scholarly journals Factors Associated With Patient's Refusal of Recommended Cancer Surgery: Based on Surveillance, Epidemiology, and End Results

2022 ◽  
Vol 9 ◽  
Author(s):  
Xianglin Hu ◽  
Hui Ye ◽  
Wangjun Yan ◽  
Yangbai Sun
Keyword(s):  
Marital Status ◽  
Cancer Patients ◽  
Metastatic Cancer ◽  
Ethnic Disparities ◽  
Cancer Surgery ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Insurance Type ◽  
Racial Ethnic ◽  
End Results

ObjectivesMost non-metastatic cancer patients can harvest a preferable survival after surgical treatment, however, patients sometimes refuse the recommended cancer-directed surgery. It is necessary to uncover the factors associated with patent's decision in taking cancer surgery and explore racial/ethnic disparities in surgery refusal.MethodsBased on the Surveillance, Epidemiology and End Results (SEER)-18 program, we extracted data of non-metastatic cancer patients who didn't undergo surgery. Ten common solid cancers were selected. Four racial/ethnic categories were included: White, black, Hispanic, and Asian/Pacific Islander (API). Primary outcome was patient's refusal of surgery. Multivariable logistic regression models were used, with reported odds ratio (OR) and 95% confidence interval (CI).ResultsAmong 318,318 patients, the incidence of surgery refusal was 3.5%. Advanced age, female patients, earlier cancer stage, uninsured/Medicaid and unmarried patients were significantly associated with higher odds of surgery refusal. Black and API patients were more likely to refuse recommended surgery than white patients in overall cancer (black-white: adjusted OR, 1.18; 95% CI, 1.11–1.26; API-white: adjusted OR, 1.56; 95% CI, 1.41–1.72); those racial/ethnic disparities narrowed down after additionally adjusting for insurance type and marital status. In subgroup analysis, API-white disparities in surgery refusal widely existed in prostate, lung/bronchus, liver, and stomach cancers.ConclusionsPatient's socioeconomic conditions reflected by insurance type and marital status may play a key role in racial/ethnic disparities in surgery refusal. Oncological surgeons should fully consider the barriers behind patient's refusal of recommended surgery, thus promoting patient-doctor shared decision-making and guiding patients to the most appropriate therapy.

Demographic factors associated with missed follow-up among solid tumor patients treated at a large multi-site academic institution

2020 ◽  
Vol 16 (32) ◽  
pp. 2635-2643
Author(s):  
Samantha L Freije ◽  
Jordan A Holmes ◽  
Saleh Rachidi ◽  
Susannah G Ellsworth ◽  
Richard C Zellars ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Odds Ratio ◽  
Regression Models ◽  
Tumor Patients ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Follow Up Care ◽  
Risk Patients ◽  
African American Race

Aim: To identify demographic predictors of patients who miss oncology follow-up, considering that missed follow-up has not been well studies in cancer patients. Methods: Patients with solid tumors diagnosed from 2007 to 2016 were analyzed (n = 16,080). Univariate and multivariable logistic regression models were constructed to examine predictors of missed follow-up. Results: Our study revealed that 21.2% of patients missed ≥1 follow-up appointment. African–American race (odds ratio [OR] 1.33; 95% CI: 1.17–1.51), Medicaid insurance (OR 1.59; 1.36–1.87), no insurance (OR 1.66; 1.32–2.10) and rural residence (OR 1.78; 1.49–2.13) were associated with missed follow-up. Conclusion: Many cancer patients miss follow-up, and inadequate follow-up may influence cancer outcomes. Further research is needed on how to address disparities in follow-up care in high-risk patients.

Study Protocol: Assessment of Racial/Ethnic Disparities in the Timeliness and Comprehensiveness of Surgery for Colorectal Cancer v1

2021 ◽  
Author(s):  
rhow not provided ◽  
Vidhya Gunaseelan ◽  
mbicket not provided
Keyword(s):  
Ethnic Group ◽  
Regression Models ◽  
Primary Outcome ◽  
Elective Surgery ◽  
Preoperative Staging ◽  
Ethnic Disparities ◽  
Study Groups ◽  
Logistic Regression Models ◽  
Racial Ethnic ◽  
Emergent Surgery

This retrospective cohort study will investigate the timeliness of surgery based on the racial/ethnic group of patients who under colorectal surgery for cancer. Patients are included if they underwent surgical procedures for colon cancer between January 1, 2015 and April 30, 2020. The primary exposure of interest is the racial/ethnic group of the patient. The primary outcome is the the timeliness of surgery, defined as having urgent/emergent surgery (less timely) vs. elective surgery (more timely). Secondary outcomes relate to comprehensiveness of surgery, and include performance of preoperative staging tests, preoperative lab testing, and preoperative teaching of patients, as well as length of stay and additional clinical outcomes. Multivariable logistic regression models will be used to adjust for other demographic and clinical differences between study groups.

scholarly journals Risk factors associated with suicide among kidney cancer patients: A Surveillance, Epidemiology, and End Results analysis

