scholarly journals Trends in the Utilization of Radiation Therapy (XRT) Among Patients with Non-Hodgkin's Lymphoma (NHL) in the United States (US)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4765-4765
Author(s):  
Vivek Kumar ◽  
Taimur Sher ◽  
Prakash Vishnu ◽  
Vivek Roy ◽  
Anne M Hazen ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Age Groups ◽  
The United States ◽  
Significant Decline ◽  
P Value ◽  
Significant Heterogeneity ◽  
Cell Transplant ◽  
Annual Percent Change ◽  
The Us ◽  
Facility Level

Abstract Background: The treatment of NHL has witnessed a paradigm shift over time, with targeted immunotherapy, stem cell transplant (SCT) among others. Historically, XRT was used quite frequently for the management of NHL but with advent of better systemic therapy, its utilization has changed. Trends and patterns of care for XRT use have never been formally reported. Methods: We identified patients with NHL diagnosis in the National Cancer Database (NCDB) between years 2004 and 2015. Demographic, clinical, facility level, initial treatment and outcome data were collected. The utilization of XRT in diffuse large B-cell (DLBCL) and non-DLBCL NHL were analyzed separately by univariate and multivariate analyses. To analyze the trends in the rates of XRT, we applied segmented linear regression to calculate the average annual percent change (AAPC) and 95% confidence Interval (CI) with a 'p' value. AAPC and CIs were calculated using the segmented package in R studio v1.1.49. Rest of the analyses was conducted using StataCorp version 15.1. Results: A total of 133,182 DLBCL and 204,933 non-DLBCL patients were identified. Among patients with DLBCL, 27,895 (20.9%) patients received RT. The rate of XRT declined from 25% in 2004 to 18.4% in 2015 with estimated AAPC of -0.59% (95%CI: -0.70- -0.49), p= 0.03 (Figure 1). In a subgroup analysis, a similar decline in the rate of XRT was evident across all the age groups, combined stages I and II vs stages III and IV and nodal vs extra nodal DLBCL (Table 1). Among non DLBCL, 33,369 (16.3%) patients received XRT. There was a statistically significant decline in the rate of XRT from 18.03% in 2004 to 16.3% in 2014 with an AAPC of -0.26 (95%CI: -0.38- -0.14) p <0.001 (Figure 1). On the subgroup analysis, the utilization of XRT declined across all the studied subgroups except among patients aged 80 years and above (Table 1). On multivariate analysis, several demographic, clinical and facility level factors were found to be significantly associated with XRT utilization in NHL (Table 2). In particular, older age groups, racial/ethnic minorities, advanced stages, higher Charlson comorbidity scores and diagnosis in the more recent calendar years were associated with lesser chances of receiving RT. Extranodal DLBCL had lower utilization while extranodal non-DLBCL had increased XRT utilization. Conclusion: There has been a significant decline in the utilization of XRT among patients with NHL (DLBCL and non-DLBCL) in the US since 2004, likely due to introduction of practice changing systemic therapeutics. There is still significant heterogeneity noted in practice patterns regarding utilization of XRT across the US. Having more standardized guidelines will help streamline delivery of evidence-based patient care. Disclosures Ailawadhi: Celgene: Consultancy; Janssen: Consultancy; Amgen: Consultancy; Takeda: Consultancy; Pharmacyclics: Research Funding.

scholarly journals National and State-Level Trends in Non-Traumatic Lower Extremity Amputation Among U.S. Medicare Beneficiaries With Diabetes, 2000-2017

2020 ◽  
Author(s):  
Jessica L Harding ◽  
Linda J Andes ◽  
Deborah B Rolka ◽  
Giuseppina Imperatore ◽  
Edward W Gregg ◽  
...  
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Age Groups ◽  
The United States ◽  
Lower Extremity Amputation ◽  
P Value ◽  
Fee For Service ◽  
Foot Care ◽  
Annual Percent Change ◽  
Extremity Amputation

