Showing papers by "Dennis Deapen published in 2016"

Comparison of SEER Treatment Data With Medicare Claims

Abstract: Background: The population-based Surveillance, Epidemiology, and End Results (SEER) registries collect information on first-course treatment, including surgery, chemotherapy, radiation therapy, and hormone therapy. However, the SEER program does not release data on chemotherapy or hormone therapy due to uncertainties regarding data completeness. Activities are ongoing to investigate the opportunity to supplement SEER treatment data with other data sources.

Breast-cancer-specific mortality in patients treated based on the 21-gene assay: a SEER population-based study

Abstract: The 21-gene Recurrence Score assay is validated to predict recurrence risk and chemotherapy benefit in hormone-receptor-positive (HR+) invasive breast cancer. To determine prospective breast-cancer-specific mortality (BCSM) outcomes by baseline Recurrence Score results and clinical covariates, the National Cancer Institute collaborated with Genomic Health and 14 population-based registries in the the Surveillance, Epidemiology, and End Results (SEER) Program to electronically supplement cancer surveillance data with Recurrence Score results. The prespecified primary analysis cohort was 40–84 years of age, and had node-negative, HR+, HER2-negative, nonmetastatic disease diagnosed between January 2004 and December 2011 in the entire SEER population, and Recurrence Score results (N=38,568). Unadjusted 5-year BCSM were 0.4% (n=21,023; 95% confidence interval (CI), 0.3–0.6%), 1.4% (n=14,494; 95% CI, 1.1–1.7%), and 4.4% (n=3,051; 95% CI, 3.4–5.6%) for Recurrence Score <18, 18–30, and ⩾31 groups, respectively (P<0.001). In multivariable analysis adjusted for age, tumor size, grade, and race, the Recurrence Score result predicted BCSM (P<0.001). Among patients with node-positive disease (micrometastases and up to three positive nodes; N=4,691), 5-year BCSM (unadjusted) was 1.0% (n=2,694; 95% CI, 0.5–2.0%), 2.3% (n=1,669; 95% CI, 1.3–4.1%), and 14.3% (n=328; 95% CI, 8.4–23.8%) for Recurrence Score <18, 18–30, ⩾31 groups, respectively (P<0.001). Five-year BCSM by Recurrence Score group are reported for important patient subgroups, including age, race, tumor size, grade, and socioeconomic status. This SEER study represents the largest report of prospective BCSM outcomes based on Recurrence Score results for patients with HR+, HER2-negative, node-negative, or node-positive breast cancer, including subgroups often under-represented in clinical trials. A common gene-panel test can help to predict the likelihood of women with breast cancer dying from the disease. Valentina Petkov at the US National Cancer Institute in Maryland and her colleagues studied a form of breast cancer that responds to hormone therapy in more than 44,500 American patients with and without spread to the lymph nodes. At diagnosis, all had taken a genomic test called Oncotype DX, which estimates the likelihood of breast-cancer recurrence on the basis of expression data from 21 genes. The team found that the test’s ‘recurrence score’ was strongly associated with the chance of death from breast cancer — independent of patient age, tumor size and tumor grade. The study provides the best evidence to date that Oncotype DX can be used to predict mortality risk, including for racial minority and other under-represented groups.

Disparities in colorectal cancer incidence among Latino subpopulations in California defined by country of origin

Abstract: In California, colorectal cancer (CRC) is the second most common cancer in Latinos. Using data from the California Cancer Registry, we investigated demographic and clinical characteristics of 36,133 Latinos with CRC living in California during 1995–2011 taking into account subpopulations defined by country of origin. Cases were defined as Latino according to the North American Association of Central Cancer Registries Hispanic Identification Algorithm, which was also used to group cases by country of origin: Mexico (9,678, 27 %), Central or South America (2,636, 7 %), Cuban (558, 2 %), Puerto Rico (295, 1 %), and other or unknown origin (22,966, 64 %; Other/NOS). 174,710 non-Hispanic white (NHW) CRC cases were included for comparison purposes. Annual age-adjusted incidence rates (AAIR) and proportional incidence ratios (PIRs) were calculated. Differences were observed for age at diagnosis, sex distribution, socioeconomic status (SES), nativity (US born vs. foreign born), stage, and tumor localization across Latino subpopulations and compared to NHW. Mexican Latinos had the lowest AAIR and Cuban Latinos had the highest. PIRs adjusted for age, SES, and nativity showed an excess of CRC males and female cases from Cuba, female cases from Puerto Rico and reduced number of female cases from Mexico. Differences in cancer incidence patterns and tumor characteristics were observed among Latino subpopulations in California. These disparities may reflect differences in cancer determinants among Latinos; therefore, given that country of origin information is unavailable for a large proportion of these patients, greater efforts to collect these data are warranted.