2019 ◽  
Vol 8 (11) ◽  
pp. 5386-5396 ◽  
Author(s):  
Chenyu Guo ◽  
Wenwen Zheng ◽  
Weiwei Zhu ◽  
Shengqiang Yu ◽  
Yuexia Ding ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cancer Patients ◽  
Kidney Cancer ◽  
Factors Associated ◽  
End Results

U.S. trends and racial/ethnic disparities in opioid access among patients with poor prognosis cancer at the end of life (EOL).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7005-7005
Author(s):  
Andrea Catherine Enzinger ◽  
Kaushik Ghosh ◽  
Nancy Lynn Keating ◽  
David M Cutler ◽  
Mary Beth Landrum ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Poor Prognosis ◽  
Ethnic Disparities ◽  
Opioid Prescription ◽  
Ed Visits ◽  
The Impact ◽  
To Receive ◽  
Racial Ethnic ◽  
Patients With Poor Prognosis

7005 Background: Heightened US opioid regulations may limit advanced cancer patients’ access to effective pain management, particularly for racial/ethnic minority and other vulnerable populations. We examined trends in opioid access, disparities in access, and pain-related emergency department (ED) visits among cancer patients near end of life (EOL). Methods: Using a 20% random sample of Medicare FFS beneficiaries, we identified 243,124 patients with poor prognosis cancers who died between 2007-2016. We examined trends in outpatient opioid prescription fills and pain-related ED visits near EOL (30 days prior to death or hospice enrollment), for the overall cohort and by race (white, black, other). Per-capita opioid supply by state was obtained from the federal Drug Enforcement Agency ARCOS database. Geographic fixed-effects models examined predictors of opioid use near EOL, opioid dose in morphine milligram equivalents (MMEs), and pain-related ED visits, adjusted for patient demographic and clinical characteristics, state, opioid supply, and year. Results: From 2007-2016 the proportion of patients with poor prognosis cancers filling an opioid prescription near EOL fell from 41.7% to 35.7%, with greater decrements among blacks (39.3% to 29.8%) than whites (42.2% to 36.5%) and other races (38.2% to 32.4%). The proportion of patients receiving long-acting opioids near EOL fell from 17% to 12% overall (15% to 9% among blacks). Among patients receiving EOL opioids, the median daily dose fell from 40MMEs (IQR 16.5-98.0) to 30MMEs (IQR 15.0–78.8). In adjusted analyses, blacks were less likely than whites to receive EOL opioids (AOR 0.85; 95% CI, 0.80 to 0.91) and on average received 10MMEs less per day (b -9.9; 95% CI -15.7 to -4.2). Patients of other race were also less likely to receive EOL opioids (AOR 0.92; 95% CI, 0.85-0.95), although their dose did not differ significantly from whites. Rates of pain-related ED visits near EOL increased from 13.2% to 18.8% over the study period. In adjusted analyses, blacks were more likely than whites to have pain-related ED visits (AOR 1.29, 95% CI, 1.16-1.37) near death, as were those of other races (AOR 1.30; 95% CI, 1.17-1.37). Conclusions: While lawmakers have sought to mitigate the impact of opioid regulations upon cancer patients, access to EOL opioids have decreased substantially over time with concomitant increases in pain-related ED visits. There are significant racial/ethnic disparities in opioid access, with blacks receiving fewer opioids at lower doses and having more ED-based care for pain near EOL.

scholarly journals Racial-Ethnic Disparities in End-of-Life Care Quality among Lung Cancer Patients: A SEER-Medicare–Based Study

2018 ◽  
Vol 13 (8) ◽  
pp. 1083-1093 ◽  
Author(s):  
Siddharth Karanth ◽  
Suja S. Rajan ◽  
Gulshan Sharma ◽  
Jose-Miguel Yamal ◽  
Robert O. Morgan
Keyword(s):  
Lung Cancer ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Ethnic Disparities ◽  
Care Quality ◽  
Life Care ◽  
Lung Cancer Patients ◽  
Racial Ethnic

Marital Status and Sexually Transmitted Infections Among African Americans

2010 ◽  
Vol 31 (9) ◽  
pp. 1147-1165 ◽  
Author(s):  
Eboni M. Taylor ◽  
Adaora A. Adimora ◽  
Victor J. Schoenbach
Keyword(s):  
African Americans ◽  
Marital Status ◽  
Racial Disparities ◽  
Racial Differences ◽  
Risk Behaviors ◽  
Ethnic Disparities ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Marriage Rates ◽  
Racial Ethnic

This article assesses the relationship between low marriage rates and racial disparities in sexually transmitted infection (STI) rates. Data from the 2002 National Survey of Family Growth was used to examine the prevalence of sexual risk behaviors by marital status. Logistic regression was used to examine whether racial differences in marriage patterns help account for racial disparities in STI rates. Results indicate that the 12-month prevalence of multiple partners and high-risk partnerships was lowest among currently married, intermediate among cohabiting, and highest among formerly and never-married respondents. Of all racial/ethnic groups, African Americans were least likely to be married. In multiple logistic analyses adjustment for marriage attenuated the association between race and STI risk behaviors for African Americans. Low marriage rates may be an important contributing factor to racial/ethnic disparities in STI rates, particularly for African Americans.

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