<i>Objective</i> <div><p>Diabetes is a leading cause of non-traumatic lower extremity amputation (NLEA) in the United States. After a period of decline, some national US data show that diabetes-related NLEA have recently increased, particularly among young and middle-aged adults. However, the trend for older adults is less clear.</p> <p> </p> <p><i>Research Design and Methods</i></p> <p>To examine NLEA trends among older adults with diabetes (≥67 years), we used 100% Medicare claims for beneficiaries enrolled in Parts A and B, also known as Fee for Service (FFS). NLEA was defined as the highest-level amputation per patient per calendar year. Annual NLEA rates were estimated from 2000 to 2017 and stratified by age group, sex, race/ethnicity, NLEA level (toe, foot, below the knee (BKA), above the knee (AKA)), and state. All rates were age and sex standardized to the 2000 Medicare population. Trends over time were assessed using Joinpoint regression and annual percent change (APC) reported.</p> <p><i> </i></p> <p><i>Results</i></p> <p>NLEA rates (per 1,000 people with diabetes) decreased by half from 8.5 in 2000 to 4.4 in 2009 (APC -7.9, p-value<0.001). However, from 2009 onwards NLEA rates increased to 4.8 (APC 1.2, p-value<0.01). Trends were similar across most age, sex and race/ethnic groups, however absolute rates were highest in the oldest age groups, blacks and men. By NLEA type, overall increases were driven by increases in rates of toe and foot NLEAs while BKA and AKA continued to decline. The majority of US states showed recent increases in NLEA, similar to national estimates. </p> <p> </p> <p> </p> <p><i>Conclusions</i></p> <p>This study of the US Medicare FFS population shows that recent increases in diabetes-related NLEAs are also occurring in older populations but at a less severe rate than among younger adults (<65 years) in the general population. Preventive foot care has been shown to reduce rates of NLEA among adults with diabetes, and the findings of the study suggest that those with diabetes – across the age spectrum – could benefit by increased attention to this strategy. </p> </div> <br>

Trends of endometrial cancer incidence from 2000 to 2015 in the United States.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5591-5591
Author(s):  
V V Pavan Kedar Mukthinuthalapati ◽  
Muhammad Zain Farooq ◽  
Shweta Gupta
Keyword(s):  
Endometrial Cancer ◽  
Age Groups ◽  
Cancer Registries ◽  
The United States ◽  
Population Based ◽  
P Value ◽  
Age Group ◽  
Histologic Subtype ◽  
The Us ◽  
Histologic Subtypes

5591 Background: Recent studies have shown that obesity related cancers are increasing in incidence in the US as the rates of obesity rise and some cancers, like colorectal cancer, are occurring in younger age groups. We studied trends in incidence of endometrial cancer (EC), one of the obesity related cancers, in a population wide analysis. Methods: We analyzed data from all cases of EC between 2000 and 2015 from 18 US cancer registries using the National Cancer Institute’s Surveillance, Epidemiology and End Results Program. SEER*Stat was used to query the database for annual percent changes (APC), incidence ratios and percent change in incidence across different age groups, years of diagnosis, histologic subtypes, grade and race. We also studied the reported rates and trends of obesity in the US. Results: APC of age-adjusted EC incidence between 2000 and 2015 was +0.9% (95% confidence interval (CI) 1.1-0.6, p value<0.05). Incidence of EC rose from 17.8 per 100,000 to 19.7 per 100,000 during the same duration. APC for EC incidence for age groups 20-39 and >40 were +3.2% (p-value <0.05) and +0.8% (p value <0.05), respectively. For the age-group 20-39, endometrioid EC was the only histologic subtype that rose in incidence, with an APC of +5.5% and absolute percentage change of 156%. The APC of EC in 20-39 age group was more for whites (3.5%, p-value<0.05) and Asians (2.2%, p-value<0.05) than blacks (1.8, p-value <0.05). CDC reported an increase in obesity rates in adults from 30.5% in 2000 to 37.7% in 2014. Table shows trends of EC incidence in age groups 20-39 and >40 years across various histologic subtypes. (Abbreviations: S significant, NS not significant, NC non-calculable). Conclusions: Endometrial cancer, especially of endometrioid histology, is increasing in incidence and is occurring more often in the younger population. The concomitant rise in obesity rates during the same period point towards a possible causality of the increased in incidence of EC. Population based strategies are needed to decrease the trends in obesity so as to decrease the risk of endometrial cancer in younger women. [Table: see text]

scholarly journals National and State-Level Trends in Non-Traumatic Lower Extremity Amputation Among U.S. Medicare Beneficiaries With Diabetes, 2000-2017

2020 ◽  
Author(s):  
Jessica L Harding ◽  
Linda J Andes ◽  
Deborah B Rolka ◽  
Giuseppina Imperatore ◽  
Edward W Gregg ◽  
...  
Keyword(s):  
Older Adults ◽  
Lower Extremity ◽  
Age Groups ◽  
The United States ◽  
Lower Extremity Amputation ◽  
P Value ◽  
Fee For Service ◽  
Foot Care ◽  
Annual Percent Change ◽  
Extremity Amputation

