Author
Sanja Percac-Lima
Bio: Sanja Percac-Lima is an academic researcher from Harvard University. The author has contributed to research in topics: Cancer screening & Medicine. The author has an hindex of 24, co-authored 58 publications receiving 1860 citations.
Papers
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TL;DR: A culturally tailored, language-concordant navigator program designed to identify and overcome barriers to colorectal cancer screening can significantly improve colonoscopy rates for low income, ethnically and linguistically diverse patients.
Abstract: Background
Minority racial/ethnic groups have low colorectal cancer (CRC) screening rates.
308 citations
Johns Hopkins University1, Vanderbilt University2, Mayo Clinic3, University of Wisconsin-Madison4, University of Colorado Boulder5, Duke University6, University of California, San Francisco7, City of Hope National Medical Center8, Harvard University9, University of Texas at Austin10, Fred Hutchinson Cancer Research Center11, Memorial Sloan Kettering Cancer Center12, University of South Florida13, Fox Chase Cancer Center14, Stanford University15, University of California, Los Angeles16, Brigham and Women's Hospital17, Case Western Reserve University18, University of Pennsylvania19, Northwestern University20, University of California, San Diego21, University of Michigan22, University of Texas Southwestern Medical Center23, Ohio State University24, Yale University25, University of Nebraska Medical Center26, University of Utah27, Roswell Park Cancer Institute28, National Comprehensive Cancer Network29
254 citations
City of Hope National Medical Center1, Johns Hopkins University2, University of Alabama at Birmingham3, Mayo Clinic4, University of Colorado Boulder5, University of California, San Francisco6, Ohio State University7, Vanderbilt University8, Stanford University9, University of Texas MD Anderson Cancer Center10, University of Washington11, University of South Florida12, Duke University13, University of Michigan14, Roswell Park Cancer Institute15, Fox Chase Cancer Center16, Brigham and Women's Hospital17, Harvard University18, Northwestern University19, University of California, San Diego20, Washington University in St. Louis21, Yale Cancer Center22, Case Western Reserve University23, Memorial Sloan Kettering Cancer Center24, University of Tennessee Health Science Center25, University of Utah26
TL;DR: This selection from the NCCN Guidelines for Ovarian Cancer focuses on the less common ovarian histopathologies (LCOHs), because new algorithms were added for LCOHs and current algorithms were revised for the 2016 update.
Abstract: This selection from the NCCN Guidelines for Ovarian Cancer focuses on the less common ovarian histopathologies (LCOHs), because new algorithms were added for LCOHs and current algorithms were revised for the 2016 update. The new LCOHs algorithms include clear cell carcinomas, mucinous carcinomas, and grade 1 (low-grade) serous carcinomas/endometrioid epithelial carcinomas. The LCOHs also include carcinosarcomas (malignant mixed Mullerian tumors of the ovary), borderline epithelial tumors (also known as low malignant potential tumors), malignant sex cord-stromal tumors, and malignant germ cell tumors.
220 citations
TL;DR: Interventions designed to target reasons for no- show are needed to help reduce the no-show rate, improve access and decrease health disparities in underserved patient populations.
Abstract: Background: Missed primary care appointments lead to poor disease control and later presentation to care. No-show rates are higher in clinics caring for underserved populations and may contribute t...
194 citations
Johns Hopkins University1, Vanderbilt University2, Mayo Clinic3, University of Wisconsin-Madison4, University of Colorado Boulder5, Duke University6, Stanford University7, University of California, San Francisco8, City of Hope National Medical Center9, University of Tennessee Health Science Center10, University of Texas MD Anderson Cancer Center11, University of Washington12, Moffitt Cancer Center13, Fox Chase Cancer Center14, University of Alabama at Birmingham15, Brigham and Women's Hospital16, University Hospitals of Cleveland17, Northwestern University18, University of California, San Diego19, University of Michigan20, Ohio State University21, Harvard University22, Yale Cancer Center23, Memorial Sloan Kettering Cancer Center24, University of Utah25, Roswell Park Cancer Institute26, National Comprehensive Cancer Network27
TL;DR: Recent updates to neoadjuvant chemotherapy recommendations, including the addition of hyperthermic intraperitoneal chemotherapy, and the role of PARP inhibitors and bevacizumab as maintenance therapy options in select patients who have completed primary chemotherapy are focused on.
Abstract: Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States, with less than half of patients living >5 years from diagnosis. A major challenge in treating ovarian cancer is that most patients have advanced disease at initial diagnosis. The best outcomes are observed in patients whose primary treatment includes complete resection of all visible disease plus combination platinum-based chemotherapy. Research efforts are focused on primary neoadjuvant treatments that may improve resectability, as well as systemic therapies providing improved long-term survival. These NCCN Guidelines Insights focus on recent updates to neoadjuvant chemotherapy recommendations, including the addition of hyperthermic intraperitoneal chemotherapy, and the role of PARP inhibitors and bevacizumab as maintenance therapy options in select patients who have completed primary chemotherapy.
