Reducing Inequalities in Cancer Outcomes: What Works?

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2013.33.e250 ◽

2013 ◽

pp. e250-e254

Author(s):

Nina A. Bickell ◽

Electra D. Paskett

Keyword(s):

Cancer Incidence ◽

Health Reform ◽

Patient Navigation ◽

Trial Data ◽

Improve Quality ◽

Cancer Outcomes ◽

Recent Trial ◽

What Works ◽

Incidence And Mortality ◽

Made In

Despite efforts to reduce disparities in cancer outcomes among vulnerable populations, certain subgroups do not experience the gains made in the reduction of cancer incidence and mortality. In this article, we review recent trial data reporting on patient-, physician-, and system-centered interventions to improve quality and reduce disparities in cancer care spanning patient navigation to health reform. We conclude with data from a state that implemented a multitiered approach, targeting patient and systems barriers, that serves as a guide for future endeavors.

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Cohort profile: the Women’s Health Accelerometry Collaboration

BMJ Open ◽

10.1136/bmjopen-2021-052038 ◽

2021 ◽

Vol 11 (11) ◽

pp. e052038

Author(s):

Kelly R Evenson ◽

John Bellettiere ◽

Carmen C Cuthbertson ◽

Chongzhi Di ◽

Rimma Dushkes ◽

...

Keyword(s):

Physical Activity ◽

Cohort Studies ◽

Women’S Health ◽

Women's Health ◽

Sedentary Behaviour ◽

Cancer Diagnosis ◽

Cancer Incidence ◽

Cancer Surveillance ◽

Cancer Outcomes ◽

Incidence And Mortality

PurposeThis paper describes the Women’s Health Accelerometry Collaboration, a consortium of two prospective cohort studies of women age 62 years or older, harmonised to explore the association of accelerometer-assessed physical activity and sedentary behaviour with cancer incidence and mortality.ParticipantsA total of 23 443 women (age mean 73.4, SD 6.8) living in the USA and participating in an observational study were included; 17 061 from the Women’s Health Study (WHS) and 6382 from the Women’s Health Initiative Objective Physical Activity and Cardiovascular Health (WHI/OPACH) Study.Findings to dateAccelerometry, cancer outcomes and covariate harmonisation was conducted to align the two cohort studies. Physical activity and sedentary behaviour were measured using similar procedures with an ActiGraph GT3X+ accelerometer, worn at the hip for 1 week, during 2011–2014 for WHS and 2012–2014 for WHI/OPACH. Cancer outcomes were ascertained via ongoing surveillance using physician adjudicated cancer diagnosis. Relevant covariates were measured using questionnaire or physical assessments. Among 23 443 women who wore the accelerometer for at least 10 hours on a single day, 22 868 women wore the accelerometer at least 10 hours/day on ≥4 of 7 days. The analytical sample (n=22 852) averaged 4976 (SD 2669) steps/day and engaged in an average of 80.8 (SD 46.5) min/day of moderate-to-vigorous, 105.5 (SD 33.3) min/day of light high and 182.1 (SD 46.1) min/day of light low physical activity. A mean of 8.7 (SD 1.7) hours/day were spent in sedentary behaviour. Overall, 11.8% of the cohort had a cancer diagnosis (other than non-melanoma skin cancer) at the time of accelerometry measurement. During an average of 5.9 (SD 1.6) years of follow-up, 1378 cancer events among which 414 were fatal have occurred.Future plansUsing the harmonised cohort, we will access ongoing cancer surveillance to quantify the associations of physical activity and sedentary behaviour with cancer incidence and mortality.

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The relationship between urologic cancer outcomes and national Human Development Index: trend from 2012 to 2018

10.21203/rs.2.14786/v1 ◽

2019 ◽

Author(s):

Nan Zhang ◽

Hua Mu ◽

Yan-rou Jiang ◽

Shi-geng Zhang

Keyword(s):

Prostate Cancer ◽

Cancer Incidence ◽

Survival Rates ◽

Substantial Reduction ◽

Mortality Rates ◽

Incidence Rates ◽

Cancer Outcomes ◽

Net Survival ◽

Incidence And Mortality ◽

Urologic Cancer

Abstract Objectives To describe the influence of the socioeconomic development on worldwide age-standardized incidence and mortality rates, as well as mortality-to-incidence ratio (MIR) and 5-year net survival of urologic cancer patients from 2012 to 2018. Methods The HDI values were obtained from the United Nations Development Programme, data on age-standardized incidence/mortality rates of prostate, bladder and kidney cancer were retrieved from the GLOBOCAN database, 5-year net survival was provided by the CONCORD-3 program. We then evaluated the association between incidence/MIR/survival and HDI, with a focus on geographic variability as well as temporal patterns during the last 6 years. Results Urologic cancer incidence rates were positively correlated with HDIs, and MIRs were negatively correlated with HDIs. Prostate cancer survival also correlated positively with HDIs, solidly confirming the interrelation among cancer indicators and socioeconomic factors. Most countries experienced incidence decline over the most recent 6 years, and a substantial reduction in MIR was observed. Survival rates of prostate cancer have simultaneously improved. Conclusion Development has a prominent influence on urologic cancer outcomes. HDI values are significantly correlated with cancer incidence, MIR and survival rates. HDI values have risen along with increased incidence and improved outcomes of urologic caner in recent years.

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