Showing papers by "Farhad Islami published in 2023"
TL;DR: In this article , the authors examined changes in patterns of cancer-related deaths during the first year of the coronavirus disease 2019 pandemic in the United States and found that the death rate (per 100,000 person-years) with cancer as the underlying cause was lower in 2020 compared with 2019.
Abstract: PURPOSE This study examined changes in patterns of cancer-related deaths during the first year of the coronavirus disease 2019 pandemic in the United States. METHODS We identified cancer-related deaths, defined as deaths attributable to cancer as the primary cause (underlying cause) or deaths with cancer documented as one of the multiple contributing factors (contributing cause) from the Multiple Cause of Death database (2015-2020). We compared age-standardized cancer-related annual and monthly mortality rates for January-December 2020 (first pandemic year) to January-December 2015-2019 (prepandemic) overall and stratified by sex, race/ethnicity, urban rural residence, and place of death. RESULTS We found that the death rate (per 100,000 person-years) with cancer as the underlying cause was lower in 2020 compared with 2019 (144.1 v 146.2), continuing the past trend observed in 2015-2019. By contrast, the death rate with cancer as a contributing cause was higher in 2020 than in 2019 (164.1 v 162.0), reversing the continuously decreasing trend from 2015 to 2019. We projected 19,703 more deaths with cancer as a contributing cause than expected on the basis of historical trends. Mirroring pandemic peaks, the monthly death rates with cancer as a contributing cause first increased in April 2020 (rate ratio [RR], 1.03; 95% CI, 1.02 to 1.04), subsequently declined in May and June 2020, and then increased again each month from July through December 2020 compared with 2019, with the highest RR in December (RR, 1.07; 95% CI, 1.06 to 1.08). CONCLUSION Death rates with cancer as the underlying cause continued to decrease in 2020 despite the increase in death rates with cancer as a contributing cause in 2020. Ongoing monitoring of long-term cancer-related mortality trends is warranted to assess effects of delays in cancer diagnosis and receipt of care during the pandemic.
TL;DR: Wiese et al. as discussed by the authors examined the association between the historic HOLC-based "redlining" and contemporary mortgage lending bias and stage of breast cancer at diagnosis among women aged 18 years and older in New Jersey diagnosed with first primary invasive breast cancer in 2010-2015 (N= 32,939).
Abstract:
Breast cancer is the most commonly diagnosed cancer among US women across all racial/ethnic groups. Stage at diagnosis is one of the major factors determining breast cancer prognosis. The 5-year relative survival for breast cancer ranges from 99% for localized stage at diagnosis, to 84% for regional stage, and to 27% for distant (metastatic) stage breast cancer. The proportion of women diagnosed with breast cancer at later stages (regional and distant) in the US are higher among women with lower socio-economic status and among non-Hispanic Black women. Historic mortgage security redlining, implemented by the Home Owners’ Loan Corporation (HOLC) in the 1930s across numerous US cities, continues to have a negative influence on breast cancer stage at diagnosis, largely due to continued social and economic isolation and poor living environments resulting in many adverse consequences, including lower education, limited job opportunities, no/limited health insurance coverage, and suboptimal access to care, including cancer screening services. Additionally, studies have reported that living in areas with greater contemporary mortgage lending bias towards the non-Hispanic Black population (measured as higher odds of mortgage denial) is associated with late-stage breast cancer diagnosis in several US metropolitan areas.
In this study, we aim to examine the association between the historic HOLC-based “redlining” and contemporary mortgage lending bias and stage of breast cancer at diagnosis among women aged 18 years and older in New Jersey diagnosed with first primary invasive breast cancer in 2010-2015 (N= 32,939). The study population was derived from the New Jersey State Cancer Registry. Historic “redlining” data based on 1930s neighborhood boundaries and transformed to corresponding 2010 census tracts borders were obtained from Inter-university Consortium for Political and Social Research. Mortgage lending bias score for the study period was calculated at the census tract level following methodology developed by Beyers and colleagues. Associations between census tract-level historic “redlining”, contemporary mortgage lending bias and breast cancer stage at diagnosis were evaluated using multinomial logistic regression models after adjusting for age alone, and then for age, race/ethnicity, marital status, and health insurance status.
