Residential mobility among adult cancer survivors in the United States

Abstract Background While residential mobility affects people’s health, the dynamic of neighborhood tenure and its associated factors among cancer patients and survivors have not been studied in detail. This cross-sectional study aimed to identify sociodemographic factors associated with neighborhood tenure and relocation after the first cancer diagnosis among U.S. adult cancer survivors and patients. Methods Based on a nationally representative sample of non-institutionalized civilian adults (≥18 years, n = 185,637) from the 2013–2018 National Health Interview Survey, we compared neighborhood tenure between adults with and without a history of cancer, and identified factors associated with their neighborhood tenure and relocation after the first cancer diagnosis, using propensity score matching, and logistic regression models with survey design incorporated. Results Among adults with cancer (9.0%), 39.6% had a neighborhood tenure ≤10 years (vs. 61.2% among those without cancer), and 25.6% (equivalent to 5.4 million) relocated after their first cancer diagnosis. The odds of having shorter neighborhood tenure was higher among the cancer group in the propensity-matched samples (odds ratio = 1.05; 95% CI: 1.05–1.06; n = 17,259). Among cancer survivors, the odds of neighborhood relocation were negatively associated with increasing age, perceived neighborhood social cohesion, having high school level education, and being married; while positively associated with having family income below the poverty threshold, being uninsured, and living in non-Northeast regions. Conclusions High residential mobility was found among a sizable proportion of adults with a history of cancer, and was associated with multiple socioeconomic factors. Incorporating and addressing modifiable risk factors associated with residential mobility among cancer patients and survivors may offer new intervention opportunities to improve cancer care delivery and reduce cancer disparities.

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Physical Comorbidities and Depression in Recent and Long-Term Adult Cancer Survivors: NHANES 2007–2018

Cancers ◽

10.3390/cancers13133368 ◽

2021 ◽

Vol 13 (13) ◽

pp. 3368

Author(s):

Dafina Petrova ◽

Andrés Catena ◽

Miguel Rodríguez-Barranco ◽

Daniel Redondo-Sánchez ◽

Eloísa Bayo-Lozano ◽

...

Keyword(s):

Cancer Survivors ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Depression Symptoms ◽

Depression Risk ◽

Adult Cancer Survivors ◽

Before And After ◽

Nationally Representative ◽

Risk Of Cancer

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a sample of 2073 adult cancer survivors drawn from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2007–2018) in the U.S. Based on information regarding 16 chronic conditions, the number of comorbidities diagnosed before and after the cancer diagnosis was calculated. The number of comorbidities present at the moment of cancer diagnosis was significantly related to depression risk in recent but not in long-term survivors. Recent survivors who suffered multimorbidity had 3.48 (95% CI 1.26–9.55) times the odds of reporting significant depressive symptoms up to 5 years after the cancer diagnosis. The effect of comorbidities was strongest among survivors of breast cancer. The comorbidities with strongest influence on depression risk were stroke, kidney disease, hypertension, obesity, asthma, and arthritis. Information about comorbidities is usually readily available and could be useful in streamlining depression screening or targeting prevention efforts in cancer patients and survivors. A multidimensional model of the interaction between cancer and other physical comorbidities on mental health is proposed.

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Risk of acute renal failure among breast cancer patients and chemotherapy treatment of breast cancer patients with a history of renal insufficiency in a commercially-insured population in the United States

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e22104 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e22104-e22104 ◽

Cited By ~ 1

Author(s):

W. J. Langeberg ◽

C. D. O'Malley ◽

C. W. Critchlow ◽

J. P. Fryzek

Keyword(s):

