Impact of race on incidence and survival from colorectal cancer in young adults in the United States.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 62-62
Author(s):  
Dhruvika Mukhija ◽  
Sajan Nagpal
Keyword(s):  
Colorectal Cancer ◽  
Older Adults ◽  
Young Adults ◽  
American Indian ◽  
Alaska Native ◽  
The United States ◽  
Tumor Location ◽  
Asian Pacific ◽  
The Impact ◽  
White Patients

62 Background: Multiple studies have reported an increasing incidence of colorectal cancer (CRC) in young( < 45 years)adults.However, the impact of race on the incidence, tumor location and survival in adults < 45 years with CRC has not been explored. Methods: Using Surveillance,Epidemiology and End Results database,we identified patients with CRC and abstracted data on patient demographics,tumor location and survival between 1973-2014, and compared these variables in patients 18-44 years with those > 45 years. Cases where CRC was not the first/only malignancy were excluded.Categorical variables were compared using the Chi-square test and overall survival was analyzed using Kaplan-Meier method. Results: Overall, 453,019 patients were included (27, 352 < 45,and 425,667 >45 years). 81.7% among those > 45 years were caucasian, as compared to 74.3% < 45 years of age. Among those < 45, 14.3% were black, 10.3% were Asian/Pacific Islander (API) and 1.1% were American Indian/Alaska Native (compared to 10.1%, 7.5% and 0.6% respective in adults > 45) (p < 0.0001*) (Table). 73.1% of those < 45 had left sided disease (descending, sigmoid colon and rectum) as compared to 60.1% in those > 45 (p < 0.0001*).Survival was poorer for non-white patients (black, API and AI) (94 months, 95%CI 90-100) as compared to white patients (153 months, 95%CI 145-161) overall, and individually for the < 45 and >45 years subgroups as well. Conclusions: Racial distribution in patients with CRC differs significantly among patients < 45 as compared to older adults,with incidence in young American Indian/Alaska Natives approaching 2 times that of older adults,and 1.5 times in young Blacks and Asian/Pacific Islanders.Non-white races have poorer survival across all age groups.With rates of CRC rising sharply in young adults, underlying reasons for these differences require further investigation to better channelize efforts for education and screening. [Table: see text]

scholarly journals Head and Neck Cancer among American Indian and Alaska Native Populations in California, 2009–2018

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5195
Author(s):  
Brooke R. Warren ◽  
Jennifer R. Grandis ◽  
Daniel E. Johnson ◽  
Alessandro Villa
Keyword(s):  
Head And Neck Cancer ◽  
Survival Rate ◽  
American Indian ◽  
Head And Neck ◽  
Neck Cancer ◽  
Alaska Native ◽  
Pacific Islander ◽  
Asian Pacific Islander ◽  
Asian Pacific ◽  
White Patients

The purpose of this study was to determine the incidence of HPV-positive (HPV+) and HPV-negative (HPV-) head and neck cancer (HNC) in the American Indian/Alaska Native (AI/AN) population in California to assess whether incidence is higher among AI/ANs compared to other ethnicities. We analyzed data from the California Cancer Registry, which contains data reported to the Cancer Surveillance Section of the Department of Public Health. A total of 51,289 HNC patients were identified for the years 2009–2018. Outcomes of interest included sex, stage at presentation, 5-year survival rate, tobacco use, and HPV status. AI/AN and White patients had the highest burden of late stage HNC (AI/AN 6.3:100,000; 95% CI 5.3–7.4, White 5.8:100,000; 95% CI 5.7–5.9) compared to all ethnicities or races (Black: 5.2; 95% CI 4.9–5.5; Asian/Pacific Islander: 3.2; 95% CI 3–3.3; and Hispanic: 3.1; 95% CI 3–3.2 per 100,000). Additionally, AI/AN and White patients had the highest burden of HPV+ lip, oral cavity, and pharynx HNC (AI/AN 0.9:100,000; 95% CI 0.6–1.4, White 1.1:100,000; 95% CI 1–1.1) compared to all ethnicities or races (Black: 0.8:100,000; 95% CI 0.7–0.9; Asian/Pacific Islander: 0.4; 95% CI 0.4–0.5; and Hispanic: 0.6; 95% CI 0.5–0.6). AI/ANs had a decreased 5-year survival rate compared to White patients (AI/AN 59.9%; 95% CI 51.9–67.0% and White 67.7%; 95% CI 67.00–68.50%) and a higher incidence of HNC in former and current tobacco users. These findings underscore the disparities that exist in HNC for California AI/AN populations. Future studies should aim to elucidate why the unequal burden of HNC outcomes exists, how to address increased tobacco usage, and HPV vaccination patterns to create culturally and community-based interventions.