<i>Objective</i> <div><p>Diabetes is a leading cause of non-traumatic lower extremity amputation (NLEA) in the United States. After a period of decline, some national US data show that diabetes-related NLEA have recently increased, particularly among young and middle-aged adults. However, the trend for older adults is less clear.</p> <p> </p> <p><i>Research Design and Methods</i></p> <p>To examine NLEA trends among older adults with diabetes (≥67 years), we used 100% Medicare claims for beneficiaries enrolled in Parts A and B, also known as Fee for Service (FFS). NLEA was defined as the highest-level amputation per patient per calendar year. Annual NLEA rates were estimated from 2000 to 2017 and stratified by age group, sex, race/ethnicity, NLEA level (toe, foot, below the knee (BKA), above the knee (AKA)), and state. All rates were age and sex standardized to the 2000 Medicare population. Trends over time were assessed using Joinpoint regression and annual percent change (APC) reported.</p> <p><i> </i></p> <p><i>Results</i></p> <p>NLEA rates (per 1,000 people with diabetes) decreased by half from 8.5 in 2000 to 4.4 in 2009 (APC -7.9, p-value<0.001). However, from 2009 onwards NLEA rates increased to 4.8 (APC 1.2, p-value<0.01). Trends were similar across most age, sex and race/ethnic groups, however absolute rates were highest in the oldest age groups, blacks and men. By NLEA type, overall increases were driven by increases in rates of toe and foot NLEAs while BKA and AKA continued to decline. The majority of US states showed recent increases in NLEA, similar to national estimates. </p> <p> </p> <p> </p> <p><i>Conclusions</i></p> <p>This study of the US Medicare FFS population shows that recent increases in diabetes-related NLEAs are also occurring in older populations but at a less severe rate than among younger adults (<65 years) in the general population. Preventive foot care has been shown to reduce rates of NLEA among adults with diabetes, and the findings of the study suggest that those with diabetes – across the age spectrum – could benefit by increased attention to this strategy. </p> </div> <br>

Abstract WMP60: Temporal Trends in Incidence, Prevalence and Epidemiological Characteristics of Cerebral Venous Thrombosis in the United States

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Fadar Otite ◽  
Smit Patel ◽  
Richa Sharma ◽  
Pushti Khandwala ◽  
Devashish Desai ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cerebral Venous Thrombosis ◽  
The United States ◽  
P Value ◽  
Joinpoint Regression ◽  
The Us ◽  
Epidemiological Characteristics ◽  
Over Time ◽  
Age And Sex

Background: The primary aim of this study is to describe current trends in racial-, age- and sex-specific incidence, clinical characteristics and burden of cerebral venous thrombosis (CVT) in the United States (US). Methods: Validated International Classification of Disease codes were used to identify all adult new cases of CVT (n=5,567) in the State Inpatients Database of New York and Florida (2006-2016) and all cases of CVT in the entire US from the National Inpatient Sample 2005-2016 (weighted n=57,315). Incident CVT counts were combined with annual US Census data to compute age and sex-specific incidence of CVT. Joinpoint regression was used to evaluate trends in incidence over time. Results: From 2005-2016, 0.47%-0.80% of all strokes in the US were CVTs but this proportion increased by 70.4% over time. Of all CVTs over this period, 66.7% were in females but this proportion declined over time (p<0.001). Pregnancy/puerperium (27.4%) and cancer (11.8%) were the most common risk factors in women, while cancer (19.5%) and central nervous trauma (11.3) were the most common in men. Whereas the prevalence of pregnancy/puerperium declined significantly over time in women, that of cancer, inflammatory conditions and trauma increased over time in both sexes. Annual age and sex-standardized incidence of CVT in cases/million population ranged from 13.9-20.2, but incidence varied significantly by sex (women: 20.3-26.9; men 6.8-16.8) and by age/sex (women 18-44yo: 24.0-32.6%; men: 18-44yo: 5.3-12.8). Age and sex-standardized incidence also differed by race (Blacks:18.6-27.2; whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006-2016 but most of this increase was driven by increase in all age groups of men (combined annualized percentage change (APC) 9.2%, p-value <0.001), women 45-64 yo (APC 7.8%, p-value <0.001) and women ≥65 yo (APC 7.4%, p-value <0.001). Incidence in women 18-44 yo remained unchanged over time . Conclusion: The epidemiological characteristics of CVT patients in the US is changing. Incidence increased significantly over the last decade. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or artefactual increase from improved detection.