Breast implants and anaplastic large cell lymphomas among females in the California Teachers Study cohort

Abstract: Babor, F., Manser, A.R., Fischer, J.C., Scherenschlich, N., Enczmann, J., Chazara, O., Moffett, A., Borkhardt, A., Meisel, R. & Uhrberg, M. (2014) KIR ligand C2 is associated with increased susceptibility to childhood ALL and confers an elevated risk for late relapse. Blood, 124, 2248–2251. Braud, V.M., Allan, D.S., Wilson, D. & McMichael, A.J. (1998) TAPand tapasin-dependent HLA-E surface expression correlates with the binding of an MHC class I leader peptide. Current Biology, 8, 1–10. Corrah, T.W., Goonetilleke, N., Kopycinski, J., Deeks, S.G., Cohen, M.S., Borrow, P., McMichael, A. & Brackenridge, S. (2011) Reappraisal of the relationship between the HIV-1-protective single-nucleotide polymorphism 35 kilobases upstream of the HLA-C gene and surface HLAC expression. Journal of Virology, 85, 3367–3374. Geraghty, D.E., Stockschleader, M., Ishitani, A. & Hansen, J.A. (1992) Polymorphism at the HLAE locus predates most HLA-A and -B polymorphism. Human Immunology, 33, 174–184. Majumder, D., Bandyopadhyay, D., Chandra, S., Mukherjee, N. & Banerjee, S. (2006) Lack of HLA-E surface expression is due to deficiency of HLA-E transcripts in the malignant hematopoietic cells of leukemic patients. Leukemia Research, 30, 242–245. Pende, D., Spaggiari, G.M., Marcenaro, S., Martini, S., Rivera, P., Capobianco, A., Falco, M., Lanino, E., Pierri, I., Zambello, R., Bacigalupo, A., Mingari, M.C., Moretta, A. & Moretta, L. (2005) Analysis of the receptor-ligand interactions in the natural killer-mediated lysis of freshly isolated myeloid or lymphoblastic leukemias: evidence for the involvement of the Poliovirus receptor (CD155) and Nectin-2 (CD112). Blood, 105, 2066–2073. Sleiman, M., Brons, N.H., Kaoma, T., Dogu, F., Villa-Forte, A., Lenoble, P., Hentges, F., Kotsch, K., Gadola, S.D., Vilches, C. & Zimmer, J. (2014) NK cell killer Ig-like receptor repertoire acquisition and maturation are strongly modulated by HLA class I molecules. J Immunol, 192, 2602–2610. Thomas, R., Apps, R., Qi, Y., Gao, X., Male, V., O’HUigin, C., O’Connor, G., Ge, D., Fellay, J., Martin, J.N., Margolick, J., Goedert, J.J., Buchbinder, S., Kirk, G.D., Martin, M.P., Telenti, A., Deeks, S.G., Walker, B.D., Goldstein, D., McVicar, D.W., Moffett, A. & Carrington, M. (2009) HLA-C cell surface expression and control of HIV/AIDS correlate with a variant upstream of HLA-C. Nature Genetics, 41, 1290–1294. Verheyden, S., Ferrone, S., Mulder, A., Claas, F.H., Schots, R., De Moerloose, B., Benoit, Y. & Demanet, C. (2009) Role of the inhibitory KIR ligand HLA-Bw4 and HLA-C expression levels in the recognition of leukemic cells by Natural Killer cells. Cancer Immunology, Immunotherapy, 58, 855–865.

Body size over the life-course and the risk of endometrial cancer: the California Teachers Study

Abstract: Obesity is a public health epidemic and a major risk factor for endometrial cancer. Here, we identify key aspects of body size which jointly, over the life-course (since adolescence), are associated with endometrial cancer risk. Among 88,142 participants in the California Teachers Study, 887 were diagnosed with invasive type 1 endometrial cancer between 1997–1998 and 2012. Multivariable Cox proportional hazards models provided estimates of hazard rate ratios (HR) and 95% confidence intervals (CI) for endometrial cancer associated with life-course body size phenotypes, which incorporated validated measures. Among women currently using hormone therapy, endometrial cancer risk was only associated with height (HR 1.78, 95% CI 1.32–2.40 for ≥67 vs. <67 inches). Among women not using hormone therapy, tall women who were overweight/obese in adolescence (HR 4.33, 95% CI 2.51–7.46) or who became overweight/obese as adults (HR 4.74, 95% CI 2.70–8.32) were at greatest risk. Considering absolute body mass, changes in adiposity over time, and body fat distribution together, instead of each measure alone, we identified lifetime obesity phenotypes associated with endometrial cancer risk. These results more clearly define specific risk groups, and may explain inconsistent findings across studies, improve risk prediction models, and aid in developing targeted interventions for endometrial cancer.