Dental Care Utilization and Service Needs Among American Indian/Alaska Native/Native Hawaiian Elders: 2008 to 2017

2018 ◽  
Vol 31 (10) ◽  
pp. 1917-1940
Author(s):  
Shawnda Schroeder ◽  
Collette Adamsen ◽  
Cole Ward
Keyword(s):  
Older Adults ◽  
Native American ◽  
American Indian ◽  
Dental Care ◽  
Alaska Native ◽  
Native Hawaiian ◽  
The United States ◽  
Care Utilization ◽  
Dental Care Utilization ◽  
Need For Treatment

Objective: This study describes trends in self-reported dental care utilization and services needed among American Indian/Alaska Native/Native Hawaiian (AI/AN/NH) elders 2008 to 2017, including demographic and socioeconomic variability. Method: Researchers utilized data from the Survey of Elders administered by the National Resource Center on Native American Aging, representing all regions of the United States and 262 tribes. Data were analyzed comparing means over time and between/within groups. Results: Between April 2008 and March 2017, there was a statistically significant ( p < .001) increase in the proportion of older adults who visited a dentist and an increase in need for treatment. A smaller proportion of older adults reported need for treatment among those who were privately insured, high income, had no tobacco use, were employed, and had visited a dental professional in the last year. Discussion: These findings highlight current dental needs among tribal elders while also identifying elders at greater risk of poor oral health.

scholarly journals Association between Race and Cancer-Related Mortality among Patients with Colorectal Cancer in the United States: A Retrospective Cohort Study

2019 ◽  
Vol 16 (2) ◽  
pp. 240 ◽  
Author(s):  
Sayaf Alshareef ◽  
Nasser Alsobaie ◽  
Salman Aldeheshi ◽  
Sultan Alturki ◽  
Juan Zevallos ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Cohort Study ◽  
American Indian ◽  
Alaska Native ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
The United States ◽  
The Us ◽  
Related Mortality

Colorectal cancer (CRC) is the third most common cause of mortality in the United States (US). Differences in CRC mortality according to race have been extensively studied; however, much more understanding with regard to tumor characteristics’ effect on mortality is needed. The objective was to investigate the association between race and mortality among CRC patients in the US during 2007–2014. A retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) Program, which collects cancer statistics through selected population-based cancer registries during in the US, was conducted. The outcome variable was CRC-related mortality in adult patients (≥18 years old) during 2007–2014. The independent variable was race of white, black, Asian/Pacific Islander (API), and American Indian/Alaska Native (others). The covariates were, age, sex, marital status, health insurance, tumor stage at diagnosis, and tumor size and grade. Bivariate analysis was performed to identify possible confounders (chi-square tests). Unadjusted and adjusted logistic regression models were used to study the association between race and CRC-specific mortality. The final number of participants consisted of 70,392 patients. Blacks had a 32% higher risk of death compared to whites (adjusted odds ratio (OR) 1.32; 95% confidence interval (CI) 1.22–1.43). Corresponding OR for others were 1.41 (95% CI 1.10–1.84). API had nonsignificant adjusted odds of mortality compared to whites (0.95; 95% CI 0.87–1.03). In conclusion, we observed a significant increased risk of mortality in black and American Indian/Alaska Native patients with CRC compared to white patients.

MATERNAL EDUCATIONAL ATTAINMENT AND SEX RATIO AT BIRTH BY RACE IN THE UNITED STATES, 2007–2015

2018 ◽  
Vol 51 (3) ◽  
pp. 457-462 ◽  
Author(s):  
Victor Grech
Keyword(s):  
Educational Attainment ◽  
American Indian ◽  
Alaska Native ◽  
Maternal Education ◽  
Pacific Islander ◽  
The United States ◽  
Live Births ◽  
Asian Pacific Islander ◽  
Education Levels ◽  
Asian Pacific