The study included 21,038 local, 9,765 regional, and 2,136 distant stage breast cancer cases. After adjusting for age, race/ethnicity, marital status, and health insurance, women living in historically redlined census tracts were more likely to be diagnosed with regional (OR=1.23; 95% CI 1.03-1.48) and distant (OR=1.55; 95% CI 1.09-2.22) stage breast cancer compared to women living in other census tracts. Odds for regional (OR=1.14; 95% CI 1.06-1.23) and distant (OR=1.33; 95% CI 1.16-1.53) stage breast cancer were also significantly higher for women living in areas with highest mortgage lending bias score. Stratifying by age (< 65 and >=65 years) showed similar patterns (data not shown).
Both historic “redlining” and contemporary mortgage lending bias were associated with being diagnosed with breast cancer at later stages, notably distant stage. Targeting the legacy of systematic racism and addressing any contemporary discriminatory policies may help reduce breast cancer disparities in the diagnosis stage and thus mortality.
Association between the historic redlining and contemporary mortgage lending bias and stage of breast cancer at diagnosis among women aged ≥18 years in New Jersey, 2010-2015 Note: For contemporary mortgage lending bias, highest score is indicative of highest bias (highest proportion of mortgage denial) towards Black people. *Fully adjusted model includes covariates: age, race/ethnicity, marital status, health insurance status ^Areas designated ”Best” were individual housing markets with sufficient levels of financing and were preserved exclusively for White and wealthy population. Areas defined as “Hazardous” were those lacking financial resources and were designated for Black and poor population.
Citation Format: Daniel Wiese, Antoinette M. Stroup, Ahmedin Jemal, Kevin A. Henry, Farhad Islami. Associations of historic and contemporary “redlining” with breast cancer stage at diagnosis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-06-01.
TL;DR: In this paper , cause-specific proportional hazards models were used to estimate HR (hazard ratio), overall and stratified by SPC types, comparing the risk of cancer or cardiovascular death in Hispanic, non-Hispanic Asian or Pacific Islander (API), or non- Hispanic Black (Black) persons to that in white persons.
Abstract: 12093 Background: Racial and ethnic disparities in survival after first primary cancer diagnoses have been well documented. Yet comprehensive data for disparities after subsequent primary cancer (SPC) are lacking despite the growing burden of SPCs. Methods: This study included 230,370 persons diagnosed with one of the 13 common SPCs at ages≥20 years during 2000-2013 in 18 Surveillance, Epidemiology, and End Results registries. Cause-specific proportional hazards models were used to estimate HR (hazard ratio), overall and stratified by SPC types, comparing the risk of cancer or cardiovascular death in Hispanic, non-Hispanic Asian or Pacific Islander (API), or non-Hispanic Black (Black) persons to that in non-Hispanic White (White) persons. HRs were adjusted for sex, first primary cancer type and stage, age and year of SPC diagnosis (base model); and additionally household income, urbanicity, SPC stage, subtype, and treatment receipt (surgery, radiotherapy, chemotherapy) (final model). Results: During 54 months of median follow-up, 109,757 cancer deaths and 18,283 cardiovascular deaths occurred among persons with SPCs. Overall, HRs for cancer death were higher among Black (HR = 1.21, 95% CI = 1.18-1.23) and Hispanic (HR = 1.10, 95% CI = 1.07-1.13) persons compared with White persons, but lower among API persons (HR = 0.93, 95% CI = 0.90-0.96) in the base model. When stratified by SPC types, the increased HRs were evident for 10 of 13 cancers among Black persons with the greatest HR among those with uterine corpus cancer (HR = 1.87, 95%CI = 1.63-2.15) and for 7 of 13 cancers among Hispanic persons with the highest HR among those with melanoma (HR = 1.46, 95%CI = 1.21-1.76). For cardiovascular death, compared with White persons, the overall HR was higher among Black (HR = 1.42, 95% CI = 1.35-1.49) persons but lower among API (HR = 0.75, 95%CI = 0.69-0.81) and Hispanic (HR = 0.90, 95% CI = 0.84-0.96) persons. The risk of cardiovascular death was higher for 11 of 13 cancers among Black persons with the greatest HR among those with pancreatic (HR = 1.80, 95%CI = 1.17-2.75), thyroid (HR = 1.70, 95%CI = 1.12-2.57), and kidney (HR = 1.63, 95%CI = 1.38-1.93) cancers. Additional adjustments in the final model reduced the elevated HRs substantially especially for cancer death among Black or Hispanic persons, although the associations remained statistically significant for most cancers. Conclusions: Among persons with SPCs, Black persons had a higher risk of death from both cancer and cardiovascular disease, whereas Hispanic persons had a higher risk of death from cancer. Adjusting for differences in potentially modifiable factors attenuated the associations substantially, highlighting opportunities for interventions toward health equities among cancer survivors.