164 citations
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Journal Article•
TL;DR: Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves.
Abstract: www.mobilehealthmap.org 617‐442‐3200 New research shows that mobile health clinics improve health outcomes for hard to reach populations in cost‐effective and culturally competent ways . A Harvard Medical School study determined that for every dollar invested in a mobile health clinic, the US healthcare system saves $30 on average. Mobile health clinics, which offer a range of services from preventive screenings to asthma treatment, leverage their mobility to treat people in the convenience of their own communities. For example, a mobile health clinic in Baltimore, MD, has documented savings of $3,500 per child seen due to reduced asthma‐related hospitalizations. The estimated 2,000 mobile health clinics across the country are providing similarly cost‐effective access to healthcare for a wide range of populations. Many successful mobile health clinics cite their ability to foster trusting relationships. Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves. A communications academic argued that mobile health clinics’ unique use of space is important in facilitating these relationships. Mobile health clinics park in the heart of the community in familiar spaces, like shopping centers or bus stations, which lend themselves to the local community atmosphere.
2,003 citations
University of Virginia1, Louisiana State University2, University of Minnesota3, Emory University4, University of Pennsylvania5, Fred Hutchinson Cancer Research Center6, Durham University7, University of Texas MD Anderson Cancer Center8, University of California, San Francisco9, American Cancer Society10
TL;DR: This guideline update used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence.
Abstract: In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence. Screening with any one of multiple options is associated with a significant reduction in CRC incidence through the detection and removal of adenomatous polyps and other precancerous lesions and with a reduction in mortality through incidence reduction and early detection of CRC. Results from modeling analyses identified efficient and model-recommendable strategies that started screening at age 45 years. The ACS Guideline Development Group applied the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria in developing and rating the recommendations. The ACS recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) examination, depending on patient preference and test availability. As a part of the screening process, all positive results on noncolonoscopy screening tests should be followed up with timely colonoscopy. The recommendation to begin screening at age 45 years is a qualified recommendation. The recommendation for regular screening in adults aged 50 years and older is a strong recommendation. The ACS recommends (qualified recommendations) that: 1) average-risk adults in good health with a life expectancy of more than 10 years continue CRC screening through the age of 75 years; 2) clinicians individualize CRC screening decisions for individuals aged 76 through 85 years based on patient preferences, life expectancy, health status, and prior screening history; and 3) clinicians discourage individuals older than 85 years from continuing CRC screening. The options for CRC screening are: fecal immunochemical test annually; high-sensitivity, guaiac-based fecal occult blood test annually; multitarget stool DNA test every 3 years; colonoscopy every 10 years; computed tomography colonography every 5 years; and flexible sigmoidoscopy every 5 years. CA Cancer J Clin 2018;68:250-281. © 2018 American Cancer Society.
1,153 citations
TL;DR: This is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their disabling illness or injury.
760 citations
TL;DR: To improve survival in this aggressive disease, access to appropriate evidence‐based care is requisite and individualized precision medicine will require prioritizing clinical trials of innovative treatments and refining predictive biomarkers that will enable selection of patients who would benefit from chemotherapy, targeted agents, or immunotherapy.
Abstract: Ovarian cancer is the second most common cause of gynecologic cancer death in women around the world. The outcomes are complicated, because the disease is often diagnosed late and composed of several subtypes with distinct biological and molecular properties (even within the same histological subtype), and there is inconsistency in availability of and access to treatment. Upfront treatment largely relies on debulking surgery to no residual disease and platinum-based chemotherapy, with the addition of antiangiogenic agents in patients who have suboptimally debulked and stage IV disease. Major improvement in maintenance therapy has been seen by incorporating inhibitors against poly (ADP-ribose) polymerase (PARP) molecules involved in the DNA damage-repair process, which have been approved in a recurrent setting and recently in a first-line setting among women with BRCA1/BRCA2 mutations. In recognizing the challenges facing the treatment of ovarian cancer, current investigations are enlaced with deep molecular and cellular profiling. To improve survival in this aggressive disease, access to appropriate evidence-based care is requisite. In concert, realizing individualized precision medicine will require prioritizing clinical trials of innovative treatments and refining predictive biomarkers that will enable selection of patients who would benefit from chemotherapy, targeted agents, or immunotherapy. Together, a coordinated and structured approach will accelerate significant clinical and academic advancements in ovarian cancer and meaningfully change the paradigm of care.
663 citations
TL;DR: When you read more every page of this disability in america toward a national agenda for prevention, what you will obtain is something great.
Abstract: Read more and get great! That's what the book enPDFd disability in america toward a national agenda for prevention will give for every reader to read this book. This is an on-line book provided in this website. Even this book becomes a choice of someone to read, many in the world also loves it so much. As what we talk, when you read more every page of this disability in america toward a national agenda for prevention, what you will obtain is something great.
469 citations