SummaryMany factors influence the male:female birth ratio (number of male births divided by total births, M/T). Studies have suggested that this ratio may be positively correlated with the education levels of mothers. This study assessed the effect of maternal education on M/T in the US population overall and by racial group. Number of live births by sex of the child, maternal educational level reached and race were obtained from the Centres for Disease Control (CDC Wonder) for the period 2007–2015. The total study sample comprised 28,268,183 live births. Overall, for the four available recorded racial groups (Asian/Pacific Islander, White, American Indian/Alaska Native and Black/African American), M/T rose significantly with increasing education levels (p<0.0001). When analysed by race, this relationship was only found for White births (p<0.0001). The M/T of Black births rose with increasing maternal education level up to associate degree level (p=ns), then fell significantly with higher levels of education (χ2=4.5, p=0.03). No significant trends were present for Asian/Pacific Islander or American Indian/Alaska Native births. Socioeconomic indicators are generally indicators of better condition and in this study educational attainment was overall found to be positively correlated with M/T, supporting the Trivers–Willard hypothesis.

Urban/rural disparities in stage at presentation of colorectal cancer among young adults in the United States, 2007-2015.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3598-3598
Author(s):  
Victoria Nguyen ◽  
David J. Delgado ◽  
Rachel Gray Denneny ◽  
Jay Subramoney ◽  
Brandon George ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Young Adults ◽  
Multivariable Analysis ◽  
The United States ◽  
Tumor Location ◽  
Lower Odds ◽  
Younger Age ◽  
Signet Ring ◽  
Urban Rural

3598 Background: The overall incidence rate of colorectal cancer (CRC) has declined in recent decades but is rising in young adults (YA). Disparities also exist in CRC presentation and geographical residence. We examined associations between urban/rural residence and CRC stage at presentation among YA 18-50 years old, using the Surveillance, Epidemiology, and End Results (SEER) 1973-2015 registry. Methods: Retrospective cohort study using SEER patients (pts) diagnosed with CRC between 2007-2015, aged 18-50. Urban/rural status was defined at the county level as large metro, small metro, urban non-metro, and rural. Pts were grouped by age: 18-30, 31-40, and 41-50 years old. Stage was defined as in-situ/localized and regional/distant. We used multivariable logistic regression to describe associations between urban/rural status with stage at presentation, adjusting for tumor location, histology, grade, and patient attributes (e.g. insurance status). Results: 27,198 CRC pts were analyzed: 62.2% large metro, 27.4% small metro, 9.4% urban non-metro, and 67.1% regional/distant stage. In multivariable analysis, YA in urban non-metro counties had lower odds of regional/distant stage at presentation compared to YA in large metro counties (OR = 0.87, 95% CI = 0.79-0.97). Associations between small metro and rural status with stage at presentation were not significant (OR = 0.94, 95% CI = 0.89-1.01 and OR = 0.84, 95% CI = 0.64-1.10, respectively). YA with Medicaid or no insurance had higher odds of regional/distant CRC (OR = 1.28, 95% CI = 1.17-1.39 and OR = 1.34, 95% CI = 1.20-1.51, respectively) compared to YA privately insured. Other factors in YA associated with higher odds of regional/distant CRC included signet-ring histology, poorly-, moderately-, and undifferentiated grade, and younger age (18-30 and 31-40 years old). Conclusions: YA in urban non-metro areas had lower odds of regional/distant CRC at presentation compared to YA in large metro areas. YA with Medicaid, no insurance, signet-ring histology, poorly-, moderately-, and undifferentiated grade, and younger age had higher odds of regional/distant CRC at presentation. Further research is needed to explore the etiology of these differences.

scholarly journals A Confluence of Policy Inequality: Health Disparities in Old Age Among American Indian and Alaska Native Populations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Sadie Giles
Keyword(s):  
United States ◽  
Health Disparities ◽  
Life Course ◽  
American Indian ◽  
Old Age ◽  
Alaska Native ◽  
Political History ◽  
The United States ◽  
The Political ◽  
The Life Course

Abstract Racial health disparities in old age are well established, and new conceptualizations and methodologies continue to advance our understanding of health inequality across the life course. One group that is overlooked in many of these analyses, however, is the aging American Indian/Native Alaskan (AI/NA) population. While scholars have attended to the unique health inequities faced by the AI/NA population as a whole due to its discordant political history with the US government, little attention has been paid to unique patterns of disparity that might exist in old age. I propose to draw critical gerontology into the conversation in order to establish a framework through which we can uncover barriers to health, both from the political context of the AI/NA people as well as the political history of old age policy in the United States. Health disparities in old age are often described through a cumulative (dis)advantage framework that offers the benefit of appreciating that different groups enter old age with different resources and health statuses as a result of cumulative inequalities across the life course. Adding a framework of age relations, appreciating age as a system of inequality where people also gain or lose access to resources and status upon entering old age offers a path for understanding the intersection of race and old age. This paper will show how policy history for this group in particular as well as old age policy in the United States all create a unique and unequal circumstance for the aging AI/NA population.