Breast Cancer ◽

Renal Failure ◽

Acute Renal Failure ◽

Renal Insufficiency ◽

Cancer Patients ◽

Cancer Diagnosis ◽

The United States ◽

First Year ◽

Breast Cancer Patients ◽

History Of

e22104 Background: Risk of acute renal failure (ARF) among breast cancer (BC) patients may increase with nephrotoxic chemotherapy and other exposures, but this risk is not well characterized. Furthermore, among patients who present with renal insufficiencies (RI) at cancer diagnosis, subsequent treatment patterns are not well described. Methods: We performed a retrospective cohort study using a large national commercial claims database. The cohort included all women diagnosed with BC from 2000 to 2007 who were 18–64 years at diagnosis with no history of cancer (n=13,296). We defined a diagnosis of BC as at least one inpatient or two outpatient claims more than 30 days apart with an ICD-9 code of 174. Among patients with no history of RI (n=13,150), we calculated the cumulative incidence (CI) of ARF_the proportion with at least one inpatient or two outpatient claims with an ICD-9 code of 584 or 586 in the first year following cancer diagnosis. Treatment for BC patients with a history of RI (n=146) was also assessed. Results: Among BC patients with no history of RI, 0.3% were diagnosed with ARF within a year after cancer diagnosis. The CI of ARF was higher in patients with metastases: 0.7% for any metastasis, 2.3% for bone metastasis, and 0.1% for no metastasis. The CI of ARF among patients undergoing radiation or mastectomy was similar to the overall rate (0.3%) but was higher in patients receiving nephrotoxic chemotherapy (1.0%) or intravenous bisphosphonates (IV BPs) (2.1%). The CI of ARF was higher in patients with congestive heart failure (1.4%), diabetes (0.9%), and/or hypertension (0.8%) at cancer diagnosis compared to patients without these comorbidities (0.2%). Among BC patients with a history of RI, 7.5% were administered nephrotoxic chemotherapy, 30.1% received potentially nephrotoxic chemotherapy, and 1.4% were given IV BPs. Conclusions: Breast cancer patients who present with comorbidities, develop metastases, or are given nephrotoxic chemotherapy or IV bisphosphonates are at higher risk of acute renal failure in the first year after breast cancer diagnosis. More research is warranted on the treatment of breast cancer patients with a history of renal insufficiency. [Table: see text]

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Is cancer history associated with asset ownership, debt, and net worth in the United States?

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e18085 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e18085-e18085

Author(s):

Maryam Doroudi ◽

Diarmuid Coughlan ◽

Matthew P. Banegas ◽

K Robin Yabroff

Keyword(s):

United States ◽

Cancer Survivors ◽

The United States ◽

Medical Expenditure ◽

Age Group ◽

Asset Ownership ◽

Cancer History ◽

Net Worth ◽

History Of ◽

History Of Cancer

e18085 Background: Financial hardships experienced by cancer survivors in the United States have become significant social and public health issues. Few studies have assessed the underlying financial holdings, including ownership and values of assets and debts, of individuals following a cancer diagnosis. This study assessed the association between a cancer history and asset ownership, debt, and net worth. Methods: We identified 1,603 cancer survivors and 34,915 individuals without a history of cancer aged 18-64 from the nationally representative Medical Expenditure Panel Survey (MEPS) Household Component and Asset sections (years 2008-2011). Descriptive statistics were used to assess demographic characteristics, cancer history, asset ownership, debt, and net worth by cancer history. Regression analysis was conducted to assess the association between cancer history and net worth, stratified by age group (18-34, 35-44, 45-54, and 55-64 years) to reflect stages of the life-course. Results: Asset ownership was least common for cancer survivors and individuals without a cancer history in the 18-34 age group and most common in the 55-64 age group. Cancers survivors aged 45-54 had a lower proportion of home ownership than individuals without a cancer history (59% vs 67%; p = 0.001). Nearly 20% of all respondents reported at least some debt. The proportion of cancer survivors with debt was higher than individuals without a history of cancer, especially in the 18-34 age group (41% vs 27%; p < 0.001), although it did not vary by age group. When asset and debt values were combined to assess net worth, cancer survivors aged 45-54 were significantly more likely to have a negative net worth and significantly less likely to have a positive net worth than those individuals without a history of cancer in fully adjusted models. Findings on net worth were similar in the 18-34 age group, although only statistically significant in unadjusted and partially adjusted models. Conclusions: We found that cancer history is associated with asset ownership, debt, and net worth, especially in those aged 45-54 years. Longitudinal studies to assess patterns of financial holdings throughout the cancer experience are warranted.

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Psycho-Oncology: Cancer patients with past suicide attempts, or a family history of suicide.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e23173 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e23173-e23173

Author(s):

Daniela Gercovich ◽

Ernesto Gil Deza ◽

Flavio Tognelli ◽

Carlos Fernando Garcia Gerardi ◽

Claudia Lorena Acuna ◽

...