TL;DR: Lee et al. as mentioned in this paper used Cox proportional hazards regression to model survival time as a function of social isolation, measured by "living alone" and sociodemographic, behavioral, and health characteristics.
Abstract:
Background Social isolation or living alone can negatively affect mental health, sleep quality, eating behavior, immunity, proinflammatory response to stress, and receipt of care in cancer patients (e.g., assistance with nutrition and mobility, emotional and informational support), which may increase the risk of death from cancer. Previous studies, however, have shown inconsistent findings on the association between social isolation and cancer mortality. To address the literature gap, we examined this association among working-age adults stratified by sociodemographic characteristics using a nationally representative cohort with long-term mortality follow-up.
Method We used the pooled 1998-2019 data for adults aged 18-64 years at enrollment from the National Health Interview Survey (NHIS) linked to National Death Index (N=473,648) with up to 22 years of follow-up. Cox proportional hazards regression was used to model survival time as a function of social isolation, measured by “living alone”, and sociodemographic, behavioral, and health characteristics. We estimated differential effects of social isolation on cancer mortality by age, sex, race/ethnicity, poverty level, and education, overall and for select common cancers (lung, colorectal, and female breast) with >100 deaths in the public use NHIS-linked mortality database, 1998-2004.
Results The cancer mortality risk was 32% higher (hazard ratio [HR]=1.32; 95%CI:1.25,1.39) in adults living alone, controlling for age, and 16% higher (HR=1.16; 95%CI:1.10,1.23) in adults living alone, controlling for demographic and socioeconomic characteristics, when compared to adults living with others. The association between living alone and cancer mortality persisted after additional adjustments for health-risk behaviors and health status (HR=1.10, 95%CI:1.04,1.16). Stratified models generally showed similar associations between social isolation and cancer mortality risk across categories of sex, poverty, and education in age-adjusted models. However, the association was stronger among non-Hispanic (NH) White than NH Black adults and did not exist in other racial/ethnic groups. The associations were attenuated after additional adjustments but persisted in fully adjusted models among males, females, NH White people, and adults with a college degree. In the age-adjusted models, social isolation was associated with a higher risk of death from lung (HR=1.45; 95%CI:1.81,2.45) and colorectal (HR=1.65; 95%CI:2.58,1.56), but not from female breast cancer.
Conclusions In this nationally representative study in the United States, adults living alone were at a higher risk of cancer death compared to adults living with others. These findings underscore the significance of addressing social isolation in the general population and among cancer survivors.
Citation Format: Hyunjung Lee, Gopal K. Singh, Ahmedin Jemal, Farhad Islami. Differential effects of social isolation on cancer mortality by race/ethnicity and socioeconomic status among working age adults in the United States [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1927.
TL;DR: Sung et al. as discussed by the authors found that persons with second primary prostate cancer were almost twice as likely to die from all causes as persons with first prostate cancer (HR=1.05, 1.03-1.07) cancer, whereas it was lower for lung cancer (hr=0.78, 0.77-0.79).
Abstract:
Background Second primary cancer (SPC) burden is increasing in the US, but few studies comprehensively examined survival in persons diagnosed with SPCs in relation to survivors’ antecedent cancer types.
Methods Persons aged ≥20 years and diagnosed with one of the six most common SPCs (female breast, prostate, bladder, lung, colorectum, corpus uteri) from 2000-2013 were identified from 17 Surveillance, Epidemiology, and End Results registries (n=152,204). For comparison, persons diagnosed with same type cancers occurring as first primary cancers (FPCs) were also identified (n=2,131,953). For each cancer type, differences in the risk of cancer-specific or all-cause death between SPC and FPC were estimated using multivariable Cox proportional hazards models adjusted for potential confounders. Subgroup analyses were conducted to estimate the risk difference between SPC and FPC by antecedent cancer types of those with SPCs.