scholarly journals Price Discovery in Cryptocurrency Markets

2019 ◽  
Vol 109 ◽  
pp. 97-99
Author(s):  
Igor Makarov ◽  
Antoinette Schoar
Keyword(s):  
United States ◽  
Price Discovery ◽  
The United States ◽  
Price Formation ◽  
Significant Heterogeneity ◽  
Local Markets ◽  
The Us ◽  
It Impact

We ask which markets drive bitcoin prices and how price discovery happens across different exchanges. Does the greater exuberance for cryptocurrencies outside the United States affect prices only on local markets or does it impact price formation on global cryptocurrency markets? We document significant heterogeneity in which price formation happens across exchanges and time. When markets are more integrated, shocks to prices on all exchanges contribute to price discovery. However, when markets become segmented, those exchanges that have large arbitrage spreads relative to the US price, i.e. where investors are more exuberant become much less important for price discovery.

scholarly journals Folate status in the US population 20 y after the introduction of folic acid fortification

2019 ◽  
Vol 110 (5) ◽  
pp. 1088-1097 ◽  
Author(s):  
Christine M Pfeiffer ◽  
Maya R Sternberg ◽  
Mindy Zhang ◽  
Zia Fazili ◽  
Renee J Storandt ◽  
...  
Keyword(s):  
Folic Acid ◽  
White Women ◽  
Geometric Mean ◽  
Age Groups ◽  
The United States ◽  
Reproductive Age ◽  
Serum Folate ◽  
Folate Status ◽  
Cereal Grain ◽  
The Us

ABSTRACT Background Enriched cereal-grain products have been fortified in the United States for >20 y to improve folate status in women of reproductive age and reduce the risk of folic acid–responsive neural tube birth defects (NTDs). Objectives Our objectives were to assess postfortification changes in folate status in the overall US population and in women aged 12–49 y and to characterize recent folate status by demographic group and use of folic acid–containing supplements. Methods We examined cross-sectional serum and RBC folate data from the NHANES 1999–2016. Results Serum folate geometric means increased from 2007–2010 to 2011–2016 in persons aged ≥1 y (38.7 compared with 40.6 nmol/L) and in women (35.3 compared with 37.0 nmol/L), whereas RBC folate showed no significant change. Younger age groups, men, and Hispanic persons showed increased serum and RBC folate concentrations, whereas non-Hispanic black persons and supplement nonusers showed increased serum folate concentrations. The folate insufficiency prevalence (RBC folate <748 nmol/L; NTD risk) in women decreased from 2007–2010 (23.2%) to 2011–2016 (18.6%) overall and in some subgroups (e.g., women aged 20–39 y, Hispanic and non-Hispanic black women, and supplement nonusers). After covariate adjustment, RBC folate was significantly lower in all age groups (by ∼10–20%) compared with persons aged ≥60 y and in Hispanic (by 8.2%), non-Hispanic Asian (by 12.1%), and non-Hispanic black (by 20.5%) compared with non-Hispanic white women (2011–2016). The 90th percentile for serum (∼70 nmol/L) and RBC (∼1800 nmol/L) folate in supplement nonusers aged ≥60 y was similar to the geometric mean in users (2011–2014). Conclusions Blood folate concentrations in the US population overall and in women have not decreased recently, and folate insufficiency rates are ∼20%. Continued monitoring of all age groups is advisable given the high folate status particularly in older supplement users.

The Difference in the Incidence and the Trend of Malignant Lymphomas in Japan and the United States.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2695-2695
Author(s):  
Dai Chihara ◽  
Hidemi Ito ◽  
Tomohiro Matsuda ◽  
Akiko Shibata ◽  
Tomotaka Sobue ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Hematologic Malignancies ◽  
The United States ◽  
Cumulative Exposure ◽  
Malignant Lymphomas ◽  
Annual Percent Change ◽  
Percent Change ◽  
Nodular Sclerosis ◽  
The Us ◽  
The Difference