The experience of accommodating privacy restrictions during implementation of a large-scale surveillance study of an osteoporosis medication

Abstract: PURPOSE: To explore whether privacy restrictions developed to protect patients have complicated research within a 15-year surveillance study conducted with US cancer registries. METHODS: Data from enrolling 27 cancer registries over a 10-year period were examined to describe the amount of time needed to obtain study approval. We also analyzed the proportion of patients that completed a research interview out of the total reported by the registries and examined factors thought to influence this measure. RESULTS: The average length of the research review process from submission to approval of the research was 7 months (range, CONCLUSIONS: Lengthy research review processes increased the time between diagnosis and provision of patient information to the researcher. Requiring physician permission for access to patients was associated with lower subject participation. A single national point of entry for use of cancer registry data in health research is worthy of consideration to make the research approval process efficient. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.© 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. Language: en

Validity of Race, Ethnicity, and National Origin in Population-based Cancer Registries and Rapid Case Ascertainment Enhanced With a Spanish Surname List.

Abstract: textBackground: Accurate information regarding race, ethnicity, and national origins is critical for identifying disparities in the cancer burden. Objectives: To examine the use of a Spanish surname list to improve the quality of race-related information obtained from rapid case ascertainment (RCA) and to estimate the accuracy of racerelated information obtained from cancer registry records collected by routine reporting. Subjects: Self-reported survey responses of 3954 participants from California enrolled in the Cancer Care Outcomes Research and Surveillance Consortium. Measures: Sensitivity, specificity, positive predictive value, and percent agreement. We used logistic regression to identify predictors of underreporting and overreporting of a race/ethnicity. Results: Use of the Spanish surname list increased the sensitivity of RCA for Latino ethnicity from 37% to 83%. Sensitivity for cancer registry records collected by routine reporting was ≥95% for whites, blacks, and Asians, and specificity was high for all groups (86%-100%). However, patterns of misclassification by race/ethnicity were found that could lead to biased cancer statistics for specific race/ethnicities. Discordance between self-reported and registry-reported race/ethnicity was more likely for women, Latinos, and Asians. Conclusions: Methods to improve race and ethnicity data, such as using Spanish surnames in RCA and instituting data collection guidelines for hospitals, are needed to ensure minorities are accurately represented in clinical and epidemiological research.

Residential cancer cluster investigation nearby a Superfund Study Area with trichloroethylene contamination.

Abstract: Trichloroethylene (TCE) is an industrial solvent associated with liver cancer, kidney cancer, and non-Hodgkin’s lymphoma (NHL). It is unclear whether an excess of TCE-associated cancers have occurred surrounding the Middlefield–Ellis–Whisman Superfund site in Mountain View, California. We conducted a population-based cancer cluster investigation comparing the incidence of NHL, liver, and kidney cancers in the neighborhood of interest to the incidence among residents in the surrounding four-county region. Case counts and address information were obtained using routinely collected data from the Greater Bay Area Cancer Registry, part of the Surveillance, Epidemiology, and End Results program. Population denominators were obtained from the 1990, 2000, and 2010 US censuses. Standardized incidence ratios (SIRs) with two-sided 99 % confidence intervals (CIs) were calculated for time intervals surrounding the US Censuses. There were no statistically significant differences between the neighborhood of interest and the larger region for cancers of the liver or kidney. A statistically significant elevation was observed for NHL during one of the three time periods evaluated (1996–2005: SIR = 1.8, 99 % CI 1.1–2.8). No statistically significant NHL elevation existed in the earlier 1988–1995 (SIR = 1.3, 99 % CI 0.5–2.6) or later 2006–2011 (SIR = 1.3, 99 % CI 0.6–2.4) periods. There is no evidence of an increased incidence of liver or kidney cancer, and there is a lack of evidence of a consistent, sustained, or more recent elevation in NHL occurrence in this neighborhood. This evaluation included existing cancer registry data, which cannot speak to specific exposures incurred by past or current residents of this neighborhood.

Cancer Incidence and Mortality Patterns Among Chinese Americans

Abstract: Chinese is the largest Asian ethnic group in the USA with four million individuals accounting for 23.1 % of the total Asian Americans and 1.3 % of the total US population. Given its large population size and the long history of migration to many countries throughout the world, Chinese immigrants are a valuable resource for epidemiologic investigations of cancer and other diseases to identify environmental and lifestyle risk factors and to understand the interactions between genetics and environment in disease etiology. Using data from population-based cancer registries, this chapter examines the sex-specific cancer incidence and mortality rates of common cancers among Chinese Americans and their relative risks as compared to whites or non-Hispanic (NH) whites. Comparisons of incidence trends and age-specific patterns by cancer type between Chinese Americans and Chinese in China are also provided. For most of the cancers examined, Chinese Americans have lower incidence and mortality rates than the NH whites, but they have substantially higher risk for nasopharyngeal, liver, and stomach cancers and slightly higher risk of gallbladder cancer. Except for lung and colorectal cancer, Chinese Americans display intermediate-risk level between the US whites and Chinese in China. The cancer experience of Chinese Americans highlights the significance of environmental and lifestyle factors in cancer development.