Keyword(s):

Family History ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Illicit Drugs ◽

Suicide Attempts ◽

The United States ◽

Population Characteristics ◽

History Of ◽

Psychological Risk

e23173 Background: “The suicide rate in cancer patients is twice that observed in the general population in the United States” (JNCI vol 100, 24, page 1750, 2008). This paper focuses ona population with great psychological risk: cancer patients (Pt) with previous suicide attempts (SA) or a family history of suicide (FS); both grouped under SAFS for the purpose of this study. Methods: Between 9/26/2012 and 11/28/2018 all new patients (Pt) admitted to IOHM filled out a Past Medical History Form (PMHF) (ASCO 2013 ABST. e17539) with their preexisting clinical conditions. The database was locked and anonymized. Those with a history of SAFS before cancer diagnosis were selected. Results: Out of 15,617 Pt, 184 Pt (1.2%) were SAFS(141 Pt were SA, 39 Pt were FS and 4 Pt were both). The relative risk ofSA was ten times larger for those with FS. Psychiatric Medication: Antipsychotics: 15Pt (8%), Antidepressants: 23 Pt (12%) and Benzodiazepines 45 Pt(24%), No treatment 101 Pt (55%). Population Characteristics: Sex: F:144 Pt . M: 40 Pt. Age: 56y (r = 26-88). Tumor Dx: Breast (65 Pt ) - Gastrointestinal (24 Pt) - Urological (21 Pt ) - Lung (21 Pt ) -Gynecological (19 Pt) - Hematological (11 Pt) -Head &Neck (8 Pt) - Endocrine (7 Pt) - Other (8 Pt). Stages: Early (0-I-II-III): 130 Pt, Advanced: 54 Pt. Ob-Gyn history:25 Pt (17%) nulliparous, 18 Pt (12%) with one child, 77 Pt (53%) with 2 or 3 children and 24 Pt (17%) with more than 3 children; 62 Pt (43%) had previous abortions. Average severe comorbidities (respiratory and psychiatric) was 3 per Pt (r = 0-18). Toxic habits: Smoking: 120 Pt (65%), Alcohol: 37 Pt (20%) and Illicit Drugs: 4 Pt (2%). Follow-up: 19 months (r = 0-70). No Pt had any SA, or commited suicide, during the follow-up.Living patients:177 (96%). Conclusions: 1) In our vast cohort, 184 Pt (1.2%) were identified as highly vulnerable psychiatric Pt due to SAFS. 2) Given the high psychological risk and stressful cancer diagnosis, 83 Pt (45%) were prescribed psychiatric drugs. 3) Follow-up of SAFS Pt by a multidisciplinary team is requiredfor adequate Pt and family support.

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Factors associated with self-reported history of depression diagnosis among cancer survivors aged 18 years and over in the United States

Psycho-Oncology ◽

10.1002/pon.4770 ◽

2018 ◽

Vol 27 (8) ◽

pp. 2039-2044 ◽

Cited By ~ 1

Author(s):

Gemechu B. Gerbi ◽

Stranjae Ivory ◽

Elaine Archie-Booker ◽

Mechelle D. Claridy ◽

Stephanie Miles-Richardson

Keyword(s):

United States ◽

Cancer Survivors ◽

The United States ◽

Depression Diagnosis ◽

Factors Associated ◽

History Of ◽

History Of Depression

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Use of Medications for Treating Anxiety and Depression in Cancer Survivors in the United States

Journal of Clinical Oncology ◽

10.1200/jco.2016.67.7690 ◽

2017 ◽

Vol 35 (1) ◽

pp. 78-85 ◽

Cited By ~ 20

Author(s):

Nikki A. Hawkins ◽

Ashwini Soman ◽

Natasha Buchanan Lunsford ◽

Steven Leadbetter ◽

Juan L. Rodriguez

Keyword(s):

