, patients with mATM showed significantly higher PFS than patients without mATM (p=0.016, 1yr PFS 100% vs 43%). On subgroup with sub-ventricular zone involvement (n=38) representative of aggressiveness, PFS of patients with mATM was significantly higher than others (p=0.026, 1yr PFS 100% vs 43.9%). CONCLUSIONS Our results demonstrated that mATM is involved in radio-sensitivity with immediate radiologic change after radiation therapy followed by favorable radiologic response and clinical outcome beyond the aggressive nature of high grade glioma.

scholarly journals Brain cancer survival in Canada 1996–2008: effects of sociodemographic characteristics

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
E. V. Walker ◽  
J. Ross ◽  
Y. Yuan ◽  
T. R. Smith ◽  
F. G. Davis
Keyword(s):  
Low Socioeconomic Status ◽  
Brain Cancer ◽  
Rural Areas ◽  
Brain Tumours ◽  
Cancer Survival ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Diffuse Astrocytoma ◽  
Urban Residence ◽  
Statistics Canada

Background Literature suggests that factors such as rural residence and low socioeconomic status (ses) might contribute to disparities in survival for Canadian cancer patients because of inequities in access to care. However, evidence specific to brain cancer is limited. The present research estimates the effects of rural or urban residence and ses on survival for Canadian patients diagnosed with brain cancer.Methods Adults diagnosed with primary malignant brain tumours during 1996–2008 were identified through the Canadian Cancer Registry. Brain tumours were classified using International Classification of Diseases for Oncology (3rd edition) site and histology codes. Hazard ratios (hrs) and 95% confidence intervals (cis) were estimated using Cox proportional hazards models. Events were restricted to individuals whose underlying cause of death was cancerrelated. Postal codes were used to match patient records with Statistics Canada data for rural or urban residence and neighbourhood income as a surrogate measure of ses.Results Of 25,700 patients included in the analysis, 78% died during the study period, 21% lived in rural areas, and 19% were in the lowest income group. A modest variation in survival by rural compared with urban residence was observed for patients with glioblastoma (first 5 weeks after diagnosis hr: 0.86; 95% ci: 0.79 to 0.99) and oligoastrocytoma (first 3 years after diagnosis hr: 1.41; 95% ci: 1.03 to 1.93). Small effects of low compared with high income were seen for patients with glioblastoma (first 1.5 years after diagnosis hr: 1.15; 95% ci: 1.08 to 1.22) and diffuse astrocytoma (first 6 months after diagnosis hr: 1.17; 95% ci: 1.00 to 1.36).Conclusions Our analysis did not yield evidence of strong effects of rural compared with urban residence or ses strata on survival in brain cancer. However, some variation in survival for patients with specific histologies warrants further research into the mechanisms by which rural or urban residence and income stratum influences survival.

scholarly journals OS11 - 165 Brain Cancer Survival and Conditional Survival Rates in Canada (1992-2008)

2016 ◽  
Vol 43 (S4) ◽  
pp. S5-S5
Author(s):  
F. G. Davis ◽  
Y. Yuan ◽  
Q. Shi ◽  
C. Nagamuthu ◽  
E. Andres ◽  
...  
Keyword(s):  
Survival Rate ◽  
Brain Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Diffuse Astrocytoma ◽  
Conditional Survival ◽  
Patient Death ◽  
Cancer Registry Data ◽  
Group Sex

To investigate patterns of survival and estimate conditional survival rates among brain cancer patients in Canada. METHODS: Canadian Cancer Registry data were obtained for all patients with primary brain cancer diagnosed between 1992 and 2008 (n=38,095). Follow-up ended with patient death or December 31, 2008, whichever occurred first. Crude Kaplan-Meier estimates were calculated at one, two, and five years post-diagnosis and also used to estimate conditional survival (restricted to 2000-2008). Age group, sex, residence and microscopic confirmation were considered in estimating rates for major histology types using multivariate models. RESULTS: The overall five-year survival rate was 27%. Oligodendrogliomas had the highest 5-year survival rate (65%, 95% CI: 62.5-67.4%) and glioblastomas the lowest (4.0%, 95% CI: 3.7-4.3%). Compared to Ontario, the age- and sex-adjusted 5-year glioblastoma survival estimates were lower in British Columbia, Alberta and Manitoba-Saskatchewan, lower in all other regions for diffuse astrocytoma, and lower in Manitoba-Saskatchewan for anaplastic astrocytomas. Estimates were significantly higher for oligodendrogliomas in Alberta, and for anaplastic oligodendrogliomas in Alberta and Quebec (P<0.05). Longer term conditional survival rates (surviving an additional 2 years 1-4 years after diagnosis) varied by histologic group. CONCLUSION: There is a need to further explore the underlying reasons for the observed variation in survival rates by region in an effort to improve the prognosis of brain cancer in the Canadian patient population. Conditional survival information has value for clinicians as they plan the course of treatment and follow-up for individual patients.

scholarly journals Protective Effectiveness of Long-Lasting Permethrin Impregnated Clothing Against Tick Bites in an Endemic Lyme Disease Setting: A Randomized Control Trial Among Outdoor Workers

2020 ◽  
Vol 57 (5) ◽  
pp. 1532-1538
Author(s):  
Cedar Mitchell ◽  
Megan Dyer ◽  
Feng-Chang Lin ◽  
Natalie Bowman ◽  
Thomas Mather ◽  
...  
Keyword(s):  
United States ◽  
Rhode Island ◽  
The United States ◽  
Amblyomma Americanum ◽  
Adverse Outcomes ◽  
Control Group ◽  
Tick Bites ◽  
Outdoor Workers ◽  
Significant Difference ◽  
Protective Effectiveness

Abstract Tick-borne diseases are a growing threat to public health in the United States, especially among outdoor workers who experience high occupational exposure to ticks. Long-lasting permethrin-impregnated clothing has demonstrated high initial protection against bites from blacklegged ticks, Ixodes scapularis Say (Acari: Ixodidae), in laboratory settings, and sustained protection against bites from the lone star tick, Amblyomma americanum (L.) (Acari: Ixodidae), in field tests. However, long-lasting permethrin impregnation of clothing has not been field tested among outdoor workers who are frequently exposed to blacklegged ticks. We conducted a 2-yr randomized, placebo-controlled, double-blinded trial among 82 outdoor workers in Rhode Island and southern Massachusetts. Participants in the treatment arm wore factory-impregnated permethrin clothing, and the control group wore sham-treated clothing. Outdoor working hours, tick encounters, and bites were recorded weekly to assess protective effectiveness of long-lasting permethrin-impregnated garments. Factory-impregnated clothing significantly reduced tick bites by 65% in the first study year and by 50% in the second year for a 2-yr protective effect of 58%. No significant difference in other tick bite prevention method utilization occurred between treatment and control groups, and no treatment-related adverse outcomes were reported. Factory permethrin impregnation of clothing is safe and effective for the prevention of tick bites among outdoor workers whose primary exposure is to blacklegged ticks in the northeastern United States.

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