Abstract Abstract 2695 Background: Malignant lymphomas (ML) are heterogeneous groups that the detailed classification is evolving dramatically. An incidence of malignant disease in certain population reflects cumulative exposure to environment, genetics and their combination overtime. Therefore, a comparison of incidences in various population and their secular trends is very helpful to understand etiology of disease. The aim of this study is to assess the incidence and the trend of each ML subtypes and to evaluate the difference between Japan and US. Materials and Methods: We used the data from a population-based cancer registry in Japan and from the Surveillance Epidemiology and End Results (SEER) program 9. Registry data of the US, SEER 9 included 95,155 cases and the data of Japan included 48,658 cases. The period covered in this analyses was 1993 to 2006 in Japan and 1993 to 2008 in the US. Rates of sex-specific, age-standardized incidence with 95% confidence intervals were estimated and standardized by age-adjustment according to the world standard population. We also estimated the annual percent change using joinpoint regression analysis and evaluated the significance of the trend. Results: The overall age-standardized incidence rate of all malignant lymphomas per 100,000 in 2006 was 22.4 for males and 16.0 for females in the US, 7.4 for males and 4.9 for females in Japan. The incidence is higher in the US than Japan with most of the subtypes especially for the nodular sclerosis HL, CLL/SLL and FL. In general, B-cell lymphomas showed large difference in incidence while T-cell lymphomas (TCL) showed similar incidence between Japan and the US. The total numbers of ML are constantly increasing in Japan but not in the US as shown in the figure {annual percent change (95%CI), Japan; +2.6% (2.1, 3.1), US; +0.2% (−0.0, 0.4)}. As for details, follicular lymphoma, mantle cell lymphoma, Burkitt lymphoma and the total numbers of TCL are constantly increasing in both countries. Conclusion: In conclusion, we showed the marked difference in the incidence and the trend of hematologic malignancies between Japan and the US. The incidence of hematologic malignancies is lower in Japan than the US, but is increasing significantly. The most remarkable difference in the incidence was seen with nodular sclerosis HL, CLL/SLL and FL which was consistent with previous reports. Even with the TCL, the incidence seems to be similar to higher in the US except for the ATLL. The improvement in the quality of cancer registry systems and the organization of these registries between countries enables us to unite the data worldwide that will bring us new insights. Solid line and circle are the data of the US. Dashed line and hollow circle are the data of Japan. Disclosures: No relevant conflicts of interest to declare.

Incidence trends for human papillomavirus-related (HPV-R) and unrelated (HPV-U) head and neck squamous cell carcinomas (HNSCC) in the United States (US)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6001-6001 ◽  
Author(s):  
A. Chaturvedi ◽  
E. Engels ◽  
W. Anderson ◽  
M. Gillison
Keyword(s):  
The United States ◽  
Underlying Disease ◽  
Birth Cohorts ◽  
Anatomic Site ◽  
Annual Percent Change ◽  
Absolute Increase ◽  
Incidence Trends ◽  
The Us ◽  
Smoking Behaviors ◽  
Regional Disease

6001 Background: HNSCC are etiologically heterogeneous, with one subset primarily attributable to HPV and another to tobacco and alcohol. Methods: Data from SEER9 program registries were used to investigate the potential influence of HPV on incidence and survival of HNSCC in the US from 1973–2003. HNSCCs (N=58,158) were classified by anatomic site as potentially HPV-R (base of tongue; tonsil; oropharynx; N=16,712) or HPV-U (lip; tongue; gum; floor of mouth; palate; other mouth; hypopharynx; ill-defined sites of lip, oral cavity, and pharynx; N=41,446). Joinpoint regression was used to assess incidence trends and life-table methods were used to compare survival for HPV-R and HPV-U HNSCCs. Results: For HPV-R HNSCCs, age-adjusted incidence increased significantly from 1973–2003 (annual percent change [APC] = 0.65), particularly among males (APC=1.02), whites (APC=0.89), and younger ages (APCs for 30–39 = 1.46; 40- 49=1.92; 50–59=0.61, and =60= -0.66). By contrast, HPV-U HNSCC incidence was stable from 1973–1983 and then decreased significantly from 1983–2003 (APC= -2.42). Mean age at diagnosis was younger for HPV-R HNSCC than HPV-U (61.1 vs. 64.5 years; p<0.001), and from 1973- 2003, decreased significantly for HPV-R, but increased for HPV-U. Improvements in overall survival (OS) were observed for HPV-R (all stages) and HPV-U (regional and distant) HNSCC treated by radiotherapy (RT) from 1973–2003, but were more marked for HPV-R HNSCC, e.g. absolute increase in two-year OS for regional disease of 24.4% (vs. 5.8% for HPV-U). OS for HPV-R (local and regional) was significantly better than HPV-U HNSCC if treated by RT, but worse if not so treated. Conclusions: The proportion of HNSCC that is potentially HPV- R increased in the US from 1973–2003, particularly among recent birth cohorts, perhaps due to changing sexual and smoking behaviors. Recent improvements in locoregional control with RT-based therapy may be due in part to a gradual shift in the etiology of the underlying disease. No significant financial relationships to disclose.