United States ◽

Cancer Survivors ◽

Medication Use ◽

The United States ◽

Population Based ◽

Anxiety And Depression ◽

Current Medication ◽

History Of ◽

Interview Survey ◽

History Of Cancer

Purpose This study used population-based data to estimate the percentage of cancer survivors in the United States reporting current medication use for anxiety and depression and to characterize the survivors taking this type of medication. Rates of medication use in cancer survivors were compared with rates in the general population. Methods We analyzed data from the National Health Interview Survey, years 2010 to 2013, identifying cancer survivors (n = 3,184) and adults with no history of cancer (n = 44,997) who completed both the Sample Adult Core Questionnaire and the Adult Functioning and Disability Supplement. Results Compared with adults with no history of cancer, cancer survivors were significantly more likely to report taking medication for anxiety (16.8% v 8.6%, P < .001), depression (14.1% v 7.8%, P < .001), and one or both of these conditions combined (19.1% v 10.4%, P < .001), indicating that an estimated 2.5 million cancer survivors were taking medication for anxiety or depression in the United States at that time. Survivor characteristics associated with higher rates of medication use for anxiety included being younger than 65 years old, female, and non-Hispanic white, and having public insurance, a usual source of medical care, and multiple chronic health conditions. Survivor characteristics associated with medication use for depression were largely consistent with those for anxiety, with the exceptions that insurance status was not significant, whereas being widowed/divorced/separated was associated with more use. Conclusion Cancer survivors in the United States reported medication use for anxiety and depression at rates nearly two times those reported by the general public, likely a reflection of greater emotional and physical burdens from cancer or its treatment.

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Comparison of modifiable health behaviours between persons with and without cancer: the Multiethnic Cohort

Public Health Nutrition ◽

10.1017/s136898001000340x ◽

2011 ◽

Vol 14 (10) ◽

pp. 1796-1804 ◽

Cited By ~ 15

Author(s):

Nicholas J Ollberding ◽

Gertraud Maskarinec ◽

Lynne R Wilkens ◽

Brian E Henderson ◽

Laurence N Kolonel

Keyword(s):

Risk Factors ◽

Cancer Research ◽

Cancer Survivors ◽

Health Behaviours ◽

Modifiable Risk Factors ◽

Dietary Recommendations ◽

Multiethnic Cohort ◽

Adult Cancer Survivors ◽

History Of ◽

History Of Cancer

AbstractObjectiveTo compare the prevalence of modifiable risk factors for cancer and other chronic diseases between adult cancer survivors and persons with no history of cancer.DesignCross-sectional.SettingPopulation-based sample residing in California and Hawaii.SubjectsA total of 177 003 men and women aged 45–75 years who participated in the Multiethnic Cohort Study (MEC). Logistic regression was used to examine adherence to recommendations regarding modifiable risk factors among cancer survivors (n 16 346) when compared with cohort members with no history of cancer (n 160 657).ResultsCancer survivors were less likely than cohort members with no history of cancer to meet recommendations specified in the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) 2007 report (OR = 0·97; 95 % CI 0·96, 0·99). No difference between groups was seen for adherence to dietary recommendations alone (OR = 0·99; 95 % CI 0·98, 1·01). Site-specific analyses showed that results for colorectal cancer were similar to those for all cancers combined, but survivors of breast (OR = 1·04; 95 % CI 1·02, 1·07) and prostate (OR = 1·04; 95 % CI 1·01, 1·07) cancer were more likely to meet dietary recommendations. Latino survivors were less likely to adhere to WCRF/AICR recommendations than Latino controls; however, differences across ethnic groups were not significant (Pinteraction = 0·64).ConclusionsThe modest differences found between adult cancer survivors and persons with no history of cancer suggest that a diagnosis of cancer in itself may not be associated with improvements in health behaviours related to cancer and other chronic diseases.

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Experiences of cancer patients with outpatient care in the USA: a population-based study

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2020-0124 ◽

2020 ◽

Vol 9 (13) ◽

pp. 959-967

Author(s):

Omar Abdel-Rahman

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cancer Patients ◽

Outpatient Care ◽

Healthcare Providers ◽

Multivariable Logistic Regression Analysis ◽

Factors Associated ◽

The Usa ◽

History Of ◽

History Of Cancer

Aim: To evaluate the patterns of cancer patients-assessed quality of outpatient care in the USA. Materials & methods: Medical Expenditure Panel Survey datasets for the years 2011, 2013, 2015 and 2017 were accessed and adult participants with a history of cancer diagnosis were reviewed. Participants’ assessments of different quality indicators of healthcare providers were reviewed. Multivariable logistic regression analysis for factors associated with a better overall rating of healthcare was then conducted. Results: A total of 8050 participants with a history of cancer were included. Within multivariable logistic regression analysis, factors associated with the better rating of healthcare included; older age (odds ratio [OR]: 1.017; 95% CI: 1.010–1.025), higher income OR (OR: 2.385; 95% CI: 1.735–3.277) and better self-reported health status (OR: 6.691; 95% CI: 3.928–11.396). Conclusion: Cancer patients with older age, higher income and better health status were more likely to be satisfied with the outpatient care they received. The biggest area for potential improvement of patient satisfaction seems to be related to the time spent with healthcare providers.