Results During a median follow-up of 6.5 years (interquartile range, 1.8-10.6), cancer-type specific death occurred among 34% of persons with SPCs and among 32% of persons with FPCs. The corresponding proportions for all-cause death were 67% and 53%, respectively. In multivariable models, the risk of cancer-specific death was statistically significantly higher in persons with SPC than in persons with FPC for breast (hazard ratio [HR]=1.43; 95% confidence interval [CI]=1.40-1.48), bladder (HR=1.19; 1.09-1.29), corpus uteri (HR=1.10; 1.05-1.15), and colorectal (HR=1.05, 1.03-1.07) cancer, whereas it was lower for lung cancer (HR=0.78; 0.77-0.79). The risk did not vary between groups for prostate cancer (HR=0.92; 0.79-1.06). Subgroup analyses showed large variations in HRs across survivors by antecedent cancer types. In particular, the highest HR associated with SPC (vs FPC) was among ovarian cancer survivors for colorectal cancer (HR=1.31; 1.10-1.56), gallbladder cancer survivors for breast cancer (HR=1.78; 1.09-2.91), head and neck cancer survivors for uterine cancer (HR=1.69, 1.05-2.72), gallbladder cancer survivors for bladder cancer (HR=1.87; 1.06-3.22), while the lowest HR for lung cancer was among testicular cancer survivors (HR=0.54; 0.38-0.76). Associations were generally consistent across strata of diagnosis years, race/ethnicity, household income, and urbanicity. The risks of all-cause death were also higher among persons with SPC vs FPC, including prostate cancer. Persons with second primary prostate cancer were almost twice as likely to die from all causes as persons with first prostate cancer (HR=1.83; 1.80-1.87).
Conclusion Persons with SPC generally have a higher risk of cancer-specific and all-cause death than those with FPC, suggesting that intensive SPC surveillance may benefit those at increased risk of developing SPC. Importantly, the risk difference substantially varied by survivors’ antecedent cancer type, highlighting a need for targeted strategies for treatment and survivorship care for persons with SPCs.
Citation Format: Hyuna Sung, Lauren Nisotel, Ephrem Sedeta, Farhad Islami, Ahmedin Jemal. Survival of most commonly diagnosed second primary cancers among adult cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB129.
TL;DR: In this article , the authors examined trends in cancer death rates, overall and for lung, colorectal, female breast, and prostate cancer by congressional district, in the United States.
Abstract: United States cancer death rates have been steadily declining since the early 1990s, but information on disparities in progress against cancer mortality across congressional districts is lacking. This study examined trends in cancer death rates, overall and for lung, colorectal, female breast, and prostate cancer by congressional district.
TL;DR: In this article , the authors present national and state representative prevalence estimates of modifiable cancer risk factors, preventive behaviors and services, and screening, with a focus on changes during the COVID-19 pandemic.
Abstract: We present national and state representative prevalence estimates of modifiable cancer risk factors, preventive behaviors and services, and screening, with a focus on changes during the COVID-19 pandemic. Between 2019 and 2021, current smoking, physical inactivity, and heavy alcohol consumption declined, and human papillomavirus vaccination and stool testing for colorectal cancer screening uptake increased. In contrast, obesity prevalence increased, while fruit consumption and cervical cancer screening declined during the same timeframe. Favorable and unfavorable trends were evident during the 2nd year of the COVID-19 pandemic that must be monitored as more years of consistent data are collected. Yet disparities by racial/ethnic and socioeconomic status persisted, highlighting the continued need for interventions to address suboptimal levels among these population subgroups.
TL;DR: In this paper , the authors examine the temporal and spatial diffusion of a new technology, such as digital mammography, and provide important insights into potential disparities associated with access to new medical technologies and how quickly these technologies are adopted.
Abstract: Examining temporal and spatial diffusion of a new technology, such as digital mammography, can provide important insights into potential disparities associated with access to new medical technologies and how quickly these technologies are adopted. Although digital mammography is currently a standard technology in the United States for breast cancer screening, its adoption and geographic diffusion, as medical facilities transitioned from film to digital units, has not been explored well.