scholarly journals The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America

2021 ◽  
Vol 35 ◽  
pp. 100848
Author(s):  
Ganesh M. Babulal ◽  
Valeria L. Torres ◽  
Daisy Acosta ◽  
Cinthya Agüero ◽  
Sara Aguilar-Navarro ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Latin America ◽  
Well Being ◽  
The United States ◽  
The Impact

scholarly journals Food Insecurity in the United States: Identification, Treatment, and Implications

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 772-773
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Connie Bales ◽  
Julie Locher
Keyword(s):  
United States ◽  
Older Adults ◽  
At Risk ◽  
Food Insecurity ◽  
Well Being ◽  
The United States ◽  
Health Clinic ◽  
High Risk Population ◽  
Geriatric Syndrome ◽  
The Impact

Abstract Food insecurity is an under-recognized geriatric syndrome that has extensive implications in the overall health and well-being of older adults. Understanding the impact of food insecurity in older adults is a first step in identifying at-risk populations and provides a framework for potential interventions in both hospital and community-based settings. This symposium will provide an overview of current prevalence rates of food insecurity using large population-based datasets. We will present a summary indicator that expands measurement to include the functional and social support limitations (e.g., community disability, social isolation, frailty, and being homebound), which disproportionately impact older adults, and in turn their rate and experience of food insecurity and inadequate food access. We will illustrate using an example of at-risk seniors the association between sarcopenia, the age-related loss of muscle mass and function, with rates of food security in the United States. The translational aspect of the symposium will then focus on identification of psychosocial and environmental risk factors including food insecurity in older veterans preparing for surgery within the Veterans Affairs Perioperative Optimization of Senior Health clinic. Gaining insights into the importance of food insecurity will lay the foundation for an intervention for food insecurity in the deep south. Our discussant will provide an overview of the implications of these results from a public health standpoint. By highlighting the importance of food insecurity, such data can potentially become a framework to allow policy makers to expand nutritional programs as a line of defense against hunger in this high-risk population.

scholarly journals Do millennials value travel time differently because of productive multitasking? A revealed-preference study of Northern California commuters

2021 ◽  
Author(s):  
Aliaksandr Malokin ◽  
Giovanni Circella ◽  
Patricia L. Mokhtarian
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Willingness To Pay ◽  
Travel Time ◽  
Choice Model ◽  
Mode Choice ◽  
Revealed Preference ◽  
Northern California ◽  
Factors Affecting ◽  
The Impact

AbstractMillennials, the demographic cohort born in the last two decades of the twentieth century, are reported to adopt information and communication technologies (ICTs) in their everyday lives, including travel, to a greater extent than older generations. As ICT-driven travel-based multitasking influences travelers’ experience and satisfaction in various ways, millennials are expected to be affected at a greater scale. Still, to our knowledge, no previous studies have specifically focused on the impact of travel multitasking on travel behavior and the value of travel time (VOTT) of young adults. To address this gap, we use an original dataset collected among Northern California commuters (N = 2216) to analyze the magnitude and significance of individual and household-level factors affecting commute mode choice. We estimate a revealed-preference mode choice model and investigate the differences between millennials and older adults in the sample. Additionally, we conduct a sensitivity analysis to explore how incorporation of explanatory factors such as attitudes and propensity to multitask while traveling in mode choice models affects coefficient estimates, VOTT, and willingness to pay to use a laptop on the commute. Compared to non-millennials, the mode choice of millennials is found to be less affected by socio-economic characteristics and more strongly influenced by the activities performed while traveling. Young adults are found to have lower VOTT than older adults for both in-vehicle (15.0% less) and out-of-vehicle travel time (15.7% less), and higher willingness to pay (in time or money) to use a laptop, even after controlling for demographic traits, personal attitudes, and the propensity to multitask. This study contributes to better understanding the commuting behavior of millennials, and the factors affecting it, a topic of interest to transportation researchers, planners, and practitioners.

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