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Best Practices in Counseling Young Female Cancer Survivors on Reproductive Health

Seminars in Reproductive Medicine ◽

10.1055/s-0037-1603770 ◽

2017 ◽

Vol 35 (04) ◽

pp. 378-389 ◽

Cited By ~ 7

Author(s):

Ksenya Shliakhtsitsava ◽

Deepika Suresh ◽

Tracy Hadnott ◽

H. Su

Keyword(s):

Reproductive Health ◽

Cancer Survivors ◽

Health Care Providers ◽

Chromosomal Abnormalities ◽

The United States ◽

Reproductive Age ◽

Care Providers ◽

History Of ◽

Adverse Pregnancy ◽

History Of Cancer

AbstractIn the United States, there are more than 400,000 girls and young women of reproductive-age with a history of cancer. Cancer treatments including surgery, chemotherapy, targeted therapy, and radiation can adversely impact their reproductive health. This review discusses infertility, contraception, and adverse pregnancy and child health outcomes in reproductive-aged cancer survivors, to increase awareness of these health risks for survivors and their health care providers. Infertility rates are modestly higher, while rates of using contraception and using highly effective contraceptive methods are lower in cancer survivors than in women without a history of cancer. During pregnancy, preterm births are also more common in survivors, resulting in more low-birth-weight offspring. Children of cancer survivors do not have more childhood cancers, birth defects, or chromosomal abnormalities than the general population, with the exception of families with hereditary cancer. Reproductive risks in survivors depend on cancer treatment exposures. For example, women with prior abdominal or pelvic radiation have additional risks of spontaneous abortions, small-for-gestational-age offspring and stillbirths, while those with prior chest radiation or anthracycline exposures have higher risks of cardiomyopathy. To help survivors achieve their reproductive goals safely, family planning and preconception counseling are central to survivorship care.

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Economic Burden of Cancer Survivorship Among Adults in the United States

Journal of Clinical Oncology ◽

10.1200/jco.2013.49.1241 ◽

2013 ◽

Vol 31 (30) ◽

pp. 3749-3757 ◽

Cited By ~ 180

Author(s):

Gery P. Guy ◽

Donatus U. Ekwueme ◽

K. Robin Yabroff ◽

Emily C. Dowling ◽

Chunyu Li ◽

...

Keyword(s):

United States ◽

Cancer Survivors ◽

Cancer Survivorship ◽

Economic Burden ◽

The United States ◽

Medical Expenditures ◽

Medical Expenditure ◽

Lost Productivity ◽

History Of ◽

History Of Cancer

Purpose To present nationally representative estimates of the impact of cancer survivorship on medical expenditures and lost productivity among adults in the United States. Methods Using the 2008 to 2010 Medical Expenditure Panel Survey, we identified 4,960 cancer survivors and 64,431 individuals without a history of cancer age ≥ 18 years. Direct medical costs were measured using annual health care expenditures and examined by source of payment and service type. Indirect morbidity costs were estimated from lost productivity as a result of employment disability, missed work days, and lost household productivity. We evaluated the economic burden of cancer survivorship by estimating excess costs among cancer survivors, stratified by time since diagnosis (recently diagnosed [≤ 1 year] and previously diagnosed [> 1 year]), compared with individuals without a history of cancer using multivariable regression models stratified by age (18 to 64 and ≥ 65 years), controlling for age, sex, race/ethnicity, education, and comorbidities. Results In 2008 to 2010, the annual excess economic burden of cancer survivorship among recently diagnosed cancer survivors was $16,213 per survivor age 18 to 64 years and $16,441 per survivor age ≥ 65 years. Among previously diagnosed cancer survivors, the annual excess burden was $4,427 per survivor age 18 to 64 years and $4,519 per survivor age ≥ 65 years. Excess medical expenditures composed the largest share of the economic burden among cancer survivors, particularly among those recently diagnosed. Conclusion The economic impact of cancer survivorship is considerable and is also high years after a cancer diagnosis. Efforts to reduce the economic burden caused by cancer will be increasingly important given the growing population of cancer survivors.

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