Subgroup analysis of patients enrolled in the United States in the CORRECT phase 3 trial of the multikinase inhibitor regorafenib (REG) in metastatic colorectal cancer (mCRC).

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 767-767
Author(s):  
Heinz-Josef Lenz ◽  
Eric Van Cutsem ◽  
Udit N. Verma ◽  
Marc Saltzman ◽  
Jyotsna Fuloria ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Small Sample Size ◽  
The United States ◽  
Small Sample ◽  
Wild Type ◽  
Correct Trial ◽  
Multikinase Inhibitor ◽  
Kras Status ◽  
The Us ◽  
Dose Modifications

767 Background: The CORRECT trial (NCT01103323) showed that REG improves overall survival (OS) vs placebo (PBO) in patients with mCRC who failed approved therapies (OS HR 0.77; 1-sided p=0.0052; Grothey 2013). A total of 760 patients were randomized to REG (n=505) or PBO (n=255) in more than 100 centers across North America, Europe, Asia, and Australia. We conducted a post-hoc exploratory subgroup analysis of the 83 (11%) patients from 18 US centers. Methods: Eligible patients had an ECOG PS ≤1 and had received approved therapies, including a fluoropyrimidine, oxaliplatin, irinotecan, and bevacizumab, and if KRAS wild-type cetuximab and/or panitumumab. Data from the overall cohort, including US patients, are provided for perspective. Descriptive statistics are shown. Results: Of the 83 US patients, 36 (43%) were randomized to PBO and 47 (57%) to REG. Baseline characteristics of the US group were consistent with the overall cohort: median age in the US was 58 yr (range, 34 – 85) vs 61 (22 – 85) overall, 49% of US patients were ECOG PS1 (vs 46%), and 46% received ≤ 3 treatments for mCRC (vs 52%). KRAS status mutant/wild-type was 57%/34% in the US vs 57%/39% overall. All patients in the trial had prior bevacizumab and 57% of US patients also had prior cetuximab and/or panitumumab (vs 51% overall). However, higher proportion of patients in the US were Black (11% vs 2%), KRAS status unknown (10% vs 4%), and had colon as the primary disease site (82% vs 65%). Mean percentages of planned REG dose were similar (76% US vs 79% overall) and mean REG treatment duration was 3.1 mos in US vs 2.8 mos overall. Rates of dose modifications REG/PBO were 87%/47% in the US vs 76%/38% overall and grade ≥3 adverse events REG/PBO were 74%/64% vs 78%/49%, respectively. Based on 44 total death events, the HR for OS in the US subgroup was 0.46 (95%CI 0.25 – 0.84) favoring REG; median OS was 4.7 mos for PBO, but could not be estimated for REG due to censored data. However, this analysis was based on a relatively small sample size and event count. Conclusions: Patients treated in the CORRECT study in the US appear similar to the overall cohort and results are generally consistent with the overall findings of the trial. Clinical trial information: NCT01103323.

Intergenerational Transfers and Public Expenditure on the Elderly in Modern Britain

1988 ◽  
Vol 8 (2) ◽  
pp. 129-146 ◽  
Author(s):  
Paul Johnson ◽  
Jane Falkingham
Keyword(s):  
Social Services ◽  
Elderly Population ◽  
Public Expenditure ◽  
Age Groups ◽  
The Elderly ◽  
The United States ◽  
Generational Conflict ◽  
The Us ◽  
Families With Children ◽  
Poor Children

ABSTRACTIn the United States, much attention has recently been directed to the issue of whether the welfare system has become over-generous to the retired population, at the expense of families with children. The proportion of the US elderly population living in poverty has fallen significantly in the last fifteen years while the number of poor children has increased rapidly, and it has been suggested that this lack of investment in the next generation of workers may have disastrous longterm consequences for the U.S. economy. This paper considers whether similar trends are evident in Britain. It reviews data on the poverty and income of the elderly population, and finds little unequivocal evidence of relative economic gain over the last two decades, although it is clear that many children have suffered from the recent rise in unemployment-induced poverty. It also looks at direct public expenditure on the elderly through both the pension and the health and personal social services systems, and finds no evidence of a transfer of public resources away from children and towards the elderly population. The paper concludes that the British welfare state has been remarkably neutral in its allocation of resources between generations, and that, in the British context, any discussion of inter-generational conflict for welfare resources establishes a false dichotomy, because economic inequality within broad age groups is much greater than inequality between age groups.

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